COI_7-1-22.pdf

05/18/2022

Moody Insurance Agency, Inc.

8055 East Tufts Avenue Suite 1000 Denver CO 80237

Moody Insurance Agency, Inc.

(303) 824-6600 (303) 370-0118 certrequest@moodyins.com

Advanced Healthstyles Fitness Equipment, Inc., DBA: Advanced Exercise Equipment, Inc.

861 Southpark Drive Ste 100 Littleton CO 80120

Westfield Insurance Company 24112

21-22 Master

A TRA1497975 07/01/2021 07/01/2022

1,000,000 500,000 5,000 1,000,000 2,000,000 2,000,000

A TRA1497975 07/01/2021 07/01/2022

1,000,000

A

TRA1497975 07/01/2021 07/01/2022

2,000,000 2,000,000

A Installation Floater

TRA1497975 07/01/2021 07/01/2022

Jobsite Limit $100,000 Catastrophe Limit $200,000 Deductible $1,000

Arizona Department of Public Safety 2102 W. Encanto Blvd.

Phoenix AZ 85009

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

Advanced Healthstyles Fitness Equipment, Inc., DBA: Advanced Exercise Equipment, Inc.

Moody Insurance Agency, Inc.

25 Certificate of Liability Insurance: Notes

CONTRACTUAL LIABILITY APPLIES PER POLICY TERMS & CONDITIONS

General Liability To the Extent Provided in Form CG 7137 (12/17):

Blanket Additional Insured status applies when required by written contract.

Coverage applies as Primary and Non-contributory when required by written contract.

Blanket Waiver of Subrogation applies when required by written contract.

To the Extent Provided in Form CG 2010 (12/19):

Blanket Additional Insured status (Ongoing Operations) applies when required by written contract.

To the Extent Provided in Form CG 2037 (12/19):

Blanket Additional Insured status (Completed Operations) applies when required by written contract.

To the Extent Provided in Form CG 2001 (12/19):

Coverage applies as Primary and Non-contributory when required by written contract.

Automobile Liability To the Extent Provided in Form CA 7077 (10/13):

Blanket Additional Insured status applies when required by written contract.

To the Extent Provided in Form CA 0449 (11/16):

Coverage applies as Primary and Non-contributory when required by written contract.

To the Extent Provided in Form CA 0444 (10/13):

Blanket Waiver of Subrogation applies when required by written contract.

Umbrella Liability Umbrella Liability follows form on the following underlying coverages including additional insured and waiver of subrogation statuses: General Liability and Automobile Liability.

IMPORTANT

Please note that copies of policy forms will not be sent out by mail. If you require copies of policy forms/endorsements, please submit your request to CertRequest@moodyins.com and reference the insured's name.

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:

COMMERCIAL GENERAL LIABILITY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PRIMARY AND NONCONTRIBUTORY -

OTHER INSURANCE CONDITION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

LIQUOR 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 avail-able to an additional insured under your pol-icy provided that:

(1) The additional insured is a Named In-sured 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 contrib-ution from any other insurance available to the additional insured.

¢ Insurance Services Office, Inc., 2018 CG 20 01 12 19

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 Organization(s) Location(s) Of Covered Operations

All persons or organizations when you have All Locations agreed in writing in a contract or agreement that such persons or organizations be added as an additional insured.

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

POLICY NUMBER: TRA 1497975

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 adver-tising 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 oper-ations for the additional insured(s) at the location(s) designated above.

However:

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

2. If coverage provided to the additional in-sured is required by a contract or agree-ment, 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 addi-tional exclusions apply:

This insurance does not apply to "bodily in-jury" 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 addi-tional 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 or-ganization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.

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 of insurance;

whichever is less.

This endorsement shall not increase the ap-plicable limits of insurance.

¢ Insurance Services Office, Inc., 2018 CG 20 10 12 19

POLICY NUMBER: COMMERCIAL GENERAL LIABILITY

ADDITIONAL INSURED - OWNERS, LESSEES OR

CONTRACTORS - COMPLETED OPERATIONS

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured Person(s) Or Organization(s) Location(s) And Description Of Covered Operations

All persons or organizations when you have All Locations agreed in writing in a contract or agreement that such persons or organizations be added as an additional insured.

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

TRA 1497975

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" or "property damage" caused, in whole or in part, by "your work" at the location desig-nated and described in the schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard".

However:

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

2. If coverage provided to the additional in-sured is required by a contract or agree-ment, 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;

whichever is less.

This endorsement shall not increase the ap-plicable limits of insurance.

¢ Insurance Services Office, Inc., 2018 CG 20 37 12 19

COMMERCIAL AUTO

PRIMARY AND NONCONTRIBUTORY -

OTHER INSURANCE CONDITION

This endorsement modifies insurance provided under the following:

AUTO DEALERS COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply un-less modified by the endorsement.

A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance - Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary:

This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance avail-able to an "insured" under your policy pro-vided that:

1. Such "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 contrib-ution from any other insurance available to such "insured".

B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary:

This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "in-sured" under your policy provided that:

1. Such "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 contrib-ution from any other insurance available to such "insured".

¢ Insurance Services Office, Inc., 2016 CA 04 49 11 16

BUSINESS AUTO ENDORSEMENT

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

SCHEDULE

The coverage provided by this endorsement is summarized below and is intended to provide a general coverage description only. For the details affecting each coverage, please refer to the terms and condi-tions in this endorsement.

A. Who Is An Insured broadened:

Additional Insured by Contract, Agreement or Permit Legally Incorporated Subsidiaries Newly Acquired Organizations

B. Supplementary Payments Bail Bonds - $5000 Loss of Earnings - $500

C. Fellow Employee Exclusion Amendment D. Coverage Extensions

Transportation Expenses Personal Effects (Excess Basis)

E. Additional Coverages Expenses paid for returning a stolen covered auto Fire Department Service Charge

F. Airbag Coverage - Accidental Discharge G. Glass Repair - Waiver of Deductible H. Knowledge and Notice of an Accident, Claim or Suit I. Unintentional Failure To Disclose Hazards J. Worldwide Coverage K. Definitions

Bodily Injury Redefined

In addition to the policy amendments contained in A. through K. listed above, the endorsements listed below will automatically be attached to your policy to complete the coverage provided by the Signature Series Business Auto Endorsement:

Audio, Visual and Data Electronic Equipment Coverage Added Limits - CA 99 60 Auto Loan/Lease Gap Coverage - CA 20 71 Drive Other Car Coverage - Broadened Coverage For Named Individuals - (Executive Officers/Spouses) - CA 99 10 Employee Hired Autos - CA 20 54 Employees As Insureds - CA 99 33 Hired Auto Physical Damage (Refer to Auto Declarations page) Rental Reimbursement Coverage - CA 99 23 Waiver of Transfer of Rights of Recovery (Waiver of Subrogation) - CA 04 44

A. WHO IS AN INSURED BROADENED

SECTION II - COVERED AUTOS LIABILITY

COVERAGE, item A. Coverage, 1. Who Is An Insured is amended to include the following additional paragraphs:

d. Any legally incorporated subsidiary of yours in which you own more than

50% of the voting stock on the ef-fective date of this endorsement.

However, "insured" does not include any subsidiary that is an "insured" under any other liability policy or would be an "insured" under such a policy but for its termination or the exhaustion of its limit of insurance.

CA 70 77 10 13

Coverage under this provision is af-forded only for the first 180 days af-ter you acquire or form the organization or until the end of the policy period, whichever comes first.

e. Any organization you newly acquire or form, other than a partnership or joint venture, and over which you maintain ownership or a majority in-terest. However, coverage under this provision:

(1) Does not apply if the organiza-tion you acquire or form is an "insured" under another auto li-ability policy or would be "in-sured" under such a policy but for its termination or the ex-haustion of its limits of insur-ance;

(2) Does not apply to "bodily injury" or "property damage" that oc-curred before you acquired or formed the organization; and

(3) Is afforded only for the first 180 days after you acquire or form the organization or until the end of the policy period, whichever comes first.

f. Any person or organization with whom you agreed in writing in a contract, agreement or permit, to provide insurance such as is af-forded under this policy.

This provision only applies if the written contract or agreement has been executed or permit has been issued, prior to the "bodily injury" or "property damage".

B. SUPPLEMENTAL PAYMENTS

SECTION II - COVERED AUTOS LIABILITY

COVERAGE, item A. Coverage, 2. Coverage Extensions, a. Supplementary Payments, sub-paragraphs (2) and (4) are deleted and re-placed with the following:

(2) Up to $5,000 for cost of bail bonds (including bonds for re-lated traffic law violations) re-quired because of an "accident" we cover. We do not have to furnish these bonds.

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

C. FELLOW EMPLOYEE EXCLUSION AMEND-

MENT

SECTION II - COVERED AUTOS LIABILITY

COVERAGE, item B. Exclusions, 5. Fellow Employee does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire.

D. COVERAGE EXTENSIONS

SECTION III - PHYSICAL DAMAGE COVER-

AGE, Item A. Coverage, 4. Coverage Exten-sions, a. Transportation Expenses is replaced with the following:

a. Transportation Expenses

We will pay up to $100 per day to a maximum of $1,800 for transporta-tion expense incurred by you be-cause of the total theft of a covered "auto" of the private passenger type.

We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for transportation expenses 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".

The following is added to Item 4. Cover-age Extensions:

c. Personal Effects

We will pay up to $500 for the "loss" of your personal effects that are contained in a covered "auto" due to the total theft of the covered "auto."

We will pay only for those personal effects that are contained in covered "autos" for which you carry either Comprehensive or Specified Causes Of Loss Coverage.

Our payment for "loss" of or damage to personal effects will apply only on an excess basis over other collect-ible insurance.

E. ADDITIONAL COVERAGES

SECTION III - PHYSICAL DAMAGE COVER-

AGE, A. Coverage, is amended to include the following additional coverage items:

5. We will pay the expense of returning a stolen covered "auto" to you.

6. Fire Department Service Charge

When a fire department is called to save or protect a covered "auto", its equip-ment, its contents or occupants from a Covered Cause Of Loss, we will pay up to $1,000 for your liability for Fire De-partment Service Charges:

(a) Assumed by contract or agreement prior to loss; or

(b) Required by local ordinance.

No deductible applies to this additional coverage.

F. AIRBAG COVERAGE - ACCIDENTAL DIS-

CHARGE

SECTION III - PHYSICAL DAMAGE COVER-

AGE, Item B. Exclusions, subparagraph 3.a.

is deleted and replaced with the following:

a. Wear and tear, freezing, mechanical or electrical breakdown.

Mechanical breakdown does not ap-ply to the accidental discharge of an airbag.

G. GLASS REPAIR - WAIVER OF DEDUCTIBLE

SECTION III - PHYSICAL DAMAGE COVER-

AGE, item D. Deductible the following para-graph is added:

No deductible shall apply to glass dam-age if the glass is repaired rather than replaced.

H. KNOWLEDGE AND NOTICE OF AN ACCI-

DENT, CLAIM OR SUIT

SECTION IV - BUSINESS AUTO CONDITIONS,

Item A. Loss Conditions is amended as fol-lows:

Subparagraph a. under Item 2. Duties In The Event Of Accident, Claim, Suit Or Loss, is amended to include the following paragraphs:

This requirement applies when the "accident," claim, "suit" or "loss" is first known to:

(1) You, if you are an individual;

(2) A partner, if you are a partner-ship; or

(3) An executive officer or insur-ance manager, if you are a cor-poration.

Subparagraph b.(2) under 2. Duties In The Event Of Accident, Claim, Suit Or Loss is amended as follows:

(2) Immediately send us copies of any request, demand, order, notice, summons or legal paper received concerning the claim or "suit."

Your employees may know of documents received concerning a claim or "suit". This will not mean that you have such know-ledge, unless receipt of such documents is known to you, any of your executive officers or partners or your insurance manager.

I. UNINTENTIONAL FAILURE TO DISCLOSE

HAZARDS

Under SECTION IV - BUSINESS AUTO CON- DITIONS, B. General Conditions, 2.

Concealment, Misrepresentation Or Fraud is amended to include the following additional paragraph:

If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure.

J. WORLDWIDE COVERAGE

Under SECTION IV - BUSINESS AUTO CON- DITIONS, B. General Conditions, 7. Policy Period, Coverage Territory, subparagraph (5) is deleted and replaced with the following:

(5) Anywhere in the world, if:

(a) A covered "auto" of the private passenger type is leased, hired, rented or borrowed without a driver for a period of 45 days or less; and

(b) The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, Puerto Rio or Canada or in a settlement we agree to.

(c) If, for such "autos" a "suit" is brought outside the territory de-scribed in 7.(1) through 7.(4) above, we will reimburse the insured for defense expenses incurred with our written con-sent, but we will make no pay-ment, nor will we reimburse the insured for damages.

K. DEFINITIONS

Under SECTION V - DEFINITIONS, Item C. is replaced by the following:

C. "Bodily injury" means bodily injury, sick-ness or disease sustained by a person, including mental anguish, mental injury or death resulting from any of these.

"Bodily injury" includes mental anguish or other mental injury resulting from "bodily injury".

WAIVER OF TRANSFER OF RIGHTS OF

RECOVERY AGAINST OTHERS TO US

(WAIVER OF SUBROGATION)

This endorsement modifies insurance provided under the following:

AUTO DEALERS COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply un-less modified by the endorsement.

This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.

Named Insured:

Endorsement Effective Date:

SCHEDULE

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

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

POLICY NUMBER: TRA 1497975

The Transfer Of Rights Of Recovery Against Oth-ers To Us Condition does not apply to the person(s) or organization(s) shown in the Sched-ule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization.

¢ Insurance Services Office, Inc., 2011 CA 04 44 10 13

COMMERCIAL GENERAL LIABILITY CONTRACTORS ENDORSEMENT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

SCHEDULE

The coverage provided by this endorsement is summarized below and is intended to provide a general coverage description only. For the details effecting each coverage please refer to the terms and condi-tions in this endorsement.

A. Expected or Intended Injury Reasonable force

B. Liquor Liability Coverage Extension C. Non-Owned Watercraft

Increased to 60 feet D. Non-Owned Aircraft E. Damage To Property - Borrowed Equipment F. Damage To Premises Rented To You G. Personal And Advertising Injury

Contractual Personal and Advertising Injury Exclusions

H. Supplementary Payments Bail Bonds - $2,500 Loss of Earnings - $1,000

I. Additional Insureds - Automatic Status State or Governmental Agency or Subdivision or Political Subdivision Controling Interest Managers or Lessors of Premises Mortgagee, Assignee or Receiver Owners or Other Interests From Whom Land Has Been Leased Co-Owners of Insured Premises Lessor of Leased Equipment

J. Who Is An Insured broadened Joint Ventures / Partnership / Limited Liability Company Health Care Professionals (Incidental Medical Malpractice) Individual Owners of Building are Insured's Newly Formed or Acquired Entities

K. Knowledge and Notice of Occurrence L. Other Insurance Condition Amended M. Unintentional Failure To Disclose Hazards N. Waiver of Transfer Of Rights Of Recovery Against Others To Us - Automatic Status O. Liberalization P. Definitions

Bodily Injury redefined Insured Contract redefined Expanded Personal and Advertising Injury definition

A. EXPECTED OR INTENDED INJURY

Under SECTION 1, COVERAGES, COVERAGE

A. BODILY INJURY AND PROPERTY DAMAGE

exclusion a. is replaced with the following:

a. Expected Or Intended Injury

"Bodily Injury" or "property damage" expected or intended from the standpoint of the insured. This ex-clusion does not apply to "bodily in-jury" or "property damage" resulting from the use of reasonable force for the purpose of protecting persons or property.

CG 7137 12 17

martha.weitzel Typewritten text

TRA1497975

B. LIQUOR LIABILITY COVERAGE EXTENSION

SECTION 1, COVERAGES, COVERAGE A

BODILY INJURY AND PROPERTY DAMAGE

LIABILITY, Item 2. Exclusions c. Liquor Li-ability is deleted.

C. NON-OWNED WATERCRAFT

Under SECTION 1, COVERAGES, COVERAGE

A BODILY INJURY AND PROPERTY DAMAGE

LIABILITY, Item 2. Exclusions g.2(a) is re-placed with the following:

(a) Less than 60 feet long; and

D. NON-OWNED AIRCRAFT

Under SECTION 1, COVERAGES, COVERAGE

A BODILY INJURY AND PROPERTY DAMAGE

LIABILITY, Item 2. Exclusions g. Aircraft, Auto or Watercraft, the following is added:

(6) An aircraft you do not own pro-vided that:

(a) The pilot in command holds a currently effective certif-icate issued by the duly constituted authority of the United States of America or Canada, designating that person as a commercial or airline transport pilot;

(b) It is rented with a trained, paid crew; and

(c) It does not transport per-sons or cargo for a charge.

E. DAMAGE TO PROPERTY - BORROWED

EQUIPMENT

Under SECTION 1, COVERAGES, COVERAGE

A BODILY INJURY AND PROPERTY DAMAGE

LIABILITY, Item 2. Exclusions j. is deleted and replaced by the following:

j. Damage To Property:

(1) Property you own, rent or oc-cupy;

(2) Premises you sell, give away or abandon, if the "property dam-age" arises out of any part of those premises;

(3) Property loaned to you;

(4) Personal property in the care, custody or control of the in-sured;

(5) That particular part of any real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing op-erations, if the "property dam-age" arises out of those operations; or

(6) That particular part of any real property that must be restored, replaced, or repaired because "your work" was incorrectly performed on it.

Paragraphs (1), (3) and (4) of this exclusion do not apply to:

(i) "property damage" to tools or equipment loaned to you if the tools or equipment are not being used to per-form operations at the time of loss; or

(ii) "property damage" (other than damage by fire) to premises rented to you or temporarily occupied to you with the permission of the owner or to the con-tents of premises rented to you for a pe-riod of seven (7) or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as de-scribed in Section III - Limits Of Insurance.

Paragraph (2) of this exclusion does not apply if the premises are "your work" and were not occupied, rented or held for rental by you beyond one year from the date "your work" was completed.

Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you.

Paragraphs (3), (4), (5) and (6) of this exclu-sion do not apply to liability assumed under a sidetrack agreement.

Paragraph (6) of this exclusion does not apply to "property damage" included in the "products-completed operations hazard."

F. DAMAGE TO PREMISES RENTED TO YOU

Under SECTION I - COVERAGES, COVERAGE

A BODILY INJURY AND PROPERTY DAMAGE

LIABILITY, Item 2. Exclusions, the last para-graph of Item 2. Exclusions is replaced with the following:

Exclusion c. through n. do not apply to dam-age by fire or explosion 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 INSUR-

ANCE.

CG 7137 12 17

G. PERSONAL AND ADVERTISING INJURY

Under SECTION 1, COVERAGES, COVERAGE

B PERSONAL AND ADVERTISING INJURY LI-

ABILITY, Item 2. Exclusions e. Contractual Liability is deleted.

Under SECTION I - COVERAGES, COVERAGE

B PERSONAL AND ADVERTISING INJURY LI-

ABILITY, the following are added to Item 2.

Exclusions:

q. Discrimination Relating To Room, Dwelling or Premises

Caused by discrimination directly or indirectly related to the sale, rental, lease or sub-lease or prospective sale, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured.

r. Fines or Penalties

Fines or penalties levied or imposed by a governmental entity because of discrimination.

H. SUPPLEMENTARY PAYMENTS

Under SECTION I - SUPPLEMENTARY PAY- MENTS COVERAGES A AND B, item 1.b. is replaced with the following:

b. Up to $2,500 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.

Under SECTION I - SUPPLEMENTARY PAY- MENTS COVERAGES A AND B, item 1.d. is replaced with the following:

d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $1,000 a day because of time off from work.

I. ADDITIONAL INSUREDS - AUTOMATIC STA-

TUS

SECTION II - WHO IS AN INSURED is amended to include as an insured any person or organization (called additional insured) described in paragraphs a. through g. below whom you are required to add as an addi-tional insured on this policy under a written contract or written agreement. However the written contract or written agreement must be:

1. Currently in effect or becoming effective during the term of the policy; and

2. Executed prior to the "bodily injury", "property damage" or "personal injury and advertising injury", but

Only the following persons or organizations are additional insureds under this endorse-ment and coverage provided to such addi-tional insureds is limited as provided herein:

a. State or Governmental Agency or Subdivision or Political Subdivisions

A state or governmental agency or subdivision or political subdivision subject to the following provisions:

(1) This insurance applies only with respect to the following hazards for which the state or govern-mental 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;

(a) The existence, repair main-tenance, erection, con-struction, 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 ex-posures; or

(b) The construction, erection, or removal of elevators.

(2) 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 poli-tical subdivision has issued a permit or authorization.

This insurance does not apply to "bodily injury", "property dam-age" or "personal and advertis-ing injury" arising out of operations performed for the federal government, state or municipality.

b. Managers or Lessors of Premises

A manager or lessor of premises but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the premises leased to you and subject to the following additional exclu-sions:

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 con-struction or demolition oper-ations performed by or on behalf of such additional in-sured.

c. Mortgagee, Assignee or Receiver

A mortgagee, assignee or receiver but only with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance, or use of a premises by you.

This insurance does not apply to structural alterations, new con-struction or demolition operations performed by or for such additional insured.

d. Owners Or Other Interests From Whom Land Has Been Leased

An owner or other interest from who land has been leased by you but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the land leased to you and subject to the fol-lowing additional exclusions:

This insurance does not apply to:

(1) Any "occurrence" which takes place after you cease to lease that land; or

(2) Structural alterations, new con-struction or demolition oper-ations performed by or on behalf of such additional in-sured.

e. Co-owner of Insured Premises

A co-owner of a premises co-owned by you and covered under this in-surance but only with respect to the co-owners liability as co-owner of such premises.

f. Lessor of Equipment

Any person or organization from whom you lease equipment. Such person or organization are insureds only with respect to their liability arising out of the maintenance, op-eration or use by you of equipment leased to you by such person or or-ganization.

A person's or organization's status as an insured under this endorse-ment ends when their written con-tract or written agreement with you for such leased equipment ends.

With respect to the insurance af-forded these additional insureds, the following exclusions apply:

This insurance does not apply:

(1) To any "occurrence" which takes place after the equipment lease expires; or

(2) To "bodily injury", "property damage", or "personal and ad-vertising injury" arising out of the sole negligence of such ad-ditional insured.

Any insurance provided to an addi-tional insured designated under par-agraphs a. through f. above does not apply to "bodily injury" or "property damage" included within the "pro-ducts-completed operations hazard".

As respects the coverage provided under this provision, Paragraph 4.b.(1) of Section IV - Commercial General Liability Conditions is deleted and replaced with the following:

4. Other Insurance

b. Excess Insurance

(1) This insurance is excess over:

Any other insurance naming the additional insured as an insured whether primary, excess, con-tingent or on any other basis unless a written contract or written agreement specifically requires that this insurance be either primary or primary and non-contributing. Where re-quired by written contractor written agreement, we will con-sider any other insurance main-tained by the additional insured for injury or damage covered by this endorsement to be excess and non-contributing with this insurance.

J. WHO IS AN INSURED BROADENED

Under SECTION II - WHO IS AN INSURED the following is added to item 1:

f. Joint Ventures / Partnership / Lim-ited Liability Company Coverage

You are an insured when you had an Interest in a joint venture, partner-ship or limited liability company which is terminated or ended prior to or during this policy period but only to the extent of your interest in such joint venture, partnership or limited liability company. This cov-erage does not apply:

(1) Prior to the termination date of any joint venture, limited liability company or partnership; or

(2) If there is other valid and collectible insurance purchased specifically to insure the joint venture, legal liability company or partnership.

Under SECTION II - WHO IS AN INSURED, 2.a.(1)(d) is deleted and replaced with the fol-lowing:

(d) Arising out of his or her providing or failing to pro-vide professional health care services.

This does not apply to nurses, emergency medical technicians or paramedics employed by you to provide health care services, but only if you are not in the business or occupation of providing such professional services.

Under SECTION II - WHO IS AN INSURED the following is added:

4. For COVERAGE A and COVERAGE B only, the owner of any building leased to you, but only if the building owner is a shareholder in your corporation or a partner in your partnership insured by this policy, and only with respect to li-ability arising out of the ownership, maintenance or use of that part of the premises leased to you. However, this insurance does not apply:

a. To any "occurrence" or offense which takes place after you cease to be a tenant in the premises; or

b. To structural alterations, new con-struction or demolition operations performed by or on behalf of the building owner.

Under SECTION II - WHO IS AN INSURED, 3.a.

is deleted and replaced with the following:

a. Coverage under this provision is af-forded only until the end of the policy period or the next anniversary of this policy's effective date after you ac-quire or form the organization whichever is earlier.

Under SECTION II - WHO IS AN INSURED the last paragraph in this section is deleted and replaced with the following:

Except as provided in 3. above, no per-son or organization is an insured with respect to the conduct of any current or past joint venture, limited liability com-pany or partnership that is not shown as a named insured in the Declarations.

K. KNOWLEDGE AND NOTICE OF OCCURRENCE

Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 2. Duties in the Event of Occurrence, Offense, Claim Or Suit, the following is added:

e. The requirement in Condition 2.a.

applies only when the "occurrence" or offense is known to:

(1) You, if you are an individual;

(2) A partner, if you are a partner-ship;

(3) An "executive officer" or insur-ance manager, if you are a cor-poration; or

(4) A manager, if you are a limited liability company.

f. The requirement in Condition 2.b.

will not be breached unless the breach occurs after such claim or "suit" is known to:

(1) You, if you are an individual;

(2) A partner, if you are a partner-ship;

(3) An "executive officer" or insur-ance manager, if you are a cor-poration; or

(4) A manager, if you are a limited liability company.

g. Your rights under this Coverage Part will not be prejudiced if you fail to give us notice of an "occurrence," offense, claim, or "suit" and that failure is solely due to your reason-able belief that the "bodily injury" or "property damage" is not covered under this Coverage Part. However, you shall give written notice of this "occurrence," offense, claim, or "suit" to us as soon as you are aware this insurance may apply to such "occurrence," offense, claim or "suit."

L. OTHER INSURANCE CONDITION AMENDED

When required by written contract with any additional insured owner, lessee, or contrac-tor to provide insurance on a primary and noncontributory basis, Condition 4 of Section IV - Commercial General Liability Conditions is deleted and replaced by the following:

4. Other Insurance

If other valid and collectible insurance is available for a loss we cover under Cov-erage A or B of this Coverage Part, our obligations are limited as follows:

a. Primary Insurance

This insurance is primary and non-contributory except when b. below applies.

b. Excess Insurance

This insurance is excess over any of the other insurance, whether pri-mary, excess, contingent, or on any other basis:

(1) That is Fire, Extended Coverage, Builders Risk, Installation Risk, or similar coverage for your work;

(2) That is Fire insurance for prem-ises rented to you or temporar-ily occupied by you with permission of the owner; or

(3) If the loss arises out of the maintenance or use of aircraft, "autos," or watercraft to the ex-tent not subject to Exclusion g.

of Section I - Coverage A.

(4) If the loss is caused by the sole negligence of any additional in-sured, owner, lessee, or con-tractor.

When this insurance is excess, we will have no duty under Coverage A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit." If no other defends, we will undertake to do so, but we will be entitled to the other insured's rights against all those other insur-ers.

When this insurance is excess over other insurance, we will pay only our share of the amount of loss, if any, that exceeds the sum of:

(1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and

(2) The total of all deductibles and self-insured amounts under all that other insurance.

We will share the remaining loss, if any with any other insurance that is not described in this Excess Insur-ance provision and was not bought specifically to apply in excess of the limits of Insurance shown in the declarations of this Coverage Part.

M. UNINTENTIONAL FAILURE TO DISCLOSE

HAZARDS

Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 6. Representa-tions, the following is added:

d. Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of this policy shall not prejudice the coverage afforded by this policy, provided such failure to disclose all hazards or prior "oc-currences" is not intentional.

N. WAIVER OF TRANSFER OF RIGHTS OF RE-

COVERY AGAINST OTHERS TO US - AUTO-

MATIC STATUS

Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 8. Transfer Of Rights Of Recovery Against Others To Us is deleted and replaced by the following:

We waive any right of recovery we may have against any person or organization with re-spect to which the insured has waived its right of recovery.

It is further agreed that work commenced un-der letter of intent or work order, subject to subsequent reduction to writing, with cus-tomers whose customary written contracts would require a waiver of recovery rights against them also falls within this blanket waiver of recovery rights.

O. LIBERALIZATION

If we adopt a change in our forms or rules which would broaden coverage for contrac-tors under this coverage form without an ad-ditional premium charge, your policy will automatically provide the additional cover-age's as of the date the broadened coverage is effective in your state.

P. DEFINITIONS

Under SECTION V - DEFINITIONS, item 3. is deleted and replaced with the following:

3. "Bodily Injury" means bodily injury, disa-bility, sickness, or disease sustained by a person, including death resulting from any of these at any time. "Bodily injury" includes mental anguish or other mental injury resulting from "bodily injury".

Under SECTION V - DEFINITIONS, item 9. is deleted and replaced with 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 indem-nifies any person or organization for damage by fire to premises while rented to you or temporarily occu-pied 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 ordi-nance, to indemnify a municipality, except in connection with work for a municipality;

e. An elevator maintenance agree-ment;

f. That part of any other contract or agreement pertaining to your busi-ness (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort li-ability 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 survey or for injury or damage arising out of:

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

(b) Giving directions or in-structions, or failing to give them, if that is the primary cause of the injury or dam-age; or

(2) Under which the insured if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the in-sureds rendering or failure to render professional services in-cluding those listed in (1) above and supervisory, inspection, ar-chitectural or engineering, ac-tivities.

Under SECTION V - DEFINITIONS, item 14. the following is added to the definition of "Personal and advertising injury":

h. Discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but only if such dis-crimination or humiliation is:

(1) Not done intentionally by or at the direction of:

(a) The insured; or

(b) Any "executive officer", director, stockholder, partner, member or manager (if you are a limited liability company) of the insured;

(2) Not directly or indirectly related to the employment, prospective em-ployment, past employment or ter-mination of employment of any person or persons by any insured.