Sample_Insurance_Endorsement.pdf

PDF 106 KB Posted

Attached to
Pinto Lake Dock Replacement Project
Solicitation number
PK-26-09064-QB
Issued by
Santa Cruz County, Torrance City, California

About this file

This is a Commercial General Liability Insurance Endorsement for Additional Insured coverage issued for the City of Watsonville's Pinto Lake Dock Replacement Project in California. The endorsement adds the City of Watsonville, its appointed and elected officials, and employees as additional insureds under the policy, specifically with respect to liability arising from work performed by or for the contractor. The endorsement applies to the Commercial General Liability Coverage Part and modifies the existing policy to extend coverage protections to the named municipality and its representatives.

The insurance coverage provided under this endorsement is designated as primary coverage with respect to any insurance or self-insurance programs maintained by the City of Watsonville. This primary coverage designation ensures that the contractor's insurance will be the first source of recovery for claims, and no other insurance held by the certificate holder will be required to contribute to any loss. The endorsement is executed on CGL Form 20 10 11 85, which is the standard Additional Insured – Owners, Lessees or Contractors form used in the construction and contracting industry.

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Text version

Policy Number: Commercial General Liability

THIS ENDORSEMENT CHANGES THE POLICY - PLEASE READ

IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR

CONTRACTORS (FORM B).

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART.

SCHEDULE

Name of Person or Organization:

City of Watsonville, its appointed and elected officials, and its employees

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

WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you.

The insurance provided herein is primary coverage to the certificate holder with respects to any insurance or self insurance programs maintained by the certificate holder, and no insurance held or owned by the certificate holder shall be called upon to contribute to a loss.

CG 20 10 11 85

SAMPLE

File details come from the government source that posted it. Updated .