CIVITANFOUNDATIONINC-COI-6cb53d79f4524ea384e6c4614515672f.pdf
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- Attached to
- Master Agreement AZ|CTR056116
- Contract number
- CTR056116
- Issued by
- Arizona
About this file
This document is a comprehensive insurance certificate and related endorsements for Civitan Foundation, Inc., covering Commercial General Liability, Auto Liability, and Workers' Compensation insurance. The policy is issued by CopperPoint Indemnity Insurance Company and GuideOne Insurance Company, with Lovitt & Touché A Marsh and McLennan Agency, LLC as the producer. The primary additional insured is the State of Arizona, including its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees, with coverage related to activities performed by or on behalf of the Contractor (Civitan Foundation).
The insurance policies provide coverage from December 31, 2022, to December 31, 2023, with various liability limits including $1,000,000 for each occurrence, $3,000,000 general aggregate, and $1,000,000 for auto liability. The policies include specific endorsements for waivers of subrogation, additional insured status, and coverage extensions. Key coverage areas include ongoing operations, premises liability, hired and non-owned auto coverage, and protection against potential losses arising from the foundation's activities. The policies are designed to provide primary and non-contributory coverage for the State of Arizona, with specific provisions for contract number CTR056116 and comprehensive protection across multiple liability domains.
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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
10/18/2023
Lovitt & Touché A Marsh and McLennan Agency, LLC 8605 E. Raintree Drive, Suite 200 Scottsdale AZ 85260
Linda Perez
Lperez@lovitt-touche.com
CopperPoint Indemnity Insurance Company 13928 CIVIFOU-C1 GuideOne Insurance Company 15032
Civitan Foundation, Inc.
12635 N. 42nd St.
Phoenix AZ 85032
562502317
B X 1,000,000 X 1,000,000
20,000
1,000,000
3,000,000 X
010030656 12/31/2022 12/31/2023
3,000,000
B 1,000,000
X 010030657 12/31/2022 12/31/2023
B X X 1,000,000010030222 12/31/2022 12/31/2023
1,000,000 X 2,500
A X
N
1020240 1/1/2023 1/1/2024
1,000,000
1,000,000
1,000,000 B Professional Liability
Sexual Abuse or Molestation Liab.
010030656 12/31/2022 12/31/2023 Prof Agg/Occurrence
SAM Agg/Occurrence $3Mil / $1 Mil $3Mil / $1 Mil
The above-indicated Additional Insured and Waiver of Subrogation (WOS) are provided with respects to General Liability, Workers’ Compensation (WOS only) when required in a written and executed contract. Such coverage afforded by these policies (or update as applicable) for the benefit of the additional insured(s) is primary and any other coverage maintained by such additional insured(s) shall be non-contributory when required in a written and executed contract.
Supporting endorsements attached include: GCG6510 1122, CG2001 0413, CA0001 1013, GCA2300 0219 RE: Contract Number CTR056116 State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor. Coverage for General Liability is Primary and Non-Contributory per form CG See Attached...
The State of Arizona and Arizona Department of Economic Security c/o myCOI 1075 Broad Ripple Ave, Ste 313 Indianapolis IN 46220
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:
CIVIFOU-C1
1 1
Lovitt & Touché A Marsh and McLennan Agency, LLC Civitan Foundation, Inc.
12635 N. 42nd St.
Phoenix AZ 85032
25 CERTIFICATE OF LIABILITY INSURANCE
10 01 04/13. Coverage for Auto Liability is Primary and Non-Contributory per Form CA 00 01 10 13.
General Liability, Automobile Liability, and Workers Compensation coverage contains a waiver of subrogation in favor of the State of Arizona, its departments, agencies, boards, commissions, universities and its officers, agents and employees for the losses arising from work performed by or on behalf of the Contractor.
Sexual Abuse and Molestation coverage is included. 30 Day Notice of Cancellation for non-payment of premium.
POLICY NUMBER: 01-0030-656
NONPROFIT AND HUMAN SERVICES
GENERAL LIABILITY ENDORSEMENT
THIS DOCUMENT IS AN ENDORSEMENT THAT CHANGES THE POLICY. PLEASE READ IT
CAREFULLY.
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
A. SECTION I – COVERAGES, COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, 2. Exclusions is amended as follows:
1. Exclusion a. Expected or Intended Injury is deleted and replaced with:
a. "Bodily injury" or "property damage" expected or intended from the standpoint of the insured.
This exclusion does not apply to "bodily injury" or “property damage” resulting from the use of reasonable force to protect persons or property.
2. Paragraph (2) under Exclusion g. Aircraft, Auto or Watercraft is deleted and replaced with:
(2) A watercraft that you do not own that is 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 any insured whether primary, excess, or contingent.
3. Paragraph (1) under Exclusion j. Damage To Property is deleted and replaced with:
(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 to a person or damage to another's property, unless the damage to property is caused by your "client", in such case we will provide coverage for such "property damage" for which you are legally obligated to pay up to a $50,000 limit per "occurrence". This limit is the only limit of insurance for such "property damage" and will not be combined with the Each Occurrence Limit set for this in Section Ill – Limits of Insurance and will be included within and not in addition to the Each Occurrence Limit. Any and all damages paid under the terms and condition of this provision will further be applied against and will reduce the Aggregate Limit of Insurance shown on the Declarations page, and as provided in the Commercial General Liability Coverage Form in the same manner and in addition to all other coverages of the Commercial General Liability Coverage Form that are also subject to the Aggregate Limit. As used in this coverage extension, “client” means a person under your direct care and supervision, for whom you are providing goods or services.
4. The following is added to Paragraph (2) under Exclusion b. Contractual Liability:
We agree to indemnify the 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 per "occurrence". This limit of insurance is the only limit of insurance for your liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of your "client" whether or not such contract qualifies as an "insured contract". This limit will not be combined with the Each Occurrence Limit set forth in Section III – Limits of Insurance and is included within and not in addition to the Each Occurrence Limit. This coverage extension only applies to rental lease agreements. This coverage is excess over any liability insurance available to the "client", including but not limited to renter’s insurance of the “client”.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
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GCG 65 10 11 22
Any and all damages paid under the terms and conditions of this provision will further be applied against and will reduce the Aggregate Limit of Insurance shown on the Declarations page, as provided in the Commercial General Liability Coverage Form in the same manner and in addition to all other coverages of the Commercial General Liability Coverage Form that are also subject to the Aggregate Limit.
As used in this coverage extension, “client” means a person under your direct care and supervision, for whom you are providing goods or services.
5. The following is added to Exclusion n. Recall Of Products, Work Or Impaired Property:
This exclusion does not apply to the reimbursement of "product recall expenses" as provided under Paragraph 3. of SECTION I – COVERAGES, SUPPLEMENTARY PAYMENTS –
COVERAGES A AND B.
6. The last Paragraph of Subsection 2. Exclusions is deleted and replaced with:
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or sprinkler leakage 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 I – COVERAGES, COVERAGE B – PERSONAL AND ADVERTISING INJURY
LIABILITY, 2. Exclusions is amended as follows:
1. The following is added to Exclusion j. Insureds In Media And Internet Type Businesses:
This exclusion does not apply to publishing, broadcasting or telecasting that is incidental to your business.
C. SECTION I – COVERAGES, COVERAGE C – MEDICAL PAYMENTS is amended as follows:
1. Subsection 1. Insuring Agreement, Paragraph a.(3)(b) is deleted and replaced with:
(b) The expenses are incurred and reported to us within three years of the date of the accident;
and
2. Subsection 2. Exclusions, is amended as follows:
a. Exclusion a. Any Insured is deleted and replaced with:
a. Any Insured
To any insured, except "volunteer workers" or an insured as provided in e. Athletic Activities below.
b. Exclusion e. Athletics Activities is deleted and replaced with:
e. Athletics Activities
To a person injured while practicing or participating in any physical exercises or games, sports or athletic contests. This exclusion shall not apply to an insured while providing instruction with respect to any of the activities otherwise excluded by this provision.
c. Exclusion f. Products-Completed Operations Hazard is deleted and replaced with:
f. Products-Completed Operations Hazard
Included within the “products-completed operations hazard”.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
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This exclusion does not apply to “your products” sold for use or consumption on your premises, while such products are still on your premises.
This exclusion exception does not apply if COVERAGE C – MEDICAL PAYMENTS is excluded by another endorsement to this Coverage Part.
D. SECTION I – COVERAGES, SUPPLEMENTARY PAYMENTS – COVERAGES A AND B is amended as follows:
1. 1. b. is deleted and replaced with:
b. Up to $5,000 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 bonds.
2. 1. d. is deleted and replaced with:
d. All reasonable expenses incurred by the insured at our request to assist us in the "suit", including actual loss of earnings up to $1,000 a day because of time off from work.
3. 1. h. is added:
h. Up to $1,000 for "property damage" to personal property of others while in the temporary care, custody or control of an insured and caused by any person participating in your organized activities. For purposes of this supplementary payment, "property damage" does not include disappearance, wrongful abstraction or loss of use. This Supplementary Payment shall only be paid on or for the account of the owner and only when other coverage or insurance is unavailable.
4. 1. i. is added:
i. The cost to replace keys and locks at the "client’s" premises due to loss to keys entrusted to you by your "client", 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 you or any of your partners, members, officers, "employees", "managers", directors, trustees, authorized representatives or anyone to whom you entrust the keys of a "client" for any purpose commit, whether acting alone or in collusion with other persons. The following terms, when used in this Supplementary Payment, are defined as follows:
(1) "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.
(2) "Employee" means:
(a) Any natural person:
(i) While in your service or for 30 days after termination of service;
(ii) Who you compensate directly by salary, wages or commissions; and
(iii) Who you have the right to direct and control while performing services for you; or
(b) Any natural person who is furnished temporarily to you:
(i) To substitute for a permanent "employee" as defined in Paragraph (a) above, who is on leave; or
(ii) To meet seasonal or short-term workload conditions while that person is subject to your direction and control and performing services for you.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Copyright 2022 GuideOne Insurance
"Employee" does not mean:
(c) 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
(d) Any "manager", director or trustee except while performing acts coming within the scope of the usual duties of an "employee".
(3) "Manager" means a person serving in a directorial capacity for a limited liability company.
5. Paragraph 3. is added.
3. We will reimburse you for “product recall expenses” that you incur because of a “product recall” of “your product” that is first initiated during the policy period stated in the Declarations. The most we will reimburse you for the sum of all "product recall expenses" incurred for all “product recalls” initiated during the policy period is $50,000.
A complete accounting of "product recall expenses" must be provided upon our request, including receipts for all expenses that you incur. We will reimburse "product recall expenses" only if the expenses are incurred and reported to us within one year of the date the "product recall" was initiated.
Our obligation under this additional supplementary payment shall only apply if the "product recall expenses" are initiated in the "coverage territory" during the policy period because:
a. You determine that the "product recall" is necessary; or
b. An authorized government entity has ordered you to conduct a "product recall".
However, this additional supplementary payment does not apply to "product recall expenses" arising out of the product expiration or shelf life, a defect known by you prior to the time "your product" leaves your control or possession, or the defense of a claim or "suit" against you for liability arising out of a "product recall".
This payment will not reduce the limits of insurance.
E. Additional Exclusions
The following exclusions are added to Subsection 2. Exclusions under SECTION I – COVERAGES, COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2.
Exclusions under SECTION I – COVERAGES, COVERAGE B – PERSONAL AND ADVERTISING INJURY LIABILITY and Subsection 2. Exclusions under SECTION I – COVERAGES, COVERAGE
C – MEDICAL PAYMENTS:
This insurance does not apply to:
1. Special Events Or Fundraising Events
“Bodily injury”, “property damage” or “personal or advertising injury” arising directly or indirectly out of fundraising events or activities or “special events” or activities:
a. Authorized and conducted by any insured;
b. Authorized by you and conducted on your behalf by others, including but not limited to an “employee”, “temporary worker”, “volunteer worker”, member, trustee, director, licensee, subcontractor, independent contractor, or vendor.
c. Not authorized by you and conducted on your behalf by others, including but not limited to an “employee”, “temporary worker”, “volunteer worker”, member, trustee, director, licensee, subcontractor, independent contractor, or vendor.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Copyright 2022 GuideOne Insurance
We have no obligation to defend, pay on behalf of, indemnity or incur any cost or expenses for any insured or any other person or organization seeking coverage under this insurance for that portion of any claim arising out of any fundraising event or activity or “special event” or activity.
This exclusion does not apply to any fundraising event or activity or “special event” or activity for which coverage is provided by an attached endorsement.
2. Medical Or Healthcare Services
Any claim or "suit" arising out of the rendering of or failure to render "medical or healthcare services".
3. Medically Derived Injury
Any claim or "suit" arising out of a "medically derived injury”
4. Violation Of Any Statute Or Regulation
Any liability arising out of the willful or intentional violation of any statute or regulation including but not limited to the fines and penalties assessed by a court or regulatory authority.
5. Misconduct, Molestation Or Harassment
Any "bodily injury", "personal and advertising injury", mental or emotional pain or anguish, or any defamation or slander, sustained by any person arising out of or resulting from any actual or alleged act of “abuse“, "sexual misconduct or sexual molestation" or "sexual harassment" of any kind. We have no right or duty to investigate, settle, defend or pay any claim or "suit" asserting any act of “abuse”, "sexual misconduct or sexual molestation", "sexual harassment" or any breach of duty contributing to or arising from such act.
6. Professional Services
Any liability arising out of any act or omission in the providing of or failure to provide "professional services".
7. Statutory Enforcement
Any liability or responsibility to meet the requirements or standards of care enforced by any department of human services, department of elder care or similar regulatory body, regardless of the law or statutory basis of such enforcement.
8. Guaranteeing Results
Including but not limited to any contract or agreement guaranteeing the results of any “professional services” or any type or form of counseling or any type or form of medical, dental, physiological, psychological, addiction, behavioral, chiropractic, holistic, or any other similar treatment.
9. Abuse
Any claim or "suit" arising out of "abuse".
F. SECTION II – WHO IS AN INSURED is amended as follows:
1. Paragraph 3. is amended as follows:
a. Paragraph 3.a. is replaced with:
a. Coverage under this provision is afforded only until the end of the policy period during which you acquired or formed the organization.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Copyright 2022 GuideOne Insurance
b. Paragraph 3.d. is added:
d. Coverage under this provision is afforded only when the newly acquired or formed organization operates or conducts the same or similar business as you.
2. The following is also an insured:
Broadened Named Insured – Any organization and subsidiary thereof which you control and actively manage whether through ownership of voting securities, by contract, or otherwise, on the effective date of this policy. However, coverage does not apply to any organization or subsidiary not named in the Declarations as a Named Insured, if they are also insured under another similar policy, or would have been insured but for such policy’s termination or the exhaustion of its limits of insurance.
3. Each of the following is also an additional insured when you have agreed, in a written contract, that such person or organization be added as an additional insured on your policy, provided the written contract is initiated prior to an "occurrence" resulting in damages:
a. Engineers, Architects Or Surveyors
Any architect, engineer or surveyor engaged by you but only with respect to liability for “bodily injury”, “property damage” or “personal and advertising injury” caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf in connection with your premises or in the performance of your ongoing operations.
However, the insurance provided to such additional insured engineers, architects, or surveyors does not apply to “bodily injury”, “property damage” or “personal and advertising injury” arising out of the rendering of or the failure to render any professional services by or for you, including:
(1) The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or
(2) Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the “occurrence” which caused the “bodily injury” or “property damage” or the offense which caused the “personal and advertising injury”, involved the rendering of or the failure to render any professional services by or for you.
b. Owners Of Leased Land
Any person or organization from whom you lease land but only with respect to liability arising out of the ownership, maintenance or use of that part of the land leased to you.
However, the insurance afforded to these additional insured owners of leased land does not apply to:
(1) Any "occurrence" which takes place after you cease to lease that land; or
(2) Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured.
c. State Or Governmental Agency Or Subdivision Or Political Subdivision – Permits Or Authorizations
Any state or governmental agency or subdivision or political subdivision, but 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.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Copyright 2022 GuideOne Insurance
With respect to the insurance afforded these additional insureds, this insurance does not apply to:
(1) “Bodily injury”, “property damage” or “personal and advertising injury” arising out of operations performed for the federal government, state or municipality; or
(2) “Bodily injury” or “property damage” included within the “products-completed operations hazard”.
d. Contractual Obligations
Any person or organization where required by a written contract executed prior to the “occurrence”. 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.
e. Manager Or Lessor 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) Any "occurrence" which takes place after you cease to be a tenant in that premises; or
(2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization.
f. 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 be added as an additional insured on your policy. Such person or organization 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 or organization.
With respect to the insurance afforded to these additional insureds:
(1) A person's or organization's status as an additional insured ends when their contract or agreement with you for such leased equipment ends; and
(2) This insurance does not apply to any "occurrence" which takes place after the equipment lease expires.
g. Vendors
Any person or organization but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business .
The insurance afforded the vendor does not apply to:
(1) "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;
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
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(2) Any express warranty unauthorized by you;
(3) Any physical or chemical change in the product made intentionally by the vendor;
(4) 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;
(5) 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;
(6) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product;
(7) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or
(8) "Bodily injury" or "property damage” arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf.
However, this exclusion does not apply to:
(a) The exceptions contained in Subparagraphs (4) or (6); or
(b) 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.
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 such products.
h. 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 those premises. This insurance does not apply to:
(a) Any “occurrence” or offense which takes place after you cease to lease or occupy those premises; or
(b) Structural alterations, new construction and demolition operations performed by or for that person or organization.
i. State Or Governmental Agency Or Subdivision Or Political Subdivision – Permits Or Authorizations Relating To Premises
Any state or governmental agency or subdivision or political subdivision but only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies:
(1) 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;
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
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(2) The construction, erection, or removal of elevators; or
(3) The ownership, maintenance, or use of any elevators covered by this insurance.
However,
(1) A person or organization is an additional insured under this provision only for that period of time required by the written contract;
(2) No such person or organization is an insured under this provision if such person or organization is included as an insured by an endorsement issued by us and attached to the Commercial General Liability Coverage Form;
(3) The insurance afforded to such additional insured only applies to the extent permitted by law; and
(4) 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.
j. 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” or “medical or healthcare services” as a physician or psychiatrist in the treatment of a patient.
k. Home Care Providers
At the first Named lnsured's option, any person or organization under your direct supervision and control while providing on your behalf private home respite or foster home care for the developmentally disabled. Such duties do not include the furnishing or failure to furnish “professional services” or “medical or healthcare services” in the treatment of a patient.
4. With respect to the insurance afforded to these additional insureds, identified in Paragraph F.3. of this endorsement, the following is added to Section III – Limits Of Insurance:
The most we will pay on behalf of the additional insured is the lesser of:
a. The limit of insurance required by the contract or agreement; or
b. The amount of coverage available under the applicable Limits of Insurance shown in the Declarations;
This provision shall not increase the applicable Limits of Insurance shown in the Declarations.
G. SECTION III - LIMITS OF INSURANCE is amended as follows:
1. Paragraph 1. is deleted and replaced with:
1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of:
a. Insureds;
b. Claims made or “suits” brought;
c. Persons or organizations making claims or bringing “suits” or
d. Policies involved.
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2. Paragraph 6. is deleted and replaced with:
6. Subject to Paragraph 5. above, 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, while rented to or temporarily occupied by you with permission of the owner, is the higher of $1,000,000 or the amount shown in the Declarations for the Damage To Premises Rented To You Limit.
However, if damage by fire to premises rented to you is not otherwise excluded, the word fire in the above paragraph is replaced with fire, lightning, explosion, smoke or sprinkler leakage.
3. Paragraph 7. is deleted and replaced with:
7. Subject to Paragraph 5. above, the most we will pay under Coverage C will be the higher of $20,000 or the amount shown in the Declarations for the Medical Expense Limit, for all medical expenses because of “bodily injury”sustained by any one person.
This provision does not apply if COVERAGE C – MEDICAL PAYMENTS is excluded by another endorsement to this Coverage Part.
4. The following is added to SECTION III – LIMITS OF INSURANCE:
a. If two or more policies or Coverages issued by us apply to the same insured and these policies or Coverages also apply to the same claim or “suit” the maximum amount we will pay as damages under all of the policies or Coverages will not exceed the highest applicable Limit of Insurance that applies to any one of the policies or Coverages.
This condition does not apply to any insurance that was purchased specifically to apply in excess of the applicable Limits of Insurance shown in the Declarations.
H. SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows:
1. Subsection 4. Other Insurance, Paragraph b. Excess Insurance, Subsection (1)(a)(ii) is replaced with the following if damage to premises rented to you is not otherwise excluded:
ii. That is fire, lightning, explosion, smoke or sprinkler leakage insurance for premises rented to you or temporarily occupied by you with permission of the owner.
2. Subsection 8. Transfer Of Rights Of Recovery Against Others To Us is amended to include:
However, the insured may waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract.
3. The following condition is added:
10. Liberalization
If we revise this NONPROFIT AND HUMAN SERVICES GENERAL LIABILITY ENDORSEMENT to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective in your state.
I. SECTION V – DEFINITIONS is amended as follows:
1. Subsection 3. “Bodily injury” is deleted and replaced with the following:
3. "Bodily injury" means physical injury, sickness, or disease sustained by a person, including death of a person resulting from any of these. “Bodily injury” also means mental injury, mental anguish, humiliation, or shock sustained by a person, if directly resulting from physical injury, sickness, or disease sustained by that person.
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2. Subsection 4. “Coverage territory”is deleted and replaced by the following:
4. "Coverage territory" means anywhere in the world provided that the claim is made, and any "suit" that may arise therefrom is filed, within the United States of America (including its territories and possessions), Puerto Rico or Canada, unless further restricted by endorsement.
3. Paragraph 9. “Insured Contract” subsection a. is replaced by the following:
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, lightning, explosion, smoke or sprinkler leakage to premises while retained to you or temporarily occupied by you with permission of the owners is not an “insured contract”
4. Paragraph 14. “Personal and Advertising Injury" is amended as follows:
a. Subsection b. is deleted and replaced with the following:
b. Malicious prosecution or abuse of process
b. Subsection h. is added.
h. "Personal and advertising injury" also means injury, including consequential "bodily injury", arising out of discrimination based on race, color, religion, sex, age or national origin, except when:
(1) Done intentionally by or at the direction of, or with the knowledge or consent of:
(a) Any insured; or
(b) Any executive officer, director, stockholder, partner or member of the insured; or
(2) Directly or indirectly related to the employment, former or prospective employment, termination of employment, demotion, failure to promote or application for employment of any person or persons by an insured; or
(3) 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
(4) Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling.
This coverage does not apply to fines or penalties imposed because of discrimination.
5. For the purpose of this endorsement, the following definitions are added to Section V:
a. “Abuse” means any actual, threatened, or alleged act, error, omission, conduct or misconduct that a claim or “suit” alleges:
(1) To be, or to constitute, any form of “abuse” (including but not limited to elder “abuse”, child “abuse”, patient “abuse” or “abuse” of a dependent person) under any applicable state or federal statute; and
(2) Any non-sexual assault, non-sexual battery, or non-sexual “abuse” directed at a person;
and
Conduct or misconduct described above constitutes “abuse” regardless of whether or not it is alleged to be negligent, reckless, knowing, intentional, fraudulent, oppressive, malicious, or otherwise.
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However, “abuse” does not include employment-related "sexual harassment".
b. "Foster care services" means the provisions of personal care or training to a "foster child" including but is not limited to activities of any insured or of any "temporary worker", licensee, subcontractor, independent contractor, vendor or others in investigation, evaluation, counseling, treatment, training, material aid, supervision or monitoring of individuals or families, with respect to placement of a "foster child" as required by any Federal, State, or local code, regulation or ordinance.
c. “Foster child” means a child whose care and upbringing are entrusted to an adult other than the child’s natural or adoptive parents.
d. “Medical or healthcare services” means any type of treatment or services provided for physical, mental, veterinary or dental care, including but not limited to:
(1) Any type or form of psychiatric counseling;
(2) Any type or form of medical, dental, physiological, psychological, addiction, behavioral, chiropractic, holistic, hospice, veterinary or any other similar treatment; or
(3) The operation of a hospital, clinic open to the general public, or other medical facility or laboratory; or
(4) The providing, prescription, dispensing, or using of drugs or medical appliances or devices.
e. "Medically derived injury" means a physical, pathologic or psychiatric trauma resulting from "medical or healthcare services" provided by a “medical professional”, including death resulting therefrom, to your care recipient. "Medically derived injury" includes an aggravation of a preexisting disease or mental disorder. "Medically derived injury" does not include "property damage", "personal and advertising injury", or any injury arising from “abuse”, "sexual misconduct or sexual molestation" or "sexual harassment".
f. “Medical professional” means an anesthesiologist, chiropodist, chiropractor, dentist, medical technician, midwife, nurse anesthetist, nurse, optometrist, pharmacist, physician, podiatrist, psychiatrist, psychologist, surgeon, veterinarian, x-ray therapist, or any other individual who provides preventative, curative, or rehabilitative health care services, and is licensed where required by law.
g. "Product recall” means the recall or withdrawal of “your product” from the market or from use by any other person or organization because of a known or suspected defect in “your product” which has or is reasonably expected to cause “bodily injury” or physical injury to tangible property other than “your product”.
h. “Product recall expenses” mean those reasonable and necessary expenses paid and directly related to a “product recall”
i. "Professional services" means any service that:
(1) Involves specialized education, knowledge, labor, judgment, and skill, and is predominantly mental or intellectual (as opposed to physical or manual) in nature; and
(2) Is provided as part of the Named Insured's operations as a nonprofit or human services organization; and
(3) Subject to Paragraphs a. and b. above, "professional services" includes but is not limited to the following:
(a) Advice, guidance, or assistance;
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(b) Counseling;
(c) "Social work";
(d) Therapy;
(e) Daycare;
(f) "Foster care services"; and
(g) Job training, job placement, job referral, or vocational services.
However, "professional services" does not include any of the following: "medical or healthcare services" or any person or organization acting in the capacity of a “medical professional”, accountant, attorney, architect, engineer, real estate manager, immigration counselor, or investment manager.
j. “Sexual harassment” means unwelcome sexual advances, requests for sexual favors, or other verbal, visual or physical conduct of a sexual nature when such conduct:
(1) Is linked implicitly or explicitly with a decision affecting a term or condition of any individual's employment;
(2) Interferes with any individual's job performance;
(3) Creates an intimidating, hostile or offensive working environment for any individual; or
(4) Arises out of or is related to an unlawful employment practice as codified at 42 U.S.C.
§ 2000e, et seq., or any similar state, municipal or local code, regulation or ordinance.
k. “Sexual misconduct or sexual molestation" means any activity which is sexual in nature (whether permitted or not permitted); and includes, but is not limited to: sexual assault, sexual battery, sexual relations, sexual acts, sexual activity, sexual handling, sexual massage, sexual exploitation, sexual exhibition, sexual stimulation, fondling, intimacy, exposure of sexual organs, lewd or lascivious behavior or indecent exposure, fornication, unauthorized touching, or the photographic, video or other reproduction of sexual activity.
However, "sexual misconduct or sexual molestation" does not include employment-related "sexual harassment".
l. "Social work" means any activities or methods of any insured or your "employees", agents, representatives, “volunteer workers”, "temporary workers", licensees, subcontractors, independent contractors, vendors or others providing social services, including but not limited to:
(1) Investigation, treatment, or material aid for the economically, physically, mentally, or socially disadvantaged, or anyone else; and
(2) Activities such as child welfare, community physical or mental health, adoption services, personal counseling services, recreational activities, temporary housing or shelters or other similar activities.
m. “Special Event” means a sporting, cultural, business or other type of unique activity, in a certain place occurring during a limited or fixed interval of time (one-time, annual) and presented to a live audience brought together to watch or to participate. “Special events” include, but are not limited to, street fairs, music festivals, revenue generating or public relations activities, regardless of the location or relationship to the operations of any insured.
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PRIMARY AND NONCONTRIBUTORY –
OTHER INSURANCE CONDITION
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
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.
CG 20 01 04 13© Insurance Services Office, Inc., 2012
4.
5.
a.
(1)
(2) b.
c.
6.
a.
b.
7.
a.
b.
(1)
(2)
(3)
(4)
No Benefit To Bailee – Physical Damage Coverages
We will not recognize any assignment or grant any coverage for the benefit of any person or organization holding, storing or transporting property for a fee regardless of any other provision of this Coverage Form.
Other Insurance
For any covered "auto" you own, this Coverage Form provides primary insurance. For any covered "auto" you don't own, the insurance provided by this Coverage Form is excess over any other collectible insurance. However, while a covered "auto" which is a "trailer" is connected to another vehicle, the Covered Autos Liability Coverage this Coverage Form provides for the "trailer" is:
Excess while it is connected to a motor vehicle you do not own; or
Primary while it is connected to a covered "auto" you own.
For Hired Auto Physical Damage Coverage, any covered "auto" you lease, hire, rent or borrow is deemed to be a covered "auto" you own. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto".
Regardless of the provisions of Paragraph a. above, this Coverage Form's Covered Autos Liability Coverage is primary for any liability assumed under an "insured contract".
d. When this Coverage Form and any other Coverage Form or policy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the limits of all the Coverage Forms and policies covering on the same basis.
Premium Audit
The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy began. We will compute the final premium due when we determine your actual exposures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the balance, if any. The due date for the final premium or retrospective premium is the date shown as the due date on the bill. If the estimated total premium exceeds the final premium due, the first Named Insured will get a refund.
If this policy is issued for more than one year, the premium for this Coverage Form will be computed annually based on our rates or premiums in effect at the beginning of each year of the policy.
Policy Period, Coverage Territory
Under this Coverage Form, we cover "accidents" and "losses" occurring:
During the policy period shown in the Declarations; and
Within the coverage territory.
The coverage territory is:
The United States of America;
The territories and possessions of the United States of America;
Puerto Rico;
Canada; and
CA 00 01 10 13© Insurance Services Office, Inc., 2011
POLICY NUMBER: 01-0030-657
Liability Coverage Extensions Included or Limit of Insurance
A. Who Is An Insured-Broadened Additional Insured by Contract or Agreement Board Members Newly Acquired Entities Employees as Insureds Lessor of Leased Autos
Included Included Included Included Included
B. Supplementary Payments Coverage Extensions Bail Bonds Loss of Earnings
$5,000 $500 per day
C. Fellow Employee Coverage Included
Physical Damage Coverage Extensions Included or Limit of Insurance
A. Towing $100 per disablement B. Glass Repair – No Deductible Included
$100 per day/$2,000 maximum
C. Transportation Expenses
$100 per day/$1,000 maximum
D. Hired Auto Physical Damage-Loss of Use
E. Rental Reimbursement $100 per day for 30 days
F. Personal Effects Coverage $500 ACV/Cost to Repair or
Replace/$50,000 G. Hired Auto Physical Damage
H. Safety Equipment Coverage $500 I. Vehicle Return Coverage $500
J. Lock Recalibration $1,000 K. Auto Loan / Lease Gap Included L. Accidental Airbag Discharge Included M. Electronic Equipment – Broadened Coverage $1,000
O. Physical Damage Deductible With Vehicle Tracking System Included Exception
Business Auto Conditions Included A. Blanket Waiver of Subrogation Included
B. Two Or More Coverage Forms Or Policies Issued By Us Included
N. Original Equipment Manufacturer (OEM) Parts Replacement Included
GuideVantagesm Auto Enhancement
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
Following is a summary of the Limits of Insurance and additional coverage provided by this endorsement. This summary identifies the maximum amount of coverage for each coverage extension shown below. For complete details on coverage, refer to the actual provisions of this endorsement and the entire policy.
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GCA 23 00 02 19
A.
c.
(1)
(2) d.
e.
(1)
(2)
(3) f.
g.
Coverage extensions under this endorsement only apply in the event that no other specific coverage for these extensions are provided under this policy.
This is the start of the file's text. The full file is on GovTribe.
File details come from the government source that posted it. Updated .