CTR055543_2024-02-01_COI.pdf
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- Attached to
- Master Agreement AZ|CTR055543
- Contract number
- CTR055543
- Issued by
- Arizona
About this file
The document is a comprehensive insurance certificate and policy endorsement package for Amazing Grace Arizona Families LLC, primarily involving the State of Arizona Department of Child Safety (ADCS), Office of Procurement & Contracts. The insurance coverage is provided by multiple carriers including Philadelphia Indemnity Company, NGM Insurance Company, and CopperPoint General Insurance, with Powers-Leavitt Insurance Agency serving as the insurance producer. The policy period runs from February 1, 2023 to February 1, 2024 and covers multiple liability types including commercial general liability, automobile liability, workers' compensation, and professional liability.
The insurance package provides comprehensive coverage for services related to "Family Connections & Nurturing Parenting" with significant liability protections. Key coverage limits include $1,000,000 per occurrence for commercial general liability, $3,000,000 aggregate, and $1,000,000 for sexual abuse and professional liability. The State of Arizona Department of Child Safety is named as an additional insured, with coverage extending to the department's agencies, boards, commissions, universities, officers, and employees. The policy includes specific protections such as sexual abuse and molestation coverage, HIPAA violation coverage, and waivers of subrogation. The endorsements also provide extended coverage for various scenarios including employee indemnification, key and lock replacement, and protection for newly acquired organizations.
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1/24/2023
Powers-Leavitt Insurance Agency, Inc.
111 E Monroe Avenue, Suite 200
Buckeye AZ 85326
Darlene Terry (623)386-4452 (866)836-5280 darlenet@leavitt.com
Amazing Grace Arizona Families LLC 1945 W Desert Vista Trail Unit #74
Phoenix AZ 85085
Philadelphia Indemnity Company 018058 NGM Insurance Company 14788 CopperPoint General Insurance 13043
23 24 Master
A
X
X
X
X Y PHPK2511741 2/1/2023 2/1/2024
1,000,000
100,000
5,000
1,000,000
3,000,000
3,000,000
Abusive Conduct Liability 1,000,000
B
X X X
X Y B1P3764R 2/1/2023 2/1/2024
1,000,000
C 1021567 2/1/2023 2/1/2024
X
1,000,000
1,000,000
1,000,000
A Sexual/Phys Abuse/Molestation PHPK2511741 2/1/2023 2/1/2024 $1,000,000 Agg/$1,000,000 Ea Inc
A Professional Liability PHPK2511741 2/1/2023 2/1/2024 $3,000,000 Agg/$1,000,000 Ea Inc
RE: Family Connections & Nurturing Parenting Sexual Abuse and Molestation coverage is included. The State of Arizona Department of Child Safety (ADCS), Office of Procuement & Contracts & Geena Salzman and its departments, agencies, boards,commissions,universities,officers, officials,agents,and employees are additional insured per written contract with respect to liability arising out of the activities performed by or on behalf of the Contractor as per form PI-GLD-HS 1011 &
CG2402 0509.
State of Arizona Department of Child Safe Office of Procurement & Contracts 3003 N Central Avenue Phoenix, AZ 85012
Jay Broadbent/DT
Y
The ACORD name and logo are registered marks of ACORD
CERTIFICATE HOLDER
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
AUTHORIZED REPRESENTATIVE
CANCELLATION
DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE
LOCJECT
PRO-
POLICY
GEN'L AGGREGATE LIMIT APPLIES PER:
OCCURCLAIMS-MADE
COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurrence) $
DAMAGE TO RENTED
EACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
$RETENTIONDED
CLAIMS-MADE
OCCUR
AGGREGATE $
EACH OCCURRENCE $UMBRELLA LIAB
EXCESS LIAB
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
INSR
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY) LIMITS
PER
STATUTE
OTH-
ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe under DESCRIPTION OF OPERATIONS below
(Mandatory in NH)
OFFICER/MEMBER EXCLUDED?
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
HIRED AUTOS
NON-OWNED
AUTOS AUTOS
AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE $
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.
INSD
ADDL
WVD
SUBR
N / A
(Ea accident)
(Per accident)
OTHER:
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.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE
(A/C, No, Ext):
PRODUCER
ADDRESS:
FAX
(A/C, No):
CONTACT
NAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING COVERAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INS025 (201401)
The State of Arizona Department of Child Safety (ADCS), Office of Procuement & Contracts & Geena Salzman, and its departments, agencies, boards,commissions,universities,officers, officials,agents,and employees are additional insured per written contract with respect to liability arising out of the activities performed by or on behalf of the Contractor involving automobiles owned, leased, hired or borrowed by the contractor per form 64K290 0418.
Waiver of Subrogation applies in favor of the State of Arizona Department of Child Safety (ADCS), Office of Procuement & Contracts & Geena Salzman, its departments, agencies, boards, commissions, universities and its officers, officials, agents, employees for losses arising from work performed by or on behalf of the contractor per forms CG2404 0509, 64K290 0418 and WC000313 0484 per written contract.
COMMENTS/REMARKS
COPYRIGHT 2000, AMS SERVICES INC.OFREMARK
COMMERCIAL GENERAL LIABILITY
CG 24 04 05 09
CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization:
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions:
We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above.
The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees for losses arising from work performed by or on behalf of the contractor.
POLICY NUMBER: PHPK2511741
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us).
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
State
AZ
Schedule Blanket/Schedule/State
BLANKET
Blanket Waiver: Anyone for whom you have agreed to provide this Waiver subject to the terms of this endorsement
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
This document may have been uploaded to the CopperPoint Portal.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Insurance Company CopperPoint General Insurance Company Countersigned by
WC 00 03 13
(Ed. 4-84)
© 1983 National Council on Compensation Insurance.
Endorsement Effective 02/01/2023 Policy No. 1021567 Insured Amazing Grace Arizona Families LLC
Endorsemen
� � ��PI-GLD-HS�(10/11)�
Page�1�of�12�
Includes�copyrighted�material�of�Insurance�Services�Office,�Inc.,�with�its�permission.� ©�2011�Philadelphia�Indemnity�Insurance�Company�
�THIS�ENDORSEMENT�CHANGES�THE�POLICY.��PLEASE�READ�IT�CAREFULLY.�
GENERAL�LIABILITY�DELUXE�ENDORSEMENT:�
HUMAN�SERVICES��
This�endorsement�modifies�insurance�provided�under�the�following:�
COMMERCIAL�GENERAL�LIABILITY�COVERAGE�
It�is�understood�and�agreed�that�the�following�extensions�only�apply�in�the�event�that�no�other�specific�coverage�for� the�indicated�loss�exposure�is�provided�under�this�policy.��If�such�specific�coverage�applies,�the�terms,�conditions�and� limits�of�that�coverage�are�the�sole�and�exclusive�coverage�applicable�under�this�policy,�unless�otherwise�noted�on� this�endorsement.���The�following�is�a�summary�of�the�Limits�of�Insurance�and�additional�coverages�provided�by�this� endorsement.��For�complete�details�on�specific�coverages,�consult�the�policy�contract�wording.��� � � � � � �
Coverage�Applicable� Limit�of�Insurance� Page�#�
Extended�Property�Damage�� Included� 2�
Limited�Rental�Lease�Agreement�Contractual�Liability� $50,000�limit� 2�
Non-Owned�Watercraft� Less�than�58�feet� 2�
Damage�to�Property�You�Own,�Rent,�or�Occupy� $30,000�limit� 2�
Damage�to�Premises�Rented�to�You� $1,000,000� 3�
HIPAA� Clarification� 4�
Medical�Payments� $20,000� 5�
Medical�Payments�–�Extended�Reporting�Period� 3�years� 5�
Athletic�Activities� Amended� 5�
Supplementary�Payments�–�Bail�Bonds� $5,000� 5�
Supplementary�Payment�–�Loss�of�Earnings� $1,000�per�day� 5�
Employee�Indemnification�Defense�Coverage�� $25,000� 5�
Key�and�Lock�Replacement�–�Janitorial�Services�Client�Coverage� $10,000�limit� 6�
Additional�Insured�–�Newly�Acquired�Time�Period� Amended� 6�
Additional�Insured�–�Medical�Directors�and�Administrators� Included� 7�
Additional�Insured�–�Managers�and�Supervisors�(with�Fellow����� Employee�Coverage)�
Included� 7�
Additional�Insured�–�Broadened�Named�Insured�� Included� 7�
Additional�Insured�–�Funding�Source� Included� 7�
Additional�Insured�–�Home�Care�Providers�� Included� 7�
Additional�Insured�–�Managers,�Landlords,�or�Lessors�of�Premises� Included� 7�
Additional�Insured�–�Lessor�of�Leased�Equipment�� Included� 7�
Additional�Insured�–�Grantor�of�Permits� Included� 8�
Additional�Insured�–�Vendor� Included� 8�
Additional�Insured�–�Franchisor� Included� 9�
Additional�Insured�–�When�Required�by�Contract� Included� 9�
Additional�Insured�–�Owners,�Lessees,�or�Contractors� Included� 9�
Additional�Insured�–�State�or�Political�Subdivisions� Included� 10�
Policy PHPK2212086
Page�2�of�12�
Includes�copyrighted�material�of�Insurance�Services�Office,�Inc.,�with�its�permission.� ©�2011�Philadelphia�Indemnity�Insurance�Company�
Duties�in�the�Event�of�Occurrence,�Claim�or�Suit� Included� 10�
Unintentional�Failure�to�Disclose�Hazards� Included� 10�
Transfer�of�Rights�of�Recovery�Against�Others�To�Us� Clarification� 10�
Liberalization� Included� 11�
Bodily�Injury�–�includes�Mental�Anguish� Included� 11�
Personal�and�Advertising�Injury�–�includes�Abuse�of�Process,� Discrimination��
Included� 11�
A.�� Extended�Property�Damage��
� SECTION�I�–�COVERAGES,�COVERAGE�A�BODILY�INJURY�AND�PROPERTY�DAMAGE�
� LIABILITY,�Subsection�2.�Exclusions,�Paragraph�a.�is�deleted�in�its�entirety�and�replaced�by�the� � following:�� � � a.� Expected�or�Intended�Injury� � � � “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.��� B.� Limited�Rental�Lease�Agreement�Contractual�Liability��
� SECTION�I�–�COVERAGES,�COVERAGE�A.�BODILY�INJURY�AND�PROPERTY�DAMAGE�
� LIABILITY,�Subsection�2.�Exclusions,�Paragraph�b.�Contractual�Liability�is�amended�to�include�the� � following:��
� � � (3)��Based�on�the�named�insured’s�request�at�the�time�of�claim,�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.��This�coverage�extension�� � � � � only�applies�to�rental�lease�agreements.���This�coverage�is�excess�over�any�renter’s��� � � � � liability�insurance�of�the�client.� C.� Non-Owned�Watercraft�
� SECTION�I�–�COVERAGES,�COVERAGE�A�BODILY�INJURY�AND�PROPERTY�DAMAGE�
� LIABILITY,�Subsection�2.�Exclusions,�Paragraph�g.�(2)�is�deleted�in�its�entirety�and�replaced�by�the� � following:� � � � (2)� A�watercraft�you�do�not�own�that�is:� � � � � (a)� Less�than�58�feet�long;�and� � � � � (b)� Not�being�used�to�carry�persons�or�property�for�a�charge;�� � � � This�provision�applies�to�any�person,�who�with�your�consent,�either�uses�or�is�responsible�for� � � � the�use�of�a�watercraft.��This�insurance�is�excess�over�any�other�valid�and�collectible��� � � � � insurance�available�to�the�insured�whether�primary,�excess�or�contingent.��� D.� Damage�to�Property�You�Own,�Rent�or�Occupy�
� SECTION�I�–�COVERAGES,�COVERAGE�A�BODILY�INJURY�AND�PROPERTY�DAMAGE�
Page�3�of�12�
Includes�copyrighted�material�of�Insurance�Services�Office,�Inc.,�with�its�permission.� ©�2011�Philadelphia�Indemnity�Insurance�Company�
�� LIABILITY,�Subsection�2.�Exclusions,�Paragraph�j.�Damage�to�Property,�Item�(1)�is�deleted�in�its� � entirety�and�replaced�with�the�following:�
� � � (1)� Property�you�own,�rent,�or�occupy,�including�any�costs�or�expenses�incurred�by�you,�or�� � � � � any�other�person,�organization�or�entity,�for�repair,�replacement,�enhancement,�� � � � � � � restoration�or�maintenance�of�such�property�for�any�reason,�including�prevention�of�injury� � � � � to�a�person�or�damage�to�another’s�property,�unless�the�damage�to�property�is�caused�by� � � � � your�client,�up�to�a�$30,000�limit.����A�client�is�defined�as�a�person�under�your�direct�care� � � � � and�supervision.�� E.���Damage�to�Premises�Rented�to�You�
� 1.� If�damage�by�fire�to�premises�rented�to�you�is�not�otherwise�excluded�from�this�Coverage�Part,� � � � the�word�“fire”�is�changed�to�“fire,�lightning,�explosion,�smoke,�or�leakage�from�automatic�fire�� � � protective�systems”�where�it�appears�in:� � � a.� The�last�paragraph�of�SECTION�I�–�COVERAGES,�COVERAGE�A�BODILY�INJURY�AND�� � � � PROPERTY�DAMAGE�LIABILITY,�Subsection�2.�Exclusions;�is�deleted�in�its�entirety�and�� � � � replaced�by�the�following:�
� � Exclusions�c.�through�n.�do�not�apply�to�damage�by�fire,�lightning,�explosion,�smoke,�or�� � � leakage�from�automatic�fire�protective�systems�to�premises�while�rented�to�you�or�� � � � temporarily�occupied�by�you�with�permission�of�the�owner.�A�separate�limit�of�insurance�� � � applies�to�this�coverage�as�described�in�SECTION�III�–�LIMITS�OF�INSURANCE.� � � b.� SECTION�III�–�LIMITS�OF�INSURANCE,�Paragraph�6.�is�deleted�in�its�entirety�and�replaced� � � � by�the�following:�
� � � � Subject�to�Paragraph�5.�above,�the�Damage�To�Premises�Rented�To�You�Limit�is�the�� � � � � most�we�will�pay�under�Coverage�A�for�damages�because�of�"property�damage"�to�any�� � � � � one�premises,�while�rented�to�you,�or�in�the�case�of�damage�by�fire,�lightning,�explosion,� � � � � smoke,�or�leakage�from�automatic�fire�protective�systems�while�rented�to�you�or�� � � � � � � temporarily�occupied�by�you�with�permission�of�the�owner.� � � c.� SECTION�V�–�DEFINITIONS,�Paragraph�9.a.,�is�deleted�in�its�entirety�and�replaced�by�the�� � � � following:�
� � � � � A�contract�for�a�lease�of�premises.�However,�that�portion�of�the�contract�for�a�lease�of�� � � � � � premises�that�indemnifies�any�person�or�organization�for�damage�by�fire,�lightning,�� � � � � � � explosion,�smoke,�or�leakage�from�automatic�fire�protective�systems�to�premises�while�� � � � � � rented�to�you�or�temporarily�occupied�by�you�with�permission�of�the�owner�is�not�an�� � � � � � � "insured�contract";� � 2.�� SECTION�IV�–�COMMERCIAL�GENERAL�LIABILITY�CONDITIONS,�Subsection�4.�Other�� � � � Insurance,�Paragraph�b.�Excess�Insurance,�(1)�(a)�(ii)�is�deleted�in�its�entirety�and�replaced�by� � � the�following:�
That�is�insurance�for�fire,�lightning,�explosion,�smoke,�or�leakage�from�automatic�fire� protective�systems�for�premises�rented�to�you�or�temporarily�occupied�by�you�with�permission� of�the�owner;�
� 3.� The�Damage�To�Premises�Rented�To�You�Limit�section�of�the�Declarations�is�amended�to�the���������� � � greater�of:�
Page�4�of�12�
Includes�copyrighted�material�of�Insurance�Services�Office,�Inc.,�with�its�permission.� ©�2011�Philadelphia�Indemnity�Insurance�Company�
� � a.� $1,000,000;�or� � � b.���The�amount�shown�in�the�Declarations�as�the�Damage�to�Premises�Rented�to�You�Limit.� � � This�is�the�most�we�will�pay�for�all�damage�proximately�caused�by�the�same�event,�whether�such� � � damage�results�from�fire,�lightning,�explosion,�smoke,�or�leaks�from�automatic�fire�protective��� � � systems�or�any�combination�thereof.�
F.� HIPAA�
� SECTION�I�–�COVERAGES,�COVERAGE�B�PERSONAL�AND�ADVERTISING�INJURY�LIABILITY,�
� is��amended�as�follows:��
� 1.�� Paragraph�1.�Insuring�Agreement�is�amended�to�include�the�following:�
� � We�will�pay�those�sums�that�the�insured�becomes�legally�obligated�to�pay�as�damages�because� � � of�a�“violation(s)”�of�the�Health�Insurance�Portability�and�Accountability�Act�(HIPAA).��We�have�� � � the�right�and�the�duty�to�defend�the�insured�against�any�“suit,”�“investigation,”�or�“civil�proceeding”� � � seeking�these�damages.���However,�we�will�have�no�duty�to�defend�the�insured�against�any�“suit”� � � seeking�damages,�“investigation,”�or�“civil�proceeding”�to�which�this�insurance�does�not�apply.� � 2.�� Paragraph�2.�Exclusions�is�amended�to�include�the�following�additional�exclusions:� � � This�insurance�does�not�apply�to:� � � a.� Intentional,�Willful,�or�Deliberate�Violations�
� Any�willful,�intentional,�or�deliberate�“violation(s)”�by�any�insured.� b.� Criminal�Acts� � Any�“violation”�which�results�in�any�criminal�penalties�under�the�HIPAA.� c.� Other�Remedies� � Any�remedy�other�than�monetary�damages�for�penalties�assessed.� d.� Compliance�Reviews�or�Audits� � Any�compliance�reviews�by�the�Department�of�Health�and�Human�Services.�
� 3.� SECTION�V�–�DEFINITIONS�is�amended�to�include�the�following�additional�definitions:� � � a.� “Civil�proceeding”�means�an�action�by�the�Department�of�Health�and�Human�Services�(HHS)� � � � arising�out�of�“violations.”� � � b.� “Investigation”�means�an�examination�of�an�actual�or�alleged�“violation(s)”�by�HHS.��However,� � � � “investigation”�does�not�include�a�Compliance�Review.� � � c.� “Violation”�means�the�actual�or�alleged�failure�to�comply�with�the�regulations�included�in�the��
� � � HIPAA.�
Page�5�of�12�
Includes�copyrighted�material�of�Insurance�Services�Office,�Inc.,�with�its�permission.� ©�2011�Philadelphia�Indemnity�Insurance�Company�
G.��Medical�Payments�–�Limit�Increased�to�$20,000,�Extended�Reporting�Period� �� If�COVERAGE�C�MEDICAL�PAYMENTS�is�not�otherwise�excluded�from�this�Coverage�Part:�� � 1.� The�Medical�Expense�Limit�is�changed�subject�to�all�of�the�terms�of�SECTION�III�-�LIMITS�OF�� � � INSURANCE�to�the�greater�of:� � � a.� $20,000;�or�� � � b.� The�Medical�Expense�Limit�shown�in�the�Declarations�of�this�Coverage�Part.�
� 2.���SECTION�I�–�COVERAGE,�COVERAGE�C�MEDICAL�PAYMENTS,�Subsection�1.�Insuring������ ������ � Agreement,�a.�(3)�(b)�is�deleted�in�its�entirety�and�replaced�by�the�following:��
�� � � � (b)���The�expenses�are�incurred�and�reported�to�us�within�three�years�of�the�date�of�the�� � � � � � accident.� � H.�� Athletic�Activities� � SECTION�I�–�COVERAGES,�COVERAGE�C�MEDICAL�PAYMENTS,�Subsection�2.�Exclusions,� � Paragraph�e.�Athletic�Activities�is�deleted�in�its�entirety�and�replaced�with�the�following:� � e.���Athletic�Activities� � � To�a�person�injured�while�taking�part�in�athletics.� I.��� Supplementary�Payments� � SECTION�I�–�COVERAGES,�SUPPLEMENTARY�PAYMENTS�-�COVERAGE�A�AND�B�are� � amended�as�follows:� � 1.�b.�is�deleted�in�its�entirety�and�replaced�by�the�following:����������� � 1.�� b.���Up�to�$5000�for�cost�of�bail�bonds�required�because�of�accidents�or�traffic�law�violations��� � � � arising�out�of�the�use�of�any�vehicle�to�which�the�Bodily�Injury�Liability�Coverage�applies.�We� � � � do�not�have�to�furnish�these.� � 1.d.�is�deleted�in�its�entirety�and�replaced�by�the�following:� � 1.� d.�� All�reasonable�expenses�incurred�by�the�insured�at�our�request�to�assist�us�in�the��� � � � � � investigation�or�defense�of�the�claim�or�"suit",�including�actual�loss�of�earnings�up�to�$1,000�a� � � � day�because�of�time�off�from�work.�� � J.� Employee�Indemnification�Defense�Coverage� � SECTION�I�–�COVERAGES,�SUPPLEMENTARY�PAYMENTS�–�COVERAGES�A�AND�B�the� � following�is�added:� � � We�will�pay,�on�your�behalf,�defense�costs�incurred�by�an�“employee”�in�a�criminal�proceeding�� � � occurring�in�the�course�of�employment.��� � � The�most�we�will�pay�for�any�“employee”�who�is�alleged�to�be�directly�involved�in�a�criminal� � � � � proceeding�is�$25,000�regardless�of�the�numbers�of�“employees,”�claims�or�“suits”�brought�or�� � � persons�or�organizations�making�claims�or�bringing�“suits.��
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K.�� Key�and�Lock�Replacement�–�Janitorial�Services�Client�Coverage� � SECTION�I�–�COVERAGES,�SUPPLEMENTARY�PAYMENTS�–�COVERAGES�A�AND�B�is� � amended�to�include�the�following:�� � � We�will�pay�for�the�cost�to�replace�keys�and�locks�at�the�“clients”�premises�due�to�theft�or�other�� � � 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�any�one�to�whom�you�entrust�the�keys�of�a�“client”�for�any�� � � � � purpose�commit,�whether�acting�alone�or�in�collusion�with�other�persons.��� � � The�following,�when�used�on�this�coverage,�are�defined�as�follows:�
� � a.��� "Client"�means�an�individual,�company�or�organization�with�whom�you�have�a�written�contract� � � � �or�work�order�for�your�services�for�a�described�premises�and�have�billed�for�your�services.� � � b.� "Employee"�means:��� � � � (1)� Any�natural�person:� � � � � (a)��While�in�your�service�or�for�30�days�after�termination�of�service;� � � � � (b)��Who�you�compensate�directly�by�salary,�wages�or�commissions;�and� � � � � (c)��Who�you�have�the�right�to�direct�and�control�while�performing�services�for�you;�or� � � � (2)� Any�natural�person�who�is�furnished�temporarily�to�you:� � � � � (a)� To�substitute�for�a�permanent�"employee"�as�defined�in�Paragraph�(1)�above,�who�is� � � � � � on�leave;�or� � � � � (b)� To�meet�seasonal�or�short-term�workload�conditions;�� � � � � while�that�person�is�subject�to�your�direction�and�control�and�performing�services�for�you.� � � � (3)� "Employee"�does�not�mean:� � � � � (a)� Any�agent,�broker,�person�leased�to�you�by�a�labor�leasing�firm,�factor,�commission�� � � � � � merchant,�consignee,�independent�contractor�or�representative�of�the�same�general� � � � � � character;�or� � � � � (b)� �Any�"manager,"�director�or�trustee�except�while�performing�acts�coming�within�the�� � � � � � scope�of�the�usual�duties�of�an�"employee."�
� � c.� �"Manager"�means�a�person�serving�in�a�directorial�capacity�for�a�limited�liability�company.� L.���Additional�Insureds�
� SECTION�II�–�WHO�IS�AN�INSURED�is�amended�as�follows:�
� 1.��� If�coverage�for�newly�acquired�or�formed�organizations�is�not�otherwise�excluded�from�this���
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� � Coverage�Part,�Paragraph�3.a.�is�deleted�in�its�entirely�and�replaced�by�the�following:�
� � a.���Coverage�under�this�provision�is�afforded�until�the�end�of�the�policy�period.�
� 2.� Each�of�the�following�is�also�an�insured:� � � a.� Medical�Directors�and�Administrators�–�Your�medical�directors�and�administrators,�but�� � � � only�while�acting�within�the�scope�of�and�during�the�course�of�their�duties�as�such.��Such�� � � � duties�do�not�include�the�furnishing�or�failure�to�furnish�professional�services�of�any�physician� � � � or�psychiatrist�in�the�treatment�of�a�patient.��
� � b.�� Managers�and�Supervisors�–�Your�managers�and�supervisors�are�also�insureds,�but�� � � � � only�with�respect�to�their�duties�as�your�managers�and�supervisors.�Managers�and�� � � � � � supervisors�who�are�your�“employees”�are�also�insureds�for�“bodily�injury”�to�a�co-�� � � � � � “employee”�while�in�the�course�of�his�or�her�employment�by�you�or�performing�duties��� � � � � related�to�the�conduct�of�your�business.��
� � � This�provision�does�not�change�Item�2.a.(1)(a)�as�it�applies�to�managers�of�a�limited�� � � � � � liability�company.�� � � c.� Broadened�Named�Insured�–�Any�organization�and�subsidiary�thereof�which�you�control�and� � � � actively�manage�on�the�effective�date�of�this�Coverage�Part.���However,�coverage�does�not�� � � � apply�to�any�organization�or�subsidiary�not�named�in�the�Declarations�as�Named�Insured,�if� � � � � they�are�also�insured�under�another�similar�policy,�but�for�its�termination�or�the�exhaustion�of� � � � its�limits�of�insurance.�� � � d.� Funding�Source�–�Any�person�or�organization�with�respect�to�their�liability�arising�out�of:� � � � (1)� �Their�financial�control�of�you;�or� � � � (2)� �Premises�they�own,�maintain�or�control�while�you�lease�or�occupy�these�premises.��� � � � This�insurance�does�not�apply�to�structural�alterations,�new�construction�and�demolition�� � � � � operations�performed�by�or�for�that�person�or�organization.�� � � e.� Home�Care�Providers�–�At�the�first�Named�Insured's�option,�any�person�or�organization�� � � � under�your�direct�supervision�and�control�while�providing�for�you�private�home�respite�or��� � � � foster�home�care�for�the�developmentally�disabled.��� � � f.� Managers,�Landlords,�or�Lessors�of�Premises�–�Any�person�or�organization�with�respect�� � � � to�their�liability�arising�out�of�the�ownership,�maintenance�or�use�of�that�part�of�the�premises�� � � � leased�or�rented�to�you�subject�to�the�following�additional�exclusions:� � � � This�insurance�does�not�apply�to:� � � � (1)���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.��� � � g.� Lessor�of�Leased�Equipment�–�Automatic�Status�When�Required�in�Lease�Agreement�� � � � With�You�–�Any�person�or�organization�from�whom�you�lease�equipment�when�you�and�such� � � � person�or�organization�have�agreed�in�writing�in�a�contract�or�agreement�that�such�person�or� � � � organization�� is�to�be�added�as�an�additional�insured�on�your�policy.��Such�person�or��� �
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� � � 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.���� � � � A�person’s�or�organization’s�status�as�an�additional�insured�under�this�endorsement�ends�� � � � when�their�contract�or�agreement�with�you�for�such�leased�equipment�ends.� � � � With�respect�to�the�insurance�afforded�to�these�additional�insureds,�this�insurance�does�not�� � � � apply�to�any�“occurrence”�which�takes�place�after�the�equipment�lease�expires.�� � � h.� Grantors�of�Permits�–�Any�state�or�political�subdivision�granting�you�a�permit�in�connection� � � � with�your�premises�subject�to�the�following�additional�provision:� � � � (1)� This�insurance�applies�only�with�respect�to�the�following�hazards�for�which�the�state�or�� � � � � political�subdivision�has�issued�a�permit�in�connection�with�the�premises�you�own,�rent�or� � � � � control�and�to�which�this�insurance�applies:�
� � � � (a)� The�existence,�maintenance,�repair,�construction,�erection,�or�removal�of�advertising� � � � � � signs,�awnings,�canopies,�cellar�entrances,�coal�holes,�driveways,�manholes,�� � � � � � � marquees,�hoist�away�openings,�sidewalk�vaults,�street�banners�or�decorations�and� � � � � � similar��exposures;�� � � � � (b)� The�construction,�erection,�or�removal�of�elevators;�or�� � � � � (c)��The�ownership,�maintenance,�or�use�of�any�elevators�covered�by�this�insurance.� � � i.� Vendors�–�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,�subject�
� � � to�the�following�additional�exclusions:�� � � � (1)� The�insurance�afforded�the�vendor�does�not�apply�to:�� � � � � (a)� "Bodily�injury"�or�"property�damage"�for�which�the�vendor�is�obligated�to�pay�� � � � � � � � damages�by�reason�of�the�assumption�of�liability�in�a�contract�or�agreement.�This�� � � � � � exclusion�does�not�apply�to�liability�for�damages�that�the�vendor�would�have�in�the�� � � � � � absence�of�the�contract�or�agreement;�� � � � � (b)� Any�express�warranty�unauthorized�by�you;�
� � � � (c)��Any�physical�or�chemical�change�in�the�product�made�intentionally�by�the�vendor;�� � � � � (d)� Repackaging,�except�when�unpacked�solely�for�the�purpose�of�inspection,�� � � � � � � � demonstration,�testing,�or�the�substitution�of�parts�under�instructions�from�the�� � � � � � � manufacturer,�and�then�repackaged�in�the�original�container;� � � � � (e)� Any�failure�to�make�such�inspections,�adjustments,�tests�or�servicing�as�the�vendor�� � � � � � has�agreed�to�make�or�normally�undertakes�to�make�in�the�usual�course�of�business,� � � � � � in�connection�with�the�distribution�or�sale�of�the�products;�� � � � � (f)� Demonstration,�installation,�servicing�or�repair�operations,�except�such�operations�� � � � � � performed�at�the�vendor's�premises�in�connection�with�the�sale�of�the�product;��
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� � � � (g)� Products�which,�after�distribution�or�sale�by�you,�have�been�labeled�or�relabeled�or�� � � � � � used�as�a�container,�part�or�ingredient�of�any�other�thing�or�substance�by�or�for�the�� � � � � � vendor;�or� � � � � (h)� "Bodily�injury"�or�"property�damage"�arising�out�of�the�sole�negligence�of�the�vendor� � � � � � for�its�own�acts�or�omissions�or�those�of�its�employees�or�anyone�else�acting�on�its�� � � � � � behalf.��However,�this�exclusion�does�not�apply�to:� � � � � � (i)� The�exceptions�contained�in�Sub-paragraphs�(d)�or�(f);�or� � � � � � (ii)� Such�inspections,�adjustments,�tests�or�servicing�as�the�vendor�has�agreed�to� � � � � � � � make�or�normally�undertakes�to�make�in�the�usual�course�of�business,�in�� � � � � � � � � connection�with�the�distribution�or�sale�of�the�products.� � � � (2)��This�insurance�does�not�apply�to�any�insured�person�or�organization,�from�whom�you�� � � � � have�acquired�such�products,�or�any�ingredient,�part�or�container,�entering�into,�� � � � � � � accompanying�or�containing.� � � j.� Franchisor�–�Any�person�or�organization�with�respect�to�their�liability�as�the�grantor�of�a��� � � � franchise�to�you.�� � � k.� As�Required�by�Contract�–�Any�person�or�organization�where�required�by�a�written�contract� � � � executed�prior�to�the�occurrence�of�a�loss.��Such�person�or�organization�is�an�additional��� � � � insured�for�"bodily�injury,"�"property�damage"�or�"personal�and�advertising�injury"�but�only�for� � � � liability�arising�out�of�the�negligence�of�the�named�insured.�The�limits�of�insurance�applicable� � � � to�these�additional�insureds�are�the�lesser�of�the�policy�limits�or�those�limits�specified�in�a�� � � � contract�or�agreement.��These�limits�are�included�within�and�not�in�addition�to�the�limits�of�� � � � insurance�shown�in�the�Declarations� � � l.� Owners,�Lessees�or�Contractors�–�Any�person�or�organization,�but�only�with�respect�to�� � � � liability�for�"bodily�injury,"�"property�damage"�or�"personal�and�advertising�injury"�caused,�in�� � � � whole�or�in�part,�by:� � � � (1)� Your�acts�or�omissions;�or� � � � (2)� The�acts�or�omissions�of�those�acting�on�your�behalf;�
� � � in�the�performance�of�your�ongoing�operations�for�the�additional�insured�when�required�by�a� � � � contract.��
� � � With�respect�to�the�insurance�afforded�to�these�additional�insureds,�the�following�additional�� � � � exclusions�apply:� � � � This�insurance�does�not�apply�to�"bodily�injury"�or�"property�damage"�occurring�after:� � � � � (a)� All�work,�including�materials,�parts�or�equipment�furnished�in�connection�with�such�� � � � � � work,�on�the�project�(other�than�service,�maintenance�or�repairs)�to�be�performed�by� � � � � � or�on�behalf�of�the�additional�insured(s)�at�the�location�of�the�covered�operations�has� � � � � � been�completed;�or� � � � � (b)� That�portion�of�"your�work"�out�of�which�the�injury�or�damage�arises�has�been�put�to� � � � � � its�intended��use�by�any�person�or�organization�other�than�another�contractor�or�� � � � � � � subcontractor�engaged�in�performing�operations�for�a�principal�as�a�part�of�the�same� � � � � � project.��
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� � m.��State�or�Political�Subdivisions�–�Any�state�or�political�subdivision�as�required,�subject�to�� � � � the�following��provisions:�� � � � (1)��This�insurance�applies�only�with�respect�to�operations�performed�by�you�or�on�your�behalf� � � � � � for�which�the�state�or�political�subdivision�has�issued�a�permit,�and�is�required�by��� � � � � � � contract.� � � � (2)��This�insurance�does�not�apply�to:�� � � � � (a)� "Bodily�injury,"�"property�damage"�or�"personal�and�advertising�injury"�arising�out�of�� � � � � � operations�performed�for�the�state�or�municipality;�or�� � � � � (b)� "Bodily�injury"�or�"property�damage"�included�within�the�"products-completed��� � � � � � � operations�hazard."�� M.� Duties�in�the�Event�of�Occurrence,�Claim�or�Suit� � SECTION�IV�–�COMMERCIAL�GENERAL�LIABILITY�CONDITIONS,�Paragraph�2.�is�amended�as� � follows:� � a.�is�amended�to�include:�
� � This�condition�applies�only�when�the�“occurrence”�or�offense�is�known�to:� � � � (1)��You,�if�you�are�an�individual;� � � � (2)��A�partner,�if�you�are�a�partnership;�or� � � � (3)��An�executive�officer�or�insurance�manager,�if�you�are�a�corporation.�� � b.�is�amended�to�include:�
� � This�condition�will�not�be�considered�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�partnership;�or� � � � (3)��An�executive�officer�or�insurance�manager,�if�you�are�a�corporation.�� N.� Unintentional�Failure�To�Disclose�Hazards� � SECTION�IV�–�COMMERCIAL�GENERAL�LIABILITY�CONDITIONS,�6.�Representations�is� � amended�to�include�the�following:�
� � It�is�agreed�that,�based�on�our�reliance�on�your�representations�as�to�existing�hazards,�if�you��� � � should�unintentionally�fail�to�disclose�all�such�hazards�prior�to�the�beginning�of�the�policy�period�of� � � this�Coverage�Part,�we�shall�not�deny�coverage�under�this�Coverage�Part�because�of�such�failure.��� O.� Transfer�of�Rights�of�Recovery�Against�Others�To�Us�
� SECTION�IV�–�COMMERCIAL�GENERAL�LIABILITY�CONDITIONS,�8.�Transfer�of�Rights�of��
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� Recovery�Against�Others�To�Us�is�deleted�in�its�entirety�and�replaced�by�the�following:�
� � If�the�insured�has�rights�to�recover�all�or�part�of�any�payment�we�have�made�under�this�Coverage� � � Part,�those�rights�are�transferred�to�us.�The�insured�must�do�nothing�after�loss�to�impair�them.�At� � � our�request,�the�insured�will�bring�"suit"�or�transfer�those�rights�to�us�and�help�us�enforce�them.��
� � Therefore,�the�insured�can�waive�the�insurer’s�rights�of�recovery�prior�to�the�occurrence�of�a��� � � loss,�provided�the�waiver�is�made�in�a�written�contract.� P.� Liberalization� � SECTION�IV�–�COMMERCIAL�GENERAL�LIABILITY�CONDITIONS,�is�amended�to�include�the� � following:�
� � If�we�revise�this�endorsement�to�provide�more�coverage�without�additional�premium�charge,�we�� � � will�automatically�provide�the�additional�coverage�to�all�endorsement�holders�as�of�the�day�the�� � � revision�is�effective�in�your�state.� Q.���Bodily�Injury�–�Mental�Anguish� � SECTION�V�–�DEFINITIONS,�Paragraph�3.�Is�deleted�in�its�entirety�and�replaced�by�the�following:� � � “Bodily�injury”�means:�� � � a.� Bodily�injury,�sickness�or�disease�sustained�by�a�person,�and�includes�mental�anguish�� � � � � resulting�from�any�of�these;�and� � � b.� Except�for�mental�anguish,�includes�death�resulting�from�the�foregoing�(Item�a.�above)�at�any� � � � time.�
R.� Personal�and�Advertising�Injury�–�Abuse�of�Process,�Discrimination� � If�COVERAGE�B�PERSONAL�AND�ADVERTISING�INJURY�LIABILITY�COVERAGE�is�not� � otherwise�excluded�from�this�Coverage�Part,�the�definition�of�“personal�and�advertising�injury”�is� � amended�as�follows:� � 1.� SECTION�V�–�DEFINITIONS,�Paragraph�14.b.�is�deleted�in�its�entirety�and�replaced�by�the�� � � � following:� � � b.� Malicious�prosecution�or�abuse�of�process;� � 2.���SECTION�V�–�DEFINITIONS,�Paragraph�14.�is�amended�by�adding�the�following:��� � � Discrimination�based�on�race,�color,�religion,�sex,�age�or�national�origin,�except�when:� � � a.� Done�intentionally�by�or�at�the�direction�of,�or�with�the�knowledge�or�consent�of:� � � � (1)� Any�insured;�or� � � � (2)� Any�executive�officer,�director,�stockholder,�partner�or�member�of�the�insured;��� � � � b.� Directly�or�indirectly�related�to�the�employment,�former�or�prospective�employment,� � � � � � termination�of�employment,�or�application�for�employment�of�any�person�or�persons�by�an�� � � � insured;��
Page�12�of�12�
Includes�copyrighted�material�of�Insurance�Services�Office,�Inc.,�with�its�permission.� ©�2011�Philadelphia�Indemnity�Insurance�Company�
� � � c.� Directly�or�indirectly�related�to�the�sale,�rental,�lease�or�sublease�or�prospective�sales,�rental,� � � � lease�or�sub-lease�of�any�room,�dwelling�or�premises�by�or�at�the�direction�of�any�insured;�or�
� � � d.� Insurance�for�such�discrimination�is�prohibited�by�or�held�in�violation�of�law,�public�policy,�� � � � legislation,�court�decision�or�administrative�ruling.�
� � The�above�does�not�apply�to�fines�or�penalties�imposed�because�of�discrimination.����
File details come from the government source that posted it. Updated .