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HomeMy WebLinkAboutCertificate of Insurance 2015ACORD TM CERTIFICATE OF LIABILITY INSURANCE Date 3MM/DD/YR) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Heffernan Insurance Brokers CONTACT Cheryl vanWestrop NAME; PHONE 925-934-8500 A/C,No, Ext : FAX 925-934-8278 A/C,No : 1350 Carlback Avenue Walnut Creek, CA 94596 CA License #0564249 EMAIL Cheryly(d�heffins.com ADDRESS: GENERAL L LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE © OCCUR X INSURERS AFFORDING COVERAGE NAIC # INSURED Ferreira Service, Inc. INSURER A: National Fire Ins. Co. of Hartford 20478 INSURER B: Attn: Susan Ferreira INSURER C: INSURER D: 2600 Old Crow Canyon Road Suite 100 San Ramon, CA 94583 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL L LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE © OCCUR X ' 5095014867 3/23/2015 3/23/2016 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED $100,000 PREMISES (Ea occurrence) MED EXP (Any one person) $5,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L. AGGREGATE LIMIT APPLIES PER POLICY MX PROJECT Loc PRODUCTS - COMP/OP AGG $2,000,000 EMPLOYEE BENEFITS Included AX AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEAUTOS HIRED AUTOS X NON -OWNED AUTOS 6012580640 3/23/2015 3/23/2016 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) BODILY INJ U RY (Per person) $ BODILY BODILY INJURY (Per accident) $ X PROPERTYDAMAGE (Per accident) $ $ A X UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE 6011250654 3/23/2015 3/23/2016 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 XI DED RETENTION $10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVEI OFFICER/MEMBER EXCLUDED?❑ (Mandatory In N.H.) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC STATU- OTHER TORY LIMITS E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT ....... i0N OF OPERA T IONS 1 LOCA I IONS i V EHiC LES (Attach AGVRU lel, Additional Remarks Schedule, it more space is required) Project: A-3965 HVAC Maint. Town of Los Altos Hills, its elective and appointed officers, employees and volunteers are named as additional insured on General Liability policy if required by written contract per attached endorsement. Employers Liability Limit $1,000,000 (Per Accident/Aggregate Policy Limit). CERTIFICATE HOLDER CANCELLATION AGVRU 25 (2010/05) The ACORD name and logo are registered marks of ACORD ©1-8-2010 ACORD CORPORATION. All rights reserved. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Los Altos Hills AUTHORIZED 26379 Fremont Road REPRESENTATIVE Los Altos Hills, CA 94022 ' AGVRU 25 (2010/05) The ACORD name and logo are registered marks of ACORD ©1-8-2010 ACORD CORPORATION. All rights reserved. POLICY NUMBER: 5095014867 F—MR7 F= 7fils endor.sernant modMo In'suranoo provided under the folfowlq: COW4M.ERGIAL GENE AI LIABILITY COVERAOE PART This Insuranca does not Apply to "Bodily Injury", 'property risme e" or 'personal and advardaing Injurylarse ng, Dld Of any current or oomploW operation porl'brmed by you or on your behalf wh , Ich Is or was Insurad onder an Owner Controlled InsUfano Program (O.C.1,R) or Contractor C.Dritrolled Insuranoo Program (C.C.A.P.), offieRvise referred to as a . conaolidated (.rap -up) InsuranooproorariP. 11ils excluMon applies, whether or not the "consolidated (w -up) Insuranoo prograW, -1 710a (Ed 000) 1. Provldbs coverage, Iden1loal to that, provided 4y,IbIs ceverage Part,, 2. 3. RemIns in egdcL 00ons*latad (wrap-up) Imurance program' means a oonstruoUnn, areol[on or demolition project for WhIch Ilia prIma oon1raoti3r1pr6jW manager or owner of the construallon, project has secured 0eneral Ilablilty insuranoe owerIng some or all of Ilia oonkactors or subconiractors Involved InIbe, proloot. -11:36 0? Page 11 or 1 (ed. 0,1100) W 0 �1* �,-. li � � � I I � I � I � I l , , 11 1 1 1 � I 1 1111111 11 111111-11 ll�ill,,11,111 ll 111 mmmm It is understood and agreed thl this endorsement, amends the COMM ERC1AL G ENERAL LIASI LITY COVERAG E PART as follow& The changes, this endorsement makes do not apply witll respeattD any coverage that.has been tkoluded oramonded by another endorserrient attached to this policy Coverage Is sarnmaflzed lxlow, For particular -arid lionitstions affecting, each coverage, Blease refer to the oorrespondIng policy provisions In the Indy of this endorsement, 4, dditional Insureds Seven additional insured extensions, 'i -'Bodily Injury- Expanded Definition s. droad Knowtodge of Occurrancel Notice of Occurren" 4, Broad Named insured 6. Broadened Liability Coverage For Damage To "Your Product" And, "Your Work" Limit, 1001 000. 6, Contractual 1-Tablilty-RaUroads 7, Contractual LiAblitty For personal And Adverttsing InJury �k —Electronio Data Liabitity 1 -Ill, of Electronic Data Urnit,, $100,Q00, 9. ex panded Personal And' Advertis Ing Injury - 01 scrim Inatlon or Humiliation 10, Expected Or Intended Injury Reescillableforce -oi! 1 illjlly[rlji alIrlir Drinpilert Vdarnage.11 ft General aggregate l Umits Of Insurance -Iyer Project 42, In Rom Actlons 13., Inc[dental Health Care Malpractice Coverage Cove mg a for yo u r Interest] n such ter minal ed or ended organIzations, 46. Legal LiabifitylAllenifted PremisasSorrowed Equipment Coverage Extended penis, Default limit increased to $500,000 for Damage to iPre-mises. Rented To You. $25,000 fim it for "property damage" to borrowed tools or equi pm e nf at a Jobsite, 16. Liberalization Clause 47. Liquor Liability Coverage F-xiension Ik Medical Payments Um its 1 ncreasod to $15,01 04 Reporting Increased to throe yeafs from the data of accident. 19,, Non -owned Aircraft Coverage --fkwo-ftl—own —edWaterc —raft lnorease4 to 75 feet, 21 Primary And Non-Contri b,uto ry To Other Insurance 22. Property Damage - Elevators 23, Supplementary Payments Cost ofbail borl in creased to $5,000. Daily loss of earnings Increased to $1,000a 24, Unintentional Failure To Disclose Hazards 25. Waiver of Subrogation - Blank Waiver of subwhetter re Itten contract or wr[tt nt, enslon G�18552-J (Ed,. 07.12) Page I of 12 Coliyripht, CNA All Rightla Reservad, POLICY NUMBER: 5095014867 HIROIIKKEd SECTION 11 — WHO IS AN INSURED is amended to Include as'an insured any person or organ ization (called additional insured). described In paragraphs A. through ougfi G. below whom you are required to add as an ladolfibrial insured on this policy under a written oonl ract or wrIlte n agreement, provided the written contract of written ag reeme nt; I. Is currently in effect or becomes effective durl ng th e terra of this policy ,, and 11, Was executed prior to'tho "bodily injury.,"' "property dam,age or "'personal Injury and advertising injury" for which the additional Insured seeks coverage. town ve,r, , wo. will not provide the additional irisured any broader, coverage or any higher limit of Insurance than the least that Is, a. The maximum permitted by law; b. Required in the written contract or written agreement,, c. Afforded to, ypu. u rider this policy;, or d, Described in the appficable, paragraphs A, through G, below. 2113MEW33= Any persons or organizations with a controlling, Interest In, you but only with, respect to their Ilabifity,aasing out of: 1. Their finsncla[ controil of you, or 2. Premises, they own, maintaln or control while you lease or occupy these premises. This Insurance dues not apply to structural alterations, new construction and demolition operations performed by or for suchaddillonal insured. A co-owner of"a premises co -owned by you and covered under th is 1 n -Sura n ce butonly with respect to the oa-owrlees ItabIllity, as co-owner of such premises. C. L"sor-Ecfuipmerrt 1, Any person or organization from whom you lease equllm ent, but only with respect to liability for "bodily Injury," "property damage" or "personal and advertising Injury" caused, In whole or In part, by your maintenance, operation or use, of equipment leased to you by such person or organization. G -18652-J (Ed, 01-12) Page 2 of 12 2. With respect to the Insurance afforded to these additional insureds, this insurance does not. -apply to any "oocurrenco" which takes, place after the equipment lease expires, fl ,An owner or other interest from whom land has been leased by you but tartly with respect. to liab,111ity arising out of the owne.rship, maintenance or use of that specific part of the land leased to 'you'and subject to the following add ltlon.alex.dusl'ons: ThisInsura nee does not apply to, 1. Any "occurrence'l which takes plate after you cease to leaso that, band; or 2. Structural alterations, new construction or demolition operations performed by or on, behalf of such additional insured. ,A manager or lesser of premises but only with respect to liability arising out of the ownership, rnaii nte rianw o r Use of that spa cific part of the premises leased to you and su bj art to the following additional exclusions,, This insurance does not, apply to, 11. Any "oocurrence" which takes place after you cease to be a tenant In that premises, or 2. Structural alterations, new construction or demolition operations performed by or on behalf of such additional Insured, ,A m6rtgagee, assignee or receiver but oriily with respect to their HaUllity as mortgagee, assignee, or reoelvar and arising out of the ownership, rulainteranice, or use of a premises by you. ThIsInsurance does, notapply to, structural alterations, new construction or demolition operations performed by or for such additionall, insured, G. State, or Governmental Agency Gr Subdivision or Political Subdivislona A state or govemmenfM agency or subdivision oriaGiffical subdivision subject to the folloyAng provisions: 1,, This insurance applies only with respect to the following hrazards for which the state or government@,[ agency or stiWivislon or potillcal subdivision has Issued a permit or Copydght, CNA All Rfghlz Reserid ed. POLICY NUMBER: 5095014867 authorization In connection with premises you own, rent, or control and to which this instiranbe 6pplIes:. aThe existence, maintenance, repair, construct.iDn, erection, or removal of advertising signs, awnlngsr canopies, Geller ' eotranus, - coal holes, rd rIveways, manholes, marquees, hoislaway open[rias, sidewalk vaults., street banners,, or decorations and similar ex0osures; or b, The coagtructlon, erection, or removal of elevators.,, or ca The ownership, maintenance or use of any elevators covered by this insurarice. 2. This Insurance applies only with respect to operations performed` by you or on your behalf for Which the state or6overnroental agency or su bdivislo n or political[ subdivision has Issued a permit or authorization, 3. This Insurance does not apply tai a. "Bodily Injury," "property damage"" or "personal and advertising injury" arising out of operations perform ed for the rederAl governm6nit, state or municipality,, or b. "Bodily Injury" or "property damage" Inoluded w1thin the "products- complete.doperaltons fi�zard," A governmental permit whIQh requires you 'lo add the governmental entity as an additional Insured veil trigger this Provislo n 1. as if the permit were a written oordrect, - ,2, BOD I LY INJU RY — EXPANDED UEFI NITIO N SECTION V — DIEFIN ITIONS, the definition: of "bodily Injury" is changed to read: "15odily Injurr means bbfilly Injury, slOness or disease sustalned by a person, Including deelb, h urnillation, shook, mental anguish or ment.a 1, Infury by that person at any II'ma.which results as ar ,consequence of the bodily Injury, sickness or disease, 1. BROAD KNOWLEDGE OF OCCURRENCE1 NOTICE OF 00GURRENCE I G-1 8662-J (Ed,. 07-12) M�l � You must give, us, or our authorized representative notice of an "occurrence," offons-0, claim, or "seuit" only when the ,"occurrence,' offense, claim or "suit" is known to� (1), You, if you are an individual: (2) A partner, if you are a partnership,, (3) An, I executive officer or the employee designated by you to give such notice, if you a re a corponallow, or (4) A manager, if you are a limited [lablitily company. Your rights underthis Caverage Part wrill not be prejucliced If you fail to give us notice of an Noccurrence,4 offense, claim or "suit"' and that, failure is solely due to your reasonable, belief' that the "Ibodily Injury" or',property damage" is Rot covered under this Coverage Part, However, yo, shallgive written notice olithis "oocurrence,"oflense, clalm or 'suit" to us as soon as you are aware khat this Insurance may apply to such "'oocurrdnce," offense claim or "suit." A. Any SUbsidiiary or affiliate organization, other than a partnership, Joint venture or limited liability company, In 'which a Named Insured specifically , shown In the Declarations has management control., dimotly or through one. Q 'r more subsidiary organizations, 01, the time of loss will qualify as a Named Insured but, only if there Is no other similar Insurance, available to such organization, nor similar insurancei which would be available but for exhaustion of Its I I nn'lls . For the, purpose of this provision. similar r Insuranae means general liability or equivalent Insurance,, no matter whether its coverage is broader or narrower than that provided by this Insurance. But if the only other, slimillar insurance Is for a "oonsolWated (wrapqip) program," than a subsidiary thait quallfles as a Named Insured on -such project specific Insurance can $0,11 qualify as a Named Insured on this Insurance, but not for projects, covered by the "consolidated (wrap-up) program." IFlease see Item 26.0. of this endorsement for Cond Iflo n 2. Dirties In The Event of Or-currence, the definition of "consolidated (wrap-up) OffOnse, Claim or Suit of SECTION IV — prograrn.'"] COMMERCIAL GENERAL LIABILITY CONDITIONS Is amendled to add the following provisions, G -18552-J (El 07-12) Page 3 of 12 C�yrloht, CNA All RkDhla Poserved, B, This. endorsement,, does. not apply to any organization for which coverage Is exGl Wed by another endorsement attached to this policy, C. Only for the purpose of this endorsernent: 1. Management control means,,, a. Ownership Interest representing more tban 50% of the Ming, appointment, or clesIgnation power for the subsidiary orgaftization's governing body; or b. Kaviing 'the right, pursuant to a written contritc.t., or pursuant. to the Ery -fans, ,charter,, operating agreement, or similar, document, of 6 specifically shown N , amG.d [nsured Or MItTDIeld, subsidiary organization to select, appoint, or destgnalei, a majority of the subsIdlary organization's governing body. Such ,,ontracl; of document most have besn oreated prior' to the time of loss, or c. Having the right, pursuant to a written trust agreement, 'to Protect,, control the use of, encumber or transfer and sell property held by a trust. 2. Governing bod;means the Board Of y Directors of acorporation. 3. Loss means-, a, The occurring of the "bocfily injury" or "property damage",,or b. The committing of the offense that, caused the 'persona[ and advertising Injury," D. The.Insurance, provided bythis policy appfliesto, Named Insureds when 'trading under their own n a rnes, or udder such trading ng n a rn as or doing- busIness-as (05A). names as any should choose to employ. S. BROADENED LIABILITY COVERAGE FOR DAMAGE TO "YOUR, PRODUCT" AND "YOUR, WORW' A. Under SECTION I — COVERAGE, A — BODILY INJURY AND PROPERrY DAMAGE LIABILITY, Paragraph 2. Excfus[ons is amended to delete exclusions k. and I. and reolace Iftern with the following- , o I r7 k. Damage to Your Product G-1 8662.,1' (Ed. 01-12) (1 Fire,' M moke,,, M Collapse: or (4) Exploslo,m 11. Damag a to Your Wa rk "RrDped y damage' to "Your work" arising out of it, or any part of it and Included In the "products-cornoleted operations hazard.11 This exclusion does not apply.: (I) It the damaged work, or the work out of -,*Wch the damages arises was performed on your behalf by a, subcontractor, or (2) It the cause of loss to the damaged work arises as a result ofi. (a) Fire,,,, (b) Smoke, (c) Collapse; or (di pxplos[Gn. IB, The following paragraph Is added to SECTION !1111 — LIMITS OF INSURANCE,, Subject to 6, above, $100,000 Is the most, we will pay under Coverage A for the, 6um, of darnages arising Out Of any one "oorurrenW ,because of "property damage" to "your produioll, and "your work", that Is caused by fire, smoke, collapse of explosion and Is included within I hie "product��completed operations hazard." This su bl'! m it does not apply tb 'property damage" to "Your work" if the, damag ad work or the work out of Which the damage arises was performed on YOLIT behalf by a subcontractor. G, This Provision 5: Broadened 1-tablifty Cavera,Q e [:or Damage To "Your Product" And "Your, WoW* does not apply if an endorsennent of the same name is attached to this policy, 6CONTRACTUALLIABILITY— RAILROADS With respect to operations - performed. within 50: feel of railroad property, the, definition of "Insured contract" in SECTION V — DEFIN IT IONS is replaced by the foll owing. "Insured Contract" means-. a,., A contract for a lease, of premises, Hovie%oer, "Property damage"' to "your product" arlsIng that portion of the contract for a lease of out of It,. or any part of It except when premises that indomnifies nrl,y person or caused by or resulting frorn: organization, for damage by fire to promises while rented to you or temporarily occupied by G -18652-J (Ed. 07-12) Page 4 of 12 Copyrjht, CNA All Rightist Reserved, you with permlss[on of the owner is not art 1risured ooatraol,",, b. A sidetrack agreement;: c. Any easement or license agreement, d. An obligation, as required by ordinaree, to indeimri[ify 6 -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 (Inelluding an Indemnification of a,, municipality In-connectlon with work performed for a municipality) under which you assume the toil; IlaWky of another party to pay for, "bodily lnjpry�' or "pr'oberly damage" to a ttilrd person, or organization. Tort flabilfty 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 a r da mage arising eut of: (a) Preparing, approving or failing to prepare Of approve maps, sbop drawings, opinions, reports, surveys, field orders, change orders or drawings and specificatlam, or (b) Giving dlrectlbns. or Instructions, or failing'to give them, it that is the primary cause of the Injury o r do rn ag a, (2) Uhd ' 6r whi6h the Insured, if an, architect, engineer OF SUrVOYOF, 8$SLlMW,5 4ability for an injury OF damage arising out of the insured's rendering or failure to render professional services, InatudIng. those listed In (1) above and supervisory, Inspe-otton, a rahiteotoral or engilneorl ng. activities, Lir der SECT] ON I — C(VER AG E B —PE RSONAL AND ADVERTISING INJURY LIASILITY, Pa,ragr,aph 2. Exclusions Is amended to delete exclusion e. Contractual Liability. This provision 7. does nut apply to any person or organPzatIonwho otherwise qualities as an additional Insured orf this Coverage Part, exclusion p. Electronic Data and replace It. with the following-, [This insurance does not apply to.] p. Electronic Data Damages arising :out of, the loss of, los§ of use of, damage to, corruption of, inability to access, or Inability to manipulate "electronic data" that does not result from pbysical Injury to tangible pfoperty, However, this exclusion does riot apply to liability fordamages because of "bodily Injury," 8. The-follow[ng paragraph Is added to SECTION III — LIMI'T'S OF I N SURANCE,, Subject. to 66 above, $100, DDO [S the most we will pay u ' nder Coverage A for all damages arising out of any one 'occurrence" because of 'property damage' that resents from physical injury to tangible property and arlsasoull: of "electronic, da 6."' C. The following definition is, added to the SECTION V — DE f INITIONS: "Mobtr * oni'c dota" means'Infon-nation, facts or prog rams; Wired as'Or on , cleated or used on, or transmitted to or from comptite r soft.ware (IneJuding. systems and applicallonssoftware), hard o r fl oppy disks, CD-ROM$, tapes, drives, cellis, data processing devices or any other media which,, are used with, electronically controlled equipi-nent. D. For the purposes of the. coverage provided by this endorsement the definition of "propedy damage" in SECTION V —, DEFINITIONS is replaced by the follovAn, g : 17. "Property damage" means. a, Phys[oall Injury to tangible property, including all resviting loss of use of that property. All such loss of use shall 'be deemed to occur at the time of the. physical injury that caused It; b, Lessofuse ref tangible property thatis nat physically Injured. All such lass of use shall be deemed to occur at the time of the "occurrance"that caused it, or C. Loss of, loss of use of, damage to, corruption of, inability 'I'D access, or Inability to properly manipulate "electronic data," resulting from A. Under SECTION I —, COVERAGE A — BODILY physical Injury to tangible property. All INJURY AND PROPERTY DAMAGE, such loss of "electroii1c data" shall be Paragraph 2. Exclulsiont is arrionded to delete G -18652-J (Ed. 07.12) Page 5 of 12 Copyr!jhi i CRA All Rights Rewrvad, deemed ID occur at the time of the "Iocouf rence" that caused It, For the purposes of this Insurance, '"electronic data"' is not tangible property, N 6'T-1 I I 12 V11 0 K N, j t 4 1 yJ I I In r av a 0 A. SECTION V — DEHNITIONS Is amended to add the following to the definition of �Personell and advertising Injur': h, DWriminatfon or humillation that, results In Injury to the feeffings or reputation of a natural person, but only if such dWoriminatiorr or, humillation is: (1[ Not done Intentionally by or at the direction of,, (a) The insured; or (b) Any mexewl]Ve, officer," director, stockholder', Partner, Member or manager (if you are a limited liability company) of the insured; and (2) Not directly or Indfreotly 'related to the employment, prospective employment, past employment or termination of employ Ment of any person or persons by any Insured. B. Under SECTION I — COVERAGE B — PERSONAL AND ADVERTISING INJURY LIA1310TY, ' Paragraph 2, Exclusions Is amended to add, the' following additional exclusions: [This Insurance does not apply toJ Discrimination Relating To Room, Dwelling or Wemises "Personal or advertising Injury" caused by discrimination direetty or Indirectly related to the sale, rental, lease orsub46ase or prospect Ne sale" rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any Insured. Fines Or Penalties Fines or penaities levied or Imposed by a governmental entity because of discrimination. G-1 8652-J (Ed, 07-12) Page 6 of 12 G -18652-d (Ed. 07-12) Th Is provision S., does not apply to any person or o rgan ization who otheRvise qualifies as ars 'additional Insured on thi' Coverage Pail, 10. EXPECTE D OR INTENDED INJURY Under SECTION I — COVERAGE A — EDGILY INJURY AND PROPERTY DAmAGE LIABILITY, Paragraph 2. Exclusions is amended to delete exclusion a. Expected or Intended Injury and replace it with the following, [This insurance does notapply to.] a. Expected or intended Injury "Sodily injury" or"property damage" expected or intended from the standpoint of the Insured, Th Is excluslon does not apply to "Ibodfly I nj u ry" or "property damage" resulting from the use of reasonable force to prDlect persons or property., 11. GENERAL AGGREGATE LIMITS OF INSURANCE - PER !PROJECT A. For each construction project away from premises you own or, rent, a separate Construction Project General Aggregate Llmljr� equal to the amount of the General Aggregate Limit, Is the most we Will pay for the sum cif; 1, All 0arnages, under Coverage A, except damages because of "bodily Injury" or "property damage"" Included in the .products"oornpleted operations hazard.", llad 2, All medical expenses under Coverage G, that arise 'from, "occurreacee or accidents which call be attributed solely to Ongoing operations at :that construction project. Such payments sha I I not reduce the e nera I ,aggregate Unlit shown inthe Dedaratl6ns, nor the Construction PrQjacl Aggregate Limit of any other oonstruotion project, B. All: 1. Damages under Coverage B, regardless of the number of locations or construction projects Involved; 2, Damages under, Coverage A, caused by "000tirrences" whloh cannot be attributed solely to ongoing operations at a 'single construction project, except damages because of Obodily injury" or "property CQpyrlght, CNA All, RighlA Rewrved, M A r3Tn damage" Included In the "Oroduct prnrtnpleted operalions hazard and 3. Medical expenses ander Coverage caused by accidents which cannot be attributed solely to ongoing operations at a single construction project:, ,will reduce the General Aggregate Llrnit sho. n Irl the Declar~atians. C. The lirnits shown in the Declarations for Each attend , for Damage To Premises Rented To You and for Medical Expense continue to apply, but. will be subject to either the on tructtion Project aggregate Limit or the General aggregate Limit, depending on whether the "occurrence" can, be attrilbuted solely to ongoing operatlons at a partioular construction project, De When coverage for liability arising out of the � roductsmoompleted operations hazard" I provided, any payments for 'da ages, because of "bodily Inj,utry'I or "property damage" Included In the "products -completed operations, hazard.," regardless of the number of locations Involved will reduce the Products—CompletedOperations Aggregate Limit shown in tine Dectarattons.. E. If a single construction project away (turn premises owned by or rented to the insured has been abandoned and then restarted, or if the aarthorized contracting parties deviate from plans, blueprints, designs, sRe Iflcatiorns or timetables" the project will still be deemed to be the same construction project. k The prbvlslorn� of SECTION III — LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as Opula(ed.12. IN REM ACTIONS Any action In rem against any,vessel owned or operated by or for you, or phartered by or for you Will be treated In the same rrnarnrner as though the action were in personam against you. tris rear is a term .used to designate actions instituted against the thine, as dIstinct from motions rage I nst the person, which are said to be in per onar`h„ 13. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE , Willi respect only to "bodily injury" that ari es out. of a "health care mold al," COVERAGE A.— BODILY INJURY AND PROPERTY DAMAGE amended to replace Insuring Agreement Emm Paro r phs 1,1).(1 ) anti 1 Hb.(2) with the following: b" This Insurance applies- to "bodily, injury,, only if you are not in the business of providing prnfesslonai health care services, and. only If, (d) The "bodily injury' Is caused by an "o urronc&&' that, tales ,place 111 the "coveraga territory." Forte purpose of this insurance., (a) 'Bodily Injury" caused by rr "health care incident"will f nsidered caused by an "ecourrence"; and (b) All acts, error's or omissions that are locllly connected by any common fact, circumstarice, situation, transaot,on, event, advice or decision will fie considered to. consiltule a single "=urrenco"; () The "Incadlly, injury" occurs during the policy period,. All "bodily injury" arising from ars "occurrence"' will be deemed to have occurred at the time of the first. act, error, or ornissi,bn that ls part of the ""occurra,noh"'; and S. With respect only to the Insurance provided by this Provision 13., Exclusion 2.e. Employees Liability of SECTION I COVERAGE BODILY INJURY AND PROPERTY DAMAGE, Is amended to ap{ rnd the following: Only for "bodliy injury,"' not covered by other liability Insur n . 000irrding state-sanctloned self Irnsrrrarioe) available to the insured (or which would be available but for exhaustion of Its limits)" this exclusion does not apply to "bodily injury" that arises out of'a "health care. Incident," C. SECTION V — DEFINITIONS is amended .to add the following', now definition; "Health care incident" means a negligent act, error or ornlasion by, your "employaeos" or "volunteer workers" working, cern your behalf in the rendering of or failure tc render- professional health caro services in any of the folling c,apacitles, or the related furnishing of food, beverages, medical' supplies or appliarr s; a. Physician; b. Nurse c, mer envy medloal technician; d. Paramedic; Copyrrghk, CNA All Rghis Reftrved. POLICY NUMSER, 509,5014867 g, Athieft trainer; h. AudlelogIst,, L Physical therapia; j. Psycfiojoglst� It. Speech therapist,, 1. other a Ifled health protessl onal, or m.. Provider of first aid or G ' ood Samaritan services rendered In an emergency and for which no 'payment Is demanded or received. D. SECTION I — 'COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE, Paragraph 2. ExcAuslons Is amended to add tete, follow ling additional exclusions, These new. exclusions -apply only to this Incidental Health Care MalpractIcoCcvaragC [This insurance does not apply to:] Di honesty or Crime Any dishonest, criminal or Malicious act, error or omission, 01 inicat Trials I Product Testing Auls, errors or omissions that oocur in the course of human ollffical trials or product testing. MadicarelMetlicaid.Frau ld Mledloare or Medicaid fraud or abuse - Services Excluded by Endorsement Any ""health care Incident" for which oove'rag e, Is excluded by endomment. E� SECTION V — DEFINITION$ fs amended to add the fo[lowlng, subparagrapo to Paragraph C of thedefinitlon of "Insured w ntract"-, Para+�i,aph f. does" not Include that part of any contract, or agreemont,- (4) Under whl.ch you assume Another's tort llablilly for "badily injury' arising.but of the rendering of or failure to render professional health care services, F. SECTION It — WHO IS AN INSURED is arnended to add the following provisibris, 1. Your, "employees" are insureds with respect, to-,, a, "bodily Injury"' to a co-"employeell while In the course of the 00-"eMPI`DYee!S" Q,18652 -J (Ed. 07-12), Page, 8 of 12 -18652-1 (Ed, 07-12) employment by you or wh 11 e pe rf orrning duties related to the conduct of your businesw, and b. 'bodily injury" to a "Voturtteer worker' while performing duties retated to the conductof your business, when such "bodrilyinjury" arises out of a "health care Incident." 2, Your "volunteer workers" are Insureds wlth respect to, a" "bodily Injury" to a Do -"volunteer worker" while performing duties.reillated to the',Wnduct of your business; and b. "bodily Injury' to an "emoloyee" wbile in the course of the "employeels" employment by, you or while performing duties related to the qonduct of your business-, when such "bodily Injiory" arises out of a "health rare Incident." 3. Paragraphs !.a. (1)(ai, (b) and (cl of SECTION 11 — WHO IS, AN INSURED do not apply to "bodilly injury" for which insurance Is provided this Provision 13. C Paragraph 2A,(1)(d) of SECTION it — WHIS AN INSURED Is deleted. G. With respect to the Insurance provided by this Provis,lon 11, the following is added to Paragraph .b. t') at SECTION IV — COMMERCIAL GENERAL, 1-1AWLITY CONDITIONS! To the extent this insurance applies, it is excess, over any of the other insurance: (including qu , allfied self insurance), whether primary, exom., contingent or on any other basis, except for insurance purchesed specifically by you to be excess of this polloy. 145 JOINT VENTURES I PARTNERSHIP 1 L1MITED UABILITY COMPANIES A. The followInQ Is added to, SECTION 11 — WHO IS AN INSURED,, 4, You are an Insured 'when you had an interest in a joint vanturei partnership or limited liability company which terminated or ended prior to or during this policy period, but only to the extent of your interest In such joint venture, partnership or limited liability company. This coverage does not. apply.,. 0opyrkght, ONA All fthl� Ream %I, LIA a, Prior to the, term (nation.date of any joint venture, partnership or [Irnited liability company-, ba If there is other valid and collectible insurance purchased specificalry to insure the partinersi ' i1p, Joint, venture or limited I'lability company or c, To a joint ventum,partnership or limited liability cornpany which Is or wasInsured under a "oonsolldefed (wrap-up) institanceprogram.." [Please 'see [tam 2O.C. of this endorsement for the definition of "corfsal Id aled (wra p -,u p) program,"] B. The last paragraph of'SE0TION 11 — WHO, IS AN INSURED Is deleted and replaced by the foliowlng; Except as provided under the ContraotDrs" General L[ability.Extensim Endorsement or by, the aftabhmen t of another endorsement (it any), no person or organI7,01ort Is. an [nisured. with respeot to the ponduct of any current or past partnership, joint * venture or limited liability company that Is not shown as a Named Insured in the Declarations, Z A, Under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY' DAMAGE, Paragraph 2. EXCIUSIMS Is amended to delete exclusion j. Damage to Property in its entirety and replace It with the following - 1. Damage to Property "'Property damage" to:,, (1) Property yore ow rent, Or occulay; (2) Premises you sell, give away or abandon, If tlio "property damage" arises out of any part of those Premises; (3) Property loaned to you, (4) Personal property in the care, custody or control of the insur6&, (5) That parlIcular part of'real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are, Performing operations, if thd "property damage" arises out of those operations; or C -18662-J (Ed. 07-12) Page, 9 of 1:2 (6) That particular part of arty property that Must bo restored, repaired or N. -Placed because "'your work", was Incorrectly performed on It, Paragraph (2) of this exclusion does not apply if the premises are "your word:" Paragraphs (3) and (4) of this exclusion do riot apply to "property damage" to tools, or equipment loaned to you. A separate limit of Insurance applies to sucli tools or equipment that are damaged while be -Ing Used in,your oporailons. Paragraphs (1), (3) and! (4j of this exclusion do nOt.apply to "'property damage" (other than damage by fire) to prernises rented to you or temporarily occupied by you with the permIsMon of the owner, or to the contents of premises rented to you for a Period of 7 or fewer consecutive, days. A separate limit of Insuronce, applites to Damage To Premises Rented To You as descriNd in SECTION III — LIMITS OF INSURANCE, Paragraphs (;), j4),, p and (6) of this exclusion do not apply to liability assumed under, a sidetrack agreement, Paragraph j of 'this exclusion does not apply to "property damage" Included In the "products -cum plated operations hazard." Et. Under SECTION I — COVERAGE A ® BODILY INJURY AND PROPERTY DAMAGE the last Paragraph of Paragraph 2. E)€.clusiom is deleted, and replaced by the following. Exclusions c¢ through n. do, not apply to da ' mage by fire, to prervises while rented W you or temporarily ow-upled by YOU With Permission of the owner nor to the contents Of promises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described In SECTION III — LIMITS OF INSURANCE. 0. The. following paragraph Is added to SECTION III — LIMITS OF INSURANCE-, SuVIer,t to S. above, $26,000 Is the most. vie will pay under Coverage; A for damages arising out of any one '"oocurrenoWl because of "property dam6ge� to tools or equipment loaned to you by others that occurs while, the quipment is being used to perform operations, D. Paragraph 6.. Damage To Premises Rented To You Limit of SECTION III — LIMITS OF INSURANCE is replaced,, by the f6l[awing: CopyrygM, CNA Alt Ifs Resewed. POLICY INUM13 ER: 50S50 14867 6. Subject, to Paragraph; S. above, (the Each Occurrence. Limit), the Damage To Premises Rented, To You Limit is the most we, Wl[,,,l pay under SECTION — I — COVERAGE, A for damages because of "property damage" to any one promises while rented to you or temporarily occupled by you with, the pqrmiss[o4 of -the'dwrier, Including contents of such premises rented to 'you for a perlod of 7 or fewer consecutive days. The Damage To Premises Rented To You Limit, Is the greater of. 3002MM The Damage To Promises,, Rented To You Limit shown: in the Declarations. Ew ParagrdpJh 4.b.,(1)(4)(11) of SECTION IV — COMMERGIAL GENERAL LIABILITY CONDITIONS Is deleted and replaced, by the ,following,-, (11) That, is property insurance for premises rented to you, for premises temporarily occupied by you with the permission of the owner; ort for personal property of others In your care, custody or control', F. This Provision 16. does not apply if DAFnapTo Premises Rented To Yw LiabIllity urger SECTION — t — COVERAGE A is excluded by endorsement. If we adopt a change In our forms or rules which would broaden coverage for co We otors, under this endorsement without- an, additional prernium charge, your policy, Mil automatically provide the additional coverage as, of the date the revisillon is effective 'in your state; 17µ LIQUOR, LIABILITY Under $EGTION I— VEi E A — DODILY . INJURY AND PROPERTY DAMAGE, Paragraph Z Exclusions Is amended to delete exclusion o. Liquor Liability. This provision 17. does not apply to any person, or organization whootherw[se qualifies as an additional insured on. this Coverage Bad. ECR610100, saftykTAgiW A. Paragrap[4 7. Medical Expense Limit, of SECTION 111 — LIMITS OF INSURANCE is' deleted and replaced by the foltowlng,, 7. Subject to Paragraph S. above (the Each Occurrence Limit), the Medical, Expense UmIt is the most, we mill pay under G-IB052-J (Ed, 07-12) Page 10 of 12 SECTION — I — COVE -RAGS C for all medical 'expenses, because of "bodily InJ0rV' sustained by any one person, The Medical ExpenseLlmit is the greaterot mfflamiil (2) The amount shown in the Declarations for M-edt at Expense Limit. S. Paragraph l.a.(3)(b) of :SECTION I — COVERAGE C MEDICAL PAYMENTS, is reply by the followling" (W The expenses are. Incurred, and reported to; us within three, years of the date of the accident; and This paragraph S. does not apply to med[,cal expenses Incurred in the state of Missouri. Under SECTION I — COVERAGE. A —BOD[LY INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is; amended such that exclusion q. Aircraft, ,Auto or Watercraft, does not apply to an Wrctaftyou do not dwri, provided that: 1. The pilot in command holds a currently offerAlve certificate issued by the duty constituted authority of the United States of America or Canada, designating that person as 4.commerclat or airitne transport, pillot; Z The aircraft is rented to you With a trained, paid crew; and 1 The aircraft does not transport, persons or cargo for a charge. Under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is a me nd edto delete subparagraph (2) ofexcAusioin U. Aircraft, Auto or. Watercraft and repilwe 11 with the following. fThis exclwfon does not apply to:] (2) A watercraft you do notown that is: (a) Less than 75'feet long, and (b) Not being used, to, carrypersons or property for a charge. 21. PRIMARY AND NION-CONTRIBUTORY TO OTHER INSURANCE With respect to -any person or organization that is an additional Insured under this Coverag e Part, the folloWIng is added to Paragraph 4. of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Copyright., CNA Ail Right% Reserved, M If you have agreed In w6ling'In a contract or agreement that this Insuranbe Is primary and non- contributory relative loan additional Insured's o Insurann, e, I hen'this insurance Is primary and we. will not seek contribution from that other Insurance,, For the purpose of this Provision 21., the additional Insured's own Insurance means insurance on which the additional insured is a Narned Insured, This ProvIslon 21 k does not apply In situations where the endorsement on this policy affording coverage to the additional Insured specifies that this Insurance is excess.over any other Insurance available to that additional [asured, A. Under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE,, Paragraph 2, Exclusions Is amended such that excluMon k. Damage to Your Product, and subparagraph (3), j and m or exclusion j.. Damage to Property, do not apply "property damage" that results from the use of elevators. 8, 'With respect only to the coverage provided by this endorsement, Condition 4. Other Insurance In SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is amended 'to add the following subparagraph; b.jl)(a)(v): I . Excess Insurance (1) Thts Insurance is excess over, ta) Any of the other Insurance, whether primary, excess, contingent or on any other basis: (v) That Is Property Insuranco covering property of others da imaged front the use of elevators,, A. Under Settion I —, Supplamenwry Payments — Coverages A and 13, Paragraph Ib., the limit of $260 shown for the cost of ball bonds Is replaced by $5,000: S. In Paragraph l.d,,,, the limit. of $250 shown for daily loss of eamings, is r6ptaCed by $1,000. 24. 111NINTENTIONAL FAILURE TO DISCLOSE HAZARDS If unintentlonaily you slhould fall to disclose all existing hazards at the Inception datooi your policy, vie will not Bony coverage under this Coveraga Part becaLlSOUt such failure. 0-1 M2_41 (Ed. 07-12) UndarSECT[ON IV ­ COMMERCIAL, GENFERAI_ LABILITY CO N DITIONS, The Transfer Of Rights Of Recovery Agal nst, Oth ars To, Us Condition Is amended Icy the addition of the Nlowfng, We waive any righ-1, of recovery we may have, against any person or organization because of payments we make for InjOry, or dam0gearising out of:: 1. Your ongoing operations, or 2, "Your worV Included In tile "produo(s completed operations ftazard," However, this waiver, applies only whenyou ha agreed in writing to waive such rights, of recovery in a contract or agreement, and only, If the contraot, or agreement, 1. Is in effect or, bevornes effective daring the ler mof this poliq, and 2, Was executed pr[orlo loss, Note: The following provision does not apply to any puNlo construction project Ia the state of Oklahoma, nor to any construction pr,ojeot irt the state of Alaska, thal'6 not permitted to be insured under 0, "consolidated, (wrap-up) 1mrance program" by applicable state statute or regulation; If the endorsernent EXCLUSION — N TRU T OSI N,STRUCT[ON WMP-UP or another exclusionary endorsement pertal n Ing to Owner Controlled Insurance Programs (p,C,J,P.) or Co ntracto r Control led Insurance Programs (o.C.I.P.) Is,attached totills policy, then the following changes apply. - A. The -followi0g, wording is added to the .endorsement: With respect to a "consolidated (' -wrap u Insurance program" ,,P roject In which you are or, were involved, this exclusion does not apply to those sums you become legalty obligated; to pay as damages, because of-, 1"Bodily Injury," ",property damage," or "personal or advertising llijuW' that, occurs during your ongoing operHtlons at, the project, or during such operations Of anyone aefing on your behalf-, not 2. "Bodilly injury" or "property damage" CapyOgbl, GRA.All Rights ftsemd. POLICY NUMBER, 509,5014Q57 operations hazard" that arises out of those poAlons of the project that are not .1rosidenUal struGtures.11, 15, SECTION IV — COMMERC[Al- GENERAL LIABILITY CONDITION,18 is arnends.dto add the following subparagraph 4.b.jl)(c) to Condition 4. Other tnsurance, [This insurance is excess over (c) Any, of the otharinsurancewhother primary, excess, ounfinuent or any other basis that is !]nsuranco available to you as, a. resultof your being -a partiblipant in a "consolidated (wrap-up) insurance, program," but only as respects your involvement In that lcoosolldatbd (rap, -up), Insurance pro g ram.' G. SECTION V — DEHNITIONS is. amended to add the following definitiow, "'ConsbIlOated (,yrapup) insurance program" means a construction, erection ordemolitlGa, project for which., the p",me.contractorlprojeol manager or owner of the construct,10 projaot has , s secured general !lability Insurance covering some or all of the contractors. or suMontractors All other terms and canditiallis of the Policy rernaln unchanged. involved in the projoct,,Such as an Owner Controlled insurance Program (b. 1P.,) or Contractor Gontro.11.ed Insurance Program A 0.I. P) "Residential structure" means any structure where.30% or more of the square foot area is used. or Is Intended to be used fprbuman residency including but not limited to' single or multifamily housing, apartments, condoi"niiniu;rns,.townliouses, boloperatives or planned, unit developments and also Includes their common, areas and/or appurtenant structures Oncluding pools, hot tubs, detaohed garages' gUesjr houses or any similar structures). When there is no individual ownership of unitsrasidential structure does not Include . mill Itary hous] ng . college/university housing or dormftorles, long term care facilities, hotels, or motels. Residential structure also does, not In olude hospitals, or prisons,, Th Is provision 26.does not apply to any person or organization who otherwise qualifies as on additional Insured on this Coverage Part,, Th4,5 endbrsement, whicli forms a part, of aW Is for attaOment to the Policy, issued by the designated Insurers, Lakes effect on the. effective date of seta. Policy st the hour stated In se Id Policy, unless a aotber effective date Is shown, be low, and expires concurrently Mth said; Policy. -1$ 5 -J (Ed, 07-12) Page 12 of 12 Material used Mth permilssion of I$0 Properties, Joe Cqyyrj�hf, CNA AU Rlglft Rwewed.