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HomeMy WebLinkAboutT-6217 - Certificate of Insurance - 10/16/2018 A�� 10//" CERTIFICATE OF LIABILITY INSURANCE DAT MM12//22001188 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 carttficate holder Is an ADDITIONAL INSURED,the policy(les)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). PRODUCER NAME: Sally Hayes Beecher Carlson Insurance Services, LLC PHONE 303-996-5413 FpAJXC Ne: 8000 E. Maplewood Ave. E-MAIL SS: shayes@beecherearlaon.com ADDRE Suite 350 INSURERS AFFORDING COVERAGE NAIC M Greenwood village CO 80111 INSURERA:L10 ds of London Underwriters INSURED INSURER B WCP Developers, LLC INSURER C: WC Ashlan Hayes LLC INSURER D: 1446 Tollhouse Rd.,Suite 103 INSURER E: Clovis CA 93611 INSURER F: COVERAGES CERTIFICATE NUMBER:AahlanHayaa6217 REVISION NUMBER: 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 CONTRACTOR 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. INSR TYPE OF INSURANCE AC SR POLICY NUMBER MMIODNYYV IDEFF D Y EXP LTR LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS-MADE M OCCUR PREMISES En occurrence S 100,000 X LCC000228 10/15/2018 10/15/2021 MED EXP(Any one person) $ excluded PERSONAL&ADV INJURY S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 X POLICY❑ PRO- LOCPRODUCTS-COMPIOPAGG $ 2,000,000 OTHEM JECT $ AUTOMOBILE LIABILITY En ncd COMBINED ant $ 4ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NOWOWNED PROPERTY DAMAGE HIRED AUTOS AUTOS a AUMBRELLALIAB X OCCUR LCCX-000161 10/15/2018 10/15/2021 EACH OCCURRENCE S 8,000,000 XIEXCESS LIAR CLAIMS-MADE AGGREGATE S 8,000,000 I DED RETENTIONS RISK MANAGEM DIV1,510N $ WORKERS COMPENSATIOIJ TAT TE ERR- AND EMPLOYERS'LIABILITY ANY PROPRJETORJPARTNEF4EXECUTIVE YNIA IN Approved EL.EACH ACCIDENT a OFFJCERIMEMBER EXCLUDED? El IMandatorylnNH) Approved w ang )S ❑ E.L.DISEASE-EA EMPLOYEE $ It yes,describe under DESCRIPTION OF OPERATIONS below y E.L.DISEASE-POLICY LIMIT S o \ Moned IX to DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 701,Additional Remarks Schedule,may be attached If more space Is required) Re: Subdivision Agreement and Street Work (Streets, Concrete, Street Lights & Dry Utilities) for Tract 6217, WC Ashlan Hayes, LLC Project The City of Fresno, its officers, officials, agents, employees and volunteers are additional insured as respects to General Liability insurance. This insurance is primary, and our obligations are not affected by any other insurance carried by such additional insured whether whether primary, excess, contingent, or on any other basis. See additional insured endorsement #CG2012 0509. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fresno THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 2600 Fresno Street ACCORDANCE WITH THE POLICY PROVISIONS. Room 4064 AUTHORIZED REPRESENTATIVE Fresno, CA 93721-3620 ,Sally Hayes/SALHAY Ao t47.-- 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) POLICY NUMBER LCC 00 0228 COMMERCIAL GENERAL LIABILITY ENDORSEMENT: 11 CG 20 12 05 09 EFFECTIVE DATE: 1011512018 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION -PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following:Commercial General Liability SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: City of Fresno 2600 Fresno Street Fresno,CA 93721 Information required to complete this Schedule,if not shown above,will be shown in the Declarations. Section II-Who Is An Insured is amended to include as 2.this insurance does not apply to: an insured any state or governmental agency or a. "Bodily injury", Property damage"or"Personal and subdivision or political subdivision shown in the Schedule, advertising injury"arising out of operations subject to the following provisions: performed for the federal government state or municipality;or 1.This insurance applies only with respect to operations b. "Bodily injury"or"Property damage"included within performed by you or on your behalf for which the state or the"Products-completed operations hazard", governmental agency or subdivision or political subdivision has issued a permit or authorization It is understood and agreed that in the event of a Claim or "suit"arising out of the Named Insured's Negligence,this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party above shall be excess and non-contributory. CG 20 12 05 09 Copyright,Insurance Services Offices, Inc., 1997 Page 1 POLICY NUMBER LCCX 00 0161 COMMERCIAL GENERAL LIABILITY ENDORSEMENT: 1 CG 20 12 05 09 EFFECTIVE DATE: 1011512018 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION -PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: Excess SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: City of Fresno 2600 Fresno Street Fresno,CA 93721 Information required to complete this Schedule,if not shown above,will be shown in the Declarations. Section II-Who Is An Insured is amended to include as 2.this insurance does not apply to: an insured any state or governmental agency or a. "Bodily injury",Property damage"or"Personal and subdivision or political subdivision shown in the Schedule, advertising injury"arising out of operations subject to the following provisions: performed for the federal government state or municipality;or "Bodily injury"or"Property damage"included within 1.This insurance applies only with respect to operations b. the"Products-completed operations hazard". performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization It is understood and agreed that in the event of a Claim or "suit"arising out of the Named Insured's Negligence,this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party above shall be excess and non-contributory, CG 2012 05 09 Copyright,Insurance Services Offices, Inc.,1997 Page 1 WATHCAS-02 LATER A�oRo CERTIFICATE OF LIABILITY INSURANCE DATE 09/12/2018 b9112/2018 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 have ADDITIONAL I NSURED provisions or be endorsed. J 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). PRODUCER License#OE02096 NCONTACT — DiBuduo&DeFendis Insurance Brokers,LLC PHONE P.O.Box 5479 (AJC,No,Ext):(659)432-0222 �A c,Nol:� &�431-7941 E- AIL Fresno,CA 93755-5479 A DRESS: - _ INSURERIS)AFFORDING COVERAGE NAIL# INSURER A_Nationwido Mutual Insurance Comp@ _ _.;23787 INSURED INSURERB _ IreSs Insurange_Co_m�; y. _ .10855 WCP Developers,LLC INSURER C.' _ 1446 Tollhouse Rd.,#103 INSURER D: Clovis,CA 93611 INSURER E- INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 INSRTYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR IN_1113YV D COMMERCIAL GENERAL LIABILITY EACH 90C171 Rt ENCEro FIE _ CLAIMS-MADE OCCUR RISK MANAGEMEN DIVISION DAmAGEs. Eaopr�arLens�l Approved f�C' MED EXP(Any oneperu,* 5 J` Approvedh ng E s ❑ PERSONAL&ADV INJURY S 1 GEN'L AGGREGATE LIMIT APPLIES PER: �" �_G, DIERALAGORE[4TE= _ S POLICY _ JECT LOCI f ti J` l,���(� AROfH1CTS-Cfl1APlOP.AGC 15 �� VJ 1`f� V OTHER: L� - A AUTOMOBILE LIABILITY SICgned Dd O (COMB9INdI-_"D Sl]INGLE LIMIT S _ 1,000,000 X ANY AUTO X X ACP3037161509 0110112018 01/0112019 gMO XNJURY(per pemojn..-5 OWNED SCHEDULEp AUTOS ONLY ETHNOS qq 9f4E71LrikJLIRY:(PeE_... n):S . AUTOS ONLY AUTq�CY ptQP7Y_pP,MAGE 5 X Comp Ded$250 X Call Ded 5500 It�t oem7R. UMBRELLA LIAB OCCUR EACH OGCIJRi2ENCE .S EXCESS LIAB CLAIMS-MADE �_AGGRC-GATE $_ DED RETENTIONS WORKERS COMPENSATION ! X :,�ZTAw ...EL2. ANDEMPLOrERs LIABILITY WAWC907578 01/0112018 01101/2019 11000,000 ANY PROPRIETORIPARTNEWEXECUTIVE Y 7 N X E L EACH ACC'ICIEN7� S QQF�FlCCE�l�AAEMg �EXCLUDED7 N NIA 1,0001000 (Mandatary in NH) - e L.DISEASE-EA EMPLOYEES If yea,descnbe under 1,DOOy000 Dy5CRIPTI N flFOPERATIONS below _, E L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Service work performed under written contract or agreement The City of Fresno,its officers,officials,employees,agents and volunteers are named as additional insured as respects to Auto Liability per attached blanket policy forst AC70050316.This insurance is primary,and our obligations are not affected by any other insurance carried by such additional insured whether primary,excess,contingent,or on any other basis per attached blanket policy form CA00011013(pg 9-12). Waiver of subrogation for Auto Liability per attached policy form AC70050316 and to Employers Liability per attached form WC990410B(9-14) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fresno ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 2600 Fresno Street,RM 1030 Fresno,CA 93721 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy#ACP3037161509 1/01/18-01/01/19 COMMERCIAL AUTO AC 70 05 03 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO PROTECTION - GOLD This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SUMMARY OF COVERAGES A. Effect of This Endorsement B. Newly Acquired or Formed Entities C. Employees as Insureds— Nonowned Autos > D. Additional Insured by Contract, Permit or Agreement E. Supplementary Payments—Bail Bonds F. Supplementary Payments—Loss of Earnings G. Personal Effects and Property of Others Extension H. Prejudgment Interest Coverage I. Fellow Employee—Officer, Managers and Supervisors J. Hired Auto Physical Damage K. Temporary Substitute Autos—Physical Damage Coverage L. Expanded Towing Coverage M. Auto Loan or Lease Coverage N. Original Equipment Manufacturer Parts—Leased Private PassengerTypes O. Deductible Amendments P. Rental Reimbursement Coverage Q. Expanded Transportation Expense R. Extra Expense—Stolen Autos S. Physical Damage Limit of Insurance T. New Vehicle Replacement Cost U. Physical Damage Coverage Extension V. Transfer of Rights of Recovery Against Others To Us W. Section IV—Business Auto Conditions—Notice of and Knowledge of Occurrence X. Hired Car Coverage Territory Y. Emergency Lock Out Z. Cancellation Condition AC 70 05 03 16 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 7 with its permission ACP BA 30-2-7161509 L80N R 17089 INSURED COPY AC7005031600 0001 47 0004049 Policy#ACP3037161509 1/01/18-01/01/19 COMMERCIAL AUTO AC 70 05 0316 A. EFFECT OF THIS ENDORSEMENT If specifically required by the written contract or Coverage provided under this policy is modified agreement referenced in the paragraph above, by the provisions of this endorsement. If there any coverage provided by this endorsement to is any conflict between the provisions of this an additional insured shall be primary and endorsement and the provision(s) of any state- any other valid and collectible insurance avail- specific endorsement also attached to this poli- able to the additional insured shall be non- cy, then the provision(s) of the state-specific contributory with this insurance. If the written endorsement shall apply instead of the provi- contract does not require this coverage to be sions of this endorsement that are in conflict, primary and the additional insured's coverage to but only to the extent of the conflict, and only to be non-contributory, then this insurance will be the extent necessary to bring such provisions excess over any other valid and collectible insur- into conformance with the state requirement(s) ance available to the additional insured. contained in the provision(s)of the state-specific endorsement. E. SUPPLEMENTARY PAYMENTS — BAIL B. NEWLY ACQUIRED OR FORMED ENTITIES BONDS The Named Insured shown in the Declarations is Supplementary Payments of SECTION II — amended to include any organization you newly COVERED AUTOS LIABILITY COVERAGE is acquire or form, other than a partnership, joint revised as follows: venture, or limited liability company, and over (2) Up to $2,500 for cost of bail bonds(including which you maintain ownership or majority (more bonds for related traffic law violations) than 50%) interest; if there is no other similar in- required because of an "accident"we cover. surance available to that organization. Coverage We do not have to furnish these bonds. under this provision is afforded until the 180th F. SUPPLEMENTARY PAYMENTS — LOSS OF day after you acquire or form the organization or EARNINGS the end of the policy period, whichever is later. C. EMPLOYEES AS INSUREDS — NONOWNED Supplementary Payments of the SECTION II — COVERED AUTOS LIABILITY COVERAGE is AUTOS revised as follows: The following is added to paragraph A.1. Who Is (4) All reasonable expenses incurred by the "in- An Insured of SECTION 11 — COVERED AUTOS sured" at our request, including actual loss LIABILITY COVERAGE: of earnings up to $500 a day because of d. Any "employee" of yours is an "insured" time off from work. while using a covered "auto" you don't own, G PERSONAL EFFECTS AND PROPERTY OF hire or borrow in your business or your per- OTHERS EXTENSION sonal affairs. D. ADDITIONAL INSURED BY CONTRACT, 1. The. Care, Custody or Control Exclusion of SECTION II — COVERED AUTOS PERMIT OR AGREEMENT LIABILITY COVERAGE, does not apply to The following is added to A.1. Who Is An In- "property damage" to property, other than sured of SECTION II — COVERED AUTOS your property, up to an amount not exceed- LIABILITY COVERAGE: ing $250 in any one "accident". Coverage Any person or organization that you are re- is excess over any other valid and collectible quired to name as an additional insured in a insurance. written contract or agreement that is executed 2. The following paragraph is added to A.A. or signed by you prior to a "bodily injury" or Coverage Extensions of SECTION III — "property damage" occurrence is an "insured" PHYSICAL DAMAGE COVERAGE: for Covered Auto Liability coverage. How- c. We will pay up to $500 for your property ever, with respect to covered "autos", such that is lost or damaged as a result of a person or organization is an insured only to covered "loss", without applying a de- the extent that person or organization qualifies excess as an "insured" under A.1. Who is an Insured of otheductr le. Coverage is excess over any SECTION II — COVERED AUTOS LIABILITY other valid and collectible insurance. COVERAGE: Page 2 of 7 Includes copyrighted material of Insurance Services Office, Inc. AC 70 05 0316 with its permission ACP BA 30-2-7161509 L80N R 17089 INSURED COPY AC7005031600 0001 47 0004050 Policy#ACP3037161509 1/01/18-01/01/19 COMMERCIAL AUTO AC 70 05 03 16 H. PREJUDGMENT INTEREST COVERAGE substitute for a covered "auto" you own that The following paragraph is added to SECTION II is out of service because of its: — COVERED AUTOS LIABILITY COVERAGE, a. Breakdown; 2. Coverage Extensions, a. Supplementary b. Repair; Payments: c. Servicing; (7) Prejudgment interest awarded against the d. "Loss";or "insured" on that part of the judgment we pay. If we make an offer to pay the appli- e. Destruction cable limit of insurance, we will not pay The coverage that applies is the same as any prejudgment interest based on that the coverage provided for the vehicle being period of time after the offer. replaced. I. FELLOW EMPLOYEE — OFFICERS, MANAGERS,AND SUPERVISORS L. EXPANDED TOWING COVERAGE The Fellow Employee Exclusion in SECTION II 1. We will pay up to: — COVERED AUTOS LIABILITY COVERAGE is a. $100 for a covered "auto" you own of replaced as follows; the private passenger type, or A. "Bodily injury" to any fellow "employee" of b. $500 for a covered "auto" you own that the"insured"arising out of and in the course is not of the private passenger type, of the fellow "employee's" employment or while performing duties related to the con- for towing and labor costs incurred each duct of your business. This exclusion does time the covered "auto" is disabled. Howev- not apply to an "insured" who occupies a er, the labor must be performed at the place position as an officer, manager, or supervi- of disablement. sor. 2. This coverage applies only for an "auto" J. HIRED AUTO PHYSICAL DAMAGE covered on this policy for Comprehensive or If covered"auto"designation symbols 1 or 8 ap- Specified Causes of Loss Coverage and ply to Liability Coverage and if at least one au- Collision Coverages. to" you own is covered by this policy for Com- 3. Payment applies in addition to the otherwise prehensive, Specified Causes of Loss, or Colli- applicable amount of each coverage you sion coverages, then the Physical Damage have on a covered"auto". coverages provided are extended to "autos" you M. AUTO LOAN OR LEASE COVERAGE lease, hire, rent or borrow without a driver; and 1. In the event of a total "loss" to a covered provisions in the Business Auto Coverage Form "auto", we will pay any unpaid amount due applicable to Hired Auto Physical Damage apply on the loan or lease, including up to a max- up to a limit of $100,000. The deductible will be imum of $500 for early termination fees or equal to the largest deductible applicable to any penalties, for your covered"auto" less: owned "auto" for that coverage. Any Compre- a. The amount paid under SECTION III — hensive deductible does not apply to fire or PHYSICAL DAMAGE COVERAGE of lightning. this policy; and K. TEMPORARY SUBSTITUTE AUTOS — PHYSICAL DAMAGE COVERAGE b. Any: The following is added to paragraph C. Certain 1) Overdue lease/loan payments at the Trailers, Mobile Equipment And Temporary time of the"loss"; Substitute Autos of SECTION I - COVERED 2) Financial penalties imposed under a AUTOS: lease for excessive use, abnormal If Physical Damage Coverage is provided by wear and tear or high mileage; this Coverage Form, the following types of 3) Security deposits not refunded by a vehicles are also covered "autos" for Physi- lessor; cal Damage Coverage: 4) Costs of extended warranties, Credit Any "auto" you do not own while used with Life insurance, Health, Accident, or the permission of its owner as a temporary Disability insurance purchased with the lease; and AC 70 05 03 16 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 7 with its permission ACP BA 30-2-7161509 L80N R 17089 INSURED COPY AC7005031600 0001 47 0004051 Policy#ACP3037161509 1/01/18-01/01/19 COMMERCIAL AUTO AC 70 05 03 16 5) Carry-over balances from previous No deductible applies to glass if the glass is re- leases. paired, in a manner acceptable to us, rather than 2. This coverage only applies to a "loss"which replaced. is also covered under this policy for Com- P. RENTAL REIMBURSEMENT COVERAGE prehensive, Specified Causes of Loss, or 1. This coverage applies only to a covered"au- Collision coverage. to" for which Physical Damage Coverage is 3. Coverage does not apply to any unpaid provided on this policy. amount due on a loan for which the covered 2. We will pay for rental reimbursement ex- "auto"is not the sole collateral. penses incurred by you for the rental of an N. ORIGINAL EQUIPMENT MANUFACTURER "auto"because of"loss" to a covered"auto". PARTS — LEASED PRIVATE PASSENGER Payment applies in addition to the otherwise TYPES applicable amount of each coverage you Under Paragraph C. Limit of Insurance of have on a covered "auto." No deductibles SECTION III — PHYSICAL DAMAGE apply to this coverage. COVERAGE, Section 4 is added as follows: 3. We will pay only for those expenses incurred 4. We will use new original equipment vehicle during the policy period beginning 24 hours manufacturer parts for any private passen- after the"loss" and ending, regardless of the ger type covered "auto" where required by policy's expiration, with the lesser of the the lease agreement which has a term of at following number of days: least six months. If a new original equip- a. The number of days reasonably ment vehicle manufacturer part is not in pro- required to repair or replace the covered duction or distribution we may use a like, "auto". If "loss" is caused by theft, this kind and quality replacement part. number of days is added to the number O. DEDUCTIBLE AMENDMENTS of days it takes to locate the covered The following are added to the Deductible provi- "auto"and return it to you. sion of SECTION III — PHYSICAL DAMAGE b. The number of days shown in the COVERAGE: Schedule. If another policy or coverage form that is not an 4. Our payment is limited to the lesser of the automobile policy or coverage form issued by following amounts: this company applies to the same"accident", the a. Necessary and actual expenses following applies: incurred. 1. If the deductible under this coverage is the b. $75 for any one day or for a maximum smaller (or smallest) deductible, it will be of 30 days. waived: 5. This coverage does not apply while there 2. If the deductible under this coverage is not are spare or reserve"autos"available to you the smaller(or smallest) deductible, it will be for your operations. reduced by the amount of the smaller (or 6. If "loss" results from the total theft of a cov- smallest)deductible. ered "auto" of the private passenger type, If a Comprehensive or Specified Causes of Loss we will pay under this coverage only that Coverage "loss" from one "accident" involves amount of your rental reimbursement ex- two or more covered "autos", only the highest penses which is not already provided for un- deductible applicable to those coverages will be der SECTION III — PHYSICAL DAMAGE applied to the "accident," if the cause of the loss COVERAGE Coverage Extension. is covered for those vehicles. This provision only Q. EXPANDED TRANSPORTATION EXPENSE applies if you carry Comprehensive or Specified Paragraph A.4.a. of SECTION III — PHYSICAL Causes of Loss Coverage for those vehicles, DAMAGE COVERAGE is replaced by the follow- and does not extend coverage to any covered "autos" for which you do not carry such ing: coverage. We will pay up to $50 per day to a maximum of $1500 for temporary transportation expense in- curred by you because of the total theft of a Page 4 of 7 Includes copyrighted material of Insurance Services Office, Inc AC 70 05 03 16 with its permission. ACP BA 30-2-7161509 L80N R 17089 INSURED COPY AC7005031600 0001 47 0004052 Policy#ACP3037161509 1/01/18-01/01/19 COMMERCIAL AUTO AC 70 05 0316 covered "auto" of the private passenger type. ment manufacturer or other sources in- We will only pay for those covered "autos" for cluding non-original equipment manu- which you carry Comprehensive or Specified facturers and Causes of Loss Coverage. We will pay for tem- b. If a repair or replacement results in bet- porary transportation expenses incurred during ter than like kind or quality, we will not the period beginning 24 hours after the theft and pay for the amount of the net improve- ending, regardless of the policy's expiration, ment. when the covered"auto"is returned to use or we pay for its"loss". 5. If we offer to pay the actual cash value of the damaged or stolen property, we will R. EXTRA EXPENSE—STOLEN AUTOS value auto advertising wraps, paint customi- The following paragraph is added to Coverage zation, and similar business related advertis- Extensions of SECTION III — PHYSICAL ing modifications, in addition to the actual DAMAGE COVERAGE: cash value of the property. Auto advertising c. We will pay for up to $5,000 for the expense wraps, paint customization, and similar of returning a stolen covered "auto" to you. business related advertising modifications We will pay only for those covered "autos" will be valued at the cost to replace them for which you carry Comprehensive or Spec- with an adjustment made for depreciation ified Causes of Loss Coverage and physical condition. S. PHYSICAL DAMAGE LIMIT OF INSURANCE T. NEW VEHICLE REPLACEMENT COST Under SECTION III — PHYSICAL DAMAGE The following is added to the Limit of Insurance COVERAGE, Paragraph C., Limit of Insurance provision of SECTION III — PHYSICAL is replaced by the following: DAMAGE COVERAGE: C. Limit Of Insurance 5. The provisions of paragraphs 1. and 3. do 1. The most we will pay for "loss" in any one not apply to a covered "auto" of the private "accident"is the lesser of: passenger type or a vehicle with a gross vehicle weight rating of 20,000 pounds or a. The actual cash value of the damaged less which is a"new vehicle." or stolen property as of the time of the In the event of a total "loss" to your new ve- hicle to which this coverage applies, we will b. The cost of repairing or replacing the pay at your option: damaged or stolen property. a. The verifiable "new vehicle" purchase 2. $1500 is the most we will pay for "loss" in price you paid for your damaged vehi- any one "accident" to all electronic equip- cle, not including any insurance or war- ment that reproduces, receives or transmits ranties purchased; audio, visual or data signals which, at the time of"loss", is: b. If it is available, the purchase price, as negotiated by us, of a "new vehicle" of a. Permanently installed in or upon the the same make, model, and equipment covered "auto" in a housing, opening or or the most similar model available, not other location that is not normally used including any furnishings, parts, or by the "auto" manufacturer for the in- equipment not installed by the manufac- stallation of such equipment. turer or manufacturers'dealership;or. b. Removable from a permanently installed c. The market value of your damaged ve- housing unit as described in Paragraph hicle, not including any furnishings, 2.a. above or is an integral part of that parts, or equipment not installed by the equipment;or manufacturer or manufacturer's dealer- c. An integral part of such equipment. ship. 3. An adjustment for depreciation and physical We will not pay for initiation or set up costs condition will be made in determining actual associated with loans or leases cash value in the event of a total "loss". As used in this endorsement, a "new 4. The cost of repairing or replacing may: vehicle" means an "auto" of which you are a. Be based on an estimate which includes the original owner that has not been previ- parts furnished by the original equip- AC 70 05 03 16 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 7 with its permission ACP BA 30-2-7161509 L80N R 17089 INSURED COPY AC7005031600 0001 47 0004053 Policy#ACP3037161509 1/01/18-01/01/19 COMMERCIAL AUTO AC 70 05 03 16 ously titled and which you purchased less a. Your obligation in the Duties in the Event than 365 days before the date of the"loss". of Accident, Claim, Suit or Loss Condi- tion relative to notification requirements U. PHYSICAL DAMAGE COVERAGE applies only when the "accident" or EXTENSIONS "loss"is known to: Under SECTION III — PHYSICAL DAMAGE (1) You, if you are an individual; COVERAGE, A. Coverage, Coverage Exten- (2) A partner, if you are a partnership; sions, b. Loss of Use Expenses is replaced by (3) A member, if you are a limited liability the following: company;or b. Loss of Use Expenses (4) An executive officer or insurance For Hired Auto Physical Damage, we will manager, if you are a corporation. pay expenses for which an "insured" be- b. Your obligation in the. Duties in the Event comes legally responsible to pay for loss of of Accident, Claim, Suit or Loss Condition use of a vehicle rented or hired without a relative to providing us with documents driver, under a written rental contract or concerning a claim or "suit" will not be agreement. We will pay for loss of use ex- considered breached unless the breach penses if caused by: occurs after such claim or"suit" is known (1) Other than collision if the Declarations to: indicate that Comprehensive Coverage (1) You, if you are an individual; is provided for any covered"auto"; (2) A partner, if you are a partnership; (2) Specified Causes of Loss only if the (3) A member, if you are a limited Declarations indicate that Specified liability company;or Causes of Loss Coverage is provided (4) An executive officer or insurance for any covered"auto";or manager, if you are a corporation. (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered"auto." X. HIRED CAR—COVERAGE TERRITORY However, the most we will pay for any Item (5) of the Policy Period, Coverage Territory expenses for loss of use is $50 per day, to a GeneralConditionss replaced by the following: maximum of$1,500.The insurance provided (5) Anywheren theworldif a covered"auto" is by this provision is excess over any other leased, hired, rented or borrowed without a collectible insurance. driverfor a period of 30 days or less;and V. TRANSFER OF RIGHTS OF RECOVERY Y. EMERGENCY LOCKOUT AGAINST OTHERS TO US We will reimburse you up to $100 for reasonable The following is added to the Transfer Of Rights expense incurred for the services of a locksmith Of Recovery Against Others To Us Condition: to gain entry into your covered "auto" subject to We waive any right of recovery we may these provisions: have against any person or organization to 1. Your door key, electronic key or key entry the extent required of you by a written con- pad has been lost, stolen or locked in your tract executed prior to any "accident' be- covered "auto" and you are unable to enter cause of payments we make for damages such"auto" , or under this coverage form. 2. Your keyless entry device battery dies and W. NOTICE OF AND KNOWLEDGE OF you are unable to enter such "auto" as a re- OCCURRENCE sult, SECTION IV— BUSINESS AUTO 3. Your key, electronic key or key entry pad CONDITIONS, Paragraph A is amended as has been lost or stolen and you have follows: changed the lock to prevent an unauthorized 6. NOTICE OF AND KNOWLEDGE OF entry; and OCCURRENCE Page 6 of 7 Includes copyrighted material of Insurance Services Office, Inc AC 70 05 03 16 with its permission. ACP BA 30-2-7161509 L80N R 17089 INSURED COPY AC7005031600 0001 47 0004054 Policy#ACP3037161509 1/01/18-01/01/19 COMMERCIAL AUTO AC 70 05 0316 4. Original copies of receipts for services of a If we cancel for any reason other than non- locksmith must be provided before reim- payment of premium, we will mail or deliver bursement is payable. to the First Named Insured written notice of Z. CANCELLATION CONDITION cancellation at least 60 days before the ef- fective date of cancellation. This provision Paragraph A.2. of the COMMON POLICY does not apply in those states that require CONDITION — CANCELLATION applies more than 60 days prior notice of cancella- except as follows: tion. AC 70 05 03 16 Includes copyrighted material of Insurance Services Office, Inc., Page 7 of 7 with its permission ACP BA 30-2-7161509 L80N R 17089 INSURED COPY AC7005031600 0001 47 0004055 Policy 4ACP3037161509 1/01/18-01/01/19 4. Loss Payment—Physical Damage 5. Other Insurance Coverages a. For any covered "auto" you own, this At our option, we may: Coverage Form provides primary a. Pay for, repair or replace damaged or insurance. For any covered"auto" you don't stolen property; own, the insurance provided by this b. Return the stolen property, at our expense. Coverage Form is excess over any other collectible insurance. However, while a We will pay for any damage that results to covered "auto" which is a "trailer" is the"auto"from the theft; or connected to another vehicle, the Covered c. Take all or any part of the damaged or Autos Liability Coverage this Coverage stolen property at an agreed or appraised Form provides for the"trailer" is: value. (1) Excess while it is connected to a motor If we pay for the "loss", our payment will vehicle you do not own; or include the applicable sales tax for the (2) Primary while it is connected to a damaged or stolen property. covered"auto"you own. 5. Transfer Of Rights Of Recovery Against b. For Hired Auto Physical Damage Coverage, Others To Us any covered "auto" you lease, hire, rent or If any person or organization to or for whom we borrow is deemed to be a covered "auto" make payment under this Coverage Form has you own. However, any "auto" that is rights to recover damages from another, those leased, hired, rented or borrowed with a rights are transferred to us. That person or driver is not a v r " organization must do everything necessary to c. Regardless of the provisions of Paragraph secure our rights and must do nothing after a. above, this Coverage Form's Covered "accident"or"loss"to impair them. Autos Liability Coverage is primary for any B. General Conditions liability assumed under an "insured 1. Bankruptcy contract". Bankruptcy or insolvency of the"insured"or the d. When this Coverage Form and any other "insured's" estate will not relieve us of any Coverage Form or policy covers on the obligations under this Coverage Form. same basis, either excess or primary, we 2. Concealment,Misrepresentation Or Fraud will pay only our share. Our share is the proportion that the Limit of Insurance of our This Coverage Form is void in any case of Coverage Form bears to the total of the fraud by you at any time as it relates to this limits of all the Coverage Forms and Coverage Form. It is also void if you or any policies covering on the same basis. other "insured", at any time, intentionally 6. Premium Audit conceals or misrepresents a material fact concerning: a. The estimated premium for this Coverage a. This Coverage Form; Form is based on the exposures you told us b. The covered"auto"; you would have when this policy began.We will compute the final premium due when c. Your interest in the covered"auto";or we determine your actual exposures. The d. A claim under this Coverage Form. estimated total premium will be credited 3. Liberalization against the final premium due and the first Named Insured will be billed for the If we revise this Coverage Form to provide balance, if any. The due date for the final more coverage without additional premium premium or retrospective premium is the charge, your policy will automatically provide date shown as the due date on the bill. If the additional coverage as of the day the the estimated total premium exceeds the revision is effective in your state. final premium due, the first Named Insured 4. No Benefit To Bailee—Physical Damage will get a refund. Coverages b. If this policy is issued for more than one We will not recognize any assignment or grant year, the premium for this Coverage Form any coverage for the benefit of any person or will be computed annually based on our organization holding, storing or transporting rates or premiums in effect at the beginning property for a fee regardless of any other of each year of the policy. provision of this Coverage Form. CA 00 01 1013 ©Insurance Services Office, Inc., 2011 Page 9 of 12 ACP BA 30-2-7161509 L80N R 17089 INSURED COPY CA0001101300 0001 47 0004034 Policy#WAWC907578 01/01/18-01/01/19 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 10B (Ed. 9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS 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.) The additional premium for this endorsement shall be 2% of the total manual premium otherwise due on such remuneration. The minimum premium for this endorsement is $350. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE BLANKET WAIVER Person/Organization Blanket Waiver—Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description Waiver Premium All CA Operations 1965.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 01/01/2018 Policy No. WAWC907578 Endorsement No. Insured Premium$ Insurance Company Cypress Insurance Company Countersigned by WC 99 0410B (Ed.9-14)