CTR063147 Certificate of Insurance FY26 Accepted.pdf
PDF 2 MB Posted
- Attached to
- Master Agreement AZ|CTR063147
- Contract number
- CTR063147
- Issued by
- Arizona
About this file
This document is a comprehensive insurance certificate and related policy endorsements for Senergy Petroleum, issued by multiple Zurich Insurance Companies and other insurers. The primary certificate of liability insurance is for Senergy Petroleum, with the State of Arizona and Arizona Department of Transportation (ADOT) listed as the certificate holder. The policies cover various types of insurance including commercial general liability, automobile liability, workers' compensation, pollution liability, and motor truck cargo insurance, effective from July 1, 2025 to July 1, 2026.
The insurance package provides coverage limits ranging from $1,000,000 to $10,000,000 across different policy types, with specific endorsements expanding coverage provisions. The policies are specifically related to ADOT lubricants contract CTR063924, with additional insured status granted to the State of Arizona and ADOT for general liability, auto liability, and pollution liability policies. The insurance is primary and non-contributory, with waivers of subrogation, and includes provisions for comprehensive coverage of vehicles, employee protections, physical damage, hired auto coverage, and various other specialized insurance extensions. Deductibles vary, with general liability at $0 and auto liability at $2,500.
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Text version
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
(A/C, No):
FAX
ADDRESS:
PRODUCER
(A/C, No, Ext):
PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
OTHER:
(Per accident)
(Ea accident)
N / A
SUBR
WVD
ADDL
INSD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY
NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-
STATUTE
PER
LIMITS(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED
$PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY
PRO-
JECT LOC
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
6/20/2025
Arthur J. Gallagher Risk Management Services, LLC 6967 South River Gate Dr.
Suite 200 Salt Lake City UT 84047
Carolyn Maldonado 801-924-1400 801-924-1441 certrequests@ajg.com
Zurich American Insurance Company 16535 BRADHAL-01 Markel American Insurance Company 28932
Senergy Petroleum 1470 N Horne St Gilbert, AZ 85233
Gemini Insurance Company 10833 RSUI Indemnity Company 22314 Mosaic US Holdings LLC QBE Specialty Insurance Company 11515
381275647
A X 2,000,000 X 1,000,000
10,000
2,000,000
4,000,000 X
Y Y GLO018810607 7/1/2025 7/1/2026
4,000,000
A 2,000,000
X
Y Y BAP018810707 7/1/2025 7/1/2026
C D F
X 10,000,000 X
GVE100295603
NHA601397
140001740
7/1/2025 7/1/2025 7/1/2025
7/1/2026 7/1/2026 7/1/2026 10,000,000
A X
N
Y WC018810507 7/1/2025 7/1/2026
1,000,000
1,000,000
1,000,000 E B
Upset & Overturn Pollution Motor Truck Cargo
PEN4368324AA
MKLM5IM0057019
7/1/2024 7/1/2025
7/1/2026 7/1/2026
Limit Per Occ/Agg Cargo Limit
$1,000,000 $100,000
Verification of insurance subject to the terms and conditions of the policy.
General Liability Deductible: $0 Auto Liability Deductible: $2,500
RE: CTR063924. | ADOT lubricants The State of Arizona or Arizona Department of Transportation, ADOT are Additional Insured as respects General Liability, Auto Liability and Pollution Liability policies, pursuant to and subject to the policy's terms, definitions, conditions and exclusions. The insurance provided is primary and any other insurance shall See Attached...
The State of Arizona or Arizona Department of Transportation 1324 N. 22nd Ave. MD 12BA Phoenix AZ 85009
Cindy Lewis Accepted
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:
BRADHAL-01
1 1
Arthur J. Gallagher Risk Management Services, LLC Senergy Petroleum 1470 N Horne St Gilbert, AZ 85233
25 CERTIFICATE OF LIABILITY INSURANCE
be excess only, and not contributing. Waiver of Subrogation applies in favor of Additional Insured with respects to General Liability, Auto Liability, Workers Compensation and Pollution Liability policies, pursuant to and subject to the policy's terms, definitions, conditions and exclusions.
GLO018810607 7/1/2025
General Liability Supplemental Coverage Endorsement
• ZURICH
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Policy No: I Effective Date:
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
The following changes apply to this Coverage Part. However, endorsements attached to this Coverage Part will supersede any provisions to the contrary in this General Liability Supplemental Coverage Endorsement.
A. Broadened Named Insured
1. The following is added to Section II - Who Is An Insured:
Any organization of yours, other than a partnership or joint venture, which is not shown in the Declarations, and over which you maintain an ownership interest of more than 50% of such organization as of the effective date of this Coverage Part, will qualify as a Named Insured. However, such organization will not qualify as a Named Insured under this provision if it:
a. Is newly acquired or formed during the policy period;
b. Is also an insured under another policy, other than a policy written to apply specifically in excess of this Coverage Part; or
c. Would be an insured under another policy but for its termination or the exhaustion of its limits of insurance.
Each such organization remains qualified as a Named Insured only while you maintain an ownership interest of more than 50% in the organization during the policy period.
2. The last paragraph of Section II - Who Is An Insured does not apply to this provision to the extent that such paragraph would conflict with this provision.
B. Newly Acquired or Formed Organizations as Named Insureds
1. Paragraph 3. of Section II -Who Is An Insured is replaced by the following:
3. Any organization you newly acquire or form during the policy period, other than a partnership or joint venture, and over which you maintain an ownership interest of more than 50% of such organization, will qualify as a Named Insured if there is no other similar insurance available to that organization. However:
a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier;
b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and
c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
U-GL-1345-C CW (03/20)
An additional premium will apply in accordance with our rules and rates in effect on the date you acquired or formed the organization.
2. The last paragraph of Section II - Who Is An Insured does not apply to this provision to the extent that such paragraph would conflict with this provision.
C. Insured Status - Employees
Paragraph 2.a.(1) of Section II -Who Is An Insured is replaced by the following:
2. Each of the following is also an insured:
a. Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for:
(1) "Bodily injury" or "personal and advertising injury":
(a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co-"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business;
(b) To the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as a consequence of Paragraph (1 )(a) above;
(c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1 )(a) or (b) above; or
(d) Arising out of his or her providing or failing to provide professional health care services.
However:
Paragraphs (1 )(a) and (1 )(d) do not apply to your "employees" or "volunteer workers", who are not employed by you or volunteering for you as health care professionals, for "bodily injury" arising out of "Good Samaritan Acts" while the "employee" or "volunteer worker" is performing duties related to the conduct of your business.
"Good Samaritan Acts" mean any assistance of a medical nature rendered or provided in an emergency situation for which no remuneration is demanded or received.
Paragraphs (1 )(a), (b) and (c) do not apply to any "employee" designated as a supervisor or higher in rank, with respect to "bodily injury" to co-"employees". As used in this provision, "employees" designated as a supervisor or higher in rank means only "employees" who are authorized by you to exercise direct or indirect supervision or control over "employees" or "volunteer workers" and the manner in which work is performed.
D. Additional Insureds - Lessees of Premises
1. Section II - Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) who leases or rents a part of the premises you own or manage who you are required to add as an additional insured on this policy under a written contract or written agreement, but only with respect to liability arising out of your ownership, maintenance or repair of that part of the premises which is not reserved for the exclusive use or occupancy of such person or organization or any other tenant or lessee.
This provision does not apply after the person or organization ceases to lease or rent premises from you.
However, the insurance afforded to such additional insured:
a. Only applies to the extent permitted by law; and
b. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured.
2. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section Ill - Limits Of Insurance:
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
The most we will pay on behalf of the additional insured is the amount of insurance:
a. Required by the written contract or written agreement referenced in Subparagraph D.1. above (of this endorsement); or
b. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less.
This Paragraph D. shall not increase the applicable Limits of Insurance shown in the Declarations.
E. Additional Insured - Vendors
1. The following change applies if this Coverage Part provides insurance to you for "bodily injury" and "property damage" included in the "products-completed operations hazard":
Section II - Who Is An Insured is amended to include as an additional insured any person or organization (referred to throughout this Paragraph E. as vendor) who you have agreed in a written contract or written agreement, prior to loss, to name as an additional insured, 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:
However, the insurance afforded to such vendor:
a. Only applies to the extent permitted by law; and
b. Will not be broader than that which you are required by the written contract or written agreement to provide for such vendor.
2. With respect to the insurance afforded to these vendors, the following additional exclusions apply:
a. 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;
(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.
b. 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.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
c. This insurance does not apply to any of "your products" for which coverage is excluded under this Coverage Part.
3. With respect to the insurance afforded to the vendor under this endorsement, the following is added to Section Ill - Limits Of Insurance:
The most we will pay on behalf of the vendor is the amount of insurance:
a. Required by the written contract or written agreement referenced in Subparagraph E.1. above (of this endorsement); or
b. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less.
This Paragraph E. shall not increase the applicable Limits of Insurance shown in the Declarations.
F. Additional Insured - Managers, Lessors or Governmental Entity
1. Section II - Who Is An Insured is amended to include as an insured any person or organization who is a manager, lessor or governmental entity who you are required to add as an additional insured on this policy under a written contract, written agreement or permit, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:
a. Your acts or omissions; or
b. The acts or omission of those acting on your behalf; and resulting directly from:
a. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit;
b. Ownership, maintenance, occupancy or use of premises by you; or
c. Maintenance, operation or use by you of equipment leased to you by such person or organization.
However, the insurance afforded to such additional insured:
a. Only applies to the extent permitted by law; and
b. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured.
2. This provision does not apply:
a. Unless the written contract or written agreement has been executed, or the permit has been issued, prior to the "bodily injury", "property damage" or offense that caused "personal and advertising injury";
b. To any person or organization included as an insured under Paragraph 3. of Section II - Who Is An Insured;
c. To any lessor of equipment if the "occurrence" or offense takes place after the equipment lease expires;
d. To any:
(1) Owners or other interests from whom land has been leased by you; or
(2) Managers or lessors of premises, if:
(a) The "occurrence" or offense takes place after the expiration of the lease or you cease to be a tenant in that premises;
(b) The "bodily injury", "property damage" or "personal and advertising injury" arises out of the structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor; or
(c) The premises are excluded under this Coverage Part.
3. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section Ill - Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
U-GL-1345-C CW (03/20)
Highlight
a. Required by the written contract or written agreement referenced in Subparagraph F.1. above (of this endorsement); or
b. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less.
This Paragraph F. shall not increase the applicable Limits of Insurance shown in the Declarations.
G. Damage to Premises Rented or Occupied by You
1. The last paragraph under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following:
Exclusions c. through n. do not apply to damage by "specific perils" to premises while rented to you or temporarily occupied by you with permission of the owner. A separate Damage To Premises Rented To You Limit of Insurance applies to this coverage as described in Section Ill - Limits Of Insurance.
2. Paragraph 6. of Section Ill - Limits Of Insurance is replaced by the following:
6. 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 one or more "specific perils" to any one premises, while rented to you or temporarily occupied by you with permission of the owner.
H. Broadened Contractual Liability
The "insured contract" definition under the Definitions Section is replaced by the following:
"Insured contract" means:
a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by "specific perils" to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract";
b. A sidetrack agreement;
c. Any easement or license agreement;
d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury", "property damage", or "personal and advertising injury" arising out of the offenses of false arrest, detention or imprisonment, to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement.
Paragraph f. does not include that part of any contract or agreement:
(1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of:
(a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or
(b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage;
or
(2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in Paragraph (1) above and supervisory, inspection, architectural or engineering activities.
I. Definition - Specific Perils
The following definition is added to the Definitions Section:
"Specific perils" means:
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
a. Fire;
b. Lightning;
c. Explosion;
d. Windstorm or hail;
e. Smoke;
f. Aircraft or vehicles;
g. Vandalism;
h. Weight of snow, ice or sleet;
i. Leakage from fire extinguishing equipment, including sprinklers; or
j. Accidental discharge or leakage of water or steam from any part of a system or appliance containing water or steam.
J. Limited Contractual Liability Coverage - Personal and Advertising Injury
1. Exclusion e. of Section I - Coverage B - Personal And Advertising Injury Liability is replaced by the following:
2. Exclusions
This insurance does not apply to:
e. Contractual Liability
"Personal and advertising injury" for which the insured has assumed liability in a contract or agreement.
This exclusion does not apply to:
(1) Liability for damages that the insured would have in the absence of the contract or agreement; or
(2) Liability for "personal and advertising injury" if:
(a) The "personal and advertising injury" arises out of the offenses of false arrest, detention or imprisonment;
(b) The liability pertains to your business and is assumed in a written contract or written agreement in which you assume the tort liability of another. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement; and
(c) The "personal and advertising injury" occurs subsequent to the execution of the written contract or written agreement.
Solely for purposes of liability so assumed in such written contract or written agreement, reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of "personal and advertising injury" described in Paragraph (a) above, provided:
(i) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same written contract or written agreement; and
(ii) Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged.
2. Paragraph 2.d. of Section 1- Supplementary Payments - Coverages A and Bis replaced by the following:
d. The allegations in the "suit" and the information we know about the "occurrence" or offense are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee;
3. The following is added to the paragraph directly following Paragraph 2.f. of Section I - Supplementary Payments
- Coverages A and B:
Notwithstanding the provisions of Paragraph 2.e.(2) of Section I - Coverage B - Personal And Advertising Injury Liability, such payments will not be deemed to be damages for "personal and advertising injury" and will not reduce the limits of insurance.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
K. Supplementary Payments
The following changes apply to Supplementary Payments - Coverages A and B:
Paragraphs 1.b. and 1.d. are replaced by the following:
b. Up to $2,500 for the 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.
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 $500 a day because of time off from work.
L. Broadened Property Damage
1. Property Damage to Contents of Premises Rented Short-Term
The paragraph directly following Paragraph (6) in Exclusion j. of Section I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following:
Paragraphs (1 ), (3) and (4) of this exclusion do not apply to "property damage" to premises (other than damage by "specific perils"), including "property damage" to the contents of such premises, rented to you under a rental agreement for a period of 14 or fewer consecutive days. A separate Limit of Insurance applies to Damage to Premises Rented to You as described in Section Ill - Limits Of Insurance.
2. Elevator Property Damage
a. The following is added to Exclusion j. of Section I - Coverage A - Bodily Injury And Property Damage Liability:
Paragraphs (3) and (4) of this exclusion do not apply to "property damage" arising out of the use of an elevator at premises you own, rent or occupy.
b. The following is added to Section 111- Limits Of Insurance:
Subject to Paragraph 5. above, the most we will pay under Coverage A for damages because of "property damage" to property loaned to you or personal property in the care, custody or control of the insured arising out of the use of an elevator at premises you own, rent or occupy is $25,000 per "occurrence".
3. Property Damage to Borrowed Equipment
a. The following is added to Exclusion j. of Section I - Coverage A - Bodily Injury And Property Damage Liability:
Paragraph (4) of this exclusion does not apply to "property damage" to equipment you borrow from others at a jobsite.
b. The following is added to Section Ill - Limits Of Insurance:
Subject to Paragraph 5. above, the most we will pay under Coverage A for damages because of "property damage" to equipment you borrow from others is $25,000 per "occurrence".
M. Expected or Intended Injury or Damage
Exclusion a. of Section I - Coverage A- Bodily Injury And Property Damage Liability is replaced by the following:
a. Expected Or Intended Injury Or Damage
"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.
N. Definitions - Bodily Injury
The "bodily injury" definition under the Definitions Section is replaced by the following:
"Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death sustained by that person which results from that bodily injury, sickness or disease.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
0. Insured Status - Amateur Athletic Participants
Section II - Who Is An Insured is amended to include as an insured any person you sponsor while participating in amateur athletic activities. However, no such person is an insured for:
a. "Bodily injury" to:
(1) Your "employee", "volunteer worker" or any person you sponsor while participating in such amateur athletic activities; or
(2) You, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company) while participating in such amateur athletic activities; or
b. "Property damage" to property owned by, occupied or used by, rented to, in the care, custody or control of, or over which the physical control is being exercised for any purpose by:
(1) Your "employee", "volunteer worker" or any person you sponsor; or
(2) You, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company).
P. Non-Owned Aircraft, Auto and Watercraft
Exclusion g. of Section 1- Coverage A- Bodily Injury And Property Damage Liability is replaced by the following:
g. Aircraft, Auto Or Watercraft
"Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading".
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" involved the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured.
This exclusion does not apply to:
(1) A watercraft while ashore on premises you own or rent;
(2) A watercraft you do not own that is:
(a) Less than 51 feet long; and
(b) Not being used to carry persons for a charge;
(3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured;
(4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft;
(5) An aircraft that is hired or chartered by you or loaned to you, with a paid and licensed crew, and is not owned in whole or in part by an insured; or
(6) "Bodily injury" or "property damage" arising out of:
(a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged; or
(b) The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment".
Q. Definitions - Leased Worker, Temporary Worker and Labor Leasing Firm
1. The "leased worker" and "temporary worker" definitions under the Definitions Section are replaced by the following:
"Leased worker" means a person leased to you by a "labor leasing firm" under a written agreement between you and the "labor leasing firm", to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker".
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
"Temporary worker" means a person who is furnished to you to support or supplement your work force during "employee" absences, temporary skill shortages, upturns or downturns in business or to meet seasonal or short term workload conditions. "Temporary worker" does not include a "leased worker".
2. The following definition is added to the Definitions Section:
"Labor leasing firm" means any person or organization who hires out workers to others, including any:
a. Employment agency, contractor or services;
b. Professional employer organization; or
c. Temporary help service.
R. Definition - Mobile Equipment
Paragraph f. of the "mobile equipment" definition under the Definitions Section is replaced by the following:
f. Vehicles not described in Paragraph a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo.
However, self-propelled vehicles with the following types of permanently attached equipment, exceeding a combined gross vehicle weight of 1000 pounds, are not "mobile equipment" but will be considered "autos":
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction or resurfacing; or
(c) Street cleaning;
(2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers;
and
(3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment.
S. Definitions - Your Product and Your Work
The "your product" and "your work" definitions under the Definitions Section are replaced by the following:
"Your product":
a. Means:
(1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by:
(a) You;
(b) Others trading under your name; or
(c) A person or organization whose business or assets you have acquired; and
(2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products.
b. Includes:
(1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance, use, handling, maintenance, operation or safety of "your product"; and
(2) The providing of or failure to provide warnings or instructions.
c. Does not include vending machines or other property rented to or located for the use of others but not sold.
"Your work":
a. Means:
(1) Work, services or operations performed by you or on your behalf; and
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
(2) Materials, parts or equipment furnished in connection with such work, services or operations.
b. Includes:
(1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance, use, handling, maintenance, operation or safety of "your work"; and
(2) The providing of or failure to provide warnings or instructions.
T. Duties in the Event of Occurrence, Offense, Claim or Suit Condition
The following paragraphs are added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV- Commercial General Liability Conditions:
Notice of an "occurrence" or of an offense which may result in a claim under this insurance or notice of a claim or "suit" shall be given to us as soon as practicable after knowledge of the "occurrence", offense, claim or "suit" has been reported to any insured listed under Paragraph 1. of Section II - Who Is An Insured or an "employee" authorized by you to give or receive such notice. Knowledge by other "employees" of an "occurrence", offense, claim or "suit" does not imply that you also have such knowledge.
In the event that an insured reports an "occurrence" to the workers compensation carrier of the Named Insured and this "occurrence" later develops into a General Liability claim, covered by this Coverage Part, the insured's failure to report such "occurrence" to us at the time of the "occurrence" shall not be deemed to be a violation of this Condition. You must, however, give us notice as soon as practicable after being made aware that the particular claim is a General Liability rather than a Workers Compensation claim.
U. Other Insurance Condition
Paragraphs 4.a. and 4.b.(1) of the Other Insurance Condition of Section IV - Commercial General Liability Conditions are replaced by the following:
4. Other Insurance
If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows:
a. Primary Insurance
This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in Paragraph c. below. However, this insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that:
(1) The additional insured is a Named Insured under such other insurance; and
(2) You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured.
Other insurance includes any type of self insurance or other mechanism by which an insured arranges for funding of its legal liabilities.
b. Excesslnsurance
(1) This insurance is excess over:
(a) Any of the other insurance, whether primary, excess, contingent or on any other basis:
(i) That is property insurance, Builder's Risk, Installation Risk or similar coverage for "your work";
(ii) That is property insurance purchased by you (including any deductible or self insurance portion thereof) to cover premises rented to you or temporarily occupied by you with permission of the owner;
(iii) That is insurance purchased by you (including any deductible or self insurance portion thereof) to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner;
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
U-GL-1345-C CW (03/20)
(iv) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section 1- Coverage A- Bodily Injury And Property Damage Liability;
or
(v) That is property insurance (including any deductible or self insurance portion thereof) purchased by you to cover damage to:
Equipment you borrow from others; or
Property loaned to you or personal property in the care, custody or control of the insured arising out of the use of an elevator at premises you own, rent or occupy.
(b) Any other primary insurance (including any deductible or self insurance portion thereof) available to the insured covering liability for damages arising out of the premises, operations, products, work or services for which the insured has been granted additional insured status either by policy provision or attachment of any endorsement. Other primary insurance includes any type of self insurance or other mechanism by which an insured arranges for funding of its legal liabilities.
(c) Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis.
V. Unintentional Failure to Disclose All Hazards
Paragraph 6. Representations of Section IV- Commercial General Liability Conditions is replaced by the following:
6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are accurate and complete;
b. Those statements are based upon representations you made to us; and
c. We have issued this policy in reliance upon your representations.
Coverage will continue to apply if you unintentionally:
a. Fail to disclose all hazards existing at the inception of this policy; or
b. Make an error, omission or improper description of premises or other statement of information stated in this policy.
You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to inception of this Coverage Part.
W. Waiver of Right of Subrogation
Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Commercial General Liability Conditions is replaced by the following:
8. Transfer Of Rights Of Recovery Against Others To Us
a. 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.
b. If the insured waives its right to recover payments for injury or damage from another person or organization in a written contract executed prior to a loss, we waive any right of recovery we may have against such person or organization because of any payment we have made under this Coverage Part. The written contract will be considered executed when the insured's performance begins, or when it is signed, whichever happens first. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest.
X. Liberalization Condition
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
U-GL-1345-C CW (03/20)
The following condition is added to Section IV - Commercial General Liability Conditions:
Liberalization Clause
If we revise this Coverage Part to broaden coverage without an additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective in the state shown in the mailing address of your policy.
All other terms, conditions, provisions and exclusions of this policy remain the same.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
U-CA-424-H CW (10/21)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Coverage Extension Endorsement
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Policy No. BAP018810705 Effective Date: 7/1/2023
This endorsement modifies insurance provided under the:
Business Auto Coverage Form Motor Carrier Coverage Form
A. Amended Who Is An Insured
1. The following is added to the Who Is An Insured Provision in Section II – Covered Autos Liability Coverage:
The following are also "insureds":
a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any “employee” of yours is also an “insured” while operating an “auto” hired or rented under a contract or agreement in an “employee’s” name, with your permission, while performing duties related to the conduct of your business.
b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don’t own, hire or borrow to transport your clients or other persons in activities necessary to your business.
c. Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a. and A.1.b. in this endorsement.
d. Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less.
2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance – Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form:
Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form.
B. Amendment – Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II – Covered Autos Liability Coverage are replaced by the following:
(2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds.
(4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work.
C. Fellow Employee Coverage The Fellow Employee Exclusion contained in Section II – Covered Autos Liability Coverage does not apply.
BAP018810707 7/1/2025
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Includes copyrighted material of Insurance Services Office, Inc., with its permission.
D. Driver Safety Program Liability and Physical Damage Coverage
1. The following is added to the Racing Exclusion in Section II – Covered Autos Liability Coverage:
This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations.
2. The following is added to Paragraph 2. in B. Exclusions of Section III – Physical Damage Coverage of the Business Auto Coverage Form and Paragraph 2.b. in B. Exclusions of Section IV – Physical Damage Coverage of the Motor Carrier Coverage Form:
This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations.
E. Lease or Loan Gap Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section:
Lease Or Loan Gap Coverage
In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered "auto", less:
a. Any amount paid under the Physical Damage Coverage Section of the Coverage Form; and
b. Any:
(1) Overdue lease or loan payments at the time of the "loss";
(2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage;
(3) Security deposits not returned by the lessor;
(4) Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the loan or lease; and
(5) Carry-over balances from previous leases or loans.
F. Towing and Labor Paragraph A.2. of the Physical Damage Coverage Section is replaced by the following:
We will pay up to $75 for towing and labor costs incurred each time a covered "auto" that is a "private passenger type", light truck or medium truck is disabled. However, the labor must be performed at the place of disablement.
As used in this provision, "private passenger type" means a private passenger or station wagon type "auto" and includes an "auto" of the pickup or van type if not used for business purposes.
G. Extended Glass Coverage The following is added to Paragraph A.3.a. of the Physical Damage Coverage Section:
If glass must be replaced, the deductible shown in the Declarations will apply. However, if glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced.
H. Hired Auto Physical Damage – Increased Loss of Use Expenses The Coverage Extension for Loss Of Use Expenses in the Physical Damage Coverage Section is replaced by the following:
Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We will pay for loss of use expenses if caused by:
(1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto";
(2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered "auto"; or
(3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto".
However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $3000.
I. Personal Effects Coverage
The following is added to the Coverage Provision of the Physical Damage Coverage Section:
Personal Effects Coverage
a. We will pay up to $750 for "loss" to personal effects which are:
(1) Personal property owned by an "insured"; and
(2) In or on a covered "auto".
b. Subject to Paragraph a. above, the amount to be paid for "loss" to personal effects will be based on the lesser of:
(1) The reasonable cost to replace; or
(2) The actual cash value.
c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered "auto".
No deductible applies to this coverage. However, we will not pay for "loss" to personal effects of any of the following:
(1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other documents of value.
(2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches, precious or semi-precious stones.
(3) Paintings, statuary and other works of art.
(4) Contraband or property in the course of illegal transportation or trade.
(5) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment.
Any coverage provided by this Provision is excess over any other insurance coverage available for the same "loss".
J. Tapes, Records and Discs Coverage
1. The Exclusion in Paragraph B.4.a. of Section III – Physical Damage Coverage in the Business Auto Coverage
Form and the Exclusion in Paragraph B.2.c. of Section IV – Physical Damage Coverage in the Motor Carrier Coverage Form does not apply.
2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical Damage Coverage Section:
We will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual or data…
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