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21-066 Amendment #4 dated 8-19-24 Tripepi Smith for Communications Graphic Design Services1
FOURTH AMENDMENT TO AGREEMENT 262
BETWEEN THE CITY OF CUPERTINO AND TRIPEPI
SMITH AND ASSOCIATES, INC., FOR
COMMUNICATIONS GRAPHIC DESIGN SERVICES
This Fourth Amendment to Agreement 262 between the City of Cupertino and Tripepi Smith
and Associates, Inc., is by and between the City of Cupertino, a municipal corporation (hereinafter
"City") and Tripepi Smith and Associates, Inc., a Corporation (“Contractor”) whose address is PO
Box 52152, Irvine, CA, 92619, and is made with reference to the following:
RECITALS:
A. The City and Contractor entered into an Agreement for Communications Graphic
Design Services, effective July 1, 2021, Agreement 262 (“Original Agreement”) with a term
expiring on June 30, 2022.
B. The City and the Contractor entered into a First Amendment for Communications
Graphic Design Services, effective June 30, 2022 (“First Amendment”) with a term expiring
on June 30, 2023.
C. The City and the Contractor entered into a Second Amended and Reinstated
Agreement for Communications Graphic Design Services, effective July 20, 2023 (“Second
Amendment”) with a term expiring on August 30, 2024.
D. The City and the Contractor entered into a Third Amended Agreement for
Communications Graphic Design Services and Additional Communications Support, effective
December 19, 2023 (“Third Amendment”) with a term expiring on August 30, 2024.
E. The Original Agreement, First Amendment, Second Reinstated Amendment, and
Third Amendment are collectively referred to as the “Agreement” unless otherwise indicated.
F. City and Contractor desire to modify the Agreement on the terms and conditions set
forth herein.
NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as
follows:
1. SERVICES:
Paragraph 2 of the Agreement is modified to read as follow:
Contractor agrees to provide the services and perform the tasks (“Services”) set forth in detail
in Scope of Services, attached here and incorporated as Exhibit A-4. Contractor further agrees
to carry out its work in compliance with any applicable local, State, or Federal order regarding
COVID-19.
Exhibit A-3 to the Agreement is replaced with Exhibit A-4, attached hereto.
2. TIME OF PERFORMANCE:
Paragraph 3 of the Agreement is modified to read as follow:
2
3.1 This Agreement begins on the Effective Date and ends on June 30, 2025 (“Contract
Time”), unless terminated earlier as provided herein. Contractor’s Services shall begin on the
effective date and shall be completed by June 30, 2025. The City’s appropriate department
head or the City Manager may extend the Contract Time through a written amendment to this
Agreement, provided such extension does not include additional contract funds. Extensions
requiring additional contract funds are subject to the City’s purchasing policy.
3.2 Schedule of Performance. Contractor must deliver the Services in accordance with the
Schedule of Performance, attached and incorporated here as Exhibit B-3.
3.3 Time is of the essence for the performance of all the Services. Contractor must have
sufficient time, resources, and qualified staff to deliver the Services on time.
Exhibit B-2 to the Agreement is replaced with Exhibit B-3, attached hereto.
3. COMPENSATION:
Paragraph 4 of the Agreement is modified to read as follow:
4.1 Maximum Compensation. City will pay Contractor for satisfactory
performance of the Services an amount that will be based on actual costs but that will be
capped so as not to exceed $87,500 (Contract Price), based upon the scope of Services in
Exhibit A-4 and the budget and rates included in Exhibit C-4. Compensation attached and
incorporated here. The maximum compensation includes all expenses and
reimbursements and will remain in place even if Contractor’s actual costs exceed the
capped amount. No extra work or payment is permitted without written approval of the
City.
Exhibit C-3 of the Agreement is replaced with a new Exhibit C-4, attached hereto.
4. Except as expressly modified herein, all other terms and covenants set forth in the
Agreement shall remain the same and shall be in full force and effect.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
[SIGNATURE PAGE TO FOLLOW]
3
IN WITNESS WHEREOF, the parties hereto have caused this modification of Agreement
to be executed.
CITY OF CUPERTINO TRIPEPI SMITH AND ASSOCIATES, INC.
By By
Title Title
Date Date
APPROVED AS TO FORM
City Attorney
ATTEST:
City Clerk
EXPENDITURE DISTRIBUTION
Item Amount
Base $17,500
1st Amendment $18,000
2nd Amendment $19,000
3rd Amendment $30,000
4th Amendment $3,000
Total $87,500
Ryder Todd Smith
President
08/19/2024
Christopher D. Jensen
Deputy City Manager
08/19/2024
EXHIBIT A-4
EXHIBIT A-4: Scope of Services
The Contractor will perform graphic design services for The Cupertino Scene, a City-wide
newsletter, and deliver two final PDFs (web and print) for each newsletter.
Contractor will also assist the City Manager's Office with additional communications support,
determined on an as needed basis, at an hourly rate outlined in Exhibit C-4.
EXHIBIT B-3
EXHIBIT B-3: SCHEDULE OF PERFORMANCE
The Contractor will complete graphic design services and deliver a final PDF version of the
newsletter on the following dates:
• Monday, August 19, 2024
o Publish September - November 2024 Edition
• Monday, November 18, 2024
o Publish December 2024 – March 2025 Edition
• Tuesday, March 18, 2025
o Publish April – June 2025 Edition
• Tuesday, June 17, 2025
o Publish July – August 2025 Edition
This schedule is subject to change per City Manager direction.
EXHIBIT C-4
EXHIBIT C-4: COMPENSATION
Scene Hourly Rate:
• No more than 15 hours at $147/hr standard rate per newsletter
• An $110/hr contingency rate will apply after standard rate has been exhausted
• No more than 20 hours of contingency rate may be used during this term
Additional Communications Support Hourly Rate:
• Any work consultant performs for Communications Support will be charged at the
appropriate hourly standard rate as outlined in the below rate sheet.
• Invoices shall include a description of the services being invoiced, number of hours worked,
and any supporting documentation, as needed.
This fourth amendment will add $3,000 to the base agreement. The total Not to Exceed amount for
the Scene Hourly Rate + Additional Communications is $87,500 as illustrated in the table below.
CUMULATIVE COMPENSATION
CONTRACT AMOUNT
Base $17,500
1st Amendment $18,000
2nd Amendment $19,000
3rd Amendment $30,000
4th Amendment $3,000
TOTAL $87,500
Exh. D-Insurance Requirements for Design Professionals & Consultant Contracts
1
Form Updated Jan. 2022
Consultant shall procure prior to commencement of Services and maintain for the duration of the contract,
at its own cost and expense, the following insurance policies and coverage with companies doing business in
California and acceptable to City.
INSURANCE POLICIES AND MINIMUMS REQUIRED
1. Commercial General Liability (CGL) for bodily injury, property damage, personal injury liability for
premises operations, products and completed operations, contractual liability, and personal and
advertising injury with limits no less than $2,000,000 per occurrence (ISO Form CG 00 01). If a
general aggregate limit applies, either the general aggregate limit shall apply separately to this
project/location (ISO Form CG 25 03 or 25 04) or it shall be twice the required occurrence limit.
a. It shall be a requirement that any available insurance proce eds broader than or in excess of the
specified minimum insurance coverage requirements and/or limits shall be made available to the
Additional Insured and shall be (i) the minimum coverage/limits specified in this agreement; or (ii) the
broader coverage and maximum limits of coverage of any insurance policy, whichever is greater.
b. Additional Insured coverage under Consultant's policy shall be "primary and non -contributory,"
will not seek contribution from City’s insurance/self-insurance, and shall be at least as broad as ISO
Form CG 20 10 (04/13).
c. The limits of insurance required may be satisfied by a combination of primary and umbrella or
excess insurance, provided each policy complies with the requirements set forth in this Contract. Any
umbrella or excess insurance shall contain or be endorsed to contain a provision that such cov erage
shall also apply on a primary basis for the benefit of City before the City’s own insurance or self -
insurance shall be called upon to protect City as a named insured.
2. Automobile Liability: ISO CA 00 01 covering any auto (including owned, hired, and non-owned
autos) with limits no less than $1,000,000 per accident for bodily injury and property damage.
3. Workers’ Compensation: As required by the State of California, with Statutory Limits and
Employer’s Liability Insurance of no less than $1,000,000 per occurrence for bodily injury or disease.
◻ Not required. Consultant has provided written verification of no employees.
4. Professional Liability for professional acts, errors and omissions, as appropriate to Consultant’s
profession, with limits no less than $2,000,000 per occurrence or claim, $2,000,000 aggregate. If written
on a claims made form:
a. The Retroactive Date must be shown and must be before the Effective Date of the Contract.
b. Insurance must be maintained for at least five (5) years after completion of the Services.
c. If coverage is canceled or non-renewed, and not replaced with another claims-made policy form
with a Retroactive Date prior to the Contract Effective Date, the Consultant must purchase
“extended reporting” coverage for a minimum of five (5) years after completion of the Services.
EXHIBIT D
Insurance Requirements
Design Professionals & Consultants Contracts
Exh. D-Insurance Requirements for Design Professionals & Consultant Contracts
2
Form Updated Jan. 2022
OTHER INSURANCE PROVISIONS
The aforementioned insurance shall be endorsed and have all the following conditions and provisions:
Additional Insured Status
The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers
(“Additional Insureds”) are to be covered as additional insureds on Consultant’s CGL and automobile
liability policies. General Liability coverage can be provided in the form of an endorsement to Consultant’s
insurance (at least as broad as ISO Form CG 20 10 (11/ 85) or both CG 20 10 and CG 20 37 forms, if later
editions are used).
Primary Coverage
Coverage afforded to City/Additional Insureds shall be primary insurance. Any insurance or self -insurance
maintained by City, its officers, officials, employees, or volunteers shall be excess of Consultant’s insurance
and shall not contribute to it.
Notice of Cancellation
Each insurance policy shall state that coverage shall not be canceled or allowed to expire, except with written
notice to City 30 days in advance or 10 days in advance if due to non-payment of premiums.
Waiver of Subrogation
Consultant waives any right to subrogation against City/Additional Insureds for recovery of damages to the
extent said losses are covered by the insurance policies required herein. Specifically, the Workers’
Compensation policy shall be endorsed with a waiver of subrogation in favor of City for all work performed
by Consultant, its employees, agents and subconsultants. This provision applies regardless of whether or not
the City has received a waiver of subrogation endorsement from the insurer.
Deductibles and Self-Insured Retentions
Any deductible or self-insured retention must be declared to and approved by the City. At City’s option, either:
the insurer must reduce or eliminate the deductible or self -insured retentions as respects the City/Additional
Insureds; or Consultant must show proof of ability to pay losses and costs related investigations, claim
administration and defense expenses. The policy shall provide, or be endorsed to provide, that the self -insured
retention may be satisfied by either the insured or the City.
Acceptability of Insurers
Insurers must be licensed to do business in California with an A.M. Best Rating of A-VII, or better.
Verification of Coverage
Consultant must furnish acceptable insurance certificates and mandatory endorsements (or copies of the policies
effecting the coverage required by this Contract), and a copy of the Declarations and Endorsement Page of the
CGL policy listing all policy endorsements prior to commencement of the Contract. City retains the right t o
demand verification of compliance at any time during the Contract term.
Subconsultants
Consultant shall require and verify that all subconsultants maintain insurance that meet the requirements of
this Contract, including naming the City as an additional insured on subconsultant’s insurance policies.
Higher Insurance Limits
If Consultant maintains broader coverage and/or higher limits than the minimums shown above, City shall be
entitled to coverage for the higher insurance limits maintained by Consultant.
Adequacy of Coverage
City reserves the right to modify these insurance requirements/coverage based on the nature of the risk, prior
experience, insurer or other special circumstances, with not less than ninety (90) days prior written notice.
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
PRODUCER CONTACT
NAME:
FAXPHONE
(A/C, No):(A/C, No, Ext):
E-MAIL
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY)
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $
DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)
MED EXP (Any one person)$
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $
PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT
OTHER:$
COMBINED SINGLE LIMIT
$(Ea accident)
ANY AUTO BODILY INJURY (Per person)$
OWNED SCHEDULED
BODILY INJURY (Per accident)$AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
$AUTOS ONLY AUTOS ONLY (Per accident)
$
OCCUR EACH OCCURRENCE
CLAIMS-MADE AGGREGATE $
DED RETENTION $
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below
INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N
N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
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.
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 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).
COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
$
$
$
$
$
The ACORD name and logo are registered marks of ACORD
6/18/2024
(417) 895-4616
30104
Tripepi Smith And Associates, Inc
P.O. Box 52152
Irvine, CA 92619
19682
37540
A 2,000,000
84SBABG4S3U 6/20/2024 6/20/2025 1,000,000
10,000
2,000,000
4,000,000
4,000,000
Business Liability General Aggre
2,000,000A
84SBABG4S3U 6/20/2024 6/20/2025
1,000,000A
84SBABG4S3U 6/20/2024 6/20/2025 1,000,000
10,000
B
84WECBG4S68 6/20/2024 6/20/2025 1,000,000
1,000,000
1,000,000
C E&O Liability W226EE230701 4/1/2024 Each Loss 2,000,000
C E&O Liability W226EE230701 4/1/2024 4/1/2025 Aggregate Limit 3,000,000
City, its City Council, boards and commissions, officers, employees and volunteers shall be named as an additional insured as respects to General Liability
Insurance in regards to the operations of the named insured and as required by this Agreement, per form SS00080405 (pages 11-13 of 24). The naming of an
additional insured shall not affect any recovery to which such additional insured would be entitled under this policy if not named as such additional insured.
An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of any nature on this policy or any
extension thereof. The General Liability is Primary and Non-Contributory where required by written contract, per form SS00080405 (page 17 of 24).
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014
TRIPSMI-01 PHISH1
Digital Insurance LLC-Clayton, MO
8235 Forsyth Blvd #1200
Clayton, MO 63105
Shawny Phillips
shawny.phillips@onedigital.com
Hartford Underwriters Ins Co
Hartford Fire Insurance Co
Beazley Insurance Company
X
4/1/2025
X
X
X
X X
X
X
ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSDWVD
PRODUCER CONTACTNAME:
FAXPHONE(A/C, No):(A/C, No, Ext):
E-MAILADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $
DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)
MED EXP (Any one person)$
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $
PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT
OTHER:$
COMBINED SINGLE LIMIT $(Ea accident)
ANY AUTO BODILY INJURY (Per person)$
OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident)
$
OCCUR EACH OCCURRENCE
CLAIMS-MADE AGGREGATE $
DED RETENTION $
PER OTH-STATUTE ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below
INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N
N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
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.
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 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).
COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
$
$
$
$
$
The ACORD name and logo are registered marks of ACORD
4/26/2024
License # 0H18131
(818) 530-0321 (818) 933-2285
Tripepi Smith & Associates
P.O. Box 52152
Irvine, CA 92619
A Technology & Cyber Liability (E&O) W226EE240701 4/1/2024 Aggregate 3,000,000
Each Loss 2,000,000
Retention/Deductible 2,500
City of Cupertino is named as an Additional Insured but only as respects to claims arising out of the Named Insured's wrongful acts as covered by the policy.
Prior Knowledge Date: 04/01/2018
Retroactive Date(s):
1M Each Loss / 2M Aggregate - Full Unknown Prior Acts
2M Each Loss / 3M Aggregate - 04/19/2021
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014
TRIPSMI-01 HHUI
Momentous Insurance Brokerage, A Marsh & McLennan Agency LLC
Company
5990 Sepulveda Blvd., #550
Van Nuys, CA 91411
Hanson Hui
hanson.hui@mmibi.com
Lloyd's of London
4/1/2025
Form: SC 00 01 10 18 10
Your policy includes the liability coverages listed below. The limits in the right-hand column show the
maximum amount we’ll pay.
FORM NUMBER FORM NAME LIMIT OF INSURANCE
SL 00 00 10 18 BUSINESS LIABILITY COVERAGE FORM
Damage To Premises Rented To You Limit $1,000,000
General Aggregate Limit $4,000,000
Liability and Medical Expenses Limit $2,000,000
Medical Expenses Limit $10,000
Personal and Advertising Injury Limit $2,000,000
Products-Completed Operations Aggregate Limit $4,000,000
Property Damage Liability Deductible No Deductible
ADDITIONAL BUSINESS LIABILITY COVERAGES
SL 30 42 10 18 ADDITIONAL INSURED - DESIGNATED PERSON OR
ORGANIZATION
SL 30 36 10 18 ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
SL 30 48 10 18 ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
SL 30 40 10 18 ADDITIONAL INSURED - STATE OR GOVERNMENTAL
AGENCY OR SUBDIVISION OR POLITICAL
SUBDIVISION - PERMITS OR AUTHORIZATIONS
SL 30 47 10 18 ADDITIONAL INSURED - VENDORS
SL 30 32 06 21 BLANKET ADDITIONAL INSURED BY CONTRACT Included
1
SL 30 26 10 18 HIRED AUTO AND NON-OWNED AUTO LIABILITY Included
1
1Included in Business Liability Limit(s)
ADDITIONAL INSUREDS SCHEDULES
Form Number Form Name
Additional Insured Name
and Address Location
SL 30 47 10 18 ADDITIONAL INSURED -
VENDORS
CITY OF FULLERTON, ITS
ELECTED OR APPOINTED
OFFICIALS, OFFICERS
EMPLOYEES AND VOLUNTEERS
303 W COMMONWEALTH AVE,
FULLERTON, CA 92832
N/A
THE CITY OF ONTARIO, ITS
DIRECTORS, OFFICIALS,
EMPLOYEES, AGENTS AND
VOLUNTEERS
303 E B ST, ONTARIO, CA 91764
N/A
CITY OF MENIFEE
29844 HAUN RD, SUN CITY, CA
92586
N/A
Form: SC 00 01 10 18 11
ADDITIONAL INSUREDS SCHEDULES
Form Number Form Name
Additional Insured Name
and Address Location
THE CITY OF GLENDALE, AND ITS
OFFICERS, AGENTS, EMPLOYEES
AND REPRESENTATIVES
613 E. BROADWAY, GLENDALE,
CA 91206
N/A
CITY OF LAGUNA BEACH
505 FOREST AVENUE, LAGUNA
BEACH, CA 92651
N/A
THE CITY OF TRACY, INCLUDING
ITS ELECTED OFFICIALS,
OFFICERS EMPLOYEES, AGENTS,
AND VOLUNTEERS
333 CIVIC CENTER PLAZA,
TRACY, CA 95376
N/A
SL 30 48 10 18 ADDITIONAL INSURED - OWNERS,
LESSEES OR CONTRACTORS -
SCHEDULED PERSON OR
ORGANIZATION
CITY OF PALMDALE
38250 SIERRA HIGHWAY,
PALMDALE, CA 93550
N/A
CITY OF BURLINGAME
501 PRIMROSE RD, BURLINGAME,
CA 94010
N/A
THE CITY OF WEST COVINA AND
ITS ELECTED AND APPOINTED
BOARDS OFFICERS,OFFICIALS,
AGENTS, EMPLOYEES
1444 WEST GARVEY AVENUE S,
WEST COVINA, CA 91790
N/A
CITY OF CUPERTINO, ITS CITY
COUNCIL, BOARDS AND
COMMISSIONS, OFFICERS,
EMPLOYEES & VOLUNTEERS
10300 TORRE AVENUE,
CUPERTINO, CA 95014
N/A
COUNTY OF ORANGE, ITS
ELECTED AND APPOINTED
OFFICIALS, OFFICERS AGENTS
AND EMPLOYEES
1300 S. GRAND AVENUE SUITE
STE. A, 2ND FLOOR, SANTA ANA,
CA 92703
N/A
SL 30 36 10 18 ADDITIONAL INSURED - OWNERS,
LESSEES OR CONTRACTORS -
COMPLETED OPERATIONS
CITY OF CUPERTINO, ITS CITY
COUNCIL, BOARDS AND
COMMISSIONS, OFFICERS,
EMPLOYEES & VOLUNTEERS
10300 TORRE AVENUE,
CUPERTINO, CA 95014
ALL LOCATIONS
Form: SC 00 01 10 18 12
ADDITIONAL INSUREDS SCHEDULES
Form Number Form Name
Additional Insured Name
and Address Location
COUNTY OF MARIN
3501 CIVIC CENTER DRIVE #325,
SAN RAFAEL, CA 94903
LOC 001 BLDG 001, 002,
003
THE CITY OF WEST COVINA & ITS
ELECTED AND APPOINTED
BOARDS, OFFICERS, OFFICIALS,
AGENTS, EMPLOYEES
1444 WEST GARVEY AVENUE S,
WEST COVINA, CA 91790
ALL LOCATIONS
THE CITY OF CUPERTINO, ITS
CITY COUNCIL, OFFICERS,
OFFICIALS EMPLOYEES, AGENTS,
SERVANTS AND VOLUNTEERS
10300 TORRE AVENUE,
CUPERTINO, CA 95014
LOC 001 BLDG 001, 002,
003
SL 30 40 10 18 ADDITIONAL INSURED - STATE
OR GOVERNMENTAL AGENCY OR
SUBDIVISION OR POLITICAL
SUBDIVISION - PERMITS OR
AUTHORIZATIONS
THE COSTA MESA SANITARY
DISTRICT, IT'S ELECTED AND
APPOINTED OFFICIALS, AGENTS,
OFFICERS, VOLUNTEERS AND
EMPLOYEES
290 PAULARINO AVENUE, COSTA
MESA, CA 92626
N/A
SL 30 42 10 18 ADDITIONAL INSURED -
DESIGNATED PERSON OR
ORGANIZATION
CULVER CITY, MEMBERS OF ITS
CITY COUNCIL, ITS BOARDS &
COMMISSIONS OFFICERS,
AGENTS & EMPLOYEES
9770 CULVER CITY BLVD,
CULVER CITY, CA 90232
N/A
KINGS COUNTY AND ITS
OFFICERS, EMPLOYEES AND
AGENTS
1400 W. LACEY BLVD, BLDG #4,
HANFORD, CA 93230
N/A
CITY OF ORANGE
300 E. CHAPMAN AVE, ORANGE,
CA 92866
N/A
ALL OTHER BUSINESS LIABILITY FORMS
Form Number Form Name
SL 21 01 10 18 EXCLUSION - AIRCRAFT PRODUCTS LIABILITY
SL 20 46 10 18 EXCLUSION - DESIGNATED PROFESSIONAL SERVICES
SL 20 06 10 18 EXCLUSION - NUCLEAR ENERGY LIABILITY
SL 20 78 10 18 EXCLUSION - SILICA - BUSINESS LIABILITY COVERAGE FORM
Form: SC 00 01 10 18 13
ALL OTHER BUSINESS LIABILITY FORMS
Form Number Form Name
SL 90 13 10 18 NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S)
BUSINESS LIABILITY COVERAGE PREMIUM:$497*
* Price is subject to fees and surcharges. For more details, refer to Page 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Form SL 30 32 06 21 Page 1 of 3
© 2021, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
BLANKET ADDITIONAL INSURED BY CONTRACT
This endorsement modifies insurance provided under the following:
BUSINESS LIABILITY COVERAGE FORM
Except as otherwise stated in this endorsement, the terms and conditions of the Policy apply.
A.The following is added to Section C. WHO IS AN INSURED:
Additional Insureds When Required By Written Contract, Written Agreement Or Permit
The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you
have agreed, in a written contract or written agreement, or when required by a written permit issued by a state or
governmental agency or subdivision or political subdivision that such person or organization be added as an
additional insured on your Coverage Part, provided the injury or damage occurs subsequent to the execution of
the contract or agreement, or the issuance of the permit.
A person or organization is an additional insured under this provision only for that period of time required by the
contract, agreement or permit.
However, no such person or organization is an additional insured under this provision if such person or
organization is included as an additional insured by any other endorsement issued by us and made a part of this
Coverage Part.
The insurance afforded to such additional insured will not be broader than that which you are required by the
contract, agreement, or permit to provide for such additional insured.
The insurance afforded to such additional insured only applies to the extent permitted by law.
The limits of insurance that apply to additional insureds are described in Section D. LIABILITY AND MEDICAL
EXPENSES LIMITS OF INSURANCE. How this insurance applies when other insurance is available to an
additional insured is described in the Other Insurance Condition in Section E. LIABILITY AND MEDICAL
EXPENSES GENERAL CONDITIONS.
a. Vendors
Any person(s) or organization(s) (referred to below as vendor), 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 and only if this Coverage Part provides coverage for "bodily injury" or "property damage"
included within the "products-completed operations hazard".
(1)The insurance afforded to the vendor is subject to the following additional exclusions:
This insurance does not apply to:
(a)"Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of
the assumption of liability in a contract or agreement. This exclusion does not apply to liability for
damages that the vendor would have in the absence of the contract or agreement;
(b)Any express warranty unauthorized by you;
(c)Any physical or chemical change in the product made intentionally by the vendor;
(d)Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or
the substitution of parts under instructions from the manufacturer, and then repackaged in the original
container;
(e)Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to
make or normally undertakes to make in the usual course of business, in connection with the
distribution or sale of the products;
(f)Demonstration, installation, servicing or repair operations, except such operations performed at the
vendor's premises in connection with the sale of the product;
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Form SL 30 32 06 21 Page 2 of 3
© 2021, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
(g)Products which, after distribution or sale by you, have been labeled or relabeled or used as a
container, part or ingredient of any other thing or substance by or for the vendor; or
(h)"Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or
omissions or those of its employees or anyone else acting on its behalf. However, this exclusion
does not apply to:
(i)The exceptions contained in Paragraphs (d) or (f); or
(ii)Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally
undertakes to make in the usual course of business, in connection with the distribution or sale of
the products.
(2)This insurance does not apply to any insured person or organization from whom you have acquired such
products, or any ingredient, part or container, entering into, accompanying or containing such products.
b. Lessors Of Equipment
(1)Any person or organization from whom you lease equipment; but only with respect to their 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.
(2)With respect to the insurance afforded to these additional insureds, this insurance does not apply to any
"occurrence" which takes place after you cease to lease that equipment.
c. Lessors Of Land Or Premises
(1)Any person or organization from whom you lease land or premises, but only with respect to liability arising
out of the ownership, maintenance or use of that part of the land or premises leased to you.
(2)With respect to the insurance afforded to these additional insureds, this insurance does not apply to:
(a)Any "occurrence" which takes place after you cease to lease that land or be a tenant in that premises;
or
(b)Structural alterations, new construction or demolition operations performed by or on behalf of such
person or organization.
d. Architects, Engineers Or Surveyors
(1)Any architect, engineer, or surveyor, but only with respect to liability for "bodily injury", "property damage"
or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or
omissions of those acting on your behalf:
(a)In connection with your premises;
(b)In the performance of your ongoing operations performed by you or on your behalf; or
(c)In connection with "your work" and included within the "products-completed operations hazard", but
only if:
(i)The written contract, written agreement or permit requires you to provide such coverage to such
additional insured; and
(ii)This Coverage Part provides coverage for "bodily injury" or "property damage" included within the
"products-completed operations hazard".
(2)With respect to the insurance afforded to these additional insureds, the following additional exclusion
applies:
This insurance does not apply to "bodily injury", "property damage" or "personal and advertising
injury" arising out of the rendering of or the failure to render any professional services, including:
(i)The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions,
reports, surveys, field orders, change orders, designs or drawings and specifications; or
(ii)Supervisory, surveying, inspection, architectural or engineering activities.
This exclusion applies even if the claims allege negligence or other wrongdoing in the supervision,
hiring, employment, training or monitoring of others by an insured, if the “bodily injury”, “property
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Form SL 30 32 06 21 Page 3 of 3
© 2021, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
damage”, or “personal and advertising injury” arises out of the rendering of or the failure to render any
professional service.
e. State Or Governmental Agency Or Subdivision Or Political Subdivision Issuing Permit
(1)Any state or governmental agency or subdivision or political subdivision, but only with respect to
operations performed by you or on your behalf for which the state or governmental agency or subdivision
or political subdivision has issued a permit.
(2)With respect to the insurance afforded to these additional insureds, this insurance does not apply to:
(a)"Bodily injury", "property damage" or "personal and advertising injury" arising out of operations
performed for the federal government, state or municipality; or
(b)"Bodily injury" or "property damage" included within the "products-completed operations hazard".
f. Any Other Party
(1)Any other person or organization who is not in one of the categories or classes listed above in
Paragraphs a. through e. above, but only with respect to liability for "bodily injury", "property damage" or
"personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or
omissions of those acting on your behalf:
(a)In the performance of your ongoing operations performed by you or on your behalf;
(b)In connection with your premises owned by or rented to you; or
(c)In connection with "your work" and included within the "products-completed operations hazard", but
only if:
(i)The written contract, written agreement or permit requires you to provide such coverage to such
additional insured; and
(ii)This Coverage Part provides coverage for "bodily injury" or "property damage" included within the
"products-completed operations hazard".
(2)With respect to the insurance afforded to these additional insureds, the following additional exclusion
applies:
This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury"
arising out of the rendering of, or the failure to render, any professional architectural, engineering or
surveying services, including:
(a)The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports,
surveys, field orders, change orders, designs or drawings and specifications; or
(b)Supervisory, surveying, inspection, architectural or engineering activities.
This exclusion applies even if the claims allege negligence or other wrongdoing in the supervision, hiring,
employment, training or monitoring of others by an insured, if the “bodily injury”, “property damage”, or
“personal and advertising injury” arises out of the rendering of or the failure to render any professional
service described in Paragraphs f.(2)(a) or f.(2)(b) above.
Form SL 00 00 10 18 Page 1 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
BUSINESS LIABILITY COVERAGE FORM
Various provisions in this Policy restrict coverage. Read the entire Policy carefully to determine rights, duties and what is
and is not covered.
Throughout this Coverage Part the words "you" and "your" refer to the Named Insured shown in the Declarations. The
words "we", "us" and "our" refer to the insurance company shown in the Declarations.
"Policy period", as used in this Coverage Part,means the period from the effective date of this Coverage Part to the
expiration date of the Coverage Part as stated in the Declarations or the date of cancellation, whichever is earlier.
The word "insured" means any person or organization qualifying as such under Section C. Who Is An Insured.
Other words and phrases that appear in quotation marks have special meaning. Refer to Section F. Liability And Medical
Expenses Definitions.
A. COVERAGES
1. Business Liability Coverage (Bodily Injury, Property Damage, Personal And Advertising Injury) Insuring
Agreement
a.We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily
injury", "property damage" or "personal and advertising injury" to which this insurance applies. We will have
the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no
duty to defend the insured against any "suit" seeking damages for "bodily injury", "property damage" or
"personal and advertising injury" to which this insurance does not apply.
We may, at our discretion, investigate any "occurrence" or offense and settle any claim or "suit" that may
result. But:
(1)The amount we will pay for damages is limited as described in Section D.Liability And Medical Expenses
Limits Of Insurance; and
(2)Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment
of judgments, settlements or medical expenses to which this insurance applies.
No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for
under Coverage Extension - Supplementary Payments.
b.This insurance applies:
(1)To "bodily injury" and "property damage" only if:
(a)The “bodily injury” or “property damage” is caused by an “occurrence” that takes place in the
“coverage territory”;
(b)The "bodily injury" or "property damage" occurs during the policy period; and
(c)Prior to the policy period, no insured listed under Paragraph 1.of Section C.Who Is An Insured and
no "employee" authorized by you to give or receive notice of an "occurrence" or claim, knew that the
"bodily injury" or "property damage" had occurred, in whole or in part. If such a listed insured or
authorized "employee" knew, prior to the policy period, that the "bodily injury" or "property damage"
occurred, then any continuation, change or resumption of such "bodily injury" or "property damage"
during or after the policy period will be deemed to have been known prior to the policy period.
(2)To "personal and advertising injury" caused by an offense arising out of your business, but only if the
offense was committed in the "coverage territory" during the policy period.
c."Bodily injury" or "property damage" will be deemed to have been known to have occurred at the earliest time
when any insured listed under Paragraph 1.of Section C.Who Is An Insured or any "employee" authorized by
you to give or receive notice of an "occurrence" or claim:
(1)Reports all, or any part, of the "bodily injury" or "property damage" to us or any other insurer;
(2)Receives a written or verbal demand or claim for damages because of the "bodily injury" or "property
damage"; or
Form SL 00 00 10 18 Page 2 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
(3)Becomes aware by any other means that "bodily injury" or "property damage" has occurred or has begun
to occur.
d.Damages because of "bodily injury" include damages claimed by any person or organization for care, loss of
services or death resulting at any time from the "bodily injury".
e. Incidental Medical Malpractice
(1)"Bodily injury" arising out of the rendering of or failure to render professional health care services as a
physician, dentist, nurse, emergency medical technician or paramedic shall be deemed to be caused by
an "occurrence", but only if:
(a)The physician, dentist, nurse, emergency medical technician or paramedic is employed by you to
provide such services; and
(b)You are not engaged in the business or occupation of providing such services.
(2)For the purpose of determining the limits of insurance for incidental medical malpractice, any act or
omission together with all related acts or omissions in the furnishing of these services to any one person
will be considered one "occurrence".
2. Medical Expenses
Insuring Agreement
a.We will pay medical expenses as described below for "bodily injury" caused by an accident:
(1)On premises you own or rent;
(2)On ways next to premises you own or rent; or
(3)Because of your operations;
provided that:
(1)The accident takes place in the "coverage territory" and during the policy period;
(2)The expenses are incurred and reported to us within three years of the date of the accident; and
(3)The injured person submits to examination, at our expense, by physicians of our choice as often as we
reasonably require.
b.We will make these payments regardless of fault. These payments will not exceed the applicable limit of
insurance. We will pay reasonable expenses for:
(1)First aid administered at the time of an accident;
(2)Necessary medical, surgical, x-ray and dental services, including prosthetic devices; and
(3)Necessary ambulance, hospital, professional nursing and funeral services.
3. Coverage Extension - Supplementary Payments
a.We will pay, with respect to any claim we investigate or settle, or any "suit" against an insured we defend:
(1)All expenses we incur.
(2)Up to $1,000 for the cost of bail bonds required because of accidents or traffic law violations arising out of
the use of any vehicle to which Business Liability Coverage for "bodily injury" applies. We do not have to
furnish these bonds.
(3)The cost of appeal bonds or bonds to release attachments, but only for bond amounts within the
applicable limit of insurance. We do not have to furnish, finance, arrange for, guarantee, or collateralize
these bonds, whether the collateralization is characterized as premium or not.
(4)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.
(5)All court costs taxed against the insured in the "suit". However, such costs do not include attorneys’ fees,
attorneys’ expenses, witness or expert fees, or any other expenses of a party taxed against the insured.
(6)Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an
offer to pay the applicable limit of insurance, we will not pay any prejudgment interest based on that
period of time after the offer.
Form SL 00 00 10 18 Page 3 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
(7)All interest on the full amount of any judgment that accrues after entry of the judgment and before we
have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable limit
of insurance.
Any amounts paid under (1) through (7) above will not reduce the Limits of Insurance.
b.If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the
"suit", we will defend that indemnitee if all of the following conditions are met:
(1)The "suit" against the indemnitee seeks damages for which the insured has assumed the liability of the
indemnitee in a contract or agreement that is an "insured contract";
(2)This insurance applies to such liability assumed by the insured;
(3)The obligation to defend, or the cost of the defense of, that indemnitee, has also been assumed by the
insured in the same "insured contract";
(4)The allegations in the "suit" and the information we know about the "occurrence" are such that no conflict
appears to exist between the interests of the insured and the interest of the indemnitee;
(5)The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against
such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee; and
(6)The indemnitee:
(a)Agrees in writing to:
(i)Cooperate with us in the investigation, settlement or defense of the "suit";
(ii)Immediately send us copies of any demands, notices, summonses or legal papers received in
connection with the "suit";
(iii)Notify any other insurer whose coverage is available to the indemnitee; and
(iv)Cooperate with us with respect to coordinating other applicable insurance available to the
indemnitee; and
(b)Provides us with written authorization to:
(i)Obtain records and other information related to the "suit"; and
(ii)Conduct and control the defense of the indemnitee in such "suit".
So long as the above conditions are met, attorneys' fees incurred by us in the defense of that indemnitee,
necessary litigation expenses incurred by us and necessary litigation expenses incurred by the
indemnitee at our request will be paid as Supplementary Payments.
Notwithstanding the provisions of Paragraph 1.b.(b)of Section B.Exclusions, such payments will not be
deemed to be damages for "bodily injury" and "property damage" and will not reduce the Limits of
Insurance.
Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary litigation
expenses as Supplementary Payments ends when:
(1)We have used up the applicable limit of insurance in the payment of judgments or settlements; or
(2)The conditions set forth above, or the terms of the agreement described in Paragraph (6)above, are no
longer met.
B. EXCLUSIONS
1. Applicable To Business Liability Coverage
This insurance does not apply to:
a. Expected Or Intended Injury
(1)"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; or
(2)"Personal and advertising injury" arising out of an offense committed by, at the direction of or with the
consent or acquiescence of the insured with the expectation of inflicting "personal and advertising injury".
Form SL 00 00 10 18 Page 4 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
b. Contractual Liability
(1)"Bodily injury" or "property damage"; or
(2)"Personal and advertising injury"
for which the insured 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 because of:
(a)"Bodily injury", "property damage" or "personal and advertising injury" that the insured would have in
the absence of the contract or agreement; or
(b)"Bodily injury" or "property damage" assumed in a contract or agreement that is an "insured contract",
provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract
or agreement. Solely for the purpose of liability assumed in an "insured contract", reasonable
attorneys' fees and necessary litigation expenses incurred by or for a party other than an insured are
deemed to be damages because of "bodily injury" or "property damage" provided:
(i)Liability to such party for, or for the cost of, that party’s defense has also been assumed in the
same "insured contract"; and
(ii)Such attorneys' 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.
c. Liquor Liability
"Bodily injury" or "property damage" for which any insured may be held liable by reason of:
(1)Causing or contributing to the intoxication of any person;
(2)The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of
alcohol;
(3)Providing or failing to provide transportation with respect to any person that may be under the influence of
alcohol; or
(4)Any statute, ordinance or regulation relating to the sale, gift, distribution or use of alcoholic beverages.
This exclusion applies even if the claims allege negligence or other wrongdoing in the supervision, hiring,
employment, training or monitoring of others by an insured, if the “bodily injury” or “property damage” involved
that which is described in Paragraph (1), (2), (3) or (4) above.
However, this exclusion applies only if you are in the business of manufacturing, distributing, selling, serving
or furnishing alcoholic beverages. For the purposes of this exclusion, permitting a person to bring alcoholic
beverages on your premises, for consumption on your premises, whether or not a fee is charged or a license
is required for such activity, is not by itself considered the business of selling, serving, or furnishing alcoholic
beverages.
d. Workers' Compensation And Similar Laws
Any obligation of the insured under a workers' compensation, disability benefits or unemployment
compensation law or any similar law.
e. Employer’s Liability
"Bodily injury" to:
(1)An "employee" of the insured arising out of and in the course of:
(a)Employment by the insured; or
(b)Performing duties related to the conduct of the insured’s business; or
(2)The spouse, child, parent, brother or sister of that "employee" as a consequence of (1) above.
This exclusion applies:
(1)Whether the insured may be liable as an employer or in any other capacity; and
(2)To any obligation to share damages with or repay someone else who must pay damages because of the
injury.
Form SL 00 00 10 18 Page 5 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
This exclusion does not apply to liability assumed by the insured under an "insured contract".
f. Pollution
(1)"Bodily injury", "property damage" or "personal and advertising injury" arising out of the actual, alleged or
threatened discharge, dispersal, seepage, migration, release or escape of "pollutants":
(a)At or from any premises, site or location which is or was at any time owned or occupied by, or rented
or loaned to any insured. However, this paragraph does not apply to:
(i)"Bodily injury" if sustained within a building and caused by smoke, fumes, vapor or soot produced
by or originating from equipment that is used to heat, cool or dehumidify the building, or
equipment that is used to heat water for personal use, by the building's occupants or their guests;
(ii)"Bodily injury" or "property damage" for which you may be held liable, if you are a contractor and
the owner or lessee of such premises, site or location has been added to this Coverage Part as
an additional insured with respect to your ongoing operations performed for that additional
insured at that premises, site or location and such premises, site or location is not and never was
owned or occupied by, or rented or loaned to, any insured, other than that additional insured; or
(iii)"Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire";
(b)At or from any premises, site or location which is or was at any time used by or for any insured or
others for the handling, storage, disposal, processing or treatment of waste;
(c)Which are or were at any time transported, handled, stored, treated, disposed of, or processed as
waste by or for:
(i)Any insured; or
(ii)Any person or organization for whom you may be legally responsible;
(d)At or from any premises, site or location on which any insured or any contractors or subcontractors
working directly or indirectly on any insured's behalf are performing operations if the "pollutants" are
brought on or to the premises, site or location in connection with such operations by such insured,
contractor or subcontractor. However, this paragraph does not apply to:
(i)"Bodily injury" or "property damage" arising out of the escape of fuels, lubricants or other
operating fluids which are needed to perform the normal electrical, hydraulic or mechanical
functions necessary for the operation of "mobile equipment" or its parts, if such fuels, lubricants or
other operating fluids escape from a vehicle part designed to hold, store or receive them. This
exception does not apply if the "bodily injury" or "property damage" arises out of the intentional
discharge, dispersal or release of the fuels, lubricants or other operating fluids, or if such fuels,
lubricants or other operating fluids are brought on or to the premises, site or location with the
intent that they be discharged, dispersed or released as part of the operations being performed
by such insured, contractor or subcontractor;
(ii)"Bodily injury" or "property damage" sustained within a building and caused by the release of
gases, fumes or vapors from materials brought into that building in connection with operations
being performed by you or on your behalf by a contractor or subcontractor; or
(iii)"Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire"; or
(e)At or from any premises, site or location on which any insured or any contractors or subcontractors
working directly or indirectly on any insured’s behalf are performing operations if the operations are to
test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or
assess the effects of, "pollutants".
(2)Any loss, cost or expense arising out of any:
(a)Request, demand, order or statutory or regulatory requirement that any insured or others test for,
monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess
the effects of, "pollutants"; or
(b)Claim or “suit” by or on behalf of a governmental authority for damages because of testing for,
monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way
responding to, or assessing the effects of, "pollutants".
Form SL 00 00 10 18 Page 7 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
i. War
"Bodily injury", "property damage" or "personal and advertising injury", however caused, arising, directly or
indirectly, out of:
(1)War, including undeclared or civil war;
(2)Warlike action by a military force, including action in hindering or defending against an actual or expected
attack, by any government, sovereign or other authority using military personnel or other agents; or
(3)Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering
or defending against any of these.
j. Professional Services
"Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure
to render any professional service. This includes but is not limited to:
(1)Legal, accounting or advertising services;
(2)Preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders, change orders, designs or drawings and specifications;
(3)Supervisory, inspection, architectural or engineering activities;
(4)Medical, surgical, dental, x-ray or nursing services, treatment, advice or instruction;
(5)Any health or therapeutic service treatment, advice or instruction;
(6)Any service, treatment, advice or instruction for the purpose of appearance or skin enhancement, hair
removal or replacement or personal grooming;
(7)Optical or hearing aid services including the prescribing, preparation, fitting, demonstration or distribution
of ophthalmic lenses and similar products or hearing aid devices;
(8)Optometry or optometric services including but not limited to examination of the eyes and the prescribing,
preparation, fitting, demonstration or distribution of ophthalmic lenses and similar products;
(9)Any:
(a)Body piercing (not including ear piercing);
(b)Tattooing, including but not limited to the insertion of pigments into or under the skin; and
(c)Similar services;
(10)Pharmaceutical services including but not limited to:
(a)The administering, prescribing, preparing, distributing or compounding of pharmaceutical drugs,
vaccinations, immunizations or any of their component parts;
(b)The providing of or failure to provide home health care or home infusion products or services; and
(c)Advising and consulting customers;
(11)Computer consulting, design or programming services, including web site design.
This exclusion applies even if the claims allege negligence or other wrongdoing in the supervision, hiring,
employment, training or monitoring of others by an insured, if the “bodily injury”, “property damage”, or
“personal and advertising injury” arises out of the rendering of or the failure to render any professional
service.
Paragraphs (4)and (5)of this exclusion do not apply to the Incidental Medical Malpractice coverage afforded
under Paragraph 1.e. in Section A. Coverages.
k. Damage To Property
"Property damage" to:
(1)Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person,
organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property
for any reason, including prevention of injury to a person or damage to another's property;
(2)Premises you sell, give away or abandon, if the "property damage" arises out of any part of those
premises;
Form SL 00 00 10 18 Page 6 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
However, this paragraph does not apply to liability for damages because of "property damage" that the
insured would have in the absence of such request, demand, order or statutory or regulatory requirement,
or such claim or "suit" by or on behalf of a governmental authority.
g. Aircraft, Auto Or Watercraft
(1) Unmanned Aircraft
"Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to
others of any aircraft that is an "unmanned aircraft". Use includes operation and "loading or unloading".
This Exclusion g.(1)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 "bodily injury”
or “property damage” arises out of the ownership, maintenance, use or entrustment to others of any
aircraft that is an "unmanned aircraft".
(2) Aircraft (Other Than Unmanned Aircraft), Auto or Watercraft
"Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to
others of any aircraft (other than “unmanned aircraft”), "auto" or watercraft owned or operated by or
rented or loaned to any insured. Use includes operation and "loading or unloading".
This Exclusion g.(2)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 "bodily injury"
or "property damage" arises out of the ownership, maintenance, use or entrustment to others of any
aircraft (other than “unmanned aircraft”), "auto" or watercraft that is owned or operated by or rented or
loaned to any insured.
This Exclusion g.(2) does not apply to:
(a)A watercraft while ashore on premises you own or rent;
(b)A watercraft you do not own that is:
(i)Less than 51 feet long; and
(ii)Not being used to carry persons or property for a charge;
(c)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;
(d)Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft
(other than “unmanned aircraft”) or watercraft;
(e)"Bodily injury" or "property damage" arising out of:
(i)The operation of any of the machinery or equipment listed in Paragraph f.(2)or f.(3)of the
definition of "mobile equipment"; or
(ii)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 or motor vehicle registration law where it is
licensed or principally garaged; or
(f)An aircraft (other than “unmanned aircraft”) that is not owned by any insured and is hired, chartered
or loaned with a paid crew. However, this exception does not apply if the insured has any other
insurance for such "bodily injury" or "property damage", whether the other insurance is primary,
excess, contingent or on any other basis.
h. Mobile Equipment
"Bodily injury" or "property damage" arising out of:
(1)The transportation of "mobile equipment" by an "auto" owned or operated by or rented or loaned to any
insured; or
(2)The use of “mobile equipment” in, or while in practice or preparation for, a prearranged racing, speed or
demolition contest or in any stunting activity.
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© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
(3)Property loaned to you;
(4)Personal property in the care, custody or control of the insured;
(5)That particular part of real property on which you or any contractors or subcontractors working directly or
indirectly on your behalf are performing operations, if the "property damage" arises out of those
operations; or
(6)That particular part of any property that must be restored, repaired or replaced because "your work" was
incorrectly performed on it.
Paragraphs (1),(3)and (4)of this exclusion do not apply to "property damage" (other than damage by
fire) to premises, including the contents of such premises, rented to you for a period of 7 or fewer
consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as
described in Section D. Limits Of Insurance.
Paragraph (2)of this exclusion does not apply if the premises are "your work" and were never occupied,
rented or held for rental by you.
Paragraphs (3) and (4) of this exclusion do not apply to the use of elevators.
Paragraphs (3),(4),(5)and (6)of this exclusion do not apply to liability assumed under a sidetrack
agreement.
Paragraphs (3)and (4)of this exclusion do not apply to "property damage" to borrowed equipment while
not being used to perform operations at a job site.
Paragraph (6)of this exclusion does not apply to "property damage" included in the "products-completed
operations hazard".
l. Damage To Your Product
"Property damage" to "your product" arising out of it or any part of it.
m. Damage To Your Work
"Property damage" to "your work" arising out of it or any part of it and included in the "products-completed
operations hazard".
This exclusion does not apply if the damaged work or the work out of which the damage arises was
performed on your behalf by a subcontractor.
n. Damage To Impaired Property Or Property Not Physically Injured
"Property damage" to "impaired property" or property that has not been physically injured, arising out of:
(1)A defect, deficiency, inadequacy or dangerous condition in "your product" or "your work"; or
(2)A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in
accordance with its terms.
This exclusion does not apply to the loss of use of other property arising out of sudden and accidental
physical injury to "your product" or "your work" after it has been put to its intended use.
o. Recall Of Products, Work Or Impaired Property
Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal,
recall, inspection, repair, replacement, adjustment, removal or disposal of:
(1)"Your product";
(2)"Your work"; or
(3)"Impaired property";
if such product, work or property is withdrawn or recalled from the market or from use by any person or
organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it.
p. Personal And Advertising Injury
"Personal and advertising injury":
(1)Arising out of oral, written, electronic, or any other manner of publication of material, if done by or at the
direction of the insured with knowledge of its falsity;
Form SL 00 00 10 18 Page 9 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
(2)Arising out of oral, written, electronic, or any other manner of publication of material whose first
publication took place before the beginning of the policy period;
(3)Arising out of a criminal act committed by or at the direction of the insured;
(4)Arising out of any breach of contract, except an implied contract to use another’s "advertising idea" in
your "advertisement";
(5)Arising out of the failure of goods, products or services to conform with any statement of quality or
performance made in your "advertisement";
(6)Arising out of the wrong description of the price of goods, products or services;
(7)Arising out of:
(a)Any actual or alleged infringement or violation of any intellectual property rights, such as copyright,
patent, right of publicity, trademark, trade dress, trade name, trade secret, service mark or other
designation of origin or authenticity; or
(b)Any injury or damage alleged in any claim or “suit” that also alleges an infringement or violation of any
intellectual property right, whether such allegation of infringement or violation is made against you, or
by you or by any other party involved in the claim or “suit”, regardless of whether this insurance would
otherwise apply.
However, this exclusion does not apply if the only allegation in the claim or “suit” involving any intellectual
property right is limited to:
(i)Infringement, in your “advertisement”, of:
a.Copyright;
b.Slogan; unless the slogan is also a trademark, trade dress, trade name, service mark or other
designation of origin or authenticity; or
c.Title of any literary or artistic work; or
(ii)Copying, in your “advertisement”, a person’s or organization’s “advertising idea” or style of
“advertisement”.
Paragraph (7)(b)ii above shall not apply to claims or “suits” alleging infringement or violation of trademark,
trade dress, trade name, service mark or other designation of origin or authenticity.
(8)Arising out of an offense committed by an insured whose business is:
(a)Advertising, broadcasting, publishing or telecasting;
(b)Designing or determining content of web sites for others; or
(c)An Internet search, access, content or service provider.
However, this exclusion does not apply to Paragraphs a., b.and c.under the definition of "personal and
advertising injury" in Section F. Liability And Medical Expenses Definitions.
For the purposes of this exclusion, the placing of frames, borders, or links, or advertising, for you or
others anywhere on the Internet, is not by itself, considered the business of advertising, broadcasting,
publishing or telecasting;
(9)Arising out of an electronic chat room or bulletin board the insured hosts, owns, or over which the insured
exercises control;
(10)Arising out of the unauthorized use of another's name or product in your e-mail address, domain name or
metatags, or any other similar tactics to mislead another's potential customers;
(11)Arising out of the violation of a person's right of privacy created by any state or federal act.
However, this exclusion does not apply to liability for damages that the insured would have in the
absence of such state or federal act;
(12)Arising out of:
(a)Advertising content for others on your web site;
(b)Placing a link to a web site of others on your web site;
Form SL 00 00 10 18 Page 10 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
(c)Content from a web site of others displayed within a frame or border on your web site. Content
includes information, code, sounds, text, graphics or images; or
(d)Computer code, software or programming used to enable:
(i)Your web site; or
(ii)The presentation or functionality of an "advertisement" or other content on your web site;
(13)Arising out of a violation of any anti-trust law;
(14)Arising out of the fluctuation in price or value of any stocks, bonds or other securities;
(15)Arising out of any access to or disclosure of any person's or organization's confidential or personal
information, including patents, trade secrets, processing methods, customer lists, financial information,
credit card information, health information or any other type of nonpublic information.
This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses,
forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others
arising out of any access to or disclosure of any person's or organization's confidential or personal
information; or
(16)Arising out of the ownership, maintenance, use or entrustment to others of any aircraft that is an
"unmanned aircraft". 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 "personal and
advertising injury" arises out of the ownership, maintenance, use or entrustment to others of any aircraft
that is an "unmanned aircraft".
However, this exclusion does not apply if the only allegation in the claim or "suit" involves an intellectual
property right which is limited to:
(a)Infringement, in your "advertisement", of:
(i)Copyright;
(ii)Slogan; or
(iii)Title of any literary or artistic work; or
(b)Copying, in your "advertisement", a person's or organization's "advertising idea" or style of
"advertisement".
q. Access Or Disclosure Of Confidential Or Personal Information And Data-Related Liability
(1)Damages because of “bodily injury” or “property damage” arising out of any access to or disclosure of any
person’s or organization’s confidential or personal information, including patents, trade secrets,
processing methods, customer lists, financial information, credit card information, health information or
any other type of nonpublic information; or
(2)Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability
to manipulate "electronic data".
This exclusion applies even if such damages are claimed for notification costs, credit monitoring expenses,
forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others
arising out of that which is described in Paragraphs (1) or (2) above.
However, unless Paragraph (1)above applies, this exclusion does not apply to damages because of “bodily
injury”.
r. Employment-Related Practices
"Bodily injury" or "personal and advertising injury" to:
(1)A person arising out of any:
(a)Refusal to employ that person;
(b)Termination of that person's employment; or
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© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
(c)Employment-related practices, policies, acts or omissions, such as coercion, demotion, evaluation,
reassignment, discipline, defamation, harassment, humiliation, discrimination, malicious prosecution
or false arrest directed at that person; or
(2)The spouse, child, parent, brother or sister of that person as a consequence of "bodily injury" or "personal
and advertising injury" to that person at whom any of the employment-related practices described in
Paragraphs (a), (b), or (c)above is directed.
This exclusion applies:
(1)Whether the injury-causing event described in Paragraphs (a),(b), or (c)above occurs before
employment, during employment or after employment of that person;
(2)Whether the insured may be liable as an employer or in any other capacity; and
(3)To any obligation to share damages with or repay someone else who must pay damages because of the
injury.
s. Asbestos
(1)"Bodily injury", "property damage" or "personal and advertising injury" arising out of the "asbestos
hazard".
(2)Any damages, judgments, settlements, loss, costs or expenses that:
(a)May be awarded or incurred by reason of any claim or “suit” alleging actual or threatened injury or
damage of any nature or kind to persons or property which would not have occurred in whole or in
part but for the "asbestos hazard";
(b)Arise out of any request, demand, order or statutory or regulatory requirement that any insured or
others test for, monitor, clean up, remove, encapsulate, contain, treat, detoxify or neutralize or in any
way respond to or assess the effects of an "asbestos hazard"; or
(c)Arise out of any claim or “suit” for damages because of testing for, monitoring, cleaning up, removing,
encapsulating, containing, treating, detoxifying or neutralizing or in any way responding to or
assessing the effects of an "asbestos hazard".
t. Recording And Distribution Of Material Or Information In Violation Of Law
"Bodily injury", "property damage", or "personal and advertising injury" arising directly or indirectly out of any
action or omission that violates or is alleged to violate:
(1)The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law;
(2)The CAN-SPAM Act of 2003, including any amendment of or addition to such law;
(3)The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair
and Accurate Credit Transaction Act (FACTA); or
(4)Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN-SPAM Act of 2003
or FCRA and their amendments and additions, that addresses, prohibits or limits the printing,
dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of
material or information.
Damage To Premises Rented To You – Exception For Damage By Fire, Lightning Or Explosion
Exclusions c.through h.and k.through o.do not apply to damage by fire, lightning or explosion to premises
rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies
to this coverage as described in Section D. Liability And Medical Expenses Limits Of Insurance.
2. Applicable To Medical Expenses Coverage
We will not pay expenses for "bodily injury":
a. Any Insured
To any insured, except "volunteer workers".
b. Hired Person
To a person hired to do work for or on behalf of any insured or a tenant of any insured.
Form SL 00 00 10 18 Page 12 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
c. Injury On Normally Occupied Premises
To a person injured on that part of premises you own or rent that the person normally occupies.
d. Workers' Compensation And Similar Laws
To a person, whether or not an "employee" of any insured, if benefits for the "bodily injury" are payable or
must be provided under a workers' compensation or disability benefits law or a similar law.
e. Athletics Activities
To a person injured while practicing, instructing or participating in any physical exercises or games, sports or
athletic contests.
f. Products-Completed Operations Hazard
Included with the "products-completed operations hazard".
g. Business Liability Exclusions
Excluded under Business Liability Coverage.
C. WHO IS AN INSURED
1.If you are designated in the Declarations as:
a.An individual, you and your spouse are insureds, but only with respect to the conduct of a business, other
than that described in b. through e. below, of which you are the sole owner.
b.A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also
insureds, but only with respect to the conduct of your business.
c.A limited liability company, you are an insured. Your members are also insureds, but only with respect to the
conduct of your business. Your managers are insureds, but only with respect to their duties as your
managers.
d.An organization other than a partnership, joint venture or limited liability company, you are an insured. Your
"executive officers" and directors are insureds, but only with respect to their duties as your officers or
directors. Your stockholders are also insureds, but only with respect to their liability as stockholders.
e.A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees.
2.Each of the following is also an insured:
a. Employees And Volunteer Workers
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), or 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 that "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.
If you are not in the business of providing professional health care services, Paragraph (d)does not apply
to any nurse, emergency medical technician or paramedic employed by you to provide such services.
(2)"Property damage" to property:
Form SL 00 00 10 18 Page 13 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
(a)Owned, occupied or used by:
(b)Rented to, in the care, custody or control of, or over which physical control is being exercised for any
purpose by you, any of your "employees", "volunteer workers", any partner or member (if you are a
partnership or joint venture), or any member (if you are a limited liability company).
b. Real Estate Manager
Any person (other than your "employee" or "volunteer worker"), or any organization while acting as your real
estate manager.
c. Temporary Custodians Of Your Property
Any person or organization having proper temporary custody of your property if you die, but only:
(1)With respect to liability arising out of the maintenance or use of that property; and
(2)Until your legal representative has been appointed.
d. Legal Representative If You Die
Your legal representative if you die, but only with respect to duties as such. That representative will have all
your rights and duties under this insurance.
e. Unnamed Subsidiary
Any subsidiary and subsidiary thereof, of yours which is a legally incorporated entity of which you own a
financial interest of more than 50% of the voting stock on the effective date of this Coverage Part.
The insurance afforded herein for any subsidiary not shown in the Declarations as a named insured does not
apply to injury or damage with respect to which an insured under this insurance is also an insured under
another policy or would be an insured under such policy but for its termination or upon the exhaustion of its
limits of insurance.
3. Newly Acquired Or Formed Organization
Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company,
and over which you maintain financial interest of more than 50% of the voting stock, 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; and
b.Coverage under this provision does not apply to:
(1)"Bodily injury" or "property damage" that occurred; or
(2)"Personal and advertising injury" arising out of an offense committed
before you acquired or formed the organization.
4. Operator Of Mobile Equipment
With respect to "mobile equipment" any person is an insured while driving such equipment along a public highway
with your permission. Any other person or organization responsible for the conduct of such person is also an
insured, but only with respect to liability arising out of the operation of the equipment, and only if no other
insurance of any kind is available to that person or organization for this liability. However, no person or
organization is an insured with respect to:
a."Bodily injury" to a co-"employee" of the person driving the equipment; or
b."Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of
any person who is an insured under this provision.
5. Operator Of Nonowned Watercraft
With respect to watercraft you do not own that is less than 51 feet long and is not being used to carry persons or
property for a charge, any person is an insured while operating such watercraft with your permission. Any other
person or organization responsible for the conduct of such person is also an insured, but only with respect to
liability arising out of the operation of the watercraft, and only if no other insurance of any kind is available to that
person or organization for this liability.
However, no person or organization is an insured with respect to:
Form SL 00 00 10 18 Page 14 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
a."Bodily injury" to a co-"employee" of the person operating the watercraft; or
b."Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of
any person who is an insured under this provision.
No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or
limited liability company that is not shown as a Named Insured in the Declarations.
D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE
1. The Most We Will Pay
The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the
number of:
a.Insureds;
b.Claims made or "suits" brought; or
c.Persons or organizations making claims or bringing "suits".
2. Aggregate Limits
The most we will pay for:
a.Damages because of "bodily injury" and "property damage" included in the "products-completed operations
hazard" is the Products-Completed Operations Aggregate Limit shown in the Declarations.
b.Damages because of all other "bodily injury", "property damage" or "personal and advertising injury",
including medical expenses, is the General Aggregate Limit shown in the Declarations.
This General Aggregate limit does not apply to "property damage" to premises while rented to you or
temporarily occupied by you with permission of the owner, arising out of fire, lightning or explosion.
3. Each Occurrence Limit
Subject to 2.a.or 2.b above, whichever applies, the most we will pay for the sum of all damages because of all
"bodily injury", "property damage" and medical expenses arising out of any one "occurrence" is the Liability and
Medical Expenses Limit shown in the Declarations.
The most we will pay for all medical expenses because of "bodily injury" sustained by any one person is the
Medical Expenses Limit shown in the Declarations.
4. Personal And Advertising Injury Limit
Subject to 2.b.above, the most we will pay for the sum of all damages because of all "personal and advertising
injury" sustained by any one person or organization is the Personal and Advertising Injury Limit shown in the
Declarations.
5. Damage To Premises Rented To You Limit
The Damage To Premises Rented To You Limit is the most we will pay under Business Liability Coverage for
damages because of "property damage" to any one premises, while rented to you, or in the case of damage by
fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner.
In the case of damage by fire, lightning or explosion, the Damage to Premises Rented To You Limit applies to all
damage proximately caused by the same event, whether such damage results from fire, lightning or explosion or
any combination of these.
6. How Limits Apply To Additional Insureds
The most we will pay on behalf of a person or organization who is an additional insured under this Coverage Part
is the lesser of:
a.The limits of insurance required in a written contract, written agreement or permit; or
b.The Limits of Insurance shown in the Declarations.
Such amount shall be a part of and not in addition to the Limits of Insurance shown in the Declarations and
described in this Section.
If more than one limit of insurance under this Policy and any endorsements attached thereto applies to any claim or
"suit", the most we will pay under this Policy and the endorsements is the single highest limit of liability of all
Form SL 00 00 10 18 Page 15 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
coverages applicable to such claim or "suit". However, this paragraph does not apply to the Medical Expenses limit
set forth in Paragraph 3. above.
The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any
remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations,
unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the
additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance.
E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS
1. Bankruptcy
Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this
Coverage Part.
2. Duties In The Event Of Occurrence, Offense, Claim Or Suit
a. Notice Of Occurrence Or Offense
You or any additional insured under this Coverage Part must see to it that we are notified as soon as
practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should
include:
(1)How, when and where the "occurrence" or offense took place;
(2)The names and addresses of any injured persons and witnesses; and
(3)The nature and location of any injury or damage arising out of the "occurrence" or offense.
b. Notice Of Claim
If a claim is made or "suit" is brought against any insured, you or any additional insured under this Coverage
Part must:
(1)Immediately record the specifics of the claim or "suit" and the date received; and
(2)Notify us as soon as practicable.
You or any additional insured under this Coverage Part must see to it that we receive a written notice of the
claim or "suit" as soon as practicable.
c. Assistance And Cooperation Of The Insured
You and any other involved insured must:
(1)Immediately send us copies of any demands, notices, summonses or legal papers received in connection
with the claim or “suit”;
(2)Authorize us to obtain records and other information;
(3)Cooperate with us in the investigation, settlement of the claim or defense against the "suit"; and
(4)Assist us, upon our request, in the enforcement of any right against any person or organization that may
be liable to the insured because of injury or damage to which this insurance may also apply.
d. Obligations At The Insured's Own Cost
No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or
incur any expense, other than for first aid, without our consent.
e. Additional Insured's Other Insurance
If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available
to an additional insured under this Coverage Part, such additional insured must submit such claim or "suit" to
the other insurer for defense and indemnity.
However, this provision does not apply to the extent that you have agreed in a written contract, written
agreement or permit that this insurance is primary and non-contributory with such additional insured's own
insurance.
f. Knowledge Of An Occurrence, Offense, Claim Or Suit
Paragraphs a.and b.apply to you or to any additional insured under this Coverage Part only when such
"occurrence", offense, claim or "suit" is known to:
Form SL 00 00 10 18 Page 16 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
(1)You or any additional insured under this Coverage Part that is an individual;
(2)Any partner, if you or an additional insured under this Coverage Part is a partnership;
(3)Any manager, if you or an additional insured under this Coverage Part is a limited liability company;
(4)Any "executive officer" or insurance manager, if you or an additional insured under this Coverage Part is a
corporation;
(5)Any trustee, if you or an additional insured under this Coverage Part is a trust; or
(6)Any elected or appointed official, if you or an additional insured under this Coverage Part is a political
subdivision or public entity.
This Paragraph f. applies separately to you and any additional insured under this Coverage Part.
3. Legal action Against Us
No person or organization has a right under this Coverage Part:
a.To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or
b.To sue us on this Coverage Part unless all of its terms have been fully complied with.
A person or organization may sue us to recover on an agreed settlement or on a final judgment against an
insured; but we will not be liable for damages that are not payable under the terms of this insurance or that are in
excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability
signed by us, the insured and the claimant or the claimant's legal representative.
4. Separation Of Insureds
Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Policy to the
first Named Insured, this insurance applies:
a.As if each Named Insured were the only Named Insured; and
b.Separately to each insured against whom a claim is made or "suit" is brought.
5. Representations
a. When You Accept This Policy
By accepting this Policy, you agree:
(1)The statements in the Declarations are accurate and complete;
(2)Those statements are based upon representations you made to us; and
(3)We have issued this Policy in reliance upon your representations.
b. Unintentional Failure To Disclose Hazards
If unintentionally you should fail to disclose all hazards relating to the conduct of your business at the
inception date of this Coverage Part, we shall not deny any coverage under this Coverage Part because of
such failure.
6. Other Insurance
If other valid and collectible insurance is available for a loss we cover under this Coverage Part, our obligations
are limited as follows:
a. Primary Insurance
This insurance is primary except when b.below applies. If other insurance is also primary, we will share with
all that other insurance by the method described in c. below.
b. Excess Insurance
This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other
basis:
(1) Your Work
That is Fire, Extended Coverage, Builder's Risk, Installation Risk, Owner Controlled Insurance Program
or OCIP, Contractor Controlled Insurance Program or CCIP, Wrap Up Insurance or similar coverage for
"your work";
Form SL 00 00 10 18 Page 17 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
(2) Premises Rented To You
That is fire, lightning or explosion insurance for premises rented to you or temporarily occupied by you
with permission of the owner;
(3) Tenant Liability
That is insurance purchased by you 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;
(4) Aircraft, Auto Or Watercraft
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 B. Exclusions.
(5) Property Damage To Borrowed Equipment Or Use Of Elevators
If the loss arises out of "property damage" to borrowed equipment or the use of elevators to the extent not
subject to Exclusion k.of Section B. Exclusions.
(6) When You Are Added As An Additional Insured To Other Insurance
That is other insurance available to you covering liability for damages arising out of the premises or
operations, or products and completed operations, for which you have been added as an additional
insured by that insurance; or
(7) When You Add Others As An Additional Insured To This Insurance
That is other insurance available to an additional insured.
However, the following provisions apply to other insurance available to any person or organization who is
an additional insured under this Coverage Part:
(a) Primary Insurance When Required By Contract
This insurance is primary if you have agreed in a written contract, written agreement or permit that
this insurance be primary. If other insurance is also primary, we will share with all that other insurance
by the method described in c. below.
(b) Primary And Non-Contributory To Other Insurance When Required By Contract
If you have agreed in a written contract, written agreement or permit that this insurance is primary and
non-contributory with the additional insured's own insurance, this insurance is primary and we will not
seek contribution from that other insurance.
Paragraphs (a)and (b)do not apply to other insurance to which the additional insured has been added as
an additional insured.
When this insurance is excess, we will have no duty under this Coverage Part to defend the insured against
any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends,
we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers.
When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if
any, that exceeds the sum of:
(1)The total amount that all such other insurance would pay for the loss in the absence of this insurance;
and
(2)The total of all deductible and self-insured amounts under all that other insurance.
We will share the remaining loss, if any, with any other insurance that is not described in this Excess
Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in
the Declarations of this Coverage Part.
c. Method Of Sharing
If all the other insurance permits contribution by equal shares, we will follow this method also. Under this
approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of
the loss remains, whichever comes first.
Form SL 00 00 10 18 Page 18 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under
this method, each insurer’s share is based on the ratio of its applicable limit of insurance to the total
applicable limits of insurance of all insurers.
7. Transfer Of Rights Of Recovery Against Others To Us
a. Transfer Of Rights Of Recovery
If the insured has rights to recover all or part of any payment, including Supplementary Payments, 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. This condition does not apply to Medical Expenses Coverage.
b. Waiver Of Rights Of Recovery (Waiver Of Subrogation)
If the insured has waived any rights of recovery against any person or organization for all or part of any
payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that
right, provided the insured waived their rights of recovery against such person or organization in a contract,
agreement or permit that was executed prior to the injury or damage.
F. LIABILITY AND MEDICAL EXPENSES DEFINITIONS
1."Advertisement" means a notice that is broadcast or published to the general public or specific market segments
about your goods, products or services for the purpose of attracting customers or supporters. For the purpose of
this definition:
a.Notices that are published include material placed on the Internet or on similar electronic means of
communication; and
b.Regarding web sites, only that part of a web site that is about your goods, products or services for the
purpose of attracting customers or supporters is considered an advertisement.
2."Advertising idea" means any idea for an "advertisement".
3."Asbestos hazard" means an exposure or threat of exposure to the actual or alleged properties of asbestos and
includes the mere presence of asbestos in any form.
4."Auto" means:
a.A land motor vehicle, trailer or semi-trailer designed for travel on public roads, including any attached
machinery or equipment; or
b.Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle
insurance or motor vehicle registration law where it is licensed or principally garaged.
However, "auto" does not include "mobile equipment".
5."Bodily injury" means physical:
a.Injury;
b.Sickness; or
c.Disease
sustained by a person and, if arising out of the above, mental anguish or death at any time.
6."Coverage territory" means:
a.The United States of America (including its territories and possessions), Puerto Rico and Canada;
b.International waters or airspace, but only if the injury or damage occurs in the course of travel or
transportation between any places included in a. above;
c.All other parts of the world if the injury or damage arises out of:
(1)Goods or products made or sold by you in the territory described in a. above;
(2)The activities of a person whose home is in the territory described in a.above, but is away for a short time
on your business; or
Form SL 00 00 10 18 Page 19 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
(3)"Personal and advertising injury" offenses that take place through the Internet or similar electronic means
of communication.
provided the insured's responsibility to pay damages is determined in the United States of America (including its
territories and possessions), Puerto Rico or Canada, in a "suit" on the merits according to the substantive law in
such territory, or in a settlement we agree to.
7."Electronic data" means information, facts or computer programs stored as or on, created or used on, or
transmitted to or from computer software (including systems and applications software), on hard or floppy disks,
CD-ROMs, tapes, drives, cells, data processing devices or any other repositories of computer software which are
used with electronically controlled equipment. The term computer programs, referred to in the foregoing
description of “electronic data”, means a set of related electronic instructions which direct the operations and
functions of a computer or device connected to it, which enable the computer or device to receive, process, store,
retrieve or send data.
8."Employee" includes a "leased worker". "Employee" does not include a "temporary worker".
9."Executive officer" means a person holding any of the officer positions created by your charter, constitution, by-
laws or any other similar governing document.
10."Hostile fire" means one which becomes uncontrollable or breaks out from where it was intended to be.
11."Impaired property" means tangible property, other than "your product" or "your work", that cannot be used or is
less useful because:
a.It incorporates "your product" or "your work" that is known or thought to be defective, deficient, inadequate or
dangerous; or
b.You have failed to fulfill the terms of a contract or agreement;
if such property can be restored to use by:
a.The repair, replacement, adjustment or removal of "your product" or "your work"; or
b.Your fulfilling the terms of the contract or agreement.
12."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 fire, lightning or explosion to premises while rented to
you or temporarily occupied by you with permission of the owner is subject to the Damage To Premises
Rented To You limit described in Section D. Liability And Medical Expenses Limits Of Insurance.
b.A sidetrack agreement;
c.Any easement or license agreement, including an easement or license agreement in connection with
construction or demolition operations on or within 50 feet of a railroad;
d.Any obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a
municipality;
e.An elevator maintenance agreement; or
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" or "property damage" 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.includes that part of any contract or agreement that indemnifies a railroad for "bodily injury" or
"property damage" arising out of construction or demolition operations within 50 feet of any railroad property
and affecting any railroad bridge or trestle, tracks, road-beds, tunnel, underpass or crossing.
However, 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, designs 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
Form SL 00 00 10 18 Page 20 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
(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 (1)
above and supervisory, inspection, architectural or engineering activities.
13."Leased worker" means a person leased to you by a labor leasing firm under an 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".
14."Loading or unloading" means the handling of property:
a.After it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or
"auto";
b.While it is in or on an aircraft, watercraft or "auto"; or
c.While it is being moved from an aircraft, watercraft or "auto" to the place where it is finally delivered;
but "loading or unloading" does not include the movement of property by means of a mechanical device, other
than a hand truck, that is not attached to the aircraft, watercraft or "auto".
15."Mobile equipment" means any of the following types of land vehicles, including any attached machinery or
equipment:
a.Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public roads;
b.Vehicles maintained for use solely on or next to premises you own or rent;
c.Vehicles that travel on crawler treads;
d.Vehicles, whether self-propelled or not, on which are permanently mounted:
(1)Power cranes, shovels, loaders, diggers or drills; or
(2)Road construction or resurfacing equipment such as graders, scrapers or rollers;
e.Vehicles not described in a., b., c.,or d.above that are not self-propelled and are maintained primarily to
provide mobility to permanently attached equipment of the following types:
(1)Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical
exploration, lighting and well servicing equipment; or
(2)Cherry pickers and similar devices used to raise or lower workers;
f.Vehicles not described in 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 are not "mobile
equipment" but will be considered "autos":
(1)Equipment, of at least 1,000 pounds gross vehicle weight, 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.
However, “mobile equipment” does not include any land vehicle that is subject to a compulsory or financial
responsibility law or other motor vehicle insurance or motor vehicle registration law where they are licensed or
principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle
insurance law or motor vehicle registration law are considered “autos”.
16."Occurrence" means an accident, including continuous or repeated exposure to substantially the same general
harmful conditions.
17."Personal and advertising injury" means injury, including consequential "bodily injury", arising out of one or more
of the following offenses:
Form SL 00 00 10 18 Page 21 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
a.False arrest, detention or imprisonment;
b.Malicious prosecution;
c.The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room,
dwelling or premises that a person or organization occupies, committed by or on behalf of its owner, landlord
or lessor;
d.Oral, written, electronic, or any other manner of publication of material that slanders or libels a person or
organization or disparages a person's or organization's goods, products or services;
e.Oral, written, electronic, or any other manner of publication of material that violates a person's right of privacy;
f.Copying, in your "advertisement", a person’s or organization’s "advertising idea" or style of "advertisement"; or
g.Infringement of copyright, slogan, or title of any literary or artistic work, in your "advertisement".
18."Pollutants" means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot,
fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed.
19."Products-completed operations hazard";
a.Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and arising
out of "your product" or "your work" except:
(1)Products that are still in your physical possession; or
(2)Work that has not yet been completed or abandoned. However, "your work" will be deemed to be
completed at the earliest of the following times:
(a)When all of the work called for in your contract has been completed.
(b)When all of the work to be done at the job site has been completed if your contract calls for work at
more than one job site.
(c)When that part of the work done at a job site has been put to its intended use by any person or
organization other than another contractor or subcontractor working on the same project.
Work that may need service, maintenance, correction, repair or replacement, but which is otherwise
complete, will be treated as completed.
The "bodily injury" or "property damage" must occur away from premises you own or rent, unless your
business includes the selling, handling or distribution of "your product" for consumption on premises you own
or rent.
b.Does not include "bodily injury" or "property damage" arising out of:
(1)The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not
owned or operated by you, and that condition was created by the "loading or unloading" of that vehicle by
any insured; or
(2)The existence of tools, uninstalled equipment or abandoned or unused materials.
20."Property damage" means:
a.Physical injury to tangible property, including all resulting 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; or
b.Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at
the time of "occurrence" that caused it.
As used in this definition, "electronic data" is not tangible property.
21."Suit" means a civil proceeding in which damages because of "bodily injury", "property damage" or "personal and
advertising injury" to which this insurance applies are alleged. "Suit" includes:
a.An arbitration proceeding in which such damages are claimed and to which the insured must submit or does
submit with our consent; or
b.Any other alternative dispute resolution proceeding in which such damages are claimed and to which the
insured submits with our consent.
Form SL 00 00 10 18 Page 22 of 22
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
22."Temporary worker" means a person who is furnished to you to substitute for a permanent "employee" on leave or
to meet seasonal or short-term workload conditions.
23."Unmanned aircraft" means an aircraft that is not:
a.Designed;
b.Manufactured; or
c.Modified after manufacture;
to be controlled directly by a person from within or on the aircraft.
24."Volunteer worker" means a person who:
a.Is not your "employee";
b.Donates his or her work;
c.Acts at the direction of and within the scope of duties determined by you; and
d.Is not paid a fee, salary or other compensation by you or anyone else for their work performed for you.
25."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 or use 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.
26."Your work":
a.Means:
(1)Work or operations performed by you or on your behalf; and
(2)Materials, parts or equipment furnished in connection with such work or operations.
b.Includes:
(1)Warranties or representations made at any time with respect to the fitness, quality, durability,
performance or use of "your work"; and
(2)The providing of or failure to provide warnings or instructions.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Form SL 90 13 10 18 Page 1 of 1
© 2018, The Hartford
(May include copyrighted material of Insurance Services Office, Inc., with its permission)
NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S)
This policy is subject to the following additional Conditions:
A. If this policy is cancelled by the Company, other than for non-payment of premium, notice of such cancellation will be
provided at least thirty (30) days in advance of the cancellation effective date to the certificate holder(s) with mailing
addresses on file with the agent of record or the Company.
B. If this policy is cancelled by the company for non-payment of premium, or by the insured, notice of such cancellation
will be provided within ten (10) days of the cancellation effective date to the certificate holder(s) with mailing
addresses on file with the agent of record or the Company.
If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of
record or the Company will be sufficient proof of notice.
Any notification rights provided by this endorsement apply only to active certificate holder(s) who were issued a certificate
of insurance applicable to this policy’s term.
Failure to provide such notice to the certificate holder(s) will not amend or extend the date the cancellation becomes
effective, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the
Company or its agents or representatives.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Countersigned by
Authorized Representative
Form WC 04 03 06 (1) Printed in U.S.A.
Process Date:05/21/24 Policy Expiration Date:06/20/25
WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT - CALIFORNIA
Policy Number:84 WEC BG4S68 Endorsement Number:
Effective Date:06/20/24 Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address:TRIPEPI SMITH & ASSOCIATES
PO BOX 52152
IRVINE CA 92619
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.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work
described in the Schedule.
The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due
on such remuneration.
SCHEDULE
Person or Organization Job Description
Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from
us
Communications Graphic Design Services
Final Audit Report 2024-08-19
Created:2024-08-14
By:Webmaster Admin (webmaster@cupertino.org)
Status:Signed
Transaction ID:CBJCHBCAABAAmLveIBzs_xKzdwR3zKJ0ZSL7zweqLdjp
"Communications Graphic Design Services" History
Document created by Webmaster Admin (webmaster@cupertino.org)
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