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15-069 G. Bortolotto & Company Inc 2015 Pavement Maintenance project Phase 1RECORDING REQUESTED BY City of Cupertino WHEN RECORDED MAIL TO City Clerk's Office City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 NO FEE IN ACCORDANCE WITH GOV. CODE 27283 23494310 Regina Alcomendras Santa Clara County -Clerk-Recorder 11/09/2016 03:14 PM Ti lies: 1 Fees: $0 .00 Taxes: $0 Total: $0.00 Pages: 4 (SPACE ABOVE THIS LINE FOR RECORDER'S USE) NOTICE OF COMPLETION AND NOTICE OF ACCEPTANCE CITY PROJECT NAME: 2015 PAVEMENT MAINTENANCE PROJECT -PHASE I (City Project Number 2015-22) JW'Original 0 For Fast Endorsement "NO FEE" City of Cupertino NOTICE OF COMPLETION AND NOTICE OF ACCEPTANCE is hereby given in order to comply with the provisions of Section 27283 of the Government Code. This is to certify that the Notice of Completion and Notice of Acceptance dated April 12, 2016 for CITY PROJECT NAME: 2015 PAVEMENT MAINTENANCE PROJECT -PHASE I (City Project Number 2015-22) and the City of Cupertino, a governmental agency is hereby accepted by the City of Cupertino on November 9, 2016 and the grantee consents to recordation thereof by its duly authorized officer. I certify under Penalty of Perjury under the laws of the State of California that the foregoing paragraph is true and correct. Dated: By: November 9, 2016 Lauren Sapudar Senior Office A ss istant CUPERTINO CITY OF CUPERTINO CITY HALL 10300 TORRE AVENUE -CUPERTINO, CA 95014-3266 (408) 777-3354 -FAX (408) 777-3333 NOTICE OF ACCEPTANCE PROJECT NAME: 2015 Pavement Maintenance -Phase I (CITY PROJECT NUMBER 2015-22) Owner: City of Cupertino 10300 Torre A venue Cupertino, CA 95014 Direct Contractor: G. Bartolotto & Company, Inc. 582 Bragato Road San Carlos, CA 94070 Site Location: Various locations in Cupertino, CA Work Description: Work consisted of placing an asphalt overlay, performing digout repairs, asphalt mill and fill , replacing traffic striping and pavement markers, replacing traffic signal detectors and other miscellaneous work as shown in the plans and outlined in the specifications. Contract Date: June 11, 2015 Date of Project Acceptance: November 6, 2016 NOITCE IS HEREBY GIVEN THAT I, Timm Borden, Director of Public Works and City Engineer of the City of Cupertino, California, do hereby certify that the improvements performed at the referenced site and as described above and in the referenced contract, which was entered into, by, and between the City of Cupertino and the Direct Contractor on the date noted above, in accordance with the plans and specifications for said work, have been completed to the City's satisfaction, subject to exceptions, and accepted as noted above. Timmorden ,,/, /; t r , Date Director of Public Works and City Engineer [Notice of Accept under 175 .150903] CUPERTINO Recording Requested By: When Recorded Mail To: City of Cupertino 10300 Torre Ave . Cupertino , CA 95014 SPACE ABOVE THIS LINE IS FOR RECORDER 'S USE NOTICE OF COMPLETION Civil Code§§ 8182 , 8184 , 9204, and 9208 NOTICE IS HEREBY GIVEN THAT: 1. The undersigned is the agent of the owner of the project described below. 2 . Owner's full name is : City of Cupertino, California. 3. Owner's address is : City Hall, 10300 Torre Ave ., Cupertino , CA 95014 . 4. The nature of owner's interest in the project is : _ Fee Ownership Lessee _X_ Other: Right-of-Way on various streets 5. Construction work on the project performed on the owner's behalf is generally described as follows : City Project Name: 2015 Pavement Maintenance Project -Phase 1 (City Project No .: 2015-22) 6. The name of the original contractor for the project is: G. Bortolotto & Company, Inc . 7. The project was completed on: November 6, 2016 . 8. The project is located at: Various streets in Cupertino , CA. Verification: In signing this document, I, the undersigned , declare under penalty of perjury under the laws of the State of California that I have read this notice , and I know and understand the contents of this notice, and that the facts stated in this notice are true and correct. · Santa Clara Count ~ Si~· Timm Borden Director of Public Works and City Engineer Project No. 2015 -22 DOCUMENT 00650 AGREEMENT AND RELEASE OF ANY AND ALL CLAIMS THIS AGREEMENT AND RELEASE OF ANY AND ALL CLAIMS ("Agreement and Release"), made and entered into this 19 th day of December, 2016 , by an d between the City of Cupertino ("City"), and G Bortolotto & Co. Inc. ("Contractor"), whose place of business is at 582 Bragato Road, San Carlos, CA 94070. RECITALS A. City and Contractor entered into Contract Number 20 l 5-486 (the "Contract"). B. The Work under the Contract has been completed. Now, therefore , it is mutually agreed between City and Contractor as follows: AGREEMENT l. Conrractor will not be assessed liquidated damages except as detailed below: Origina l Contract Sum Modified Contract Sum Pay111cnt lo Date Liquidated Damages Payment Due Contractor $ 5,716278 .39 $ 6.015,602.53 $ 5.714.8 22.41 $300,780.12 2. Subject to the provisions of th is Agreement and Release , City will forthwith pay to Contractor the sum ofTlm:e Hundred Thousand, Seven Hundred-Eight Dollars and Twelve Cents ($ 300,780.12) under the Contract, Jess any amounts withheld under the Contract or represeuted by any Notice to Withho ld Funds on file v,ith City as of the date of such payment. 3. Contractor acknowledges and hereby agrees that there are no u.nresolved or outstanding claims in dispute against City arising from the Contract, except for the claims described in paragraph 4 of this Document 00650. It is the intention of ilie parties in executing this Agreement and Release that this Agreement and Release shall be effective as a full, final and general .release of all claims, demands, actions, causes of action, obligations, costs, expenses, damages, losses and liabilities of Contractor agains1 City, and all if its agents, employees, consultants (including without limitation Consulting Cupertino), inspectors, representatives, assignees and t.ransforees except for the Disputed Claims set forth in paragraph 4 of this Documeni 00650. Not11ing in this Agreement and Release shall limit or modify Contractor's continuing obligations described in paragraph 6 of this Document 00650. 4. Ibe foilowing claims are disputed (hereinafter, ihe "Disputed Claims") and are specifically excluded from the operati on of this Agreement and Release : Date Submitted Description of Claim Amount of Claim City of Cupertino Agreement a nd Release of Any and All Claims 2015 Pavement Maintenance Project -Phase I 00650 -I Project No . 2015-22 5. Consistent with California Public Conrract Code Section 7100, Contractor hereby agrees that, in consideration of the payment set forth in paragraph 2 of this Document 00650, Contractor hereby releases an<l forever discharges City, and all of its agents, employees, consultants, inspectors, assignees and trru1sforees from any and all liability, claims, demands, actions or causes of action of whatever kind or nature arising out of or in any way concerned with the Work under tlle Contract · 6. Guarantees and warranties for the Work, and any other conti.nuing obligation of Contractor, shall remain in full force and effect as specified in the Contract Documents. 7 . Contractor shall immediately defend, indemnify and hold bannless the City of Cupertino, Santa Clara County, its Architect, any of their Representatives, and all of their agents, employees, consultants, inspectors, assignees and transferees, from any and all claims, demands, actions, causes of action, obligations , costs, expenses, damages, losses and liabilities that may be as8erted against them by any of Contractor's suppliers and/or Subcontractors of any tier and/or any suppliers to them for any and all labor, materials, supplies and equipment used, or contemplated to be used in the performance of the Contract, except for the Disputed Claims set forth in paragraph 4 of this Document 00650. 8. Coniractor hereby waives the provisions of California Civil Code Section 1542, which provides as follows: A general release does not extend to claims that the creditor docs not know or suspect to exist in his favor at the time of executing the release, whklt if known by him, must have materially atTected his settlement with the debtor. 9. The provisions of ihis A.greemi!nt and Release are contractual in nature and not mere recitals and shall be considered independent and severable. and if any such provision or any part thereof shall be at any time held invalid in whole or in part under any federal, state, county, municipal or other law, ruling, or regulation, then such provision, or part thereof shall remain in force and elfoct oniy to the extent pcmlitted by law, and the remaining provisions of this Agreement and Release. Shall also remai n in full force and etfecl, and shall be enforceable. 10. Contractor represents and warrants that it is the true and Jaw!hl owner of all claims and other matters released pursuant to this Agreement and Relea e , aud that it has full right, title and authority to enter into this inslrument. Each party represents and warrants that it has been represented by counsel of its uwn choosing in connection with tl1is Agreement and Release. J J . All rights of City shall sun,jve completion of the Work or termination of the Contract, and execution of this Agreement and Releas e . City of Cupertino Ag reement and Release or Any and All Claims 2015 Pavement Maintenance Pro jecl -Phase I 00650 • 2 * * "'CAlITION: THIS IS A RELEASE -READ BEFORE EXECUTING*** Tiffi CITY OF CUPERTINO, a Municipal Corporation of the State of California ATTEST, ~ ~ [City Clerk! ( -Lt -( 1 By:---------------- Name: ______________ _ Its: _____________ _ REVIEWED AS TO FORM : ~[C~ END OF DOCUMENT Project No. 2015 -22 City of Cupertino Agreement and Release of Any and All Claims 20i 5 Pavement Maintenance Project -Phase I Project No.2015-22 o o tS - Li S DOCUMENT 00520 CONTRACT THIS CONTRACT, dated this day of ff y t e-- , 2015 , by and between G. BORTOLOTTO & COMPANY INC., whose place of business is located at 582 BRAGATO ROAD, SAN CARLOS, CA 94070 Contractor"),and the CITY OF CUPERTINO,a Municipal Corporation of the State of California("City")acting under and by virtue of the authority vested in the City by the laws of the State of California. WHEREAS,City,on the I cr day of YMA` ,2015 awarded to Contractor the following Project: PROJECT NUMBER 2015-22 2015 PAVEMENT MAINTENANCE PROJECT-PRASE 1 NOW,THEREFORE,in consideration of the mutual covenants hereinafter set forth, Contractor and City agree as follows: Article 1. Work 1.1 Contractor shall complete all Work specified in the Contract Documents,in accordance with the Specifications, Drawings,and all other terms and conditions of the Contract Documents. Article 2. Agency and Notices to City 2.1 City has designated Roger Lee, Assistant Director, Public Works - Maintenance, to act as City's Authorized Representative(s), who will represent City in performing City's duties and responsibilities and exercising City's rights and authorities in Contract Documents. City may change the individual(s) acting as City's Authorized Representative(s), or delegate one or more specific functions to one or more specific City's Representatives, including without limitation engineering,architectural,inspection and general administrative functions,at any time with notice and without liability to Contractor. Each City's Representative is the beneficiary of all Contractor obligations to City,including without limitation,all releases and indemnities. 2.2 All notices or demands to City under the Contract Documents shall be to City's Authorized Representative at: 10300 Torre Avenue,Cupertino,California 95014 or to such other person(s)and address(es)as City shall provide to Contractor. Article 3. Contract Time and Liquidated Damages 3.1 Contract Time. The Contract Time will commence to run on the date indicated in the Notice to Proceed. City may give a Notice to Proceed at any time within 30 Days after the Notice of Award. Contractor shall not do any Work at the Site prior to the date on which the Contract Time commences to run. Contractor shall achieve Final Completion of the entire Work and be ready for Final Payment in accordance with Section 00700(General Provisions)within 110 working days as provided in Document 00700(General Provisions). All work on streets near schools and all striping enchancements shall be complete prior to August 15, 2015. See Attachment A for a list school streets. Several utility main replacements will occur within the project area. Paving will follow completion of utility work. Contractor will coordinate schedule accordingly. See Attachment for a list of utility projects identified to date. City of Cupertino 00520- 1 Contract 2015 Pavement Maintenance Project-Phase 1 Addendum 1 Project No.2015-22 3.2 Liquidated Damages. City and Contractor recognize that time is of the essence of this Contract and that City will suffer financial loss in the form of contract administration expenses(such as project management and consultant expenses), if all or any part of the Work is not completed within the times specified above,plus any extensions thereof allowed in accordance with the Contract Documents. Consistent with Document 00700 (General Provisions), Contractor and City agree that because of the nature of the Project,it would be impractical or extremely difficult to fix the amount of actual damages incurred by City because of a delay in completion of all or any part of the Work. Accordingly,City and Contractor agree that as liquidated damages for delay Contractor shall pay City: 3.2.1 $1,500 for each Calendar Day that expires after the time specified herein for Contractor to achieve Substantial Completion as specified above. 3.2.2 $1,500 for each Calendar Day that expires after the time specified herein for Contractor to achieve Final Completion of the entire Work as specified above. 3.2.3 $250 per day per location for failure to adjust utility facilities as required per Document 0850 section 6. 3.2.4 $500 per day for failure to place temporary pavement markers as required by Document 850 Section 7. 3.2.5 $150 per day for failure to place final traffic striping as required by Document 0850,Section 7. 3.2.6 $100 per day per traffic loop not replaced as required by Document 0850,Section 8. 3.2.7 $5,000 for each occurrence of a violation of Document 00800, Section 1.7 WORK DAYS AND HOURS. 3.2.8 $500 per street per day for failure to complete work within time specified in paragraph 3.1. 3.2.9 Three Months Salary for each Key Personnel named in Contractor's SOQ pursuant to Article 2.G of Document 00450 (Statement of Qualifications for Construction Work) who leaves the Project and/or Contractor replaces at any point before Final Completion, for any reason whatsoever, that Contractor can demonstrate to City's satisfaction is beyond Contractor's control. Liquidated damages shall apply cumulatively and, except as provided below, shall be presumed to be the damages suffered by City resulting from delay in completion of the Work. 3.3 Liquidated damages for delay shall only cover administrative, overhead, interest on bonds, and general loss of public use damages suffered by City as a result of delay. Liquidated damages shall not cover the cost of completion of the Work, damages resulting from defective Work, lost revenues or costs of substitute facilities, or damages suffered by others who then seek to recover their damages from City(for example, delay claims of other contractors,subcontractors,tenants,or other third-parties),and defense costs thereof. Article 4. Contract Sum 4.1 City shall pay Contractor the Contract Sum for completion of Work in accordance with Contract Documents as set forth in Contractor's Bid,attached hereto: See Exhibit"A"attached City of Cupertino 00520-2 Contract 2015 Pavement Maintenance Project—Phase 1 Addendum 1 Project No.2015-22 Article 5. Contractor's Representations In order to induce City to enter into this Contract,Contractor makes the following representations and warranties: 5.1 Contractor has visited the Site and has examined thoroughly and understood the nature and extent of the Contract Documents, Work, Site, locality, actual conditions, as-built conditions, and all local conditions, and federal, state and local laws and regulations that in any manner may affect cost, progress, performance or furnishing of Work or which relate to any aspect of the means,methods,techniques,sequences or procedures of construction to be employed by Contractor and safety precautions and programs incident thereto. 5.2 Contractor has examined thoroughly and understood all reports of exploration and tests of subsurface conditions, as-built drawings, drawings, products specifications or reports, available for Bidding purposes, of physical conditions, including Underground Facilities, or which may appear in the Drawings. Contractor accepts the determination set forth in these Documents and Document 00700(General Provisions)of the limited extent of the information contained in such materials upon which Contractor may be entitled to rely. Contractor agrees that except for the information so identified, •Contractor does not and shall not rely on any other information contained in such reports and drawings. 5.3 Contractor has conducted or obtained and has understood all such examinations, investigations, explorations, tests, reports and studies (in addition to or to supplement those referred to in Section 5.2 of this Document 00520) that pertain to the subsurface conditions, as-built conditions, underground facilities, and all other physical conditions at or contiguous to the Site or otherwise that may affect the cost,progress, performance or furnishing of Work,as Contractor considers necessary for the performance or furnishing of Work at the Contract Sum, within the Contract Time and in accordance with the other terms and conditions of the Contract Documents, including specifically the provisions of Document 00700 (General Provisions); and no additional examinations, investigations, explorations, tests, reports, studies or similar information or data are or will be required by Contractor for such purposes. 5.4 Contractor has correlated its knowledge and the results of all such observations, examinations, investigations, explorations,tests,reports and studies with the terms and conditions of the Contract Documents. 5.5 Contractor has given City prompt written notice of all conflicts, errors, ambiguities, or discrepancies that it has discovered in or among the Contract Documents and as-built drawings and actual conditions and the written resolution thereof through Addenda issued by City is acceptable to Contractor. 5.6 Contractor is duly organized, existing and in good standing under applicable state law, and is duly qualified to conduct business in the State of California. 5.7 Contractor has duly authorized the execution, delivery and performance of this Contract, the other Contract Documents and the Work to be performed herein. The Contract Documents do not violate or create a default under any instrument,contract,order or decree binding on Contractor. 5.8 Contractor has listed Subcontractors pursuant to the Subcontractor Listing Law, California Public Contracting Code§4100 et seq.in document 00340(Subcontractors List) Article 6. Contract Documents 6.1 Contract Documents consist of the following documents,including all changes,addenda,and modifications thereto: Document 00002 Signature Page Document 00003 Project Directory Document 00012 Caltrans/City Cross-Reference Table Document 00100 Advertisement For Bids Document 00200 Instructions to Bidders Document 00210 Indemnity and Release Agreement Document 00400 Bid Form City of Cupertino 00520-3 Contract 2015 Pavement Maintenance Project—Phase 1 Addendum 1 Project No.2015-22 Document 00411 Bond Accompanying Bid Document 00430 Subcontractors List Document 00450 Statement of Qualifications Document 00481 Non-Collusion Affidavit Document 00482 Bidder Certifications Document 00520 Contract Document 00530 Insurance Forms Document 00610 Construction Performance Bond Document 00620 Construction Labor and Material Payment Bond Document 00630 Guaranty Document 00650 Agreement and Release of Any and All Claims Document 00660 Substitution Request Form Document 00700 General Conditions Document 00800 Special Conditions Document 00820 Traffic Control Requirements Document 00821 Insurance Document 00822 Apprenticeship Program Document 00850 Technical Specifications Document 00860 General Requirements Attachment A Work Hour Restrictions Addenda(s) Drawings/Plans 6.2 There are no Contract Documents other than those listed in this Document 00520, Article 6. The Contract Documents may only be amended, modified or supplemented as provided in Document 00700 (General Provisions). Article 7. Miscellaneous 7.1 Terms used in this Contract are defined in Document 00700 (General Provisions) and will have the meaning indicated therein. 7.2 It is understood and agreed that in no instance are the persons signing this Contract for or on behalf of City or acting as an employee, agent, or representative of City, liable on this Contract or any of the Contract Documents, or upon any warranty of authority, or otherwise, and it is further understood and agreed that liability of the City is limited and confined to such liability as authorized or imposed by the Contract Documents or applicable law. 7.3 Contractor shall not assign any portion of the Contract Documents, and may subcontract portions of the Contract Documents only in compliance with the Subcontractor Listing Law, California Public Contracting Code§4100 et seq. 7.4 The Contract Sum includes all allowances(if any). 7.5 In entering into a public works contract or a subcontract to supply goods, services or materials pursuant to a public works contract, Contractor or Subcontractor offers and agrees to assign to the awarding body all rights, title and interest in and to all causes of action it may have under Section 4 of the Clayton Act(15 U.S.C. §15)or under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, services or materials pursuant to the public works contract or the subcontract. This assignment shall be made and become effective at the time City tenders final payment to Contractor,without further acknowledgment by the parties. 7.6 Copies of the general prevailing rates of per diem wages for each craft, classification,or type of worker needed to execute the Contract,as determined by Director of the State of California Department of Industrial Relations, City of Cupertino 00520-4 Contract 2015 Pavement Maintenance Project—Phase 1 Addendum 1 Project No.2015-22 are deemed included in the Contract Documents and on file at City's office,or may be obtained of the State of California web site http://www.dir.ca.gov/DLSRJPWD/Northem.htiiil and shall be made available to any interested party on request. Pursuant to Section 1861 of the Labor Code, Contractor represents that it is aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that Code, and Contractor shall comply with such provisions before commencing the performance of the Work of the Contract Documents. 7.7 Should-any part,term or provision of this Contract or any of the Contract Documents,or any document required herei-D or therein to be executed or delivered, be declared invalid, void or unenforceable, all remaining parts, Cerins'and provisions shall remain in full force and effect and shall in no way be invalidated, impaired or affected thereby. If the provisions of any law causing such invalidity, illegality or unenforceability may be waived,they are hereby waived to the end that this Contract and the Contract Documents may be deemed valid and binding contracts, enforceable in accordance with their terms to the greatest extent permitted by applicable law. In the event any provision not otherwise included in the Contract Documents is required to be included by any applicable law, that provision is deemed included herein by this reference(or, if such provision is required to be included in any particular portion of the Contract Documents, that provision is deemed included in that portion). 7.8 This Contract and the Contract Documents shall be deemed to have been entered into in the County of Santa Clara, State of California, and governed in all respects by California law(excluding choice of law rules). The exclusive venue for all disputes or litigation hereunder shall be in Santa Clara County. Both parties hereby waive their rights under California Code of Civil Procedure Section 394 to file a motion to transfer any action or proceeding arising out .of the Contract Documents to another venue. Contractor accepts the Claims Procedure in Document 00700,Article 12,established under the California Government Code,Title 1,Division 3.6,Part 3,Chapter 5. City of Cupertino 00520-5 Contract 2015 Pavement Maintenance Project—Phase 1 Addendum 1 Project No.2015-22 IN WITNESS WHEREOF the parties have executed this Contract in quadruplicate the day and year first above written. 2015 PAVEMENT MAINTENANCE PROJECT-Phase 1 CITY:CONTRACTOR: CITY OF CUPERTINO,a Municipal Corporation of the State of California By: kgnature] Attest: C' Robert Bortolotto Please print name here] City Cler :Grace Schmidt Approved as to form by City Attorney: Title: President If Co oration: Chairman,President,or Vice President]Nwm ty Attorney: Carol Korade By.A --c a;A-77 gnature] Gary Bortolotto I hereby certify,under penalty of perjury,that David Brandt, Please print name here] City Manager of the City of Cupertino was duly authorized to execute this document. Title: Secretary If Corporation: Secretary,Assistant Secretary, Chief Financial Officer,or Assistant Treasurer] Dated: S 397341 A State Contractor's License No. Classification January 31, 2017 OilyDavid Brandt,City Manager of the City of Cupertino,a Expiration Date Municipal Corporation of the State of California Designated Representative: Taxpayer ID No. 94-2712069 Name:Roger Lee Name: Robert Bortolotto Title:Assistant Director of Public Works- Title: President/G. Bortolotto & Co. , Inc. Address: 10300 Torre Ave, Cupertino, CA 95014 Address: 582 Bragato Road, San Carlos, CA 9407, Phone:408-777-3354 Phone: 650-595-2591 Facsimile:408-777-3333 Facsimile: 650-595-0718 NOTARY ACKNOWLEDGEMENT IS REQUIRED. IF A AMOUNT: $5,716,278.39 y 2 CORPORATION, CORPORATE SEAL AND CORPORATE ACCOUNT#:270-85-821-900-921 - rai 1 1 NOTARY ACKNOWLEDEMENT AND FEDERAL TAX ID ARE REQUIRED. IF NOT A CORPORATION SOCIAL SECURITY ACCOUNT#:270-90-975-900-905-$9,200.00 NO.IS REQUIRED ACCOUNT#: gov-q pi- t 211/704 ,'7 S' FILE NO.:94,493.105 END OF DOCUMENT City of Cupertino 00520-6 Contract 2015 Pavement Maintenance Project-Phase 1 Addendum 1 CALIFORNIA CIVIL CODE§ 118B NU A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State ofCalifornia County of 8@n Mateo On May 28 2015 before me, Deborah M. Knipp, Notary Public Date Here Insert Name and Title ofthe Officer personally appeared Robert Na/ne(s)ofSigme/(s) who proved to me on the basis of satisfactory evidence to be the 6s) whose name(X) io4m subscribed zothe within instrument and acknowledged to me that hexecuted the same in hisboxgRxk authorized capacity&% and that by his/kgr/jbo signatureW on the instrument the person(g), or the entity upon behalf of which the person(sr) acted, executed the instrument. certify under PENALTY DFPERJURY under the laws of the State of California that the foregoing paragraph iotrue and correct. DEBORAH M. KNIPP WITNESS myhand and official seal. COMM, #1979771 0. Notary Public-California . Z Signature My Comm.Expires May 26 2016-t Signature of NotarUPubli6 I/I Place Notary Seal Above QP77@0AL Though this section isoptional, completing this information can deter alteration ofthe document or fraudulent reattachment ofthis form to an unintended document. Description ofAttached Document Title orType ofDocument: Document Date: Number of Pages: _______ Signor(a) Other Than Named Above Capacity(iea) Claimed by Signer(s) Signer's Name: Signer's Name: OCorporate Officer — Tit|o(s): OCorporate Officer — Tit|o(o): OPadnar — El Limited El General OPartnar — El Limited OGenena| El Individual|ndividuo|OAttomey in Fact O Individual OAttorney in Fact El Trustee O Guardian or Conservator El Trustee O Guardian or Conservator El Other: O Other: Signer Is Representing: Signer Is Representing: Project No.2015-22 A SCHEDULE OF BID PRICES BASE BID ITEMS All Bid items, including lump sums and unit prices,must be filled in completely. Quote in figures only,unless words are specifically requested. ITEM DESCRIPTION UNIT EST.QNT.Y, UNIT COST TOTAL 1 Traffic Control LS 1 Leveling Course-No. 4 Hot Mix Asphalt 7,755 2 Type A TN l 255 Leveling Course-3/8" Hot Mix Asphalt I 3 Type A TN 6,640 LZ 4 Hot Mix Asphalt, 1/2" Maximum Type A TN 32,961 266 B 5 Hot Mix Asphalt, 1/2" Maximum, Type c TN 1,667 3 3 155 o 91 6 Pavement Fabric SY 270,760 q5, 91 5 20 7 Cold Plane and Remove 4"AC SY 7,408 73 J 5 ' 8'1 8 Ke cut A LF 146,046 Z "`?4 9 ke cut B LF 7,730 3 3G1 2(0 20 10 Ke cut C LF 632 a3 J 4D6 Adjust Survey Monument Cover to 258 11 Finish Grade EA 1 ec) 46 4qD 12 'Replace Monument Box EA 35 211 7j Lower Manhole Covers Prior to Cold 13 PlaningEA s3 73 _ 1,7 19q Lower Cleanout/Water/Gas Valve 104 14 Cover Prior to Cold Planing EA j RD_ 15 Adjust Manhole Covers to Finish Grade EA 372 301 -11 97 Adjust Cleanout/Water/Gas Valve 16 Cover to Finish Grade EA 165 1 17 Install.Blue RPM's @ Fire Hydrant EA 18 4"White Thermo LF 2,200 S'T 1 19 6"White (Thermo)LF 7,105 o . 53 12"White Crosswalk/Limit Line 5,330 363 1C3 20 Thermo LF 21 12"Yellow Crosswalk Thermo LF 140 0-7 Z s C' 22 24"White Thermo LF 650 L' it 71 S 23 24"Yellow Thermo LF 710 L , O 24 Striping Detail#21 Thermo LF 1,082 S 746, ' S 25 Striping Detail#22 Thermo & Markers LF 1,716 1; . '-7 1 b 26 Stri ing Detail#23 Markers LF 3,904 1 , .5`j tC', j_q , x S 27 Striping Detail#38 Thermo & Markers LF 64 j '2_8 28 Striping Detail#38A(Thermo) LF 265 r 2-65 29" Striping Detail 38C LF 0 1 30 Striping Detail#39 Thermo LF 983 Ci.j 'S D 31 Striping Detail#39A Thermo LF 404 PCO2 Ahead Legend"WHITE (Pre-formed 32 thermo) EA 1 L4 7 C q_70 33 "Ahead Legend"Yellow Pre-formed EA 1 47® LU 0 City of Cupertino Bid Form 2015 Pavement Maintenance Project—Phase 1 00400-3 Addendum 2 i Project No.2015-22 thermo) 34 "PED" legend re-formed thermo EA 1 40 35 "KEEP" Legend Pre-formed Thermo EA 1 floc) - 1400 - 36 14 036 "CLEAR" Legend Pre-formed Thermo EA 1 4-7o- LO D_- 37 "RxR"Legend Pre-formed Thermo EA 2 7_150 V 5 o 38 "STOP" Legend Pre-formed Thermo EA 80 c>-2_rC)d D 39 "SLOW" Legend Pre-formed Thermo EA 3 400-l 2.0 D SCHOOL" Legend (Pre-formed 2 40 Thermo) EA Joc) oco 41 "XING" Le ned Pre-formed Thermo EA 3 4DV _ IOD 42 "25" Legend Pre-formed Thermo EA 25 270 y 43 "YIELD" Legend Pre-formed Thermo EA 6 439 - Z 1.(0 3` 44 "YIELD" LINE Pre-formed Therm EA 0 0 45 "BUMP" Legend Pre-formed Thermo EA 30 4oc) - 12 o D O 46 Sharrow re-formed thermo EA 87 0 47 Sharrow(paint) EA 30 48 Colored Surface Treatment SF 12,105 5 49 Green Bike Lane Pre-formed Thermo SF 6,374 G Facotory Assembled Bike Symbol Left 48 q21 50 Facingon Green Pre-formed Thermo EA t L Bike Lane Symbol Left Facing (Pre- 12 41551formedThermoEA CI53ArrowTypeIVPre-formed Thermo EA 15 300 4, 50c)- 54 5b6'" 54 Arrow Type VII L Pre-formed Thermo EA 1 450 450 55 50 55 Replace Traffic Signal Loos EA 70 3 0 1 2! 070 56 Install New Speed Bump EA 4 Z3 00 2,00 r P>ved '(!l°V C,2p—r'J -1 U,,-L:b bib- J(Jr Total Base Bid Price: / Lt )L-, }-Ltr l c I, 5eu e,-3-r\I r f i; Words) Unit Legend LS = Lump Sum EA= Each LF = Linear Feet TN =Ton or 2,000 Pounds h SY = Square Yards SF = Square Foot City of Cupertino Bid Form 2015 Pavement,Maintenance Project-Phase 1 00400-4 Addendum 2 i Premium: $27,615.00 Bond No: 12112358 P)oaeet No DO.CUbffiNr 00610. ca tsTR ieta>t:»x oalAnl sc}1 D ,. Tl GONSTRUCI'lON "APOtMA BOND: 'Bond"}:is dote..d Ma ..26 20.1.5 , s in: the:ss al sii ri of Five_Million.Seven Hundred.Sixteen Thousand.Two Hundred. eventy-Eig t:and 39/100'Dollars which it one fiundre l•.percent of the Contract Price]i attd is entcred intsd by and bpt veen the larties luted below to ensure:tlfe fatitlful perfprmance.;of the Consttction Contract li5eed below:. This. and consists ofxliis page-and:tfie Bona TeMU:and.Conditions,paragraphs 1'through`12:. attached to this page Any'smguliir reference to,. G Bortolotto& Company Inc Contragtoz"}, . The Guarantee Garnpany of North America USA'Sucety"};::tlie Crty.mf Cupertino, Ivlun c pal`'Corporanon.af the State of California.("City")or other paity shall tie considered plural where; licabte.. C iNTt I GTOR SURETY G. Bortolotto&Company Inc Tf e Guarantee.:Company of.North America IJbA Name N.ame 582 Bragato Road 1 Towne Square, Ste. A dies Prinoip lade of 3tsinesd San arlos C4 94070 Southfield, MI 4 076 City/State(ip CitylState7Z p CQNSTRT.1CP-MU CONTRACT 2015 PAVEWNT` MTFWANCE°PROJECT PIMSE I PIdO,LI `NYA1 Y$ & 05-22 ai CuperttnCalifaruia: DATm May 19. ,20:15 in&6 Amount9f$.5,716,278:39 the'PenaLSpm'' CONT.I ACTORAS`PRTNCA'AL SURETY The Guarantee o pany of North Company .(Corp Seal)G Bort & Company, Inc Company :(CQ, eal}:America U ig[tatare, c 7--Signature.: / lrameand 'tlee ,?s [ 4c 46 Name and Tale Greg McCartney Attorney-In-Fact 1BUNA)TIFRMS:AND:G IND1TdON5 Contractor and Surety;lotnily:-and severally;liiud tlzemslves,tlietr hers;.executors adininisratnrs,successors. aril ,ass ns to Ci for the:cn lete and er : erforut6nce a€;.t}ie Construction'Contracia which is.i$ tY:. 1?rnp p neorporated Lff—e'M reference. f"Contractor`completely and;properly:perfornis all of its obligations udder the Gctnstruction Get tzact, S uietyapdCamrai*r"shall,ha+enQ o It anon ander.tE s fond, 3 Ii tfeze is:no.City Default,5tiety's o.Filigahon under this Bond shall ai ise afler::. 3::i City liar declared a 0omractor, t ult,under:the Construction Contract pursuant to the terms af.the Constrncttan.Gontract;:aitd 3 w . City has agreed`tOTay:tlrg$glance of the Contract Soni: To Surety in.aecordance with ehe terms of this Band and the Construction CQnteact,or Cityy afCupertino Consttuctznn'perfoxmaltee Bond,_ 20lS Pavems ntMairitena0 Protect rase l 010614-1; Addpitdunr .. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of San Mateo On May 26, 2015 before me, Deborah M. Knipp, Notary Public Date Here Insert Name and Title of the Officer personally appeared Gregory McCartney Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person( whose name(s) is/'XX subscribed to the within instrument and acknowledged to me that he/)MX executed the same in his/p(X/ Xauthorized capacity(KX, and that by his/)(XXX f signature(X..on the instrument the personX, or the entity upon behalf of which the personK acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. DEBORAH M.KPlIPP WITNESS my hand and official seal. COMM. #.1979771 z z rNotary Public-California . o Z. San Mateo County My Comm.Expires MR 26,2016 Signature k1_110a V Signature of Ndtary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: Corporate Officer — Title(s): Corporate Officer — Title(s): Partner — Limited General Partner — Limited General Individual R1 Attorney in Fact Individual Attorney in Fact Trustee Guardian or Conservator Trustee Guardian or Conservator Other: Other: Signer Is Representing: Signer Is Representing: 02014 National Notary Association •www.Nationa]Notary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 Pio6 1. Ject 201 ; 2No 3 2 Z Ta?contxactgr selected fo perform.the Cdnstmctton.`Contract p accordance ninth khe lexms of t}s Bond and the Cous#diction Contract I. 4 'When City has satisfied the eondittons:of paragraph.3,:Surety;shall ptoiitjitly wifh41,19..:..d ays}aud;at Surety's. expense elecf>to take one of the following 9010;35; 41 Arrange for Contractors vith consent of City, to"perform and complete the Constfuctian Contract(lfut CAfy;may withi old consent,inavfich case the:Surety must electiii:4hon;described to paragraphs 4.2, . 4 3 of 4 4,belo., ;or 4 2 >Jndertake to perform and. cotiplete the Constni1.eti0h„Contract-itself,'through its agents'or through independent cunt#,ct* - provided, that,::,*ty`jsiay not:select:Contractor as its:agent or iitdepentient Contractgi wtthoutG ty'scousent;.or 4.3.. Un1.dertake . ...perform:and complete Alle Consfivctiori Contract by:obtaining `gids from qualified' contractors acgepfable to City for a contract for perfigrinance'and eoimpleti1.onw. :of the'Cons1.truction Contract,and;:upon detennination by City of the lowest.it sponsible biddex;:01".arrange.rfor a:rtintract to lie. I. y tyand the contractor selected with'Cit+'s concurr1.ence;talie secured.ruit}i.prepared for-exeatition 6 Ci performance'and payment bonds executed bq:a-qualified:surety equivalent to the bonds.:issi ect on ahe: I 11 Constructson Contract,and,f;.Sur.ty's:obtigatiotts defined tmparagraph•:6?below;:exceed the Balance of the Contract Snin,then`Surety shall pay to City the amount of such:excess;.or 4:4. Waive.its righf,ta perform and:complete;arrange`for completion;;or abtai:n a.new:contractor and with I. I. reasonable promptness:tinder the ......ristances,.and; after:investigation'and consultaUolarwith City, determine•ut good fatthits monetary obligation io City:under:.paragraph 6 below,;for the;performance and completion::of the Gonstructiori Cont act.;and:as.soon as practicable a#ler the arnpunt is dete'rmine, tender.payment_therefor#o City rvitb full explanation of the,payinefinv-_cii6lation If City accepts Surety;:s tender°under this paragraph 44, City;may still;.hold surety lsalte for future damages#}fen tutkno.n or tri liquidate l resuttiiig•fraiii'the Contractor.]]efault :7f City disputes theramnunf;of Surety's tender under#L is paragraph 4 4;`City may exercise all remedies available twat ai law to enforce Surety's liability under paragraph 6,below S:: If Surety does not proi±eed as provided'm paragraph},'atiave,then Surety shall.Tye deemed to lze:in default°on this Bond teix days after receipt of an-:additiQriat wrctten notice from City to Surety ae anding:that Surety perform its:P,.,. tons under this Bond: Atp11 times City shaTl:be entitled to enforce any:remedy available to . City at law oe'AN&tie Copskruction.Co#.tract'iuciuding•.wtthout:limitation,and by vay ofexample duly,r glfts I. 1. tti .perform.work. protect work, mtfigate.,damages, 'advance end at'xvork to- inittgate schedule delay,-.oz o dinato work with;other consultants or cotWActors 6 Surety's mciitetary g...!datioir under#his Bond is limited by flee'Atnount:of this;Bond.itlentifred Herein as:the penal$um 'This monetary obligation shall augrnent;the Balance-of the G`ontract Sum Subject to t}tese Limits, Surety's obligations uncCer flus Bond are coininensurate with the:oligatrans of trontractor undez .the Cons;ructioi .Contract SureryIs obligations shall include,but are:iot'liW d to u I The responsibilities of Contractor under:the Construction"Coittracf'for completion Qf the Cij1.nstruc#ion Co1.ntract airs;correction o edefectve work; G 1.I he responsibilities sil'Caiitractor under:the Construction Coiifro*to tiny,liquidated damages, and for damag"es for which fro:liquidated damages aim specified iii the Constructi6h Contract,.actual damages caused by Hoff perfoxinance of.,lie Coiistruchon:Contract iiicludit g,.lout not limited to all valid.and proper:backcbaiges,offsets,payments,indemnitresr or otherdaznages; 11 r 6 3 Addttr..t.m regal;design professional and'delay costs rasalting from;.Coptmctor Default or resulting from the actions ax falurexo act of the Sure :finder a a b 4;°above' but excludin ttQrneyT.' s fees incirriedtYI? r SmP E g a to eitfarce#lyes>Bond),' I. City of Cupertinqba. Construction Performance Bands 20I<l'aveinexi.ClI tai enanceProJeet Ehase I OOGIU g AddenI.dum 3: I; Ntsertt ht of:acFton shall aceruo an tln$$ond tp atxy petgott nr entity nfhea 111ah Clty`ok ita sueeoSsdrs:rrt a st.gns.. Surety hereby waives notice O,my ettange, alteration or addition tti the Ga11st1ttcttati.t~orttract orto relatea. aubaontraets,purcIlrise ardors atld other obllgatlons,thdiudtng changes df trtYtR`Sxtrety cn isents eb:All teriz5s taf 1116 Costti7hfton{orttact,'inclu+isrg pxs+vts ils Ott ofanS to'the Cnntraot10 eaCeission aflttix >cllaige,: a terahonz 3nocltftcatrott,dclgxonl or,addxtlon-to tfie Contraot. oatuuents,or oftho work regatred thereunder,, m shall t lease,or exp iera Sore[ oti tljas 3ontl ortn ari!way affect.llx s bligahons;gf$4toW on tbis Sozid-.. Any proeetitng, legal or egiilahl ,Cutdex 4Iis dioi3d shall be Itituted in arty ctnr Q€ciinlpecent lunsdlcttetl' lvl ere a proaeedtng_to pf.ending between C1ty;and Cpn..traotoi.regaidiri a Co>#stnt-c Contract, br a.tx=11x6, courts a th Cottttt © Son.4 ,4i to Cour[of cgrnpeYett4,jt5rfstitGttoti ttt the lobation ixt-Aidl:the tgoated,Coxnmunteattoiis front City to Sutity tinder patagrapli 31 of iltis Bond sTxal l be nceroed ttr tnalude tha hecessaey comma%.adder pnragra h 5'r nfthl 3Qztcl unless,expressly stated at ierwtses 1(Y; AIY zttittce to Surefy Qr Cont for sha11 be xtiailect ox Aptiverod(ai the a dress sed forth gn tllestgnatvte page of this:Bgst ,n .all, nts£zces fo C1ty shall b0 ii atled.o delluered as ptnvtded to D cumbnY ooS ¢ (Corttract). rpt Bial rec i rh o nottoe by Surety, fy Qr ontraetor;:ha+Yever cenmplishetl,,IYall be sufficient ci mpltaricz s. al`thd:date;Kecetvecl at the ford ozri au"dresses'. 1 :. Aiiy provi igtt 1n tBis Band•contiiaft v ith.-qo statutory or regulatory.;regiurement.s1ta11 lie daeined tieletecl lxerofranx gridr(rviions corifarnizng t snch ccatutory requirement shall bo aeeitied ancca?p'.arated herein: 12:1 a[aice of the Conhract Sum: 1`Lxo total;amount pa+alale i%y,G`tyo;CdtltzaGt nr ptftuaat to the feints odsCruatrnu twantiaee after ali:proper' dlustmetiks Ixave been matte uhil .ipe Gti?structtan: ontract;fcxr exampte deducttonS for progress paytients made,and lncceasesTdecreases for approtted mocittiealxons tu: thoanstcttat'14rt Contr..act 1;2 Cor[struatiQn orttxactd:ftecuxttraet bel veea.tatty and Conhaator irden'ltfied Qn Abe sigrtatuo pago t?f#liis. But d triclUt1i11,all Cphtraerl odti,lotslts aild.aliaitges•thdreto: l cbfitracto Drfauhh lYlaten4.al.fatlttre of C"ontractar, wiucll has:tiettller tieea ceirlodzecl titxr uaiued, :to perfPixn or ntlierwtsc;tn caxnp}y +ltlXthe.ternxs ofthe C'onstructxan-ContXank lnclud ng,but.not ltmat d tn;; default" or any other cptldttioti alloWing.a termmattoii for 0,, is proyyde -411.Ao%iinettt f10 gp;. t:;e cr 1. Cityetault;':YvFafertal.tatIute:of City,:aY}itcla teas r<eher• beer<xemadted tior wateti;to pay Cantractol pr¢grss payaieuts dtie usldee the Construetton_Contract or to perforJri ether;matectal;tet111s of the Constrttction'Gantraeta of sucil,fallurb iS:the cause of flie:Yisselted tuontractor l}efanit and xs:sufti etit to usttfj+Cotxkrator tetinatwti of 1116 C`otislrttcttciii, ptttraEt;. EI!TD QFT QCTrGtt+ qty o£Cnperttno Constcactaan;>exfarmattue Bold X01 Pa ieztietat'hcfairitedaalats' roJecf 00610 1 Wef enelvnt . Premium: $27,615.00 Bond No: 12112358 Txpjcgi-N6;.2015=22 DOCUty1ENT 00620 CONSTRTJCII IUIV;I A$OR.P,NO MATERML]Pt YMElY'C]30ND May.262015TITSCbtS'T'l:C'UOTfC}N I;ABbR A,NT3I4?A I IiRTR L T'AYI4I .I ITJ3OND(`e$onit")fs dated:M.. y as. a they. penal sum five Million Seven Hundred_Sixteen Thousand Two Hundred Seventy-Eight and'39/100 Dollars olis hundred p rce tt of t1ie Contract Prnce,and is enft ied into by apd:between the pa fres lrste!helow:to ensure:ttie paymctit of elatmants xndec tic Construction Contract;listed below. xtiis T3ond eonsfsts of this 0,., and:the=Bond'f nyk an. Condtttons, Iraragtaphs 1 througLi 14a: :attacftei_: to -flits age Any :singular reference ko; G ;Bortolotto,.& Company,>Inc rCaniraclor"),: The Gpuarantee Company of North.America USA iSnrety"),the City of Cupert ng;a:Mvntcipal CaYparatton of tha State of,California(i`City"}or otl errray sliall::be cops dexed' lural wliere applicable;::. p coTVTizACTOn::: sUxi1T ; G. Bortolotto& Company, Inca- The Guarantee Company of North America USA Nnine Name 582 Btagato Road 1 Tbwne Square, S.te:1470 , Address Pnneipal PTace:ofBusmeSs San.Carlos CA 94070-Sou field Ml 48076 Otty/tatelZip.. GityJStatel ip. CCNSTRUCTTON'CONTRACT- i65, ONTRACTr 201 S PAV M: NT MAR-4TENANCE,PROJECT FHASE.1 PROJECT NUMBER"1 -22 at Cnpnrt iro,GalifpMa. MATED May 19 ,20:15 in the,Amouutof$'.5716,278.39 the"P'erialS` r"ONTRACtl]RAS P1tTNCIPAL SURETY The GuaranteKomrpanCompany, (Co ,Sea111 Company:. (Co; eat) ofrthSA G. rto1otto & Company, Inc. Signature: 1... gSignature:. e Gt-1'O NameatidT tleGre o cCartne ttorne -in-FactATameandtitleo• 1 yes 1 CA r BOTvT a TRRMS AMID COiID)TT115 G4ntractar'andSurety,o nt[y and seu4raily,<b'nd thetnselvgs their}eirs;.eaecutors,adiniriis&aw—sueeessors. a»d assigns tp City apd ta^Claamatits, fa pay.:£oc Tabor xnatenaTs a?d egwlixuent fiittii'hW dor use in,the; IS;erforntaticeotl eConsFrticftonCnritCact,which;s:ncorporated.herem:byreference, , With JespoGt tO(slt}i;this obligation shall be:iiuXl acid void ifConttactoxt:: 2:1 P'sompfly-Th s pa)ment;ciirecily ar.nclirectly,for all suns due Claimants,and 2 Defends ndemriifies aad-Bolds hatiriless City.from 11 1' demands;:lieiis of suits b..:,tp person or epialy wi o fumiAed labor;.materials or.equipment:for use if+ the;necfonnance of the.Coitstruction. Contact,prodded CRy bas promptly naftfiect Contractor and:Surety(at tho address:`.set forth 6a.the signature:page of'this Bond}of.any claims;dernantls, !rens:mr setts and tendered de dhr a of sucli clairus,;deraandc,liens or suits to Cuiitractor•,ahO Suf4y,and•provided:there ts:no Gtty Default. 3: V t3tli respect to Claimants,flus abligatton stiall be uuli:and vnd.f Cgiit`rdetor promptly hakes paynent;directly: or. tndireekly through its Subcontractors, for all stiitis due.'Claitnants; If Contraotox;pr its.Sibcontxaetors;. haweyer,fail to pay any o£the parstins named in Section 3181 0£tfie.Caitfonua GFvt1`Gode,or,piounts due City of Gupertta() Coristructton Tabor and Material l?ayinient Bositi . 2UlS Pavaine>ihmi ttenaii el o]ectPhase l Q062Q:-:1.` CALIFORNIA/ALL.-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of San Mateo On May 26, 2015 before me, Deborah M. Knipp, Notary Public Date Here Insert Name and Title of the Officer personally appeared Gregory McCartney Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person( whose name(s) is/XX subscribed to the within instrument and acknowledged to me that he/)MX executed the same in his/)(XXNXauthorized capacity(NX,and that by his/)(XXXXsignature(M on the instrument the person%, or the entity upon behalf of which the personK acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. DEBORAH M.KNIPP WITNESS my hand and official seal. COMM.. #1979771 z my air Notary Public•California 70 z • San Mateo County c Signature. Comm.E fres Ma 26,2016 Signature of(Notary Pubic Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the.document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: Corporate Officer — Title(s): Corporate Officer — Title(s): Partner — Limited General Partner — Limited General Individual R Attorney in Fact Individual Attorney in Fact Trustee Guardian or Conservator Trustee Guardian or Conservator Other: D. Other: Signer Is Representing: Signer Is Representing: 02014 National Notary Association •www.NationalNotary.org ^ 1-800-US NOTARY(1-800-876-6827) Item#5907 PraXeet Na 201:5=22. under the Uitemplayment nstirance Code witli:respecffio Work or labor;performed undetAhe Contract,or fiox'. any,arnounts:required its be deducted;:withheld,and paid over fo 4he$inplaymerk.Deyelopment:DepartmenC fr4in the wages of emplby,es°of Contractor or$ubcontractors puisuant to"Sectian:13020 afthe Unemployment_. Instirance Code,with respect to such Work and=labor;tlieu Siuety shad;pay for.the same'and also;in case suit . 1s bruughf upon this Bond,a reasouable:attgrne}+'s fee,to be fixeiby the court. Consistent kith the dal;farnia:Mechanc's Lten;:l.aw, iVt1 Code§3482,et seq,"Surety shall have na obligation. to.Clatmants under-iris Bond unless the Claimant has satisfied all applicablenohce>regit eriients. 5 Surety's rotal;nbligakiort shall not ex, eti the amountoftlnsBorid;and Cheamount'ol thtsBbndshall be credited ;. for"anypayttents made in good Earth by Surety;under ths.Bond 6 Axriounts due Ganttactar under the Construction Contact shall`be a. lied$rst to.satis, claims,:ifpPfy _ yi under any::Constcuction'Perfarmarice Bond and:second, to_satisfy oblsgatioris Of'.Contractor grid Surety under;this Bond 7.. City shall riot be liable for payment of any costs,expenses,pr attorney's:fees o f ai y Clain quit tinder thus 136nd, and:sltall have under tins Bond na obligations to tnake:paymeirtsta,gve'riotic`es on 6ehA of,or"ot(erwise'have abligatlons•to Claimaots ift jWthis;Bond 8. Surety hereby waives notice of.any change,including changes of time,tc the Construction Contract or to related; j subcontracts,,purchase orders and other obligations Surety further hereby wlputates and agrees that nq change; extension of time, alteration or addition to:tlie terms:of the:Construction,Contract,or.ta the Work to.be performed thereunder;qr materials or°equipment•to:be-furnished:thereunder orthe Specificatians•aeeompanying the'same,shall in any way.affect its otiligadons under:this Bpnd and it'does hereby waive any reggnement of notice or any such change,extension of time,alteration or addition to the>tenns of the Construehon.ContracE:or to theWork or to thee-Specifications or any other.changes: 9' Suit;against:Surety ori.this Bbft may lie brought by any,_C}atmant,or its assigns;at any tune after the Claimant liar furnished the last'of the labor of naterials,.:ortioth;hut,perCivil Code§3249;must 6e commenced before the;expiration of stx'morttlis after thc,period.in whichstap notice$,-may be filed as protnded iii"Civil:Code 10 All:iiohces to Surety or co- "etc Shall be,snahed pr delivered:(at the addeess set forth on.the sigiiature page of t1uS:bond) and all not*:jo City sliatl be marled or_.delivered as provided im Docatneiit 00320..(Canttaet). ._ Actual receipt ofnotice by Surety,City or contractor,.howevee:aecorimplished,shah be sufficient c. liance,as ofthe date:reeerved at-the foregoing addresses. 1 l Thts;l3ond lies been fernished tp eomly,with alae Califacsiia Meclianta's'Lien l aw including,but riot limited to, G`7ril Gctde§§3247,3 8,et egg Apy.proviston in this}3and conflicting with said statutory requirements;s1)a11 be deemed deleted horefrom$rid provisions cotifoimmg to siiefi:statutory or oilier legal:regutrements shatl;he deem'o'. rncp posted herein; ;The intent s that this Bond.shall lie construed as a star utoty hond:.a*4,trot';as a. eOIriIrl04181;+01)glld 12; Upoii request by airy..person`or errhty appearing to 6e:a potential benefiatary of this Bond Contractor sfiall xoin tlp,rnish Ofiitisfuaco . :Bond.ot shall ermit a:copy to be made: ..p Y .:. .1?y p 14 1 r Contractor slitll pa,yto person performing Iabar.ut and about Woikprovided forin the Coitract ocuments.an amount eyual.to or more than the general pregatiang rate:of per diem wages far(1)YorIC ofa similar cliaiacrer in the locality;m wbie}i the Work is lSerfarrlied and()legal holiday and overtime work in said localitiy The.per dieiri wages shait'be an amauni equal fir or mare than alto stipulated rates`contairted in sahedule'that has been a§certained andsdetermxned by rite Director of Abe State Depai2mcnt of Xttdttstriaf Rclahoits and City to bo:tite e er preytling rata of per iltem wages for each craft or type of workman ar mechanic needed to.execute:this Contract Catttractpr;shall also cause a;copy of this determination;of pievailing.;rate of per thein tYages to.6e posft d'at each Site City Qt Cppettmp o0.:k:Labor and'1Vlatenal°Payment Botid 20 f 5;1'avemeiit Mauaienance Prod cot Phase l: 00620 ;2, l4.fantfiions; y 14.1 C18tmant. 1 n nndiv dA ar eatity laau ng a direct contract unf4 aCou'aactar or nib a 94b.coutraeror o£s Contractor.to luxtuslt labor;;utaterials oregit"prcent.far use it the Is orniance of the Cant—ct.a5;. fartirer;cicfined ni.( hfortuB Ctv[l fade§31$1 .Tlie i46'fit of this$ortd shall'bd to include Syiti otlt li tiiatiatt the#eixns``iabn maierlals or c u pient",that pati of wafer,gas,-P"I iilhta Beat,.:of gasol ue,tetophune§erv2ce vi rental:egwpm®nt used;in the Constructioxt Contact,archeetnrai;'ad' r ngjneertng serylces regtiirgd fob:pexfQrni nce of.ihe Work off.`Contractor and` :Cophacfor}s,; SuEicoutraetors,and=all a stop notice inightic asseited Elie tersn'Clatinattt shall. 4154 incJt da.the[Jne npigy ie141)evel4p fat 1?epart+o nt as referred tp:i GtvxT Gods 4 2 Coastrnstion Coatrac# The contract betwedn..Oty and Contractor Wont fzed c}n the signs ure gaffe of' ttisrogd, ticluduig;all Coiatfack l7.oeuments anti changes#hereto 4 Y 1]efu Material iatlui'e of.CiiyS vh cll had rieatuei t eeat rem cJred not>mtvedy:to,pay: ilte ontract4rtas tcgn'red Icy tiv Constryction Cantract,'piovided:thai#aztgre zs the cause of the fa}Iure:pf ContzCtaroayihe Cta mants and s:aaffic ept tn ustifyterminaitQXl:pf theonstruciioti'ir+I trgct: Ei+ID OF AQ TJ hTT" CSty bt'tap rttna C lis'trnctiog la br.Muii Matdrial Paytr ent B4ntT:<' 2015 'arieidentMatntenactcePro cat Ply sal: 0070= f THE THE GUARANTEE COMPANY OF NORTH AMERICA USA GUARANTEE Southfield, Michigan POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS:That THE GUARANTEE COMPANY OF NORTH AMERICA USA,a corporation organized and existing under the laws of the State of Michigan,having its principal office in Southfield,Michigan,does hereby constitute and appoint Gregory McCartney, Steve Suissa, Mary Baez James E. McGovern, Inc. its true and lawful attorney(s)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof,which are or may be allowed,required or permitted by law,statute,rule,regulation,contract or otherwise. The execution of such instrument(s) in pursuance of these presents,shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply,to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office. The Power of Attorney is executed and may be certified so,and may be revoked,pursuant to and by authority of Article IX,Section 9.03 of the By-Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31s`day of December,2003. The President,or any Vice President,acting with any Secretary or Assistant Secretary,shall have power and authority: 1. To appoint Attorney(s)-in-fact,and to authorize them to execute on behalf of the Company,and attach the Seal of the Company thereto,bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof;and 2. To revoke,at any time,any such Attorney-in-fact and revoke the authority given,except as provided below 3. In connection with obligations in favor of the Florida Department of Transportation only,it is agreed that the power and authority hereby given to the Attomey-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee,shall not relieve this surety company of any of its obligations under its bond. 4. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner— Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. Further,this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 6th day of December 2011,of which the following is a true excerpt: RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and such signature and seal when so used shall have the same force and effect as though manually affixed. JPaaNTeeco IN WITNESS WHEREOF,THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and its corporate seal to be affixed by its authorized officer,this 23rd day of February,2012. t yQ THE GUARANTEE COMPANY OF NORTH AMERICA USAJ yO IAA'ER P STATE OF MICHIGAN Stephen C.Ruschak,Vice President Randall Musselman,Secretary County of Oakland On this 23rd day of February,2012 before me came the individuals who executed the preceding instrument,to me personally known,and being by me duly sworn,said that each is the herein described and authorized officer of The Guarantee Company of North America USA;that the seal affixed to said instrument is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of Cynthia A. Takai IN WITNESS WHEREOF,I have hereunto set my hand at The Guarantee ate ;;: ,<_; Notary Public,State of Michigan Company of North America USA offices the day and year above written.a Y ko r' County Oakland My Commission Expires February 27,2018 A J Acting in Oakland County I,Randall Musselman,Secretary of THE GUARANTEE COMPANY OF-NORTH AMERICA USA,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY'OF NORTH AMERICA USA,which is still in full force and effect. 04v,,. NTCC, 0 IN WITNESS WHEREOF,I have thereunto set my-hand and attached the seal of said Company this 26th day of May 2015 J yORkAA' ERtt4 Randall Musselman,Secretary Project No.2015-22 DOCUMENT 00630 GUARANTY TO THE CITY OF CUPERTINO,a Municipal Corporation of the State of California("City"),for construction of 2015 PAVEMENT MAINTENANCE PROJECT—PHASE 1 CUPERTINO,CALIFORNIA The undersigned guarantees all construction performed on this Project and also guarantees all material and equipment incorporated therein. Contractor hereby grants to City for a period of one year following the date of Final Acceptance, or such longer period specified in the Contract Documents,its unconditional warranty of the quality and adequacy of all of the Work including, without limitation, all labor, materials and equipment provided by Contractor and its Subcontractors of all tiers in connection with the Work. Neither final payment nor use or occupancy of the Work performed by the Contractor shall constitute an acceptance of Work not done in accordance with this Guaranty or relieve Contractor of liability in respect to any express warranties or responsibilities for faulty materials or workmanship. Contractor shall remedy any defects in the Work and pay for any damage resulting therefrom, which shall appear within one year, or longer if specified, from the date of Final Acceptance. If within one year after the date of Final Acceptance, or such longer period of time as may be prescribed by laws or regulations, or by the terms of Contract Documents, any Work is found to be defective, Contractor shall promptly, without cost to City and in accordance with City's written instructions, correct such defective Work. Contractor shall remove any defective Work rejected by City and replace it with Work that is not defective, and satisfactorily correct or remove and replace any damage to other Work or the work of others resulting therefrom. If Contractor fails to promptly comply with the terms of such instructions,or in an emergency where delay would cause serious risk of loss or damage, City may have the defective Work corrected or the rejected Work removed and replaced. Contractor shall pay for all claims, costs,losses and damages caused by or resulting from such removal and replacement. Where Contractor fails to correct defective Work, or defects are discovered outside the correction period, City shall have all rights and remedies granted by law. Inspection of the Work shall not relieve Contractor of any of its obligations under the Contract Documents. Even though equipment,materials,or Work required to be provided under the Contract Documents have been inspected,accepted,and estimated for payment, Contractor shall, at its own expense, replace or repair any such equipment, material, or Work found to be defective or otherwise not to comply with the requirements of the Contract Documents up to the end of the guaranty period. All abbreviations and definitions of terms used in this Agreement shall have the meanings set forth in the Contract Documents,including,without means of limitation, Section 00700(General Conditions). The foregoing Guaranty is in addition to any other warranties of Contractor contained in the Contract Documents, and not in lieu of,any and all other liability imposed on Contractor under the Contract Documents and at law with respect to Contractor's duties, obligations, and performance under the Contract Documents. In the event of any conflict or inconsistency between the terms of this Guaranty and any warranty or obligation of the Contractor under the Contract Documents or at law, such inconsistency or conflict shall be resolved in favor of the higher level of obligation of the Contractor. G. Bortolotto & Co. , Inc. Contractor's Name 582 Bragato Road Address 7 San Carlos, CA 94070-6227-, City/State/Zip Date END OF DOCUMENT City of Cupertino 00630-1 Guaranty 2015 Pavement Maintenance Project—Phase 1 Wojeet-NN6.2015-'22. 60CUREiN'f'003,36 INSU"NCE FORMS INSURANCE FORMS INSTRUCTIONS FOR ITEMS 3, 4 AND 5, THE FORMS PROVIDED BY THE CITY.OF CUPERTINO MU-ST BE USED. FORMS OTHER THAN THESE,WILL NOT BE ACCEPTED. ALL DOCUMENTS NIUSTDE ORIGINALS-SUBMIT IN TRIPLICATE 1. lnsur4nc-e.Ag,,'reenlcnt-fvftist be signed by Contractor. 2.: -Certificate of Insurance; to the City of Cupertino - must be corpleted by the. insurance agent .or must provide-a, certificate oil the tciftipariVs f6fril. ThdV must contain the same information. 3. Endorsement of Addiatibn' must,ldfisured and and of Cancellation be signedgned*bytheinsurance agent for general liability and auiornob&liability only.Nofice of cancellation provided byinsured 4. Comprehensive general I iab.i I ity/conim crei a[general liability endorsementof aggregate limits of insurance.per project-must be'signed by the'in-surwice agent.for,,-e-i-ictil.-tiability.only. 5.. Waiver of subiogatiori dndoi-senieiit,NNiorker's-comp-ensatioii insurance- - must b6signed-by tile instirance agent for workc?'s compepsationionly. Cjty'of Guprtinc CPavermnillainteun, e Proipet-,PWse I InsuranmForms OG530-I 4;ETY,OF ProJect No.2015-2 2 CUPERTINO INSURANCE AGREEMENT A. Contractor is aware of the provisions of Section 3700 of the Labor Code, which requires every employer to he insured against liability for worker's compensation or undertake self- insurande- in accotdance with the provision$ Of that Code, and will comply. with Such provisions before commencing the performance of the work of this Contract. B. Contractor and all Subcontractors will carry worker's compensation insurance for the Iprotection of its employees during the progress of the work. The insurer shall waive its rights of subro-ation against the City, the City's officers. agents and employees and shall issue an endorsement to the policy evidencing same. C. Contractor shall carry at all times, on all operations hereunder, commercial general liability insurance, automobile liability insurance and builder's all risk insurance. All insurance. coverage shall be in amounts required by the City and shat)I be evidenced by the issuance of a certificate ill a form prescribed by the. City and shall be underwritten by insurance c 'ornpaniies, satisfactoryfactory to the City for all operations, sub-contract work, contractual ohligationsproduct oi-completed operations, all owned vehicles and non-owned vehicles. Saidinsurancecoverage obtained by the Contractor., excepting workers compensation coverage, shall name the Citi, its engineer, and each of its directors, officers, agents and employees. as determined by the City. as additional insureds on said policies. Insurers niust be licensed to do business in the State of California. The Insurers must also have in "A" policyholder's rating and a-financial rating of at least Class V11 in accordance with the current Best's Guide Rathiri or that is otherwise acceptable to the City: D. C efbrc Conti-actor performs any work at,or prepares or delivers materials 'to, the site of construction, Contractor shall Furnish certificates of insurance evidencing the foregoing insurance coverages and such certificatesificates shall provide the narne,aud policy number of each carrier and policy and that the insurance is in force and will not be canceled or modified without thirty (30) days written notice to the City. Contractor shall maintain all of the foregoing insurance coverages in 10 rforceuntiltheworkunderthisConti-pet is, fully completed. The requirement for cat yingr the foregoing insurance shall not derogate from the provisions for indemnification of the City by iContractor under this Contract and for the duration of the warranty period. Notwithstanding nor diminishing the obligations of Contractor with respect to the foregoing, Contractor shall maintain in f611 force and effect during the life of this Contract,the folio-wing insurance in amounts not less than the amounts specified and having a Best's Guide Rating of A. Class V11 or better or that is otherwise acceptable to the City. City Of Cupertino o 15 Pavement maiiiiemace Project-Phase I ltvstlmnce:Forms 00530-2 Project No.,201 5=22 LIMITS Work-er,*s-Compensation In accordance ivlith,the AAlotke, r's Compea4tion Empldyefs"Liability Act of the State ofCalifomia– Woiker5scomp statutory"per CA LaW-,Employers' Liability L 000'000'pr Occurrence. GenerAtiability.-commerc-ial:general,liability;, Combined single-lipil inclildipgprovisions' f6j--cobtractual liqbilitya occu.rrence; aggregate4.0 million in the gi pe rsorial..iiijfjr.y.,itidoi),eildent contractors and products—completed'overations liazard-, Automobile Liability-coinprehensive covering Combined,single lim it'of$1.0 million pdil ov.,ned,non-owned and Hired automobiles. occurrence. G.Bortolotto&Company,Inc. B Contractor'''s Name)Pat Ellis Dated*5/28 20 15 City of,Oipert-ino 2015 PAbihenrMaihwnaka-Proi kt 4htlse I IfisuranceTorms, 00530-3 CITY OF CUPERTIkO CF-RTINCATE OF VN18URANCE TO'THE CITY OF CUPERTINO This.certifies totheCity of Cupertino that the follpNvin g- de-scribed policies have been issued to She insurcd named he ow and are'in force:at time. Insured: G.Bortolotto&Company,Inc. Address: 582 Br6gato Road,San'Cadu,CA 94070 Description of operatioiislioctLioti.q/prodticts,iiistire.d (show contract name and/or number,if any): 2015 Pavement Maintenance Project-Phase 1-Project#2015-22 WOt KER'S COMPOqSATION SUllutory,Mill. Travelers Property Casqalty Co.of-America Employer's Liabilitv dame of itasttrer} 1,000,060, 1,000;000 i:000X0. Insurance Company's State License No. Check Polic"'rypp: Dich Occurrence, 1,006,000 CONTPREUE,NSIVE GENERAL LIABILITY 2,000,000 G.enera 1:A ggre-gate if al5plicable) Owners S.-Contractor.,; 2;000,00&Pr6tective Aggregate- Contractual for Specific Personal lnjlur.Conti-del Products [Jability. XCU Hazards 360,000 Broad 60,OObBroadFormP.D. Fire Damage(any one:rii-6) .S Severability of Interest C10 rise Personal Injury with Medical.Expense S 5,000. Employee ENCIUSi011 Ren-loved any one}person) or C{)t'V ME,RCIAL GL,NE,I&,l.LIABILITY Retention Travelem Property Casualty.Co.of America 00--dF627488 name of insurer) 812112015 Policy No. Expiration Pate City of Cupertino. 2015 Pavement Nfaiwenance Project.—Phise I Insurance Forms_ 005301-4 Project Sze 20'.l'A=22 A UT6TvI OTIVE NEH]CLE LfA9IfjT 1B001Le LNJURl' PRQI'Cl?TYY DAMAGE. Commercial'Forth Each;Pcrson Each Accident Lralilty Cayerage S Travelers Indemgity Each Accident nanie of it surei), or Combined Single Limit Lgoo 000 Policy No.00 QF02-7488 Ekpiratior D'ateanvis- BUILDER'S RISK"ALL RISK`.` Th s:is:ta.certrfy that the follci vin ;polis i as been r su"ed lythe below-stated conjpaiiV in, conformance with the,requirements o-f`the project,docurnerits and is.in force:a(this time. A/ I lanie"of'rnsut er) Policy No: _ Expirtition Date L rmi's"of Liabrht}<i" feductible PSE ` A copy of"tl".1 ndoirsemerits to the policy ies)'which;irrany%tray" went sinrtial)- liiyiit;ihe alcove-listed 1 pes of cauerage are attached.to;tlis CertirICate of Insurance; This;Certificate of Insurance is not pan:insurance,policy;and does not amend, extend;or after the coverage :affor&6.by the Policies 'listed' herein. Noiwithstandmg: ari}` 'requiremeSnt', term; "or condition of,any contract.6r any other clocurnent;.xvitti respect ti wfiieh-this Certificate of•lnsurance pay"be'issued or may pertain,#lie;insurance"afforded by the.policies described lierein"is:suliject to all*tlieterms,,Yclusons rid•ctinilitrcins.gl uclrpolrces: IT-IS.0) RktBIY CERTIFIED that,the:at one colic iesly{ ) Iira.j isle Itaiiiltt} ois ararice.as ieclu_ ci ley: the dnd the i'ns'ured. Pat Ellis attel 5128 15 By - D attach"Certificate=of Insurance;and Additional lrrsureci`'Enslorsent on c pa forms.• 2015 Paveifienc,,,MmnIe'wnceTrojeci—Phase 1 Forms I CITY c7F AT1I]EIT,I01!AL 1NSURED ENDORSEMENT and cupe Yttvo ENDORSENIEN-T OF PRIMARY INSURANCE and NOTICE OF POLICY CANCELLATION ENI)ORSEINIENT 2015 Pavement Maintenance Project-Phase 1-Project#2015-22 Project 1'itleartci 1``uiriter: In consideration of-the policypremium and notwiihstandiilg ahy inconsistent statement in the policy to whidh this Endorsement is attached w any other Endorsement•attached,fliereto; it is.agreed.as fallows The City of Cupertino ("'City").and its,directors. officers, engineers;agents and employees,. and all,public agencies from whom permits wili'be obtained and their tiirecfors, uffcees,eng.itieers, agents.rind employees. and rho 'State of California. and its officers, agents and employees, are I•iei•el.y declared to be additional insureds ittidertlie-terms of chis policy;'but`a tly,%th°Iespeet to the operations of the. Contractor at or upon.any of the.prei iises of, the City in connection with the Contract:with the .City; or acts or omissions of'the additional insureds.in.connectionwith. but limited to:its;eneral-supetvisian or inspection of said•operalions. The insurance afforded by tlt.is.policy is primary insurance, and.iio additional insurance held or owned by, the designated additional,insureds) sliall be:called upon to 'cover a loss under.said' additional policy. Cancellation Notice. Tile insurance afforded,by this policy shall not be.suspended, yoided, canceled, reduced:in coverage:'or in limits,.or materially°altered,except after thirty:(30)days' prior written notice by certified mail; return receipt requested, has been given to the City of Cupertino City"Y. Such notice.shal I be addressed to;the.City as indicated below.'30 day notice is provided by insured POLICY INFORMXFION I. Insurance C or ipany: Travelers Property Casualty Co.of America 2. Insurance Policy Number: COOF027488 3. Effective Dateof this Endofseiiietit: 5/28 20 15 4., Insured,G.Bortolotto&Co.Inc. All notices Herein provided to be given by.the Insurance Company to the:City in connection vvith:this:policy and these Endorsements,,shall be mailed to or delivered to the.,City at 10306 Torre Avenue;•Cupertino;California 95.014.. I it Pat Ellis print/type tiame) City(if-Cupertino 2015Tiiveinent M3intenatice Project-PBase-1 Itisuraitce.Foffw; 04530-'6' i Project No.2015-22 warrant that I have authority to bind the below listed Insurance Company and by my signature hereon do so bind this Company. Signature of Authorized Representative: Jj fz' Original signature required on all Endorsements furnished to the District) Names of Pat Ellis Agent/Agency: Dorsey, Hazeltine & Wynne Title: Broker 400 Seaport Court, #105 650-858-2375 Address: Telephone: Redwood City, CA 94063 Facsimile: City of Cupertino 2015 Pavement Maintenance Project—Phase 1 Laurance Forms 00530-7 C;TY O6 t'oject No,2015-22 COMPREHENSIVE GENERAL LIABILITY CC3MNIERCIAL GENERAL LIABILITY ENDORSEMENT OF AGGREGATE LIMITS OF CUPERTINO. IliSIJRA CE PER PROJECT Project Title and Nitinber: Project#2015-22-2015 Pavement Maintenance Project Phase 1 In consideration ofthe policy pretnium and nonvidistanding Zany inconsistent statement in the policy to which this Endorsetneut.is attached or any other Endorsement attached thereto. itis as follows: This Endorsernent modifies the insurance provided under the. General Liability Coverage part of'the field« referenced policy of i isttrance. The generral aggregate limit tinder 1. IMITS OF INSURANCE applies separately to the pt•c?jet t described as Project 2015-22,2015 Pavement Maintenance Project Phase 1 POLICY INFORMATION Travelers Property Casualty Company of America 1. l isura nce C oni pang°: lnstiranee Poli.cv Number: CO OF027488 I 3. Effective Date ofthis Endorsennent:5128 o 15 4. Insured: G.Bortolotto&Company,Inc. 5. Additional Instired: Citv of Cupertino, its directors,officers,agents and employees. All notices herein provided to be given by the Insurance Company to the City in connection with this policy and this T?.ndorsement, shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino,California 95(114. 1. Pat Ellis print/type name) warrant that I have authority to bind the below listed Insurance Conipatav and by n'ty signature hereon do so bind this Cotnpaany. Sigtnatoi-e of Awhorized Rcprt:scniativc: Original signature required on all I ndorsennents fiti-tnished to the District) Nnine;s of 1A*gent/A,ency: Pat Ellis/Dorsey,Hazeltine&Wynne Title,: Broker Address: 400' eaport"Cf.;#1U5,"Redwoo i Telephone: 650-858-2375 Facsirnite. 65OM6=TO23 C ity ofCupertino 015 Pnvcrnent aintetaarrce Project-Phase I tmsur~aitch Forins 1 f CITY OF t'roj:ct'Vo.?015-3? WAIVER OF SUBROGATION ENDORSEMENT WORKER'S COMPENSATION INSURANCE CtJP>:R"TItVO Project 2015-22,2015 Pavement Maintenance Project,Phase 1 Proaect Title and Number: In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attaclted or tiny tither Endorsement attached thereto,it is agreed as follows: It is agreed that with respect to such insurance as is afforded by the policy.the insurance Company awes any fight.orsubrogation against the City ofCupertino_and each of its directors, officers,agents, consultants and employees by reason of any paynteht made oil account of injury, including death resulting therefrom. sustained by any employee of the insured, arisin3 out of the performance of t11e l alcove-referenced Contract. I POLICY INFORMATION 1. Insurance Company:_ Travelers Indemnity Company of CT DT JUB OF027488-8-14 2. Insurance Policy Number: 5/28 153. `Irffcciiv e Date of this Endorsement: 20 4. Insured: G.Bortolotto&Company,Inc. All notices herein provided to be given by the Insurance Company to the: City in connection .with this policy and this J:ndorsentent, shall be mailed to or delivered to the City at 10300 Torre Avenue,, Cupertino.California 95014. 1, Pat Ellis print/type name) wart•ant that I have authority to bind the below listed:Insurance Company and by my sigtcatttre hereon do so bind this Company. Signature of-Authorized Representative. Original signature required on:ill Endorsements furnislied to the District) s Naattes of Pat Ellis/Dorsey,Hazeltine&Wynne AgentlAgeney: Title: Broker 400 Seaport Court,#105 650-858-2375 Address:_ P Telephone: _ r Rdwood City,CA 94063 650-856-1023Facsimile: City of Cupertino 2013 Pavement Maintenance Prc icct-Phase t Insurance farms 00530-9 CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) 5/28/2015 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 be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Pat EllisNAME: Dorsey, Hazeltine & Wynne PHONENo, 650-858-2375 FAX No:(650)856-1023 License # : 0281413 E- OMAIDREL . PEllis@dhw-ins.com P.O. BOX 50307 INSURERS AFFORDING COVERAGE NAIC N Palo Alto CA 94303 INSURERA:Travelers Pro Cas Co of Am 19038 INSURED INSURER B:The Travelers Indemnity Co. CT 25682 G. Bortolotto & Co. , Inc.INSURER C: 582 Bragato Road INSURER D: INSURER E: San Carlos CA 94070 INSURER F: COVERAGES CERTIFICATE NUMBER:14/15 Umb Inc REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADD SUER POLICY NUMBER MM/ DDY/ YYYI MMIDD YY LIMITSLTR GENERAL LIABILITY EACH OCCURRENCE 11000,000 1A AGE TORENTED X COMMERCIAL GENERAL LIABILITY PREM SES a ocEcurrence $ 300,000 A CLAIMS-MADE I OCCURCO OF027488 21/2014 /21/2015 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 X Per Project if required GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY X PRO LOC Deductible 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 B X ANY AUTO 10 OF027488 BODILY INJURY(Per person) $ ALL OWNED CHEDULED 21/2014 /21/2015 BODILY INJURY(Per accident) $ AUTOS AUTOS X HS NON-OWNED PROPERTYDAMAGE HIRED AUTOSAUTOS Per accident Deductible 1 000 X UMBRELLA LIABX OCCUR EACH OCCURRENCE 10,000,000 B EXCESS LIAB CLAIMS-MADE CUP OF027488 AGGREGATE 10,000,000 DED I X I RETENTION$ 10,00 21/2014 /21/2015 A WORKERS COMPENSATION X WC STATU- OTH- CRYANDEMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT 1,000,000 OFFICER/MEMBEREXCLUDED? NIA TJUB OF027488-8-14 21/2014 /21/2015MandatoryinNH)E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if mon:space Is required) RE: 2015 Pavement Maintenance Project--Phase I, City Project No. 2015-22 The City of Cupertino and its directors, officers, engineers, agents and employees, and all public agencies from whom permits will be obtained and their directors, officers, engineers, agents and employees; and the State of California, its officers, agents and employees are named additional insured per attached General Liability endorsement form. Additional insured for Business Auto if required by contract. Primary wording applies. General aggregate limit per project applies. Workers' Comp waiver of subrogation in favor of the City of Cupertino and its directors, officers, agents, consultants and CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Cupertino ACCORDANCE WITH THE POLICY PROVISIONS. 10300 Torre Avenue Cupertino, CA 95014 AUTHORIZED REPRESENTATIVE Anthony Wynne/PE ACORD 25(2010/05) 1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and loco are registered marks of ACORD COMMENTS/REMARKS employees. 30 day notice of cancellation provided by the named insured. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. COM I MtRQiAL'GE_ N`E-RP;I_LIABILITY POLICY NUMBER: CO IF027488 ISSUE DATE:0 8-2.9-14 THIS-ENDORSEMENT CHANGES THE'.POLICY. PLEASE READ IT CAREFULLY DE$'IGNATED'.PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement'modifies insurance provided under.the following: COMMERCIAL GENERAL LIABILITY COVERAGE-PART SCHEDULE Designated Project Qe$lgnated Project(s):General Aggeegate(§): EACH !'PROJECT" FOR WHICH YOU HAVE AGREED, IN GENERAL AGGREGATE A -WRITTEN CONTRACT WHICH IS. IN EFFECT DURING;LIMIT SHOWN ON THE THIS POLICY PERIOD, TO: PROVIDE 'A, SEPARATE DECLARATIONS. GENERAL AGGREGATE LIMIT, PROVIDED THAT THE CONTRACT IS SIGNED AND. EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "'PROPERTY DAMAGE" OCCT_Tk,&. A. For all sums:which the insurednsured becomes.legally 3. Any payments made under,COVERAGE A. obligated to pay as damages caused by "occur- for damages or under COVERAGE C. for rences", under COVERAGE A. (SECTION'll),,and medical expenses shall reduce the, Des,ig- for all me.dic,0.1 expenses caused by accidents Lfh- hbtdd Project- General Aggregate Lim,it for Tier COVERAGE C:(SECTION 1), Which-can be t.h6tAesignated "project". Such payments attributed only to operations at a single desig- shall not reduce the General Aggregate Limit nateld,"prpjpqt"shown in the Schedule,,'above: shown in.the Declarations nor shall they rp- 1. A stparate'Designated Project General 9-A duce any. other Designated Project General 1 greg6te Limit appiies,to each designated"pro- AggregateLimit for any other' designated ject", and that limit is equal to the amount of project"shown in the Schedule-above. the General Aggregate ,Limit shown in the 4. The limits shown in the.Declarations for Each Declarations, unless separate Desigh'ated. Occurrence, Damage To Pirernise§ Rented Project, General Aggregate(s) are sched I- to You and Medical _Expense continue to uled,above. apply. However, instead of being-subject to 2. The Dbsig'rfated Project General Aggregato, the .General Aggregate Limit. shown in the Lim-it i'.thb.most,we. CWill pay for the.sum of all Declarations., such limits will be subject to the damages under OVERAGE A., ;exce-pt applicable Designated Project General Ag- damages because of,""bodily inj yry, !',or"prop- gregate Limit. erty damage" included in the= "products- B; For all sums which the insured becomes legally completed operations hazard", and for medi- obligated to pay as damages caused by "occur- cal. expenses under COVERAGE C, regard- rences' under,COVERAGE A. (SECTION 1), and less of the'number,of: for all medical expenses caused by,,accidents,,un- a. Insureds;der jCOVERAGEC. "(SECTION 1), which cannot be.-attributed ohly.to operatio'h§ ata single desig-lb. Claims made of"suits" brought;QT9 nbtb.d"prpjpct"shown in the Schedule above: C.. Persons i.of:organizations miklbj claims 0('brindng,"suit$ 7,_. CG D2 11 01* Copyright, Thd Tro\iiblers:lridethhity'Cofii'aqy, 2004 Page 11,of'2 COMMERCIAL GENERAL LIABILITY 1. Any payments made under COVERAGE _A. vided, any payments for damages because of for damages or under COVERAGE C. for bodily injury' or "property damage" included in medical expenses shall reduce:the amount fhe "products-completed operations hazard" will available under the :General Aggregate Limit reduce the Products-Completed Operations Ag- or 'the Products-Completed Operations Ag- gregate Limit, and not reduce the General-Aggre- gregote.Limit,whichever is applicable; and gate Limit nor 'the Designated Project General 2. Such payments shall not reduce any Desig- Aggregate Limit. nated Project:General Aggregate Limit. E. For th&purposes of this endorsement.the Defini- C. Part.2.of SECTION 111-.LIMITS OF INSURANCE tions Section is.amended by'the addition of the is deleted and replaced by-the following: following definition:' 2. The General Aggregate Limit is the most we Project'' 'means an area .away from premises will payfor the sum of: owned by or rented to you at which you are per- forming _operations pursuant to a contract or a.. Damages.under Coverage B;and agreement.,For the, purposes of determining the- b. Damages from "occurrences" under applicable aggregate limit of insurance, each COVERAGE A (SECTION 1), and for all project" .that includes premises involving the medical expenses caused by 'accidents same or connecting lots, or premises whose con- under COVERAGE,C (SECTION 1)which vection isinterrupted only.by a street, roadway, cannot be attributed only to operations at waterway or right-of-way of a railroad shall lbe a single designated"project"shown in the considered a single"project". SCHEDULE above. F. The provisions of SECTION III LIMITS OF D. When 'coverage for liability arising out. of the INSURANCE not otherwise modified By this en- products-completed operations hazard" is pro- dorsement shall continue to apply as stipulated. Page 2 of t` Copyright,The Trovelers!lndemnify'Company,2004 C0_D2 11 01'04 Policy No. CO OF027488 COMMERCIAL GENERAL LIABILITY THIS'ENDORSEIVIENT CHANGES THE"POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED` CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL.LIABILITY COVERAGE PART 1. WHO IS AN INSURED—(Section li)is amended c) The,insurance provided to the:additional in= to include any person or organization that you sured does not ,apply to "bodily injury" or agree in a "written contract requiring insurance" property damage" caused by "your work" to include as an"additional insured on-this Cover- and included in the "products-completed op- age Part, but: erations hazard" unless the "written contract requiring insurance" specifically requires youa) Dnly with respect to lability for'bodily injury to;provide such coverage for that additionalpropertydamage"or"personal injury" and Insured, and then the.,insurance provided to b) If, and only to the extent that, the injury or the 'additional insured applies only to. such damage is caused by acts or omissions of bodily injury" or"property damage"`that oc- you or your subcontractor in the performance curs before,the end of the period_of time for, of "your work" to which the "written contract which the "written 'contract requiring insur- requiring insurance" applies: The person or ance"requires you to provide such,coverage organization does not qualify:as-an additional or the end of`the policy period, whichever is insured with respect to the,independent acts earlier. or'omissions of such person or organization. 3. The,insurance provided to the additional insured 2. The insurance provided to the additional insured bythis endorsement is excess over-my valid and bythis endorsement is.limited as follows: collectible "other insurance", whether primary,, a) In-the event that the Limits of Insurance of excess; contingent or on any other basis, that is this•Coverage Part shown in the Declarations available to the additional insured for a loss we exceed the limits of liability required by the cover under this endorsement. However, if the written contract requiring insurance", the in- written contract requiring insurance" specifically surance provided to` the additional Insured requires- that this, insurance apply on a primary shall be limited to.•the limits of:liability re- basis ,or a primary and non-contributory basis, quired' by 'that "written contract requiring in= this insurance is primary to "other• insurance" surance". This endorsement shall r"ot :in'_ available`to the,additional insured which covers crease the limits 'of insurance described in that person or organization as a named insured Section III—Limits Of Insurance. for such loss, and we will not share with that other insurance". But the-insurance provided to b) The insurance provided to the additional in- the additional insured,by this endorsement 'still is sured does not'applyto "bodily injury 'Vprop- excess over any valid and collectible "other in- erty damage" or "personal injury" arising out surance'; whether primary, excess, contingent or of'fhe rendering of, or failure to render, any on any other basis, that is available to'the addk-professional architectural, engineering or sur- tional insured when that person or organization is veying services, including: an additional insured under such, "other insur- i. Th'e preparing, approving, -or failing to ance prepare or -approve, maps shop draw- 4. As a condition of coverage provided to the Ings, opinions, reports, surveys, field or- additional insured by this endorsement:ders or change orders, or the preparing, approving, or failing, to prepare or ap- a) The additional insured must give us:written prove, drawings.and specifications; and notice as soon as practicable of an "occur- rence".or an offense which may•result in aIi. Supervis"ory 'inspection, architectural or claim. To the extent possible, such notice engineering activities. should include: CG'D211146 08 05 0 2005The==9t.Paul Travelers Companies, Inc. Page 1 6f.'2 COMMERCIAL GENERAL LIABILITY` i. How,. when,and where the, "occurrence." any provider of"other insurance",Wkich would or offense'took place; cover.- the°:additional- insured for a loss we 11. The names and addresses%d any injured cover under this endorsement. However,this persons and witnesses; and` ` condition does. not affect whether the insur-'ante, provided ,to the add'itional' insured by Iii: The nature and location of any injury or this endorsement is primary to"'other insur- damage arising out of the"occurrence"or ante" .available to the additional insured offense. which covers that person or'organizati'on as.a b) If-a claim is made or"suit is brought against named insured as described;in 'paragraph 3. the additional.insured, the additional.insured above. must: 5. The foljowing definition is added to SECTION_V. I. Immediately record the specifics of the DEFINITIONS; claim or"suit"and;the date received;and VVritten,contract requiring insurance" means li. .Notify us assoon as practicable. that part of any written contractor agreement The additional insured,must see:to it that=-we under which you are required-to include a receive written notice of-the claim or"suit",as person 'or organization as, an additional in- sured on this Coverage Part, provided that soon,as practicable. the "bodily injury",and "property.damage" oc- c) The additional insured 'must immediately curs and the "personal:injury":is caused,byan sond,us copies of°all legal papers received in offense committed: connection.with the claim or"suit',cooperate a: ,After,the signing and execution of with us in the investigation or settlement of contract or agreement by yo;u; the claim or defense against the ':'suit", and otherwise:comply,with'all.policy conditions. b. 'While that parte of.-thecontract or d) 'Th'e additional insured musttender the .de- agreement is in effect;and fen'se and indemnity of any claim or "suit" to c. Before the end of the'policy.period. Page 2 oft. 2005 The;St..Paul Travelers:Companies, Inc CG`D2 46 09 06 Policy No. CO OF 02 7488 COMMERCIAL GENERAL LIABILITY THI&ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XT-END ENDORSEMENT This endorsement modifies insurance',provided under thefollowing: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OFCOVERAGE—This endorsement broadens co've'rage.However,cov.6rage.for'any injury,,damage or medical expenses described in any of the provisions of this endorserhent may be excluded-or limited.by.another endorsement to this,Coverage Part,and these:coveragebroadening provisions do nlot".apply'to the extent that:coveraqe,-is excluded or I I imited by.such an endorsement.,The-following listing provisions I is w-general cover=. age description only.Limitations and,-exclusions may apply to these coverages. Read all the of this en- dorserneritand the-rest",of your policy carefully to-,di4terrn i6e right$;d6tios,arid."what is-and is,notcovdined. A. Aircraft Chartered With Pilot H. Blanket Additional Insured — Lessors Of Leased 13. 'Damage To Premises Rented ToYou.Equipment C. Increased-Supplementary'Payments 1'. Blanket,Additional Insured — S#aces Or Political D. Incidental Medical Milprac I tice Subdivisions—Permits, E. Who Is An Insured-:'Newly Acquired Or Formed J. Knowledge,And.Notice OfOccbrrenc.d.OtOff6rigb Organizations K. Unintentional Omission. F. Who Is An Insured Broadened Named Insured L. Blanket'Jivdr Of Subt6gation Uhriarned.Subsidiaries M. Atnended;136dily'Injury Definition G. Blanket Additional lhsured'-— Owners, Marittobirs N. Contractual Liability--Railroads Or Lessors Of Preffiisds. PROVISIONS INJURY AND. PROPERTY 'DAMAGE Ll- A.. AIRCRAFT CHARTERED-WIITH PILOT ABILITY: The f6lioWino is,adde d to Exclusion,g., A.ircraft, Exclusions c. and g., through n, do,notapply Auto Or Watercraft,in Paragraph,2.of SECT,[ON to "pr6hiise's d6ffiagb". Exclusion I —COVERAGES COVEftAGEA' BODILY IN- does hot,apply to"premises damage"caused JURY AND,PROPERTY, DAMAGE I LIABILITY,- by: This exclusion-does not apply to an aircraft that a. Fire; is, b. Explosion; a) Chartered with a pilot to any insured; c. Lightning; b) Not owned by any insured-,and d; Smoke resulting from such fire,explosion, c) Not b6ipg used to carry any person or prop- or lightning,,or grty-for a charge. e. Water; B. DAMAGE TO PREMISES RENTED TO YOU, unless-Exclusion f.of Section t—Coverage A. 1. The,first paragraph -of the exceptions.in:Ex- Bodily Injury And FProperty Damage-Liability elusion j., Damage To Pro'Perty., in.Para- is -replaced- by another endorsement to this graph 2' of SECTION., I — COVERAGES Coverage Part-that has Exclusion—All Pollu- COVERAGE A BODILY INJURY' AND tion-Injury Or Damage or Total Pollution.Ex- PROPERTY DAMAGE LIABILITY is deleted. clusion in its title. Z The f6llowing,,replaces-the,last paragraph;of A separatP limit of insurance- applies to Paragraph 2., 'Exclusions, of SECTION I premises damage" as described 'in Para- COVERAGES — COVERAGE A. BODILY. graph.6, of SECTION III — LIMITS OF IN- SURANCE., CG D3 1611 11 Q 2011 the Travelers indemnity company,AlIrldfits reserved. Page 1 of 6 coMMERClAL GENERAL LIABILITY 3. The following replaces Paragraph 6:'of':SEC C. INCREASED:SUPPLEMENTARY PAYMENTS. TION 111-LIMITS OF INSURANCE: 1. 'The following replaces Paragraph 1.b: of Subject to 5. above, the Damage To Prem- SUPPLEMENTARY PAYMENTS`— COVER-. ses Rented To You Limit is=the most we-will AGES A AND' B of SECTION I COVER- pay under Coverage A.for damages'because AGE:: of "premises;damage" to.any, one premises. b•- Up to $2;500 for the,cost.of bail bonds The Damage to Premises Rented To You required because of accidents or traffic Limit -wilt apply to. all "property damage" law,violations arising out ofthe'use of any proximately caused .by the same "occur- Vehicle to.which,the Bodily Injury Liability eence"; whether such damage results from: Coverage applies:We do not have;to fur- fire;explosion;;lightning;smoke resulting from Wish these,bonds. such fire;•explosion, or lightning; or water or any combination 6f any of these causes: 2• The following replaces Paragraph 1:d:. ,of SUPPLEMENTARY'.PAYMENTS- COVER- The Damage. To Premises Rented To YouAGES A.AND B of SECTION I COVER- Limit will be: AGES: a: The:amount. shown for the Damage To d. All reasonable`expenses incurred by'tIhe Premises Rented To 'You' Limit on the insured at our request.to assist us in.the Declarations of this Coverage Part,.or investigation or defense of'the claim or b. $300;000 if no.amount is-shown for'the suit; including actual loss of.eamings up Damage To. Premises Rented To You to $500 a day because of time off from Limit on the-Declarations of this Coverage work. Part. D. INCIDENTAL MEDICAL MALPRACTICE 4. The following 'replaces Paragraph.a.; of, the The following is added to the definition„of"oc- defriition of"insured contract”1n the DEFINI'- currence"1,n'the DEFINITIONS Section: TIONS Section: Occurrence" also means an act or omission a. A contract for.a lease of premises. How- committed in .providing or failing to prow{de ever; that portion of .the .contract for a incidental medical services", first. aid or lease of premises that indemnifies any good Samaritan services"to a persom person or organization for "premises damage"is'not ar"insured.contract"; 2. The following is added to Paragraph'2.a.(1;)of SECTION 1!—WHO IS AN INSUREDS 8The,fallowing is added`"to:the:DEFINITIONS Pa_ragrapti''(1)(dj above ;does not apply toSeotion bodily injury" arising out of providing or fail- Premises damage" means "property, dam- age"to; ing ta:provide: 1) "Incidental medical services by any of a. Any-premises while rented to;you or tem- your "employees" who is a nurse 'peacti- porarily occupied by.you with.permission tioner, registered nurse, licensed practical of-the owner;,ornUfS2, nurse-assistant, emergency'medi- b. The contents of any premises while such- cal technician or paramedic;or premises is rented to you,if you rent'such Ii) 'First aid or"Good Samaritan services" by premises for, a period of seven or:fewer any of: ;your "employees" or, `''volunteer,consecutive days.workers", other than an employed or Yol- 6: The following replaces Paragraph 4:b.(11)(b) unteer doctor. Any such "employees" or of`SECTION IV- COMMERCIAL GENERAL Volunteer workers".providing or failing to LIABILITY CONDITIONS provide first aid or"Good'Samaritan ser- b) That is insurance for"premises.damage'; vices" during their work hours for you will or be deemed to be.acting Within the scope 7,. Paragraph 4.b.(1)(c) ofSECTIONL IV` of their employment by you or.perfornming COMMERCIAL.GENERAL.LIABILITY CON- duties related to the conduct ofyour busi JITIONS is deleted.ness. Page 2of,6 2011 The Travelers lndeninity Company.All rights reserved: CG D3 16'11 11 COMMERCIAL GENERAL LIABILITY S. The following is added fo Paragraph ,5: of 4. Any organization you newly acquire or form,. SECTIONJII LIMITS'OFINSURANCE; other than a.partnership,.join t'venture:oe i'm- For the purposes of determining the applica- ited .liability company, of which you are the ble'Each Occurrence,Limit,;all related acts or sole-owner or:in:which you maintain:the na-: omissions committed'in providing or failing to jority ownership interest;, will qualify as a provide "incidental medical services",;first.aid. Named Insured if there is no otherinsurance or"Good Samaritan services"to any one per- which .,provides similar coverage to that or- son will be deemed to be one"occurrence ganizatlon...Howevoc 4:. The' following exclusion---'is.,added;;to P*0- A. Coverage under this provision is, afforde d. graph 2 , EkdIdsions,of SECTION I—Cov only: ERAGES--COVERAGE A BODILY INJURY 1) ;Until the 180th day after you acquire`or,AND PROPERTY DAMAGE LIABILITY:form?the•organization or the`kend of:the Sale O.f`:Pharmaceuticals,policy period;whichever is earlier,--if'.your Bodily injury" .or "property:damage"-arising do not report such organization in writing out of';the'willful violation:of A,penal statute or.. to us within 1,80-days.after you acquire:or ordinance_relating to-the sale of plharrnaceuti- form it;br Gals committed by, or with the knowledge of 2) 'Until :the end of the policy period, when consentof,the insured: that date is'later than 1.80 days after-you 5i. The following is added to,the DEFINITIONS acquire or'forn! such organization; if,you Section: report,such organization In writing to us Incidental medical services"means: within 180 days.after you acquire or form a: Medical,surgical,-dental, laboratory;x=ray it; and we agree in writing that if will:con- or nursing service orareatment, advice:or linos to be.a Nameddnsured untilthe:ena. instruction, or the related furnishing.of of the policy,period; food-or beverages;.or b. Coverage A.does not apply to "bodily injury" b: The"furnishing or dispensing of,drugs or or ''property: damage" that occurred before.. medical, dental; or surgical supplies. or you,acquired or formed the organization,and appliance's: c. Coverage B=does not apply,to "personal-in G66&Samaritan"services"rneans-any:emer- jury" or "advertising injury" arising out>of an gency:medical services`for which:no compen offense committed before you :acquired or sation;is demanded,or;received:. formed the organization. 6. The'following`is added to Paragraph-4.b., Ex- 1=. WHO IS AN INSUREDCOM- INSUR BROADENED NAMED cess Insurance, of SECTION IV ED-UNNAMED SUBSIDIARIES MERCIAL GENERAL LIABILITY. The:following is added.to:SECTION.ll-WHO'IS DE- The insurance'is excess over any,aiid and AN INSURE collectible'other insurance available to the in- Any,cif'3yours6bsidiaries otl erthan a partnership, sured,whether,primary; excess,contingent or jolhCVd6tue&or limited liability, company, that;-lis on any other;basis, that:is available to any of not shown as,a Named Insured Jh the, Declara- your "employees" or "volunteer workers".for tions,is,,a NamedInsured if you maintain an-own- bodily injury"that.arises out of providing or ership interest of morethan 50% in such:subsidi failing ;to ,provide "incidental medical, ser argon the,first day of the policy periods vice's";-first aid or"Good Samaritan services No:such subsidiary is an insured°for"bodily injury." to any person to the-extent knot,subject to or"property'damage"that occurred, or"personal Paragraph 2a,(1.) of Section 11 —'Who is Anor 'adrtising injury„:caused by an of- Insured. fense committed after.'the datei if any, during:the E: WHO, IS AN .INSURED. - NEWLY ACQUIRED policy, .period; that you no longer maintain an OR,'FORMED`ORGANIZA'£IONS ownership interest of more than 50%:h such sub- The following replaces ParagraphA 'ofSECTIONidia'ry.. If—_WHO IS AN INSURED:' CG D3 16 11 11 @2011 The Travelers Indemnity Company.Allrights'reserved: Page;3.=of 6 COMMERCIAL GENERAL LIABILITY G, BLANKET ADDITIONAL.IidSUf2Eb_OwNEks, H. BLANKET ADDITIONAL INSURED—LESSORS. MANAGERS OR LESSORS OF PREMISES:OF LEASED EQUIPMENT The following is added to SECTION 11 —WHO IS The following,is.added to SECTION li VVH04S AN INSURED; AN,.WSURED; Any person or organization that is''a premises Any person or organization that is,an equipment owner,`• manager or lessor and that you have lessor and that you have agreed in of written con- agreed•in a written contract or agreement to in- tract.or agreement to include as.an insured on elude°as an additional insured on this Coverage this Coverage Part-is an insured, butonly with re- Part is an insured; but onlywith respect.to liability spect to liability for:".bodily injury.","'property dam- for "bodily injury", "property damage", "personal age.","personal.injury"'or"advertising injury"that: injury"or"advertising injury"that; a. Is "boll in u " or" roe damage" 'that a. Is "bodily injury" or "property damage:' ;that y''' i ` p p ' 9. occurs, or-Is "personal injury"or"advertising:, occurs, or is "personal injury" or"advertising injury" caused"tiy an offense that,is commit- injury" caused by,an offense that is commit- ted, subsequent to the execution of that con- ted,.subsequent to the execution=of that-con- tract or agreement;and tract'or`agreement;-and b. Is_caused;--in'wholeorrin,part,Eby,%your acts'or b. Arises out of the ownership; maintenance or omissions in the maintenance, operation or use of that part:of any premises leased,to use of equipment leased to you ti you: Y Y such equipment1essor. The insurance provided to such premises'owne.r; The insurance'provided'to such equiprnent.lessbf manager or lessor is"subject to the following pro- is subject to the following provisions: visions: A. The limits; of insurance provided to such a. The limits of insurance provided to .-such equipment lessor will be the minimum limits premises owner, manager or lessor- will' be which you agreed to provide in the. written the minimum limits which you=agreed ta'pro- contract or agreement, or the limits shown on vide:-in the,written contract'or agreement; or tho Declarations„whichever'are,less.. the'limits shown on the Declarations, which- ever are less. b. The insurance provided to such equipment lessor does not apply to any"bodilyinjury" or b.. The insurance provided to such premises owner;manager or lessor does;not,applyto:: property damage" that occurs,,or personal, injury"or"advertising injury"caused by;an of-- 1) Any "bodily injury'" or "property damage" fense that,is committed after the equipment that occurs,or"personal injury"or"adver- lease.expires. tising injury" caused by an,offense that Is, c. The:-insurance provided to such -equipment committed;after°you cease to be a tenant. 1e9sbe1s excess,over any valid.`and coltectibie in that premises;or other insurance available:to such"equipment 2) Structural alterations, new construction or lessor, .whether primary, .excess, contingent demolition operations performed by oron or on any "other basis, unless you hage behalf'of such premises owner, lessor or agreed in the written contract:.or agreement manager. that this insurance must be primary to, or c. The insurance provided to 'such premises non-contributory with, such other insurance, owner, manager or lessor is excess Ever anyin which case this insurance will be primary valid and collectible other insurance available to, and non-contributory with, such other in= to.such-premises owner, manager or.lessor, surance. whether primary,. excess, contingent or ,on- I';L3LA IKET ADDITIONAL INSURED. —.STATES any other basis, unless you"have agreed iii lk POLITICAL SUBDIVISIONS'=PERMITS the written contract or agreement that'this 10- The following is added to SECTION If—WHO IS surance must be primary to; or cion-AN INSURED: contributory with; such other insurance, in which case this insurance will be primary to, Anystate or political subdivision that has issued a and non-contributory with, such other insur- permit in connection with.operations performed by ance. you or on your behalf and that-you are required Page 4 of`6, 2011 The=Travelers Indemnity Company:Alb rights`reserved. CG D316 11 11 COMMERCIAL GENERAL LIABILITY by any ordinance, law or building code to include ii)::A manager of any limited liability as an,additional insured on this Coverage Part is company; or am insured, but only with respect to liability for iii)An executive.officer or director of bodily injury" "property damage","'personal•iii= any other organization; jury"or"adve'rtising injury"°arising out of such op-that is your partner; joint venture erations. member or manager;or The insurance provided to such' state orpolitical b) :Any "employee" authorized by such subdivision,does_not apply to: partnership, joint`venture, limited l'i-. a. °Any. "bodily injury," "property damage," "per- ability company or other organization sonal injury"or"advertising injury"arising.out to:give notice of an "occurrence or of.operations performed'for that state or po-• offense. lifical subdivision; or 3j 'Notice to us of'such"occurrence"or of an b. Any "bodily injury" or "property damage" .in- offense'will be deemed to be given as eluded in the "products-completed .operations soon as practicable if it is giuen in good Kiizard". faith as-soon as practicable to your w'0rk- J. KNOWLEDGE AND NOTICE. OF OCCUR- ers' compensation. insurer. This applies RENCE OR'OFFENSE only if you subsequently give notice to..us The following is added to Paragraph 2., Duties In of the"occurrence"or offense as soon as The; Event of Occurrence; Offense, Claim or practicable after any of.the persons de- Suit, of SECTION IV COMMERCIAL GEN'. scribed in Paragraphs e. (1) or-(2),above. ERAL LIABILITY CONDITEONS:. discovers that the"occurrence'"or offense may result in,sums to which the insurance e. The. following provisions apply to Paragraph provided under this Coverage Part-may a. above, but only_ for the purposes of-the in- apply: surance provided under this Coverage Part to you pr any insured listed in Paragraph 1.or 2. However, if this Coverage Part includes; an Jen-However, Section<II_-Who is An.Insured:dorsement that provides liitiited. coverage for bodily injury" or "property damage" or pollution 1) Notice.to us'of'such "occurrence"or of- costs arising out of a discharge, release,or es- fense must be-given as soon as practica= cape of"pollutants"which contains a requirement ble.,only after the "occurrence" or,offense that the discharge, release or escape of "pollut- is kriown;by you(if you are an individual), ants"' must.be, reported to. us within a specific any,of',your partners or members who,is number of'days after its abrupt commencement, an individual (if youare a partnership or, this: Paragraph e: does not affect that require- joint venture), any of your-managers who. ment. is.an individual':(1f you area llmitedjiatiility` K UNINTENTIONAL-OMISSION company), any' of your "executive offi- cers"`or directors(if you are an organiza- The following is added to Paragraph 6.i Repre- tion oiherthan a partnership,joint venture septations, of SECTION IV — COMMERCIAL or limited liability company). or any "em- GENERAL LIABILITY CONDITIONS: ployee" authorized by you to give-notice The unintentional omission of; or unintentional of an•"occurrence"-oroffense.error in, .any.'information provided by you which 2) If you are.a partnership,,joint venture or we relied upon in,issuing this policy will not•preju- limited liability company,and none ofyour. dice your.rights:under this,ipsarance. However,. partners,r joint venture members or man- this provision does not affect.our right to collect agers are•individuals, notice to us of such additional premium or to exercise, our rights of occurrence" or offense must.be given as cancellation or nonrenewal in,;accordance With, soon as practicable only afterthe"occur applicable insurance::laws or regulations:, rence"or offense:is known by; L., BLANKET WAIVER OF"SUBROGATION a) Any individual who'is: The following is added:to'Paragraph 8.,Transfer i) A partner ormember of any,part- Of Rights Of Recovery Against Others To Us, Warship orjoint.venture; of SECTIOk !V—CphIIMERCIAL GENERAL LI- ABILITY COi, ITiONS GG W 16 11.11 2011 The Travefers Indemnity Company.All rights reserved. Page5 of 6 COMMERCIAL GENERAL LIABILITY Ififi6`insured has.agreed in a contract..or agree- 3. 'Bodily injury" means .bodily, injury; mental Ment'to.waive that insured's .right 'ofrecovery anguish, mental injury,shock,fright;disability, against any person or organization, we waive our humiliation, sickness or•disease::sustained by right of recovery against such persmor organiza- a person, including death resulting from any tion, but only for payments we make because,of:of these at anytime., a. "Bodily injury" or "property damage" that oc N. CONTRACTUAL LIABILITY-RAILROADS curs;or 1. The following replaces Paragraph,•c. of the b. "Personal injury" or "advertising injury" definition of"insured contract" in the Ds=FI141- caused by an offense that is committed; TIONS Section: subsequent to the execution of that contract' or. c. :Any easement or license agreement;' agreement. 2. Paragraph f:(1) of the definition .of "insured M. AME"LADED BODILY INJURY DEFINITION contract" in the DEFINITIONS,-SBctionJss de= feted. The following replaces the definition of "bodiiy injury"'in the DEFINITIONS Section: Page•6 of 6 2011 The Travelers IndemnityCompany.All rights reserved. CG D3 16'111.1 Policy No. 810 OF027488 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES,THE, POLI'GY.,PLEASE READ IT CAREFULLY. B USINESS AUTO EXTENSION 8NOOF ZEMzs, NE T This e4d.otsdmeht';ffiodffies'insurance-provided underthe:f6flowing; BUSINESS-AU'T'Olt-'OVERAGE:FORM WRh-:respqefAo coverag %'Prov dedndot i provisions as6mbrift,1hL ls1db§'6f'th0JC.6v.et.qe Form apply unless mod!-lied by the endorsement:P GENERAL DESCRIPTIONE$dRIPTIO OF COVERAGE § dhdo#00feht broadens.-d4 erage. However,,covaragejor anyrnludamageorMOdiotexpensesdesd-nAhyof the provisions.of this endorsement may be excluded orIimiCedbyanotherendorsementto: '0Coverage,Part,:and broadening do not,1 coverage roa eni g provisions , apply totheextentthatcoverageis6X . .,. Oorl,iftlte, d,by"sU'ch6heid Prsem dtit 7h.e,following IN('rg isa gen eral coverageqe$bfJonly: and exclusions.'may applylo.these coverages Read al[the provisionsthlstn- dorsement.gryd the.rest of your policy,carefully to:determine rights,duties,jand-Whait IIs and.is;not covered.'_ A. BROAD.FORM NAMED INSUREDH, HIRED -AUTO. PHYSICAL DAMAGE LOSS OF IKCPEAS PUrM T AGE, - TRANS.'0. OLANOTTA' bilTIONALINSORE.D. 1. PHYS"Id-AL, OMM 06, -,AT!pN,9T EXPENSES-INCREASED LIMIT ZNVELOYI EP. HIRED AUTO J. PERSONAL EFFECTS D. EMPLOYEES:AS INSURED k., AIRBAGS E. $.UPPLEMENTARY-PAYMENT8 —;INCREASED L. kOTi1C-t AND. KNOWLEDGE, OF A DENTLIMITSQR'LbSS F. HIRED AUTO. - LIMITED WORLDWIDE Mi BLANKET WAIVER. F0 SUBROGATIONCOVERAGE-INDEMNITY BASIS: MG. WAIVEW F DED'GLASS R. UNINTENTIONAL ERRORS PIR.OVISIONS A. :BROAD FORM:NAMED INSURED executed byyouthe "bodily" .injury" :orI '. . _,I,y The fbliowinq Is.;added.to,Parggraph A.1 Who is property damage" and thaflip 4 effectoccurs An Insured; of SECTION It: LIABILITY COV, during,the policy period' to be named ih ad F-RAGE, tional I insured '15"an "InsW,"insured" to .,Liability Cover- Any organization y.ou "newly.acqluire or form dur age,but on!y:fbrdamagqsto which 1this I Asurarco the . qJjpy penwhicho . over yo maintain: applies and onlytotheextent that; getoop oror- 5p% or more ownership interest arid that is.not ganizAtion qualifes as an "insured" under the Who Is An Insured provision tont d ......Ssect' na.pep in,.. .Sectioninsuredd'f Business Auto, C,6vqrage. IIyor CdVOta9d under t ls,,prvislon. iS-Offord d only tr&LOYE:y unm til the 1-80th d- ft u a uite:or form the HIRED AUTOpy'.a. er you Pq El g6hJz6.tIor.Tor the end if theperiod,'.Whibh- following I& added to Paragrap4 M.,pody1. The. ever is earlier.Wh!O is An, Insured,. of 85CT. f. N"it L-1- B. BLANKET ADDITIONAL INSURED ABILITY00-VERA-138! The folloxmhg 19' added to An,'empl6yee*ofParagraph,di ih AA,ypqrs'is an"insured"''Whilo 4 .SECTION" I..' & 11- 1. " COVERAGE6W., Insured, opera hiretl.- or rented uhd&'aWhoIsAn- S CTIO ' -I LIABILITY operating "auto" contract or agreement in that °e 'OV GE Any'Pbrs'on or organization w p is reOu red.under name with:you'r-permission,",while p0 ff6( n ing a Written contract or"agreement between'you-and duties: relatedto the. conduct ofyour' that person or organization; that is; tijhed and ness. 5,3:63-1.0 2010 The Travelers Inde Mr1lVcqMPar1*Yi Page. 1 of.4 C6lrfClUd6g-00PY00hted materld[of-Irisue.ah' Services offiqOri.,c,WM[ls permission. C:O;MMERCIALAUT.O 2'. The following replaces .Paragraph:b.. in B.S.,within such country' or`j.urisdl6tion,'for LrabilltyOti;er Insurance, of SECTION.11V_ $USI=Coverage for 'ariy cohered "auto" thatyou NESS-AUTO CONDITIONS, lease, hire, rent or obrrow wltfiout a driver for b;: For Hired Auto Physical Damage .Gayer-a•penod of 30:days or less and that is.not`an age,`the following are deemed to be cove auto" you lease, hire; rent dr borrow from erect "autos''you own! a_ny of your."employees", partners (lf`you sre a partnerahi'p}, members (If yQa limit iduaree1) Any covered "auto" you lease, hire,Iiatiihty company) ormembers of their house-rent or borrow;and t' n holds Z) Any covered "auto" hired or rented by a With res ect to any claim mado-or,-' suityouremployee_ under a contract in O p brought outside tine Uniaed States- ofthat. individual "employee's" name' America, the territories and possessionswith .your.permissi`on, while.perform= of ttie United States .of'America, ,Puertoringdutiesrelated: o. the conduct of Rlco:acid Canadayour,business T) You must arrange.:to,.defend the"in-However,any''auto't that Is leased, Hired, shred"against;and investigate onsettentedorborrowedwithdriver."rs,not,a tie any. uch_:claim .or`!suit":and keepcovered."auto". ds advised of all pcoceedings:and ac- D:._ EMPLOYEES AS INSURED: tions: The following is added'to Paragraph A 1 , Who,Is ii) Neither,;you nor any -other involvedAnInsured, of'SECTION Il - LIABILITY 6,OV insured" will make; any settlement;ERAGE: without our,consent. Any"employee" of yours Is an`"Insured"while.us= ur)Vile may, at our.discretion, participate Ing a cavered "'auto"you tlon't own, hire or borrow in:defending the"insured"against or In your business:or your personal affairs. in. the. settlement of;.. any claiirt or E. :S..UPPLEMENT.ARY'PAYMENTS - 1NCREASED. suit".. LIMITS: lV' will reimburse :the "insured" for 1.. The following replaces Paragraph A:2:a.(2),sums that:the "insured" legally must of SECTION ll LIABILITY COVERAGE: pay as. damages ;because of`'"bodily injury or"property damage" to which2) Up to $3,000 for ico"st of bail bonds (In this insurance; .applies:; that the "in=eluding bonds for related: traffic law viola sured": pays with our- consent, buttions) required" because of an "accident" only, up to the limit described=.in Fara-we cover We: do not have to furnish graph-C.,:Limit Of Insurarice,:of.SEC-these bonds: TLON II—LIABILITY C,OVERAGE. 2. Theo. foll owing re laces Para ra h A 2:a 4.;; v) 'We will reimburse the:"'Insured" forgp . . g p. of SECTION Ii. LIABILITY COVERAGE: the reasonable expenses incurred. 4) All reasonable expenses Incurred by'the with .our consent,for :your investiga- insured" at our request. Includingactual tion of such claims and:your;defense.: kiss of'carp. gs up:,to ,$500 a day be of.. the "insured" against :any such' caustlme;ofeoff from.work: suit",. but only up to and included. F. HIRED AUTO LIMI`T'ED :WORLDWICIE• COVr. within the limit described iii,Para-. graph C., Limit. Of Insurance; ofERAGEINDEMNITYBASIS SECTION HV COUER-The folloii.jng replaces Subparagraph;(p in'Par AGE, and not In. addltion 16such liinii: graph B 7:, Policy Period, Coverage;Territory; O.cir duty to make sued payments ofi SECTION, lV' — BUSINESS, AUTO CONDI- ends.when we<have used up'thwgp-T10N5 plicable. limit. of insurance, in pay- 5) Anywhere in'the'World, except any country or. merits -for ddfnages, settlements or Jurisdiction. ;while any= tirade ,sd-etior- em defense expenses. Pardo, or similar re0aition imposed by the b) This insurance is:excess .over any valid;United States: of Arnenca applies to and pro- and collectible; other insurance avallekile;hi4 is the. transaction of burin.ess :with: or Pa9e 2 of'4 010 Ttte,Travelers Indemnity Company CA:T3 5163- 10 Jncludes copyrighletl material.of Insurance Services Ofrtce;Inc viith°Its pem%isson. COMM ERCIAL.AUTO to the "insured" wheth-er primary, excess J, 'PERSONAL EFFECTS contingent or_on arty other bases The following is added to Paragraph A 4,'Cc r er= c) This in is not"a substitute'for re:- age:Extensions of SECTION Ill . PWYSICALquered; or compulsory insurance in any DAMAGE C.OVEIP GE;` country outside`the United States, its ter- Persopal Effects;rtohes'and possessiorisi Puerto Rico and` Canada, We'will pay up to $400`for "loss'' o wearing ap- You agree to maintain all :required .or parel and other;,personal effects WI`ich aire compulsoryinsurance:in any such coup- 1`.) Ownedbyan"insured"; and try up to the minimum limits required by 2) Irl or on y.Qur Go. eyed "auto'".focal law Your failure e to: comply with, coThis coverage:appGes only in the event of:a totalcompulsoryInsurancerequirementswill: theft:of yourcovered"auto":not rnvaiidatO the coverage afforded by- this policy, but;we_will only be,llable:to:the No detluctlbles apply t6 this Personal Effects same;.extent we vi oOld :have,been liable, coverage: had ybu complied with:the•cornpuisoryin= K. AIRBAGS 5urance'requremenfs: The following is added to,Paragraph 'Exclu-d) It is understood that we are not an admit- stons; of SECTION III. - PHYSICAL DAMAGEtedorauthorizedinsureroutsidetheCOVERAGE: United States of America, its territiories, and ossessions, Puerto Rico and Gari- Exclusion 3 a.;does:not apply to "loss" to:one,.orP more airba s )h a covered "auto"you own'that in=ada. IIUe assume rib:responsibility.for the furnishing of certificates of insurance, or flare dile to a.cause oche"r`than a cause of"loss" for;compliance in arty'wa with tide caws. Set forth rI Paragraphs A.1 b acid A44, buty only;of othercountriesrelating to insurance:: G W, VER OI= D;EDU.CTliaLE: GLASS a. If`that"auto" is.a:covered "auto"for°Gompre= hensive Coverage vrider!-this policy;.The following is added:to Paragraph D, D:eductiv. bee, of SECTION III PHYSICAL DAMAGE: b The'airbags,are,not covered:under'anywar- COVERAGE? rarity acid No deductible,for a covered:"auto" will .apply to c Th'e,airbags were not intentiona'll inflated. glass damage'f the glass Jgtr.06iiired,'rather than. we will:pay:up to a'maximum of$x,000.for. any. replacod:. one`:loss'`: H. HIRED:AUTO PHYSICAL DAMAGE,"LOSS'.OiF: L. NOTICE AND:KNOWLEDGE. OF ACCIDENT OR USEE—:INCREASEV LIMIT LOSS The following roplaces tfie last.'senter ce of,Para The following Js added to Paragraph A.2 a., of graph A.4:b , Lust Of Use Expenses, of SEG- SECTION.IV. .:BUSINESS AUTO.CONDITIONSr TION Ili;—PHYSICAL DAMAGE COVERAGE:Your duty to give us or our authorized represet ta= However,ahe most we will pay for-any expenses five prompt notice of the "accident"'or "loss ap- per da'::to;a.maximum of plies.only When, the "accident" of "Loss' I$,knownforloss 'of use=is $65 y, 750 tot any one"'accident".. to I. PIYSIGAL DAMAGE TRANSPORTAYIO.N a) You;(If you aI'e an';individual);. EXPENSES INCREASED LIMIT' b. A partner(ifyou area artner5hfOpi•y p p)- The following'replaces the first=sentence in:Para=e) A.member (tf you are:a limited: habtlity com-gr..aph A4.0., Transportation Expenses, of parry)•SECTION.III PHYSICAL DAMAGE COVER d An :executive affi:ceri director or insGranceAGE; ri*a'Lger(if you a're a corporation or other or-IN.e will pay up#o $5.0 per day to:a maximum .of9 at ianizor 1,500 for temporary transportation.expenseAn= a Art. "em to ee"carred by:you because:of the;total theft of a cov- O y`' p Y authorized by you to give no- eyed "auto"of.the private:passenger type;tice of the:",accident"or°lass°: GA T3 5303:10,. @260 The Travelers:Indo-mnity Company Pa ge:3 of 4Includescopyflghtedmaterialof,Intdfince,Services Offce,enc with its pemliss,ign. COMMERCIAL AUTO M*. OLANKET WAVER tlJAR00.A7bbN9 h..040.401''The Waiver applies only:to theThefolldWiript6pidoes.p%mig.raph.A.5,-,'Tratisfer person J`or'.9r§ah&dtibh, des"(9--in"a-t6d in; suchOfftlhts-6i kec6. 6.1 1, b0h W.AtO .Othdii.lro of SECT[q.N, .IV - BUSINESSSINIFESS. AUTO ,..C.ONM N.: UffiftTENTIMALTIONS: The following d'd Pdr&`Ph .R`4.- Transfer Of Rights 00:to Paragraph .2 :,CoPcP"FY Against` 666IM6ft M n. M6*9rs Tout Fraud, of AUTO-CONDITIONS:JV W6 waive any n Pit d recoveryrecove -we may have The uhifit66tj&h6j omission of', or unintentionalagainstanypersonde'0460i6rion-to.thee ex- error in any 1h.b.ftn6tiori .given by,youz1half nottent. required of, you 1$y a,: written contract Mourflbhuice.y lk IJW6r this: insuranca.; How- 11 not affedt:our.fildhi.-lo,col 6,d*ok 'Utied prior tb,any %dclddht' OVO'r this 6 OrOviddd that'ifiez'"i a0d. e -or jess, led addi fi'o.r..ta I..Prbfnium: of exercise :our right-oflads -,.&it, of operations lltdft')P dtbd byr P-01,06 4 6f4a 0).2Oblo tfie:Travelers ltldbrhnitY. ,,.C6Mp6nY.Inciudes'cnpyirighled material-bfllh.06,ra,66a,p jppemj ssjon,00)qs Off! lh6:-Awh,f S j WORKERS'COMPENSATION TRAVELER ANlj ONE TOWER s.QVAaE EMPLOYERS LiAMLITY F'bLjd'? HARTFORD, £T' 06183' ENDORSEMENT WC"03;7,6 A)- A011. POLICY NtfM6Ek-. (DTJUB-'OF02746-6-14 WAIVER OF bU'P,RIGHT TO. RECOVER FROM OTHERS ENDORSEMENT-"CALIFORNIA BLANKET WAIVER) We, have the. right to recover;our pa'ymen'ts.,froim,anyone liable fbr-a n- injury.covered by this policy."Wel"will not enfordbl-ddr-fightagai hst the pdrk 'blroro6nizatfah rfam6cl ih,thb S hbdbld. The additional premium for this enclorsemoht sh,611 be. 02.00-0. % of the California workers' conio.eh";dtioh pre- mium. Schedule Person,-or Organization Job Description ANy 'pzh66N OR ORGANIZATION FOR WHICH THE .INSURED HAS AGREED,`-Bt WRITTEN CONTRACT EXECUTED; PRIOR.RIOR TO LOSS, TO, ttkictsR-THIS A3VE9. Th4,end6 6indht changes,thd policy f6'Whichl -l's attached-and is e-'ff6cflVe 6h'th6 date issued bnl6ss-.:othdhNlsd,rs it stated. Thd,'.Inkft6tiori-.16616w Is P,600.1rdd only whd.n-",this,,e'nd'o'..rsement"is,ls.sued 'subeouent,.to'p,'r,606r6tl'6ri of the policy.) Endcrs&m.Eint Effective Policy No. Endorsemeht N6. lrsUrecl P(otnium finsuran-do Company Countarsigffed by DATE1,00,ISSUE: 08 '28-1,4 ;ST,-IA§`§lG'N, Page"I A I IMPORTANT NOTICE - INDEPENDENT AGENT AND BROKER COMPENSATION NO COVERAGE IS PROVIDED BY THIS NOTICE. THIS NOTICE DOES NOT AMEND ANY PROVISION OF YOUR POLICY. YOU SHOULD REVIEW YOUR ENTIRE POLICY CAREFULLY FOR COMPLETE INFORMATION ON THE COVERAGES PROVIDED AND TO DETERMINE YOUR RIGHTS AND DUTIES UNDER YOUR POLICY. PLEASE CONTACT YOUR AGENT OR BROKER IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE OR ITS CONTENTS. IF THERE IS ANY CONFLICT BETWEEN YOUR POLICY AND THIS NOTICE, THE PROVISIONS OF YOUR POLICY PREVAIL. For - information about how Travelers compensates independent agents and brokers, please visit www.travelers.com, call our toll-free telephone number 1-866-904-8348, or request a written copy from Marketing at One Tower Square, 2GSA, Hartford, CT 06183. PN T4 54 01 08 Page 1 of 1 Commercial Property Coverage Part to the changes in our reinsurance po- Farm Coverage Part—Farm Property—Farm sition. Dwellings, Appurtenant Structures And c. We. will not refuse to renew such cover- Household Personal Property Coverage Form age solely because the first Named In- a. We may elect not to renew such cover- sured has cancelled or did not renew a age for any reason, except as provided in policy, issued by the California Earth- b.,c. and d. below. I quake Authority, that included an earth- b. We will not refuse to renew such cover-quake policy premium surcharge. age solely because the first Named In- d. We will not refuse to renew such cover- sured has accepted an offer of earth- age solely because corrosive soil condi- quake coverage. tions exist on the premises. This restric- tion (d.) applies only if coverage is sub-However, the following applies only to in- ject to one of the following, which excludesurerswhoareassociateparticipatingin- loss or damage caused by or resultingsurersasestablishedbyCal. Ins. Code from corrosive soil conditions: Section 10089.16. We may elect not to renew such- coverage after the first 1) Commercial Property Coverage Part Named Insured has accepted an offer of Causes Of Loss—Special Form; or earthquake coverage, if one or more of 2) Farm Coverage Part — Causes Of the following reasons applies: Loss Form — Farm Property, Para- 1) The nonrenewal is based on sound graph D. Covered Causes Of Loss — underwriting principles that relate to Special. the coverages provided by this policy 3. We are not required to send notice of nonre- and that are consistent with the ap- newal in the following situations: proved rating plan and related docu- a. If the transfer or renewal of a policy, with-ments filed with the Department of out any changes in terms, conditions orInsuranceasrequiredbyexistinglaw; rates, is between us and a member of our 2) The-Commissioner of Insurance finds insurance group. that the exposure to potential losses b. If the policy has been extended for 90 will threaten our solvency or place us days or less, provided that notice hasinahazardouscondition. A hazard- been given in accordance with Paragraph ous condition includes, but is not lim- C.I. ited to, a condition in which we make. claims payments for losses resulting c. If you have obtained replacement cover- from an earthquake that occurred age, or if the first Named Insured has within the preceding two years and agreed, in writing, within 60 days of the that required a reduction in policy- termination of the policy, to obtain that holder surplus of .at least 25% for coverage. payment of those claims; or d. If the policy is for a period of no more 3) We have: than 60 days and you are notified at the a) Lost or experienced a substantial time of issuance-that it will not be re- reduction in theavailability or Hewed. scope of reinsurance coverage; e. If the first Named Insured requests a or change in the terms or conditions or risks b) Experienced a substantial in- covered by the policy within 60 days of crease in the premium charged the end of the policy period. for reinsurance coverage of our f. If we have made a written offer to the first residential property insurance Named Insured, in accordance with the policies;and timeframes shown in Paragraph CA., to the Commissioner has approved a renew the policy under changed terms or conditions or at an increased premium plan for the nonrenewals that is fair rate,when the increase exceeds 25%. and equitable, and that is responsive IL 02 70 09 12 Insurance Services Office, Inc.,2012 Page 3 of 3- materially increases any of the risks in- b. We may not cancel this policy solely be- sured against. cause the first Named Insured has: 6) A determination by the Commissioner of 1) Accepted an offer of earthquake cov- Insurance that the: erage; or a) Loss of, or changes in, our reinsur- 2) Cancelled or did not renew a policy ance covering all or part of the risk issued by the California Earthquake would threaten our financial integrity Authority (CEA) that included an or solvency; or earthquake policy premium sur- b) Continuation of the policy coverage charge. would: However, we shall cancel this policy if the i) Place us in violation of California first Named Insured has accepted a new law or the laws of the state where or renewal policy issued by the CEA that we are domiciled; or includes an earthquake policy premium surcharge but fails to pay the earthquake ii) Threaten our solvency. policy premium surcharge authorized by 7) A change by you or your representative in the CEA. the activities or property of the commer- c. We may not cancel such coverage solely cial or industrial enterprise, which results because corrosive soil conditions exist on in a materially added, increased or the premises. This restriction (c.) applies changed risk, unless the added, in- only if coverage is subject to one of the creased or changed risk is included in the following, which exclude loss or damage policy. caused by or resulting from corrosive soil b. We will mail or deliver advance written notice conditions: of cancellation, stating the reason for cancel- 1) Commercial Property Coverage Part lation, to the first Named Insured, at the mail-Causes Of Loss—Special Form; or ing address shown in the policy, and to the 2) Farm Coverage Part — Causes Of producer of record, at least:Loss Form — Farm Property, Para- 1) 10 days before the effective date of can-graph D. Covered Causes Of Loss — cellation if we cancel for nonpayment of Special. premium or discovery of fraud; or C. The following is added and supersedes any pro- 2) 30 days before the effective date of can- visions to the contrary: cellation if we cancel for any other reason Nonrenewal listed in Paragraph 3.a. B. The following provision is added to the Cancella- 1. Subject to the provisions of Paragraphs C.2. tion Common Policy Condition: and C.3. below, if we elect not to renew this policy, we will mail or deliver written notice, 7. Residential Property stating the reason for nonrenewal, to the first This provision applies to coverage on real Named Insured shown in the Declarations, property which is used predominantly for and to the producer of record, at least 60 residential purposes and consisting of not days, but not more than 120 days, before the more than four dwelling units, and to cover- expiration or anniversary date. age on tenants' household personal property We will mail or deliver our notice to the first in a residential unit, if such coverage is writ- Named Insured, and to the producer of re- ten under one of the following: cord, at the mailing address shown in the pol- Commercial Property Coverage Part icy. Farm Coverage Part—Farm Property—Farm 2. Residential Property Dwellings, Appurtenant Structures And This provision applies to coverage on real Household Personal Property Coverage Form property used predominantly for residential a. If such coverage has been in effect for 60 purposes and consisting of not more than four days or less, and is not a renewal of cov- dwelling units, and to coverage on tenants' erage we previously issued, we may can- household property contained in a residential cel this coverage for any reason, except unit, if such coverage is written under one of as provided in b.and c. below. the following: Page 2 of 3 insurance Services Office, Inc.,2012 IL 02 70 09 12 g 7 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY)COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraphs 2. and 3. of the.Cancellation Com- currence, after the effective date of the policy, mon Policy Condition are replaced by the follow- of one or more of the following: ing: 1) Nonpayment of premium, including pay- 2. All Policies In Effect For 60 Days Or Less ment due on a prior policy we issued and If this policy has been in effect for 60 days or due during the current policy term cover- less, and is not a renewal of a policy we have ing the same risks. previously issued, we may cancel this policy 2) Discovery of fraud or material misrepre- by mailing or delivering to the first Named In- sentation by: sured, at the-mailing address shown in the a) Any insured or his or her representa- policy, and to the producer of record, advance tive in obtaining this insurance; orwrittennoticeofcancellation, stating the rea- son for cancellation, at least:b) You or your representative in pursu- a. 10 days before the effective date of can- ing a claim under this policy. cellation if we cancel for: 3) A judgment by a court or an administra- tive tribunal that you have violated a Cali- fornia or Federal law, having as one of its 2) Discovery of fraud by: necessary elements an act which materi- a) Any insured or his or her repre- ally increases any of the risks insured sentative in obtaining this insur- against. ance;or 4) Discovery of willful or grossly negligent b) You or your representative in acts or omissions, or of any violations of pursuing a claim under this pol-- state laws or regulations establishing icy. safety standards, by you or your repre- sentative, which materially increase anyb. 30 days before the effective date of can- of the risks insured against. cellation if we cancel for any other rea- son. 5) Failure by you or your representative to 3. All Policies In Effect For More Than 60 Days implement reasonable loss control re- quirements, agreed to by you as a condi- a. If this policy has been in effect for more than tion of policy issuance, or which were 60 days, or is a renewal of a policy we issued, conditions precedent to our use of a par- we may cancel this policy only upon the oc- ticular rate or rating plan, if that failure IL 02 70 09.12 insurance Services Office, Inc.,2012 Page 1 of 3 Waste" means any waste material (a) containing the total amount of such material in the by-product material" other than the tailings or custody of the "insured" at the premises wastes produced by the extraction or concentra- where such equipment or device is lo- tion of uranium or thorium from any ore proc- cated consists of or contains more than essed primarily for its "source material" content, 25 grams of plutonium or uranium 233 or and (b) resulting from the operation by any per- any combination thereof, or more than son or organization of any "nuclear facility" in- 250 grams of uranium 235; cluded under the first two paragraphs of the defi- d) Any structure, basin, excavation, prem- nition of"nuclear facility". ises or place prepared or used for the Nuclear facility"means: storage or disposal of"waste"; a) Any"nuclear reactor"; and includes the site on which any of the forego- ing is located, all operations conducted on such b) Any equipment or device designed or site and all premises used for such operations. used for (1) separating the isotopes of uranium or plutonium, (2) processing or Nuclear reactor" means any apparatus designed utilizing "spent fuel", or (3) handling, or used to sustain nuclear fission in a self- processing or packaging "waste"; supporting chain reaction or to contain a critical c) Any equipment or device used for the mass of fissionable material. processing, fabricating or alloying of Property damage" includes all forms of radioac- special nuclear material" if at any time tive contamination of property. Page 2 of 2 0 ISO Properties, Inc., 2007 IL 00 2109 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form) This endorsement modifies insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply: hazardous properties" of "nuclear material", A. Under any Liability Coverage, to "bodily in- if: jury"or"property damage": 1) The "nuclear material" (a) is at any "nu- 1) With respect to which an "insured" under clear facility" owned,by, or operated by or the policy is also an insured under a nu- on behalf of, an "insured" or(b) has been clear energy liability policy issued -by Nu- discharged or dispersed therefrom; clear Energy Liability Insurance Associa-2) The "nuclear material" is contained in tion, Mutual Atomic Energy Liability Un- spent fuel" or "waste" at any time pos- derwriters, Nuclear Insurance Association sessed, handled, used, processed, of Canada or any of their successors, or stored, transported or disposed of, by or would be an insured under any such pol- on behalf of an"insured"; or icy but for its termination upon exhaustion 3) The "bodily injury" or "property damage" of its limit of liability; or arises out of the.furnishing by an "in- 2) Resulting from the "hazardous properties" sured" of services, materials, parts or of "nuclear material" and with respect to equipment in connection with the plan- which (a) any person or organization is ning, construction, maintenance, opera- required-to maintain financial protection tion or use of any "nuclear facility", but if pursuant to the Atomic Energy Act of such facility is located within the United 1954, or any law amendatory thereof, or States of America, its territories or pos- b) the "insured" is, or had this policy not sessions or Canada, this exclusion (3) been issued would be, entitled to indem- applies only to"property damage"to such nity from the United States of America, or nuclear facility"and any property thereat. any agency thereof, under any agreement 2. As used in this endorsement: entered into by the United States of America, or any agency thereof, with any Hazardous properties" includes radioactive, toxic person or organization. or explosive properties. B. Under any Medical Payments coverage, to Nuclear material" means "source material", "spe- expenses incurred with respect to "bodily in- cial nuclear material"or"by-product material". jury" resulting from the"hazardous properties" Source material", "special nuclear material", and of "nuclear material" and arising out of the by-product material" have the meanings given operation of a "nuclear facility" by any person them in the Atomic Energy Act of 1954 or in any or organization. law amendatory thereof. C. Under any Liability Coverage, to "bodily in- Spent fuel" means any fuel element or fuel com- jury" or "property damage" resulting from ponent, solid or liquid, which has been used or exposed to radiation in a"nuclear reactor". IL 00 2109 08 0 ISO Properties, Inc., 2007 Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY-NEW YORK DEPARTMENT OF TRANSPORTATION ENVIRONMENTAL HAZARD POLICY EMPLOYEE BENEFITS LIABILITY COVERAGE PART LIMITED ABOVE GROUND POLLUTION LIABILITY COVERAGE PART SELF-INSURED EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE FORM SELF-INSURED EXCESS LIQUOR LIABILITY COVERAGE FORM- SELF-INSURED EXCESS EMPLOYEE BENEFITS LIABILITY COVERAGE FORM SELF-INSURED EXCESS PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM EXCESS (FOLLOWING FORM)LIABILITY INSURANCE MEDFIRST PRODUCTS/COMPLETED OPERATIONS, ERRORS AND OMISSIONS,AND INFORMATION SECURITY LIABILITY COVERAGE FORM If aggregate insured losses attributable to terrorist ant to the federal Terrorism Risk Insurance Act. The acts certified under the federal Terrorism Risk Insur- criteria contained in the Terrorism Risk Insurance Act ance Act exceed $100 billion in a Program Year for a"certified act of terrorism"include the following: January 1 through December 31) and we have met 1. The act resulted in insured losses in excess of$5 our insurer deductible under the Terrorism Risk Insur- million in'the aggregate, attributable to all types of ance Act,we shall not be liable for the payment of any insurance subject to the Terrorism Risk Insurance portion of the amount of such losses that exceeds Act; and 100 billion, and in such case insured losses up to 2 The act is a violent act or an act that is dangerousthatamountaresubjecttoprorataallocationinac- ordance with procedures established by the Secre- to human life, property or infrastructure and is cor of the Treasury. committed by an individual or individuals as part taryof an effort to coerce the civilian population of the Certified act of terrorism" means an act that is certi- United States or to influence the policy or affect fied by the Secretary of the Treasury, in concurrence the conduct of the United States Government by with the Secretary of State and the Attorney General coercion. of the United States, to be an act of terrorism pursu- IL T3 76 10 10 2010 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services.Office,Inc.with its permission. w THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FEDERAL TERRORISM RISK INSURANCE ACT DISCLOSURE This endorsement applies to the insurance provided under the following: COMMERCIAL EXCESS LIABILITY(UMBRELLA)INSURANCE COMMERCIAL GENERAL LIABILITY COVERAGE PART CYBERFIRST LIABILITY COVERAGE ELECTRONIC MANUFACTURERS AND COMPUTER SERVICES ERRORS AND OMISSIONS LIABILITY COVERAGE FORM EMPLOYEE BENEFITS LIABILITY COVERAGE PART EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART ENVIRONMENTAL HAZARD POLICY EXCESS (FOLLOWING FORM)LIABILITY INSURANCE LAW ENFORCEMENT LIABILITY COVERAGE PART LIMITED ABOVE GROUND POLLUTION LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDFIRST PRODUCTS/COMPLETED OPERATIONS, ERRORS AND OMISSIONS,AND INFORMATION SECURITY LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART PUBLIC ENTITY MANAGEMENT LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART SELF-INSURED EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE FORM SELF-INSURED EXCESS LIQUOR LIABILITY COVERAGE FORM SELF-INSURED EXCESS EMPLOYEE BENEFITS LIABILITY COVERAGE FORM SELF-INSURED EXCESS PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY—NEW YORK DEPARTMENT OF TRANSPORTATION TRIBAL BUSINESS MANAGEMENT LIABILITY COVERAGE PROVISIONS On December 26, 2007, the President of the United States signed into law amendments to the Terrorism Risk Insurance Act of 2002 (the "Act"), which, among other things, extend the Act and expand its scope. The Act es- tablishes a program under which the Federal Government may partially reimburse"Insured Losses" (as defined in the Act)caused by"acts of terrorism".An "act of terrorism" is defined in Section 102(1) of the Act to mean any act that is certified by the Secretary of the Treasury — in concurrence with the Secretary of State and the Attorney General of the United States—to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property, or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of certain air carriers or vessels or the premises of a United States Mission; and to have been commit- ted by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. The Federal Government's share of compensation for Insured Losses is 85% of the amount of Insured Losses in excess of each Insurer's statutorily established deductible, subject to the "Program.Trigger", (as defined in the Act). In no event, however, will the federal government or any Insurer be required to pay any portion of the amount of aggregate Insured Losses occurring in any one year that exceeds $100,000,000,000, provided that such Insurer has met its deductible. If aggregate Insured Losses exceed $100,000,000,000 in any one year, your coverage may therefore be reduced. The charge for Insured Losses for each Coverage Part is included in the Coverage Part premium.The charge that has been included for each Coverage Part is indicated below, and does not include any charge for the portion of losses covered by the Federal Government under the Act. 1%of each applicable Commercial Liability Coverage premium. IL T3 68 05 10 2010 The Travelers Indemnity Company Page 1 of 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY The term "spouse"is replaced by the following: Spouse or registered domestic partner under California law. CG 32 34 0105 ISO Properties, Inc., 2004 Page 1 of 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL EXCLUSION-- EMPLOYEE BENEFITS LIABILITY This endorsement modifies insurance provided under the following: EMPLOYEE BENEFITS LIABILITY COVERAGE PART PROVISIONS This insurance does not apply to loss arising out of: 1. The wrongful termination of an employee; 2. The coercion, demotion, reassignment, discipline, or harassment of an employee; 3. Discrimination against an employee. CG T4 85 11 88 Page 1 of 1 4 P COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - IRC VIOLATIONS This endorsement modifies insurance provided under the following: EMPLOYEE BENEFITS LIABILITY COVERAGE PART PROVISIONS b. Any expense, loss or damages (i) arising out of This insurance does not apply to: the imposition of such taxes, fines, interest, penalties or other charges or (ii) resulting from a. Any taxes, fines, interest, penalties or other cost any provision of the Internal Revenue Code of imposed under, or resulting from, any provision 1986, as amended. of the Internal Revenue Code of 1986, as amended, or any similar state or local law; or CG DO 38 03 95 Copyright; The Travelers Indemnity Company, 1995 Page 1 of 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT - EBL This endorsement modifies insurance provided under the following: EMPLOYEE BENEFITS LIABILITY COVERAGE PART PROVISIONS This coverage part is amended as follows: 2. Under Section II—WHO IS AN INSURED—Item 1. Under Section I—EMPLOYEE BENEFITS LIA- 1.b. is replaced by the following: BILITY COVERAGE—Exclusion 2.c. is amended to b. A partnership or joint venture, you are an read as follows:insured. Your members, your partners, and c. Loss arising out of failure of performance of their spouses are also insureds, but only with contract by any insurer; respect to their duties as partners or mem- bers of a joint venture. CG T5 30 06 89 Page 1 of 1 COMMERCIAL GENERAL LIABILITY b. Unemployment insurance, social security e. Oral or written publication of material that benefits,workers'compensation and disability violates a person's right of privacy. benefits; 7. "Profit sharing plans" mean only such plans that c. Any other similar plan designated in the Dec- are equally available to all full time employees. laration or added thereto by endorsement. 8. "Property damage"means: 6. "Personal injury" means injury other than "bodily a. Physical injury to tangible property, including injury," arising out of one or more of the following all resulting loss of use of that property;or offenses: b. Loss of use of tangible property that is not a. False arrest, detention or imprisonment; physically injured. b. Malicious prosecution; g. "Stock subscription plans" mean only such plans c. Wrongful entry into, or eviction of a person that are equally available to all full time employ- from, a room, dwelling or premises that the ees. person occupies;10. "Suit" means a civil proceeding in which dam- d. Oral or written publication of material that ages because of an act, error or omission to slanders or libels a person or organization or which this insurance applies are alleged. "Suit" disparages a person's or organization's includes an arbitration proceeding alleging such goods, products or services; or damages to which you must submit or submit with our consent. Page 6 of 6 CG T1 01 07 86 COMMERCIAL GENERAL LIABILITY purchase it, an Extended Reporting Period En- Other Insurance) so that the insurance provided dorsement as described in paragraph 4, only if: will be excess over any other valid and collectible a. This Coverage Part is cancelled or not re- insurance available to the insured, whether pri- newed for any reason; or mary, excess, contingent or on any other basis, b. We renew or replace this Coverage Part with whose policy period begins or continues after the Endorsement takes effect. other insurance that has a Retroactive Date later than the one shown in this Coverage 5. We will determine the actual premium for the Part's Declarations. Extended Reporting Period Endorsement in ac- cordance with our rules and rates. In doing so, we2. If we provide an Extended Reporting Period, the may take into account the following:following is added to paragraph 1.b. of INSURING AGREEMENT—SECTION I: a. The exposures insured; 3) A claim first made during the Extended Re- b. Previous types and amounts of insurance; porting Period will be deemed to have been c. Limits of Insurance available under this Cov- made on the last day of the policy period pro- erage Part for future payment of damages; vided that the claim is for damages because and of an act, error or omission that occurred be- d. Other related factors. fore the end of the policy period of this policy but not before any applicable Retroactive The premium for the Extended Reporting Period Date). Endorsement will not exceed 200% of the annual The Extended Reporting Period will not reinstate premium for the Coverage Part to which the en- dorsement would be attached and will be fullyorincreasetheLimitsofInsuranceorextendtheearnedwhentheEndorsementtakeseffect. policy.period. SECTION VII—DEFINITIONS 3. The automatic Extended Reporting Period will be for 60 days, starting with the end of the policy pe- 1. "Administration"means: riod of this policy. a. Counseling employees, including their de- This automatic Extended Reporting Period ap-pendents and beneficiaries, with respect to plies only if no subsequent insurance you pur- the"employee benefit program"; chase applies to the claim, or would apply but for b. Handling records in connection with the "em- the exhaustion of its applicable limit of insurance.'ployee benefit program"; or This automatic Extended Reporting Period may - c. Effecting or terminating any employee's par- not be cancelled. ticipation in a plan included in the "employee 4. If you purchase the optional Extended Reporting benefit program." Period Endorsement, the Extended Reporting Pe- 2. "Bodily injury" means bodily injury, sickness or riod will be for one year, starting with the end of disease sustained by a person, including death the policy period of this policy. We will issue that resulting from any of these at any time. Endorsement if the first Named Insured shown in 3. "Coverage territory" means the United States oftheDeclarations: America (including its territories and 'posses- a. Makes a written request for it which we re- sions), Puerto Rico and Canada. ceive within 60 days after the end of the pol- 4. "Employee" means your officers, partners and icy period;and employees whether actively employed, disabled b. Promptly pays the .additional premium when or retired. due. 5. "Employee benefit program" means the following The Extended Reporting Period Endorsement will plans: not take effect unless the additional premium is a. Group life insurance, group accident or health paid when due. If that premium is paid when due,insurance, "profit sharing plans," pensiontheendorsementmaynotbecanceled. plans and"stock subscription plans," provided The Extended Reporting Period Endorsement will that no one other than an employee may sub- also amend paragraph 4.a. of SECTION V—EM-. scribe to such insurance or plans; PLOYEE BENEFITS LIABILITY CONDITIONS CG T1 01 07 86 Page 5 of 6 COMMERCIAL GENERAL LIABILITY a. To join us as a party or otherwise bring us Audit premiums are due and payable on no- into a "suit" asking for damages from an in- tice to the first Named Insured. If the sum of sured; or the advance and audit premiums paid for the b. To sue us on this Coverage Part unless all of policy term is greater than the earned pre- its terms have been fully complied with. mium, we will return the excess to the first Named Insured. A person or organization may sue us to recover on an agreed settlement or on a final judgment c. The first Named Insured must keep records of against an insured obtained after an actual trial; the information we need for premium com- but we will not be liable for damages that are not put ay and send us copies at such times as mwemay payable under the terms of this Coverage Part or request. that are in excess of the applicable limit of insur- 6. Representations. ance. An agreed settlement means a settlement By accepting this policy,you agree: and release of liability signed by us, the insured and the claimant or the claimant's legal repre- a. The statements in the Declarations are accu- rate and complete; sentative. 4. Other Insurance.b. Those statements are based upon represen- tations you made to us; and If other valid and collectible insurance is available to the insured for a loss we cover under this Cov- c. We have issued this policy in reliance upon erage Part, our obligations are limited as follows: your representations. a. Primary Insurance. 7. Separation of Insureds. This insurance is primary except when para- Except with respect to the Limits of Insurance, graph 4. of Section VI — Extended Reporting and any rights or duties specifically assigned to Periods applies. If this insurance is primary, the first Named Insured, this insurance applies: our obligations are not affected unless any of a. As if each Named Insured were the only the other insurance is also primary. Then, we Named Insured; and will share with all that other insurance by the b. Separately to each insured against who claim method described in b. below. is made or"suit"is brought. b. Method of Sharing. 8. Transfer of Rights of Recovery Against Others If all of the other insurance permits contribu- To Us. tion by equal shares, we will follow this If the insured has rights to recover all or part of method also. Under this approach each in- any payment we have made under this Coverage surer contributes equal amounts until it has Part, those rights are transferred to us. The in- paid its applicable limit of insurance or none sured must do nothing after loss to impair them. of the loss remains, whichever comes first. At our request, the insured will bring "suit' or If any of the other insurance does not permit con- transfer those rights to us and help us enforce tribution by equal shares, we will contribute by them. limits. Under this method, each insurer's share is g, Cancellation, Non-renewal, Renewal and based on the ratio of its applicable limit of insur- Reduction or Deletion of Coverage: ance to the total applicable limits of insurance of The following conditions also apply to this Cover-all insurers.age Part: 5. Premium Audit. All conditions relating to cancellation, non- a. We will compute all premiums for this Cover- renewal, renewal, and reduction or deletion of age Part in accordance with our rules and coverage which would apply to a Commercial rates. General Liability Coverage Part attached to b. Premium shown in this Coverage Part as ad- this policy. vance premium is a deposit premium only. At SECTION VI—EXTENDED REPORTING PERIODS the close of each audit period we will com- 1. We will provide an automatic Extended Reporting pute the earned premium for that period. Period as described in paragraph 3. or, if you Page 4 of 6 CG T1 01 07 86 COMMERCIAL GENERAL LIABILITY e. Plans included in your"employee benefit pro- SECTION V — EMPLOYEE BENEFITS LIABILITY gram"; CONDITIONS 2. The Aggregate Limit is the most we will pay for all 1. Bankruptcy. damages because of acts, errors or omissions Bankruptcy or insolvency of the insured or of the committed in the "administration" of your "em- insured's estate will not relieve us of our obliga- ployee benefit program."tions under this Coverage Part. 3. Subject to the Aggregate Limit, the Each Em- 2. Duties In the Event Of Act, Error or Omission, ployee Limit is the most we will pay for all dam- Claim or Suit. ages sustained by any one employee, including a. You must see to it that we are notified as the employee's dependents and beneficiaries, soon as practicable of an act, error or omis- because of acts, errors or omissions committed in sion which may result in a claim. Notice the "administration" of your "employee benefit should include: program." 1) What the act, error or omission was and The limits of this Coverage Part apply separately when it occurred. to each consecutive annual period and to any re- maining period of less than 12 months, starting ploye( 2) The names and addresses of any em- with the beginning of the policy period shown in result s who may suffer damages as a result of the act, error or omission. the Declarations, unless the policy period is ex- tended after issuance for an additional period of Notice of an act, error or omission is not no- less than 12 months. In that case, the additional tice of a claim. period will be deemed part of the last preceding b. If a claim is received by any insured you period for purposes of determining the Limits of must: Insurance. 1) Immediately record the specifics of the SECTION IV—DEDUCTIBLE claim and the date received; and 1. Our obligation to pay damages on behalf of the 2) Notify us as soon as practicable. insured applies only to the amount of damages in You must see to it that we receive written no- excess of the deductible amount stated in Item 6 tice of the claim as soon as practicable. . of the Declarations as applicable to "Each Em- c. You and any other involved insured must: ployee." The limits of insurance applicable to Each Employee" will be reduced by the amount 1.) Immediately send copies any - of this deductible.The Aggregate limit shall not be mands, notices, summonses orr legal pa- of by the application of such deductible peas received in connection with the claim ora"suit"; amount. 2. The deductible amount stated in the Declarations 2) Authorize us to obtain records and other applies to all damages sustained by an employee information; because of an act, error or omission covered by 3) Cooperate with us in the investigation, this insurance. settlement or defense of the claim or suit'; and 3. The terms of this insurance, including those with respect to: 4) Assist us, upon our request, in the en- forcement of any right against any person a. Our right and duty to defend any "suits" or organization which may be liable to the seeking those damages; and insured because of damage to which this b. Your duties in the event of an act, error or insurance may also apply. omission claim, or suit apply irrespective of d. No insureds will, except at their own cost, the application of the deductible amount. voluntarily make a payment, assume any ob- 4. We may pay any part or all of the deductible ligation, or incur any expense without our amount to effect settlement of any claim or suit consent. and, upon notification of the action taken, you 3. Legal Action Against Us. shall promptly reimburse us.for such part of the No person or organization has a right under this deductible amount as has been paid by us. Coverage Part: CG T1 01 07 86 Page 3 of 6 COMMERCIAL GENERAL LIABILITY 2) advice given to any person to participate SECTION II—WHO IS AN INSURED or not to participate in any plan included 1. If you are designated in the Declarations as: in the"employee benefit program"; a. An individual, you and your spouse are in- f. Loss arising out of your failure to comply with sureds, but only with respect to the conduct of the mandatory provisions of any law con- a business of which you are the sole owner. cerning workers' compensation, unemploy- ment insurance, social security or disability b. A partnership or joint venture, you are an in- benefits; sured. g. Loss for which the insured is liable because c. An organization other than a partnership or of liability imposed on a fiduciary by the Em- joint venture, you are an insured. Your direc- ployee Retirement Security Act of 1974, as tors and stockholders are also insureds, but now or hereafter amended; or only with respect to their liability as your di- rectors or stockholders. h. Loss or damage for which benefits have ac- crued under the terms of an employee benefit 2. Each of the following is also an insured: plan to the extent that such benefits are a. Each of your partners, executive officers and available from funds accrued by the insured employees who is authorized to administer for such benefits or from collectible insurance,your"employee benefit program." notwithstanding the insured's act, error or b. Your legal representative if you die, but only omission in administering the plan which pre- with respect to duties as such. That repre- cluded the claimant from receiving such sentative will have all your rights and duties benefits. under this Coverage Part. 3. Supplementary Payments 3. Any organization you newly acquire or form, other We will pay, with respect to any claim or"suit"we than a partnership or joint venture, and over defend: which you maintain ownership or majority interest, a. All expenses we incur. will be deemed to be a Named Insured if there is no other similar insurance available to that or- b. The cost of bonds to release attachments, but ganization. However: only for bond amounts within_the applicable limit of insurance. We do not have to furnish a. Coverage under this provision is afforded only these bonds. until the 90th day after you acquire, or form the organization or the end of the policy pe- c. All reasonable expenses incurred by the in- riod, whichever is earlier: sured at our request to assist us in the inves- tigation or defense of the claim or "suit," in- b. Coverage under this provision does not apply cluding actual loss of earnings up to $100 a to any negligent act, error or omission that day because of time off from work. occurred before you acquired or formed the d. All costs taxed against the insured in the organization. suit." No person or organization is an insured with re- spect to the conduct of any current or past part- e. Pre-judgment interest awarded against the nership or joint venture that is not shown as a insured on that part of the judgment we pay. If Named Insured in the Declarations. we made an offer to pay the applicable limit of insurance, we will not pay any prejudgment SECTION III—LIMITS OF INSURANCE interest based on that period of time after the 1. The Limits of Insurance shown in the Declarations offer. _ and the rules below fix the most we will pay re- f. All interest on the full amount of any judgment gardless of the number of: that accrues after entry of the judgment and a. Insureds; before we have paid, offered to pay, or de- b. Claims made or"suits"brought; posited in court the part of the judgment that is within the applicable limit of insurance. c. Persons or organizations making claims or bringing "suits." These payments will not reduce the limits of in- d. Acts, errors or omissions which result in loss; surance. or Page 2 of 6 CG T1 01 07 86 COMMERCIAL GENERAL LIABILITY EMPLOYEE BENEFITS LIABILITY COVERAGE FORM THIS FORM PROVIDES CLAIMS MADE COVERAGE. PLEASE READ THE ENTIRE FORM CAREFULLY. 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 policy the words "you" and "your" refer to the Named Insured shown in the Declarations. The words"we,""us"and "our" refer to the Company providing this insurance. The word "insured" means any person or organization qualifying as such under SECTION II —WHO IS AN IN- SURED. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION VII —DEFINI- TIONS. SECTION I — EMPLOYEE BENEFITS LIABILITY b. This insurance applies to any negligent act, COVERAGE error or omission of the insured, but only if a 1. Insuring Agreement claim for damages because of the negligent a. We will pay those sums that the insured be- act, error or omission is first made against any insured during the policy period. comes legally obligated to pay as damages because of any negligent act, error, or omis- sion of the insured, or of any other person for seeking damages will be deemed to have whose acts the insured is legally liable. The been made when notice of such claim is negligent act, error, or omission must be received and recorded by any insured or committed in. the "administration" of your by us,whichever comes first. . employee benefit program." No other obliga- 2) All claims for damages sustained by any tion or liability to pay sums or perform acts or one employee, including the employee's services is covered unless explicitly provided dependents and beneficiaries, will be for under SUPPLEMENTARY PAYMENTS. deemed to have been made at the time This insurance does not apply to any negli- the first of those claims is made against gent act, error, or omission which occurred any insured. before the Retroactive Date, if any, shown in 2. Exclusions the Declarations or which occurs after the policy expires. The negligent act, error or This insurance does not apply to: omission must take place in the "coverage a. Loss arising out of any dishonest, fraudulent, territory." We will have the right and duty. to criminal or malicious act or omission, com- defend any "suit" seeking those damages.mitted by any insured; But: b. "Bodily injury" or "property damage or "per- 1) The amount we will pay for damages is sonal injury"; limited as described in SECTION III — c. Loss arising out of failure of performance of LIMITS OF INSURANCE: contract by any insured; 2) We may at our discretion, investigate any d. Loss arising out of an insufficiency of funds to report of a negligent act, error or omission meet any obligations under any plan included and settle any claim or"suit"that may re- in the"employee benefit program"; sult: and 3) Our right and duty to defend end when e. Any claim or suit based upon: we have used up the applicable limit of 1) failure of any investment to perform as insurance in the payment of judgments or represented by any insured, or settlements. CG T1 01 07 86 Page 1 of 6 TABLE OF CONTENTS EMPLOYEE BENEFITS LIABILITY COVERAGE FORM CG T1 01 CLAIMS MADE SECTION I—COVERAGES Beginning on Page Employee Benefits Insuring Agreement ................................................. 1 Liability Coverage Exclusions 1 SupplementaryPayments ----------------------------------------------------------=------------------------------------------------------------------------------2 SECTION II--WHO IS AN INSURED ..... 2 SECTION III--LIMITS OF INSURANCE------------------------------------------------------------------------------------------------------------------------- SECTIONIV--DEDUCTIBLE-----------------------------------------------------------------------------------------------------------------------------------------=------- 3 SECTION V--EMPLOYEE BENEFITS LIABILITY CONDITIONS.........:........................................................ 3 Bankruptcy--------------------------------------.....--------..........3 Cancellation, Non-renewal, Renewal and Reduction or Deletion of Coverage......................A Duties in The Event of Act, Error or Omission......................................................................................::...... 3 LegalAction Against Us------------------------------------------------------------------------------------------------------------------------------------------------4 OtherInsurance ................................................................................................................................................................ 4 PremiumAudit 4 Representations ----------------------------------------------------------------------------------------------------------------------------------------------.......------------ 4 Separationof Insureds ----------------------------------------------------=--------------------------------------------------------------------------------------------4 Transfer of Rights of Recovery Against Others To Us4 SECTION VI—EXTENDED REPORTING PERIODS 4 SECTION VII--DEFINITIONS 5 CG-TO 43 11 88 IA. TRAVELERS J One Tower Square, Hartford, Connecticut 06183 EMPLOYEE BENEFITS LIABILITY POLICY NO.: DT22-CO-OF027488-TCT-14 COVERAGE PART DECLARATIONS ISSUE DATE: 08-29-14 INSURING COMPANY: THE TRAVELERS INDEMNITY COMPANY OF CONNECTICUT DECLARATIONS PERIOD: From 08-21-14 to 08-21-15 12:01 A.M. Standard Time at your mailing address shown in the Common Policy Declarations. The Employee Benefits Liability Coverage Part consists of these Declarations and the Coverage Form shown below. 1. COVERAGE AND LIMITS OF INSURANCE Employee Benefits Liability Coverage Form Limits of Insurance Aggregate Limit 2,000,000 Each Employee Limit 11000,000 2. AUDIT PERIOD: ANNUAL 3. FORM OF BUSINESS: CORPORATION 4. RETROACTIVE DATE: This insurance does not apply to negligent acts, errors or omissions which occurred before the Retroactive Date, if any shown below. Retroactive Date: 08-21-2019 5. EMPLOYEE BENEFIT PROGRAMS OTHER THAN THOSE LISTED IN SECTION VII—DEFINITIONS: 6. DEDUCTIBLE: NONE EACH EMPLOYEE 7. PREMIUM COMPUTATION: Rate Estimated No. per Estimated Minimum of Employees Employee Premium Premium 50 300 300 8. NUMBERS OF FORMS,SCHEDULES AND ENDORSEMENTS FORMING PART OF THIS COVERAGE PART ARE ATTACHED AS A SEPARATE LISTING. CG TO 09 09 93 Page 1 of 1 PRODUCER: DORSEY HAZELTINE & WYNNE HE741 OFFICE: WALNUT CREEK 418 e COMMERCIAL GENERAL LIABILITY POLICY NUMBER:DT22-CO-OF027488-TCT-14 ISSUE DATE:08-29-14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION-ALL HAZARDS IN CONNECTION WITH A DESIGNATED EXPOSURE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE DESCRIPTION YOUR WORK" ON OR FOR ANY PROJECT LOCATED IN THE STATE OF NEVADA_. This insurance does not apply to "bodily injury," "property damage," personal injury" or "advertising injury" arising out of: 1. Any exposure shown in the above schedule; or 2. Any supervision, instructions, recommendations or advice given or which should have been given in connection therewith. CG T4 81 11 88 Page 1 of 1 COMMERCIAL GENERAL LIABILITY POLICY NUMBER:DT22-CO-OF027488-TCT-14 ISSUE DATE:08-29-14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION-ALL HAZARDS IN CONNECTION WITH A DESIGNATED EXPOSURE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE DESCRIPTION YOUR WORK" ON OR FOR ANY PROJECT THAT, IN WHOLE OR IN PART, IS OR WILL BECOME ANY SINGLE- OR MULTI-FAMILY HOUSING, ANY RESIDENTIAL CONDOMINIUM, ANY RESIDENTIAL APARTMENT OR ANY ASSISTED LIVING FACILITY. THIS DESCRIPTION DOES NOT INCLUDE "YOUR WORK" WITHIN THE BOUNDARIES OF, OR BELOW, WHAT IS OR WILL BECOME ANY PUBLIC STREET, ROADWAY, OR RIGHT OF WAY. This insurance does not apply to "bodily injury," "property damage," personal injury" or "advertising injury" arising out of: 1. Any exposure shown in the above schedule; or 2. Any supervision, instructions, recommendations or advice given or which should have been given in connection therewith. CG T4 81 11 88 Page 1 of 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION -ASBESTOS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART CATASTROPHE UMBRELLA POLICY This insurance does not apply to "bodily injury," a. Any supervision, instructions, recommendations, property damage," "personal injury" or "advertising warnings or advice given or which should have injury" arising out of the actual or alleged presence been given in connection with the above; and or actual, alleged or threatened dispersal of asbes- b. Any obligation to share damages with or repay tos, asbestos fibers or products containing asbestos, someone else who must pay damages because provided that the injury or damage is caused or con- of such injury or damage. tributed to by the hazardous properties of asbestos. This includes: CG T4 78 02 90 Copyright,.The Travelers Indemnity Company.Page 1 of 1 r v COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - WAR This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion i. under Paragraph 2., Exclusions of B. The following exclusion is added to Paragraph 2., Section I — Coverage A — Bodily Injury And Exclusions of Section I — Coverage B — Per- Property Damage Liability is replaced by the sonal And Advertising Injury Liability: following: 2. Exclusions: 2. Exclusions: This insurance does not apply to: This insurance does not apply to: War i. War Personal injury" or "advertising injury" aris- Bodily injury" or "property damage" aris- ing, directly or indirectly, out of: ing, directly or indirectly, out of: 1) War, including undeclared or civil war;or 1) War, including undeclared or civil 2) Warlike action by a military force, includ-war; or ing action in hindering or defending 2) Warlike action by a military force, in- against an actual or expected attack, by cluding action in hindering or de- any government, sovereign or other fending against an actual or expected authority using military personnel or other attack, by any government, sovereign agents; or or other authority using military per- 3) Insurrection, rebellion, revolution, sonnel or other agents; or usurped power, or action taken by gov- 3) Insurrection, rebellion, revolution, ernmental authority in hindering or de- usurped power, or action taken by fending against any of these governmental authority in hindering regardless of any other cause or event that or defending against any of these contributes concurrently or in any sequence regardless of any other cause or event to the injury. that contributes concurrently or in any se- quence to the injury or damage. CG D2 42 01 02 Copyright,The Travelers Indemnity Company, 2002 Page 1 of 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - SILICA This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS a. Any supervision, instructions, recommendations, This insurance does not apply to 'bodily injury",warnings or advice given or which should have property damage", -"personal injury" or "advertising been given in connection with the above; and injury" arising out of or in any way related to the b. Any obligation to share damages with or repay actual, alleged or threatened discharge,-dispersal, someone else who must pay damages because emission, release, escape, handling, contact with, of such injury or damage. exposure to or inhalation or respiration of silica or This exclusion applies to all such "bodily injury" or products or substances containing silica. This in- "property damage" whether or not the "bodily injury" cludes, but is not limited to: or "property damage" is included in the "products- completed operations hazard". CG D2 40 06 01 Copyright, The Travelers Indemnity Company, 2001 Page 1 of 1 . COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - EXTERIOR INSULATION AND FINISH SYSTEM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART This insurance does not apply to "bodily injury", structure if an "exterior insulation and finish sys- property damage", advertising injury" or "personal tem", or any substantially similar system, is used injury"arising out of: on any part of that structure. 1. The design, manufacture, construction, fabrica- The following is added to DEFINITIONS (Section V): tion; distribution, sale, preparation, installation, "Exterior insulation and finish system" means an application, maintenance or repair, including re-- exterior cladding-or finish system used on any part of modeling, service, correction or replacement of any structure and consisting of: any 'exterior insulation and finish system (com- monly referred to as synthetic stucco or EIFS) or a. A rigid or semi rigid insulation board made of any part thereof, or any substantially similar sys- expanded polystyrene or other materials; and tem or any part thereof, including the application b. The adhesive and/or mechanical fasteners used or use of conditioners, primers, accessories, to attach the insulation board to the substrate; flashing, coatings, caulking or sealants in con- and nection with such a system; or c. A reinforced base coat; and 2. "Your product" or "your work" with respect to any d. A finish coat providing surface texture and color.exterior component, fixture or feature of any CG D2 04 06 01 Copyright, The Travelers Indemnity Company, 2001 Page 1 of 1 i I COMMERCIAL GENERAL LIABILITY III. ADDITIONAL DEFINITIONS ernmental authority demanding that the The following shall be added to DEFINITIONS insured test for, monitor, cleanup, re- Section V): move, contain, treat, detoxify or neutral- ize, or assess the effects of "pollutants" Limited covered pollution costs" means any cost situated on any premises, site or location or expense arising out of: which is or was at any time owned, occu- a. Any request, demand or order that the in- pied or managed by, rented or loaned to sured test for, monitor, cleanup, remove, con- you. tain, treat, detoxify or neutralize, or assess Pollution costs" means any cost or expense the effects of"pollutants"; or arising out of: b. Any claim or "suit' by or on behalf of a gov- a. Any request, demand, order or statutory ernmental authority demanding that the in- or regulatory requirement that any in- sured test for, monitor, cleanup, remove, con- sured or others test for, monitor, cleanup, tain, treat, detoxify or neutralize, or assess remove, contain,treat, detoxify or neutral- the effects of"pollutants". ize, or in any way respond to or assess Limited covered pollution costs" shall not in- the effects of"pollutants"; or clude: b. Any claim or "suit' by or on behalf of a I. Punitive or exemplary damages, or statu- governmental authority because of testing tory or administrative fines or penalties; or for, monitoring, cleaning up, removing, ii. Salaries or benefits paid to your employ- containing, treating, detoxifying or neu- ees; or tralizing, or in any way responding to, or Iii. Any cost or expense arising out of any assessing the effects of"pollutants". request,demand or order that the insured Underground storage tank" means any one or test for, monitor, cleanup, remove, con- combination of tanks (including pipes connected tain, treat, detoxify or neutralize, or as- thereto), the volume of which (including the vol- sess the effects of"pollutants"situated on ume of underground pipes connected thereto) is any premises, site or location which is or 10% or more beneath the ground surface or oth- was at any time owned, occupied or erwise covered with earthen materials. Under- managed by, or rented or loaned to you; ground pipes means all underground piping, in- or cluding but not limited to valves, elbows, joints, iv. Any cost or expense arising out of any flanges and flexible connectors attached to a tank claim or "suit' by or on behalf of a gov- system. CG D1 73 11 03 Copyright,The Travelers Indemnity Company,2003 Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. COMMERCIAL GENERAL LIABILITY 1) the discharge, release or escape of in LIMIT OF INSURANCE (Section pollutants" is either: III), paragraphs 2. and 3., whichever L at or from any premises, site or is applicable;and location, (other than at or from an 2) Our right and duty_to defend end underground storage tank"), when we have used up the applicable which is owned or occupied or limit of insurance in the payment of managed by, or rented or loaned judgments or settlements under Cov- to you during the policy period; erages A or B, medical expenses un- or; der Coverage C, or "limited covered ii. from a pipe containing sewage; pollution costs"under Coverage D. and No other obligation or liability to pay sums 2) the discharge, release or escape of or perform acts or services is covered pollutants" commences abruptly dur- unless explicitly provided for under SUP- ing the policy period and ends within PLEMENTARY PAYMENTS_— COVER- a period of 7 consecutive days after AGES A, B and D. the initial discharge, release or es-b. This insurance applies to"limited covered cape; and pollution costs"only if: 3) the discharge, release or escape of 1) The "limited covered pollution costs" pollutants" becomes known to the result from an "occurrence"that takes insured and reported in writing to us place in the"coverage territory"; and. within thirty (30) days from its abrupt 2) The same "occurrence" which results commencement; and in "limited covered_ pollution costs" 4) the "bodily injury" or "property dam- also causes "bodily injury" or "prop- age" arises only out of the discharge, erty damage" to which Coverage A release or escape of "pollutants" de- applies. scribed in (1), (2)and(3) above. 2. Exclusions 2) (This insurance also does not apply to) This insurance does not apply to: Pollution costs". H. COVERAGE D. LIMITED COVERAGE FOR a. "Limited covered pollution costs" incurred POLLUTION COSTS by any person or organization other than the Named Insured shown in the Declara- 1. Insuring Agreement tions. a. We will pay those sums that the insured b. "Limited covered pollution costs" which becomes legally obligated to pay as "lim- the insured is obligated to pay by reason ited covered pollution costs"to which this of the assumption of liability in a contract insurance applies. We will have the right or agreement. This exclusion does not and duty to defend any "suit" seeking apply to liability that the insured would limited covered pollution costs". We may have to pay "limited covered pollution at our discretion investigate any "occur- costs" in the absence of the contract or rence" and settle any claim or "suit" that agreement. may result. But: c. "Limited covered pollution. costs" if the 1) The amount we will pay for "limited bodily injury" or "property damage" aris- covered pollution costs" shall be in- ing.out of the actual, alleged or threat- cluded within, and not in addition to, ened discharge, dispersal, seepage, mi- the Each Occurrence Limit because gration, release or escape of "pollutants" of all "bodily injury" and "property is not covered under Coverage A. damage" arising out of any one "oc- 3. SUPPLEMENTARY PAYMENTS — COVER- currence". The total amount we will AGES A AND B is amended to read: pay for "limited covered pollution costs" shall be included within, and SUPPLEMENTARY PAYMENTS. — COVER- not in addition to, the limits set forth AGES A, B,AND D. Page 2 of 3 Copyright,The Travelers Indemnity Company,2003 CG D1 73 11 03 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT - POLLUTION EXCLUSION - INCLUDING LIMITED COVERAGE FOR POLLUTION COSTS - CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART I. REVISED EXCLUSION F.b) At or from any premises, site or loca- Exclusion f. of COVERAGE A. BODILY INJURY tion which is or was at any time used AND PROPERTY DAMAGE LIABILITY (Section I by or for any insured or others for the Coverages) is deleted and replaced by the handling, storage, disposal, process- following:ing or treatment of waste; This insurance does not apply to:) c) Which-are or were at any time trans- ported, handled, stored, treated, dis- f. (1) "Bodily injury" or "property damage" aris- posed of, or processed as waste by ing out of the actual, alleged or threat- or for any insured or any person or ened discharge, dispersal, seepage, mi- organization for whom you may be gration, release or escape of"pollutants": legally,responsible; a) At or from any premises, site or loca- d) At or from any premises, site or loca- tion which is or was at any time tion on which any insured or any con- owned or occupied or managed by, tractors or subcontractors working di= or rented or loaned to, any insured. rectly or indirectly on any insured's However, this paragraph does not behalf are performing operations if apply to: the operations-are to test for, monitor, i) "Bodily-injury" if sustained within clean up, remove, contain, treat, de- a building and caused by smoke; toxify or neutralize, or in any way re- fumes, vapor.or soot from equip spond- to, or assess the effects of ment used to heat that building;. pollutants"; or ii) "Bodily injury" or "property dam- e) If any' such- discharge, dispersal, age" for which you may be held seepage, migration, release or es- liable, if you are a contractor and cape of "pollutants" at or from any the. owner or lessee of such premises, site or location commences premises, site or .location has in whole or in part before the policy been added to your policy as.an period. All discharges, dispersals, additional insured with respect to seepages, migrations, releases or your ongoing operations per- escapes of"pollutants"at or from any formed for that additional insured premises, site or location shall be at that premises, site or location deemed to commence at the time of and such premises, site or loca- the initial_ discharge, release or es- tion is not and never was owned cape. However, subparagraph (e) or occupied by, or rented or does not apply to "bodily injury" or loaned to, any insured, other than property damage" included within that additional insured; or the "Products-Completed Operations iii) "Bodily injury" or "property dam- Hazard". age"arising out of-heat, smoke or Subparagraphs (a), (b) and (c) do not fumes from a"hostile fire"; apply to "bodily injury" or "property dam- age"if: CG D1 73 1103 Copyright,The Travelers Indemnity Company,2003 Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION-DISCRIMINATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS 1. COVERAGE A— BODILY INJURY AND PROP- 2. COVERAGE B — PERSONAL AND ADVERTIS- ERTY DAMAGE LIABILITY—is amended by ad- ING INJURY LIABILITY—is amended by adding ding the following additional exclusion:the following additional exclusion: This Insurance does not apply to:) This insurance does not apply to:) Bodily injury"resulting from or as a consequence Personal injury" resulting from or as a conse- of discrimination, whether intentional or uninten- quence of discrimination, whether intentional or tional, based upon a person's sex, sexual prefer- unintentional, based upon a person's sex, sexual ence, marital status, race, creed, religion, na- preference, marital status, race, creed, religion, tional origin, age, physical capabilities, character- national origin, age, physical capabilities, charac- istics or condition, or mental capabilities or con- teristics or condition, or mental capabilities or dition. condition. CG D1 42 01 99 Copyright, The Travelers Indemnity Company, 1999 Page 1 of 1 r COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - LEAD This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART CATASTROPHE UMBRELLA POLICY PROVISIONS 2. Any obligation to share damages, losses, costs, This insurance does not apply to any injury, damage, payments or expenses with or repay someone loss, cost, payment or expense, including, but not else who must make payment because of such limited to, defense and investigation, of any kind aris- injury or damage, loss, cost, payment or ex- ing out of, resulting from, caused by or contributed pense; or to by the actual or alleged presence or actual, al- 3. Any request, order or requirement to abate, leged or threatened dispersal, release, ingestion, in- mitigate, remediate, contain, remove or dispose halation or absorption of lead; lead compounds or of lead, lead compounds or materials or sub- lead which is or was contained or incorporated into stances containing lead. any material or substance. This exclusion applies, but is not limited to: 1. Any supervision, instructions, recommendations, warnings or advice given in connection with the above; CG DO 76 06 93 Page 1 of 1 4 l COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - VIOLATION OF CONSUMER FINANCIAL PROTECTION LAWS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS Consumer financial identity information" means 1. The following exclusion is added to Paragraph any of the following information for a person that 2., Exclusions, of SECTION I — COVERAGES is used or collected for the purpose of serving COVERAGE A BODILY INJURY AND as a factor in establishing such person's eligibil- PROPERTY DAMAGE LIABILITY: ity for personal credit, insurance or employment, . or for the purpose of conducting a businessViolationOfConsumerFinancialProtectiontransaction: Laws a. Part or all of the account-number, the expi- Bodily injury" or "property damage" arising out ration date or the balance of any credit, of any actual or alleged violation of a"consumer debit, bank or other financial account. financial protection law", or any other"bodily in- jury" or "property damage" alleged in any claim b. Information bearing on a person's credit or"suit"that also alleges any such violation. worthiness, credit standing or credit capac- 2. The following exclusion is added to Paragraph ity. 2., Exclusions, of SECTION I — COVERAGES c. Social security number. COVERAGE B PERSONAL AND ADVER- d. Drivers license number. TISING INJURY LIABILITY: e. Birth date. Violation Of Consumer Financial Protection Consumer financial protection law" means: Laws a. The Fair Credit Reporting Act (FCRA) andPersonalinjury" or "advertising injury" arising any of its amendments, including the Fair out of any actual or alleged violation of a "con- and Accurate Credit Transactions Act sumer .financial protection law", or any other FACTA); personal injury"or"advertising injury"alleged in any claim or "suit" that also alleges any such b. California's Song-Beverly Credit Card Act violation. and any of its amendments; or 3. The following is added to the DEFINITIONS c. Any other law or regulation that restricts or Section: prohibits the collection, dissemination, transmission, distribution or use of "con- sumer financial identity information". CG D618 10 11 -2011 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - ARCHITECTURAL, ENGINEERING OR SURVEYING PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS but only with respect to any of the following op- 1. The following exclusion is added to Paragraph 2., erations: Exclusions, of SECTION I — COVERAGES — a. Providing, or hiring independent profession- COVERAGE A BODILY INJURY AND PROP- als to provide, architectural, engineering or ERTY DAMAGE LIABILITY:surveying services to others in any insured's Architectural, Engineering Or Surveying Pro- capacity as an architect, engineer or sur- fessional Services veyor; or Bodily injury"or"property damage"arising out of b. Providing, or hiring independent profession- the rendering of or failure to render any "profes- als to-provide, architectural, engineering or surveying services in connection with con- sional services" by or on behalf of any insured, but only with respect to any of the following op- erations: 3. The following is added to the DEFINITIONS Section: a. Providing, or hiring independent profession- als to -provide, architectural, engineering or Professional services": surveying services to others in any insured's a. Includes: capacity as an architect, engineer or sur- 1 Preparing, approving, or failingto re- veyor; or p g' pp g' p pare or approve, maps, shop drawings, b. Providing, or hiring independent profession- opinions, reports, surveys, field orders or als to provide, architectural, engineering or change orders, or preparing, approving, surveying services in connection with con- or failing to prepare or approve, drawings struction work any insured performs. and specifications; and 2. The following exclusion is added to Paragraph 2.,2) Supervisory or inspection activities per- Exclusions, of SECTION I — COVERAGES — formed as part of any related architec- COVERAGE B PERSONAL AND ADVERTIS- tural, or engineering or surveying activi- ING INJURY LIABILITY: ties. Architectural, - Engineering Or Surveying b. Does not include services within construction Professional Services means, methods, techniques, sequences-and Personal injury" or"advertising injury"arising out procedures employed by you in connection . of the rendering of or failure to render any "pro- with your operations in your capacity as a fessional services"by or on behalf of any insured,construction contractor. CG D5 46 10 11 2011 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - ALL PROJECTS SUBJECT TO A WRAP-UP INSURANCE PROGRAM WITH LIMITED EXCEPTIONS FOR CERTAIN ONGOING OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS 1. The following exclusion is added to Paragraph 2., The exceptions in this exclusion do not apply to Exclusions, of SECTION I — COVERAGES — bodily injury" or "property damage" included in COVERAGE A BODILY INJURY AND PROP- the "products-completed operations hazard" even ERTY DAMAGE LIABILITY: if you are required to provide such coverage for Wrap-up Insurance Programsan additional insured by a written contract or Bodily injury" or "property damage" arising out of agreement. any project that is or was subject to a "wrap-up 2. The following is added to the DEFINITIONS Sec- insurance program". tion: This exclusion does not apply to "bodily injury" or Wrap-up insurance program" means any agree- property damage" arising out of your ongoing ment or arrangement,'including any contractor- operations that: controlled, owner-controlled or similar insurance program, under which: 1) Are being performed at any location owned by, or rented to, you that is outside the project a. Some or all of the contractors working on a site for that project and is not covered by the specific project, or specific projects, are re- wrap-up insurance program" for that project; quired to enroll in a program to obtain-insur- or ance that: 2) Are punch list or warranty work, if coverage 1) Includes the same or similar insurance as was available to the insured under the "wrap- that provided by this Coverage Part;and up insurance program" for "bodily injury" and 2) Is issued specifically for injury or damage property damage"arising out of your ongoing arising out of such project or projects; and - operations and the "bodily injury" or"property b. You are or were enrolled or allowed to enroll. damage" occurs after the expiration of all such coverage. CG D3 91 08 13 2013 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MOBILE EQUIPMENT REDEFINED - EXCLUSION OF VEHICLES SUBJECT TO MOTOR VEHICLE LAWS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS 2. "Auto" means: 1. The following replaces Paragraph(5) of Exclusion a. A land motor vehicle, trailer or semitrailer g., Aircraft,Auto Or Watercraft, in Paragraph 2. designed for travel on public roads, in- of SECTION I—COVERAGES—COVERAGE A. cluding any attached machinery- or BODILY INJURY AND ,PROPERTY DAMAGE equipment; or LIABILITY: b. Any other land vehicle that is subject to a 5) "Bodily injury" or "property damage" arising compulsory or financial responsibility law, out of: or other motor vehicle insurance law, a) The operation of machinery or equipment where it is licensed or principally garaged. that is attached to, or part of, a land vehi-However, auto" does not include "mobile cle that would qualify as "mobile equip- equipment". Ment" under the definition of "mobile equipment" if such land vehicle were not 3. The following is added as to the definition of"mo- subject to a compulsory or financial re- bile equipment"in the DEFINITIONS Section: sponsibility law, or other motor vehicle in- However, "mobile equipment" does not in- surance law, where it is licensed or prin- clude any land vehicle that is subject to a cipally garaged; or compulsory or financial responsibility law, or b) The operation-of any of the machinery or other motor vehicle insurance law, where it is equipment listed in Paragraph f.(2) or licensed or principally garaged. Such land. f.(3) of the definition of "mobile equip-- - vehicles are considered "autos". ment 4. -Paragraph 3. of SECTION II — WHO IS AN IN- 2. The following replaces the definition of "auto" in SURED is deleted. the DEFINITIONS Section: CG D3 56 05 14 2014 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - UNSOLICITED COMMUNICATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS COVERAGE B PERSONAL AND ADVERTISING 1. The following exclusion is added to Paragraph 2., INJURY LIABILITY: Exclusions, of SECTION I — COVERAGES — Unsolicited Communication COVERAGE A BODILY INJURY AND PROP- Personal injury" or"advertising injury" arising outERTYDAMAGELIABILITY: of any actual or alleged violation of any law that Unsolicited Communication restricts or prohibits the sending, transmitting or Bodily'injury" or"property damage" arising out of distributing of"unsolicited communication". any actual or alleged violation of any law that re- 3. The following is added to the DEFINITIONS Sec- stricts or prohibits the sending,transmitting or dis- tion: tributing of"unsolicited communication". Unsolicited communication" means any commu- 2. The following exclusion is added to Paragraph 2., nication, in any form, that the recipient of such Exclusions, of SECTION I COVERAGES — communication did not specifically request to re- ceive. CG D3 26 10 11 2011 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.with its permission. 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY EXCLUSION - SUITS BY ONE NAMED INSURED AGAINST ANOTHER NAMED INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. This insurance does not apply to any claim for or duties specifically assigned in this Coverage damages by any Named Insured against another Part to the First Named Insured, this insurance Named Insured because of "bodily injury", "prop- applies: erty damage", "personal injury" or"advertising in- a. As if the Named Insured were the only jury". Named Insured;and B. Condition 7. Separation of Insureds is deleted and replaced by the following: b. Separately to each insured against whom claim is made or"suit" is brought. Except with respect to the Limits of Insurance,the exclusion in A. of this endorsement and any rights CG D3 22 01 04 Copyright, The Travelers Indemnity Company,2004 Page 1 of 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - CONSTRUCTION MANAGEMENT ERRORS AND OMISSIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2., and specifications by any architect, engineer or Exclusions of Section I — Coverage A — Bodily surveyor performing services on a project on Injury And Property Damage Liability and Para- which you serve as construction manager; or graph 2., Exclusions of Section I — Coverage B — 2. Inspection, supervision, quality control, architec-Personal And Advertising Injury Liability: tural or engineering activities done by or for you This insurance does not apply to "bodily injury", on a project on which you serve as construction property damage", "personal injury" or "advertising manager. injury" arising out of: This exclusion does not apply to "bodily injury" or 1. The preparing, approving, or failure to prepare or "property damage" due to construction or demolition approve, maps, shop drawings, opinions, reports, work done by you, your "employees" or your subcon- surveys, field orders, change orders or drawings tractors. CG D2 93 11 03 Copyright,The Travelers Indemnity Company, 2003 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYMENT-RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2., B. The following exclusion is added to Paragraph 2., Exclusions of Section I —Coverage A— Bodily Exclusions of Section I — Coverage B — Per- Injury And Property Damage Liability: sonal And Advertising Injury Liability: This insurance does not apply to: This insurance does not apply to: Bodily injury"to: Personal injury"to: 1) A person arising out of any:1) A person arising out of any: a) Refusal to employ that person; a) Refusal to employ that person; b) Termination of that person's employment; b) Termination of that person's employment; or or c) Employment-related .practices, policies,c) Employment-related practices, policies, acts or omissions, such as coercion, de- acts or omissions, such as coercion, de- motion, evaluation, reassignment, disci- motion, evaluation, reassignment, disci- pline, defamation, harassment, humilia- pline, defamation, harassment, humilia- tion or discrimination directed at that tion or discrimination directed at that person; or person; or 2) The spouse, child, parent, brother or sister of 2)_The spouse, child, parent,.brother or sister of that person as a consequence of "bodily in- that person as a consequence- of "personal jury" to that person at whom any of the em- injury"to that person at whom any of the em- ployment-related practices described in Para- ployment-related practices described in Para- graphs(a), (b), or(c)above is directed. graphs(a), (b),or(c)above is directed. This exclusion applies: This exclusion applies: 1) Whether the insured may be liable as an em- 1) Whether the insured may be liable as an em- ployer or in any other capacity; and ployer or in any other capacity; and 2) To any obligation to share damages with or 2) To any obligation to share damages with or repay someone else who must pay damages repay someone else who must pay damages because of the injury. because of the injury. CG D2 88 11 03 Copyright,The Travelers Indemnity Company, 2003 Page 1 of 1 Includes copyrighted material of Insurance Services Office,,Inc.,with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FUNGI OR BACTERIA EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2., B. The following exclusion is added to Paragraph 2., Exclusions of Section I — Coverage A— Bodily Exclusions of Section I — Coverage B — Per- Injury And Property Damage: sonal And Advertising Injury Liability: 2. Exclusions 2. Exclusions This insurance does not apply to: This insurance does not apply to: Fungi or Bacteria Fungi or Bacteria a. 'Bodily injury" or "property damage"a. "Personal injury" or "advertising injury" which would not have occurred, in whole which would not have taken place, in or in part, but for the actual, alleged or whole or in part, but for the actual, al- threatened inhalation of, ingestion of, leged or threatened inhalation of, inges- contact with, exposure to, existence of, or tion of, contact with, exposure to, exis- presence of, any "fungi" or bacteria on or tence of, or presence of zany "fungi" or within a building or structure, including its bacteria on .or within a building or struc- contents, regardless of whether any other ture, including its contents, regardless of cause, event, material or product contrib- whether any other cause, event, material uted concurrently or in any sequence to or product contributed concurrently or in such injury or damage. any sequence to such injury. b. Any loss, cost or expenses arising out of b. Any loss, cost or expenses arising out of the abating, testing for, monitoring, the abating, testing for, monitoring, cleaning up, removing, containing, treat- cleaning up, removing, containing, treat- ing, detoxifying, neutralizing, remediating ing, detoxifying, neutralizing, remediating or disposing of, or in any way responding or disposing of, or in any way responding to, or assessing the effects of, "fungi" or to, or assessing the effects of, "fungi" or bacteria, by any insured or by any other bacteria, by any insured or by any other person or entity. person or entity. This exclusion does not apply to any "fungi" C. The following definition is added to.the Defini- or bacteria that are, are on, or are contained tions Section: in, a good or product intended for consump- Fungi" means any type or form of fungus, in-tion. cluding mold or mildew and .any mycotoxins, spores, scents or byproducts produced or re- leased by fungi. CG D2 43 01 02 Copyright,The Travelers Indemnity Company, 2002 Page 1 of 1 Includes copyrighted material of Insurance Services Office COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- 3. "Bodily injury" means bodily injury, mental ment to waive that insured's right of recovery anguish, mental injury, shock,fright, disability, against any person or organization, we waive our humiliation, sickness or disease sustained by right of recovery against such person or organiza- a person, including death resulting from any tion, but only for payments we make because of: of these at any time. a. "Bodily injury" or "property damage" that oc- N. CONTRACTUAL LIABILITY—RAILROADS curs; or 1. The following replaces Paragraph c. of the b. "Personal injury" or "advertising injury definition of"insured contract" in the DEFINI- caused by an offense that is committed; TIONS Section: subsequent to the execution of that contract or c. Any easement or license agreement; ' agreement. 2. Paragraph f.(1) of-the definition of "insured M. AMENDED BODILY INJURY DEFINITION contract" in the DEFINITIONS Section is de- leted. The following replaces the definition of "bodily injury" in the DEFINITIONS Section: Page 6 of 6 2011 The Travelers Indemnity Company.All rights reserved. CG D3 16 11 11 COMMERCIAL GENERAL LIABILITY by any ordinance, law or building code to include ii) A manager of any limited liability as an additional insured on this Coverage Part is company; or an insured, but only with respect to liability for iii)An executive officer or director of bodily injury", "property damage", "personal in- any other organization; jury" or"advertising injury" arising out of such op-that is your partner, joint venture erations. member or manager; or The insurance provided to such state or political b) Any "employee" authorized by such subdivision does not apply to: partnership, joint venture, limited li- a. Any "bodily injury," "property damage," "per- ability company or other organization sonal injury" or"advertising injury" arising out to give notice of an "occurrence" or of operations performed for that state or po- offense. litical subdivision; or 3) Notice to us of such "occurrence"or of an b. Any "bodily injury" or "property damage" in- offense will be deemed to be given as cluded in the "products-completed operations soon as practicable if it is given in good hazard".faith as soon as practicable to your work- J.. KNOWLEDGE AND NOTICE OF OCCUR- ers' compensation insurer. This applies RENCE OR OFFENSE only if you subsequently give notice to us The following is added to Paragraph 2., Duties In of the"occurrence" or offense as soon as The Event of Occurrence, Offense, Claim or practicable after any of the persons de- Suit, of SECTION IV — COMMERCIAL GEN- scribed in Paragraphs e. (1) or(2) above ERAL LIABILITY CONDITIONS:discovers that the"occurrence" or offense may result in sums to which the insurance e. The following provisions apply to Paragraph provided under this Coverage Part may a. above, but only for the purposes of the in- apply. surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. However, if this Coverage Part includes an en- of Section II—Who Is An Insured: dorsement that provides limited coverage for bodily injury" or "property damage" or pollution 1) Notice to us of such "occurrence" or of- costs arising out of a discharge, release or es- fense must be given as soon as practica- cape of"pollutants"which contains a requirement ble only after the "occurrence" or offense that the discharge, release or escape of "pollut- is known by you (if you are an individual), ants" must be reported to us within a specific any of your partners or members who is number of days after its abrupt commencement, an individual (if you are a partnership or this Paragraph e. does not affect that require- joint venture), any of your managers who ment. is an individual (if you are a limited liability K. UNINTENTIONAL OMISSION company), any of your "executive. offi- cers" or directors (if you are an organiza- The following is added to Paragraph 6., Repre- tion other than a partnership,joint venture sentations, of SECTION IV — COMMERCIAL or limited liability company) or any "em- GENERAL LIABILITY CONDITIONS: ployee" authorized by you to give notice The unintentional omission of, or unintentional of an"occurrence"or offense. error in, any information. provided by you which 2) If you are a partnership, joint venture.or we relied upon in issuing this policy will not preju- limited liability company, and none of your dice your rights under this insurance. However, partners, joint venture members or man- this provision does not affect our right to collect agers are individuals, notice to us of such additional premium or to exercise our rights of occurrence" or offense must be given as cancellation or nonrenewal in accordance with soon as practicable only after the "occur- applicable insurance laws or regulations. rence"or offense is known by: L. BLANKET WAIVER OF SUBROGATION a) Any individual who is: The following is added to Paragraph 8., Transfer i) _A partner or member of any part- Of Rights Of Recovery Against Others To Us, nership or joint venture; of SECTION IV— COMMERCIAL GENERAL LI-, ABILITY CONDITIONS: CG D3 16 11 11 2011 The Travelers Indemnity Company.All rights reserved. Page 5 of 6 COMMERCIAL GENERAL LIABILITY G. BLANKET ADDITIONAL INSURED —OWNERS, H. BLANKET ADDITIONAL INSURED—LESSORS MANAGERS OR LESSORS OF PREMISES OF LEASED EQUIPMENT The following is added to SECTION II —WHO IS The following is added to SECTION II —WHO IS AN INSURED: AN INSURED: Any person or organization that is a premises Any person or organization that is an equipment owner, manager or lessor and that you have lessor and that you have agreed in a written con- agreed in a written contract or agreement to in- tract or agreement to include as an insured on clude as an additional insured on this Coverage this Coverage Part is an insured, but only with re- Part is an insured, but only with respect to liability spect to liability for "bodily injury", "property dam- for "bodily injury", "property damage", "personal age", "personal injury"or"advertising injury"that: injury"or"advertising injury"that: a. Is "bodily injury" or "property damage" that a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- injury" caused by an offense that is commit- ted, subsequent to the execution of that con- ted, subsequent to the execution of that con-tract or agreement; and tract or agreement; and b. Is.caused, in whole or in part, by your acts or b. Arises out of the ownership, maintenance or use.--of that part of any premises leased to omissions in the maintenance, operation or use of equipment leased'.to you by such you.equipment lessor. The insurance provided to such premises owner, The insurance provided to such equipment lessor manager or lessor is subject to the following pro- is subject to the following provisions: . visions: a. The limits of insurance provided to such a. The limits of insurance provided to such equipment lessor will be the minimum limits premises owner, manager or lessor will be which you agreed to provide in the written the minimum limits which you agreed to pro- contract or agreement, or the limits shown on vide in the written contract or agreement, or the Declarations,whichever are less.: the limits shown on the Declarations, which- ever are less.b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or b. The insurance provided to such premises property damage" that occurs, or "personal owner, manager or lessor does not apply to: injury"or"advertising injury"Caused by an of- 1) Any "bodily injury" or "property damage fense that is committed, after the equipment that occurs, or"personal injury"or"adver- lease expires. tising injury" caused by an offense that is c. The insurance provided to such equipment committed, after you cease to be a tenant lessor is excess over any valid and collectible in that premises; or other insurance available to such equipment 2). Structural alterations, new construction or lessor, whether primary, .excess, contingent demolition operations performed by or on or on any other basis, unless you have behalf of such premises owner, lessor or agreed in the written contract or agreement manager. that this insurance must be primary to, or c. The insurance provided to such premises non-contributory with, such other insurance, owner, manager or lessor is excess over any in which case this insurance will be primary to, and non-contributory with, such other in-valid and collectible other insurance available to such premises owner, manager or lessor,surance. whether primary, excess, contingent or on I. BLANKET ADDITIONAL INSURED — STATES any other basis, unless you have agreed in OR POLITICAL SUBDIVISIONS—PERMITS the written contract or agreement that this in-The following is added to SECTION 11—;WHO IS surance must be primary to, or non- AN INSURED: contributory with, such other insurance, in which case this insurance will be primary to, Any state or political subdivision that has issued a and non-contributory with, such other insur- permit in connection with operations performed by ance. you or on your behalf and that you are required Page 4 of 6 @26.11 The Travelers Indemnity Company.All rights reserved. CG D3 161111 t COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 5. of 4. Any organization you newly acquire or form, SECTION III—LIMITS OF INSURANCE: other than a partnership, joint venture or lim- For the purposes of determining the applica- ited liability company, of which you are the ble Each Occurrence Limit, all related acts or sole owner or in which you maintain the ma- omissions committed in providing or failing to jority ownership interest, will qualify as a provide "incidental medical services", first aid Named Insured if there is no other insurance or"Good Samaritan services"to any one per- which provides similar coverage to that Or- son will be deemed to be one'occurrence". ganization. However: 4. The following exclusion is added to Para- a. Coverage under this provision is afforded graph 2., Exclusions, of SECTION I — COV- only: ERAGES—COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: 1) Until the 180th day after you acquire or form the organization or the end of the Sale Of Pharmaceuticals policy period, whichever is earlier, if you Bodily injury" or "property damage" arising do not report such organization in writing out of the willful violation of a penal statute or to us within 180 days after you acquire or ordinance relating to the sale of pharmaceuti- form it; or cals committed by, or with the knowledge or 2) Until the end of the policy period, when consent of, the insured. that date is later than 180 days after you 5. The following is added to the DEFINITIONS acquire or form such organization, if you Section:report such organization in writing to us Incidental medical services"means: within 180 days after you acquire or form a. Medical, surgical, dental, laboratory,x-ray it, and we agree in writing that it will con- or nursing service or treatment, advice or tinue to be a Named Insured until the end instruction, or the related furnishing of of the policy period; food or beverages; or b. Coverage A does not apply to "bodily injury" b. The furnishing or dispensing of drugs or or "property damage" that occurred before medical, dental, or surgical supplies or you acquired or formed the organization; and appliances. c. Coverage B does not apply to "personal in- Good Samaritan services" means any emer- jury" or "advertising injury" arising out of an gency medical services for which no compen- offense committed before you acquired or sation is demanded or received.formed the organization. 6. The following is added to Paragraph 4.b., Ex- F. WHO IS AN INSURED — BROADENED NAMED cess Insurance, of SECTION IV. — COM- INSURED—UNNAMED SUBSIDIARIES MERCIAL GENERAL LIABILITY- CONDI- TIONS: The following is added to SECTION II —WHO IS The insurance is excess over any valid and AN INSURED: collectible other insurance available to the in- Any of your subsidiaries, other than a partnership, sured, whether primary, excess, contingent or joint venture or limited liability company, that is on any other basis, that is available to any of not shown as a Named Insured in the Declara- your "employees" or "volunteer workers" for tions is a Named Insured if you maintain an own- bodily injury" that arises out of providing or ership interest of more than 50% in such subsidi- failing to provide "incidental medical ser- ary on the first day of the policy period. vices", first aid or "Good Samaritan services" No such subsidiary is an insured for"bodily injury" to any person to the extent not subject to or "property damage" that occurred, or "personalParagraph2.a.(1) of Section II — Who Is An injury" or "advertising injury" caused by an of-Insured. fense committed after the date, if any, during the E. WHO IS AN INSURED — NEWLY ACQUIRED policy period, that you .no longer maintain an OR FORMED ORGANIZATIONS ownership interest of more than 50% in such sub- The following replaces Paragraph 4. of SECTION sidiary. II—WHO IS AN INSURED: CG D3 16 11 11 2011 The Travelers Indemnity Company.All rights reserved. Page 3 of 6 Y COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph 6. of SEC- C. INCREASED SUPPLEMENTARY PAYMENTS TION III—LIMITS OF INSURANCE: 1. The following replaces Paragraph 1.b. of Subject to 5. above, the Damage To Prem- SUPPLEMENTARY PAYMENTS — COVER- ises Rented To You Limit is the most we will AGES A AND B of SECTION I — COVER- pay under Coverage A for damages because AGE: of "premises damage" to any one premises. b. Up to $2,500 for the cost of bail bonds The Damage To Premises Rented To You required because of accidents or traffic Limit will apply to all "property damage" law violations arising out of the use of any proximately caused by the same "occur- vehicle to which the Bodily Injury Liability rence , whether such damage results from: Coverage applies.We do not have to fur- fire; lightning; 9 nish these bonds.fire; explosion; li htnin smoke resulting from such fire, explosion, or lightning; or water; or 2. The following replaces Paragraph 1.d. of any combination of any of these causes: SUPPLEMENTARY PAYMENTS — COVER- The Damage To Premises Rented To You AGES A AND B of SECTION I — COVER- Limit will be: AGES: a. The amount shown for the Damage To d. All reasonable expenses incurred by the Premises Rented To You Limit on the insured at our request to assist us in the Declarations of this Coverage Part; or investigation or defense of the claim or b. $300,000 if no amount is shown for the suit", including actual loss of earnings up Damage To Premises Rented To You to $500 a day_because of time off from Limit on the Declarations of this Coverage work. Part. D. INCIDENTAL MEDICAL MALPRACTICE 4. The following replaces Paragraph a. of the 1. The following is added to the definition of"oc- definition of"insured contract" in the DEFINI- currence" in the DEFINITIONS Section: TIONS Section: Occurrence" also means an act or omission a. A contract for a lease of premises. How- committed in providing or failing to provide ever, that portion of the contract for a incidental medical services", first aid or lease of premises that indemnifies any Good Samaritan services"to a person. person or organization for "premises damage" is not an "insured contract"; 2. The following is added to Paragraph 2.a.(1) of SECTION II—WHO IS AN INSURED: 5. The following is added to the DEFINITIONS Section: Paragraph (1)(d) above does not apply to bodily injuryarising out of providing or fail- Premises damage" means "property dam- ing to provide: age"to: i) 'Incidental medical services" by any of a. Any premises while rented to you or tem- your "employees" who is a nurse practi- porarily occupied by you with permission tioner, registered nurse, licensed practical of the owner; or nurse, nurse assistant, emergency medi-- b. The contents of any premises while such cal technician or paramedic; or premises is rented to you, if you rent such ii) First aid or"Good Samaritan services" by premises for a period of seven or fewer any of your "employees" or "volunteerconsecutivedays. workers", other than an employed or vol- 6. The following replaces Paragraph 4.b.(1)(b) unteer doctor.-Any such "employees" or of SECTION IV—COMMERCIAL GENERAL volunteer workers" providing or failing to LIABILITY CONDITIONS: provide first aid or "Good Samaritan ser- b) That is insurance for"premises damage"; vices" during their work hours for you will or be deemed to be acting within the scope 7. Paragraph 4.b.(1)(c) of SECTION IV — of their employment by you or performing COMMERCIAL GENERAL LIABILITY CON- duties related to the conduct of your busi- DITIONS is deleted. ness. Page 2 of 6 2011 The Travelers Indemnity Company.All rights reserved. CG D3 16 11 11 w COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Aircraft Chartered With Pilot H. Blanket Additional Insured — Lessors Of Leased B. Damage To Premises Rented To You Equipment C. Increased Supplementary Payments 1. Blanket Additional Insured — States Or Political Subdivisions—Permits D. Incidental Medical Malpractice J. Knowledge And Notice Of Occurrence Or Offense E. Who Is An Insured — Newly-Acquired Or Formed Organizations K. Unintentional Omission F. Who Is An Insured — Broadened Named Insured L. Blanket Waiver Of Subrogation Unnamed Subsidiaries M. Amended Bodily Injury Definition G. Blanket Additional Insured — Owners, Managers N. Contractual Liability—Railroads Or Lessors Of Premises PROVISIONS INJURY AND PROPERTY DAMAGE L11_ A. AIRCRAFT CHARTERED WITH PILOT ABILITY: The following is added to Exclusion g., Aircraft, Exclusions c. and g. through n. do not apply Auto Or Watercraft,in Paragraph 2.of SECTION - to "premises damage". Exclusion- f.(1)(a) COVERAGES — COVERAGE A BODILY IN- does not apply to "premises damage" caused. JURY AND PROPERTY DAMAGE LIABILITY: by: This exclusion does not apply to an aircraft that a. Fire; is: b. Explosion; a) Chartered with a pilot to any insured; c. Lightning; b) Not owned by any insured; and d. Smoke resulting from such fire, explosion, c) Not being used to carry, any person or prop- or lightning; or erty for a charge. e. Water; B. DAMAGE TO PREMISES RENTED TO YOU unless Exclusion f. of Section I—Coverage A. 1. The first paragraph of the exceptions in Ex- Bodily Injury And Property Damage Liability clusion j., Damage To Property, in Para- is replaced by another endorsement to this graph 2. of SECTION I — COVERAGES — Coverage Part that has Exclusion—All Pollu- COVERAGE A BODILY INJURY AND tion Injury Or Damage or Total Pollution Ex- PROPERTY DAMAGE LIABILITY is deleted.clusion in its title. 2. The following replaces the last paragraph of A separate limit of insurance applies to Paragraph 2., Exclusions, of SECTION I — premises damage" as described in Para- COVERAGES — COVERAGE A. BODILY graph 6. of SECTION III — LIMITS OF IN- SURANCE. CG D3 16 11 11 2011 The Travelers Indemnity company.All rights reserved. Page'1 of 6 COMMERCIAL GENERAL LIABILITY L How, when and where the "occurrence" any provider of"other insurance"which would or offense took place; cover the additional insured for a loss we fl. The names and addresses of any injured cover under this endorsement. However, this persons and witnesses; and condition does not affect whether the insur- ance provided to the additional insured by iii. The nature and location of any injury or this endorsement is primary to "other insur- damage arising out of the"occurrence"or ance" available to the additional insured offense. which covers that person or organization as a b) If a claim is made or"suit" is brought against named insured as described in paragraph 3. the additional insured, the additional insured above. must: 5. The following definition is added to SECTION V. L Immediately record the specifics of the DEFINITIONS: claim or"suit" and the date received; and Written contract requiring insurance" means ii. Notify us as soon as practicable. that part of any written contract or agreement under which you are required to include a The additional insured must see to it that we person or organization as an additional in- receive written notice of the claim or"suit" as sured on this Coverage Part, provided that soon as practicable. the "bodily injury" and "property damage" oc- c) The additional insured must immediately curs and the "personal injury" is caused by an send us copies of all legal papers received in offense committed: connection with the claim or"suit", cooperate a. After the signing and execution of the with us in the investigation or settlement of contract or agreement by you; the claim or defense against the "suit", and otherwise comply with all policy conditions.b. While that part of the contract or d) The additional insured must tender the de- agreement is in effect; and fense and indemnity of any claim or "suit" to c. Before the end of the policy period. Page 2 of 2 0 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED—(Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance"property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products-completed op- age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for"bodily injury",requiring insurance" specifically requires you property damage"or"personal injury"; and to provide such coverage for that additional insured, and then the insurance provided to b) If, and only to the extent that, the injury or the additional insured applies only to suchdamageiscausedbyactsoromissionsofbodilyinjury" or "property damage" that oc- you or your subcontractor in the performance curs before the end of the period of time for of "your work" to which the "written contract which the "written contract requiring insur- requiring insurance" applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever is insured with respect to the independent acts earlier. or omissions of such person or organization. 3. The insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement is excess over any valid and by this endorsement is limited as follows: collectible "other insurance", whether primary, a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the Declarations available to the additional insured for a loss we exceed the limits of liability required by the cover under this endorsement. However, if the written contract requiring insurance", the in- written contract requiring insurance" specifically surance provided to the additional insured requires that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and non-contributory basis, quired by that "written contract requiring in- this insurance is primary to "other insurance" surance". This endorsement shall not in- available to the additional insured which covers crease the limits of insurance described in that person or organization as a named insured Section III—Limits Of Insurance. for such loss, and we will not share with that other insurance". But the insurance provided tob) The insurance provided to the additional in- the additional insured by this endorsement still issureddoesnotapplyto "bodily injury", "prop- excess over any valid and collectible "other in- ofdamage" or "personal injury" arising out surance", whether primary, excess, contingent oroftherenderingof, or failure to render, any on any other basis, that is available to the addi- professional architectural, engineering or sur- tional insured when that person or organization is veying services, including: an additional insured under such "other insur- L The preparing, approving, or failing to ance". prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the ings, opinions, reports, surveys, field or- additional insured by this endorsement:ders or change orders, or the preparing, approving, or failing to prepare or ap- a) The additional insured must give us written prove, drawings and specifications; and notice as soon as practicable of an "occur- ii. Supervisory, inspection, architectural or rence" or an offense which may result in a claim. To the extent possible, such notice engineering activities. should include: CG D2 46 08 05 0 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY 1. Any payments made under COVERAGE A. vided, any payments for damages because of for damages or under COVERAGE C. for bodily injury" or "property damage" included in medical expenses shall reduce the amount the "products-completed operations hazard" will available under the General Aggregate Limit reduce the Products-Completed Operations Ag- or the Products-Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gregate Limit, whichever is applicable; and gate Limit nor the Designated Project General 2. Such payments shall not reduce any Desig- Aggregate Limit. nated Project General Aggregate Limit. E. For the purposes of this endorsement the Defini- C. Part 2.of SECTION III—LIMITS OF INSURANCE tions Section is amended by the addition of the is deleted and replaced by the following: following definition: 2. The General Aggregate Limit is the most we Project" means an area away from premises will pay for the sum of: owned by or rented to you at which you are per- forming operations pursuant to a contract or a. Damages under Coverage B; and agreement. For the purposes of determining the b. Damages from "occurrences" under applicable aggregate limit of insurance, each COVERAGE A (SECTION 1) and for all project" that includes premises involving the medical expenses caused by accidents same or connecting lots, or premises whose con- under COVERAGE C (SECTION 1) which nection is interrupted only by a street, roadway, cannot be attributed only to operations at waterway or right-of-way of a railroad shall be a single designated"project"shown in the considered a single"project". SCHEDULE above.F. The provisions of SECTION III — LIMITS OF D. When coverage for liability arising out of the INSURANCE not otherwise modified by this en- products-completed operations hazard" is pro- dorsement shall continue to apply as stipulated. Page 2 of 2 Copyright,The Travelers Indemnity Company, 2004 CG D2 1101 04 COMMERCIAL GENERAL LIABILITY POLICY NUMBER: DT22-CO-OF027488-TCT-14 ISSUE DATE:08-29-14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY DESIGNATED PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL-GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Project Designated Project(s): General Aggregate(s): EACH "PROJECT" FOR WHICH YOU HAVE AGREED, IN GENERAL AGGREGATE A WRITTEN CONTRACT WHICH IS IN EFFECT DURING LIMIT SHOWN ON THE THIS POLICY PERIOD, TO PROVIDE A SEPARATE DECLARATIONS. GENERAL AGGREGATE LIMIT, PROVIDED THAT THE CONTRACT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS. A. For all sums which the insured becomes legally 3. Any payments made under COVERAGE A. obligated to pay as damages caused'by "occur- for damages or under COVERAGE C. for rences" under COVERAGE A. (SECTION 1), and medical expenses shall reduce the Desig- for all medical expenses caused by accidents un-nated project General Aggregate Limit for der COVERAGE C (SECTION I), which can be that designated "project". Such payments attributed only to operations at a single desig-shall not reduce the General Aggregate Limit nated"project"shown in the Schedule above:. shown in the Declarations nor shall they re- 1. A separate Designated. Project General Ag- duce any other Designated Project General gregate Limit applies to each designated "pro- Aggregate Limit for any other designated ject", and that limit is equal to the amount of project"shown in the Schedule above. the General Aggregate Limit shown in the 4. The limits shown in the Declarations for Each Declarations, unless separate Designated Occurrence, Damage To Premises Rented Project General Aggregate(s) are sched- To You and Medical Expense continue to uled above. apply. However, instead of being subject to 2. The Designated Project,General Aggregate the General Aggregate Limit .shown in the Limit is the most we will pay for the sum of all Declarations, such limits will be subject to the damages under COVERAGE A., except applicable Designated Project General Ag- damages because of "bodily injury" or "prop- gregate Limit. erty damage included in the "products- B. For all sums which the insured becomes legally completed operations hazard", and for medi- obligated to pay,as damages caused by "occur- cal expenses under COVERAGE C, regard- rences" under COVERAGE A. (SECTION 1), and less of the number of: for all medical expenses caused by accidents un- a. Insureds; der COVERAGE C. (SECTION 1), which cannot be attributed only to operations at a single desig- nated"project"shown in the Schedule above: c. Persons or organizations making claims or bringing"suits". CG D2 11 01 04 Copyright,The Travelers Indemnity Company, 2004 Page 1 of 2 TRAVELERSJ Report Claims Immediately Y gbCalling* 1-877-828-4132 Speak directly with a claim professional 24 hours a day, 365 days a year Unless Your Policy Requires Written Notice or Reporting COMMERCIAL INSURANCEC A Custom Insurance Policy Prepared for: G. BORTOLOTTO &COMPANY, INC. 582 BRAGATO ROAD SAN CARLOS CA 94070 xx Present#b DORSEY fAZE LTfN'E &WYNNEY................. ....... ax y, AW TRAVELERS J One Tower Square, Hartford, Connecticut 06183 TRAVELERS CORP. TEL: 1-800-328-2189 CONTRACTORS COMMON POLICY DECLARATIONS ISSUE DATE: 08/29/14 POLICY NUMBER: DT22-CO-OF027488-TCT-14 INSURING COMPANY: THE TRAVELERS INDEMNITY COMPANY OF CONNECTICUT 1. NAMED INSURED AND MAILING ADDRESS: G. BORTOLOTTO & COMPANY, INC. 582 BRAGATO ROAD SAN CARLOS, CA 94070 2. POLICY PERIOD: From 08/21/14 to 08/21/15 12:01 A.M. Standard Time at your mailing address. 3. LOCATIONS Premises Bldg. Loc. No. No. Occupancy Address SEE IL TO 03 4. COVERAGE PARTS FORMING PART OF THIS POLICY AND INSURING COMPANIES: COMMERCIAL GENERAL LIABILITY COV PART DECLARATIONS CG TO 01 11 03 TCT EMPLOYEE BENEFITS LIABILITY COV PART DECLARATIONS CG TO 09 09 93 TCT 5. NUMBERS OF FORMS AND ENDORSEMENTS FORMING A PART OF THIS POLICY: SEE IL T8 01 10 93 6. SUPPLEMENTAL POLICIES: Each of the following is a separate policy containing its complete provisions: Policy Policy No. Insuring Company SEE CALCULATION OF PREMIUM DIRECT BILL COMPOSITE RATES ENDORSEMENT 7. PREMIUM SUMMARY: Provisional Premium $ 45,540 Due at Inception Due at Each NAME AND ADDRESS OF AGENT OR BROKER: COUNTERSIGNED BY: DORSEY HAZELTINE & WYNNE (HE741) P 0 BOX 50307 PALO ALTO, CA 94303 Authorized Representative DATE: IL TO 02 11 89(REV. 09-07)PAGE 1 OF 1 OFFICE: WALNUT CREEK j TRAVELERSJW POLICY NUMBER: DT22-CO-OF027488-TCT-14 EFFECTIVE DATE: 08-21-14 ISSUE DATE: 08-29-14 LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS BY LINE OF BUSINESS. IL TO 02 11 89 COMMON POLICY DECLARATIONS IL T8 01 10 93 FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS IL TO 01 01 07 COMMON POLICY CONDITIONS IL TO 03 04 96 LOCATION SCHEDULE IL T3 02 07 86 CALCULATION OF PREMIUM-COMPOSITE RATE(S) GENERAL LIABILITY - CONTRACTORS CG TO 01 11 03 COML GENERAL LIABILITY COV PART DEC CG D3 05 07 08 DEDUCTIBLE LIABILITY INSURANCE CG TO 07 09 87 DECLARATIONS PREMIUM SCHEDULE . CG TO 08 11 03- KEY TO DECLARATIONS PREMIUM SCHEDULE CG TO 34 11 03 TABLE OF CONTENTS CG 00 01 10 01 COMMERCIAL GENERAL LIABILITY COV FORM CG D4 20 07 08 AMEND OTHER INS COND MEAN OTHER INS/INSR CG D4 71 02 09 AMEND COVERAGE B - PERS & ADV INJURY CG 21 70 01 08 CAP ON LOSSES-CERTIFIED ACTS-TERRORISM CG D2 03 12 97 - AMEND-NON CUMULATION OF EACH OCC CG D2 11 01 04 DESIGNATED PROJECT(S) GEN AGGR LIMIT CG D2 46 08 05 BLANKET ADDITIONAL INSURED (CONTRACTORS) CG D3 16 11 11 CONTRACTORS XTEND ENDORSEMENT CG D2 43 01 02 FUNGI OR BACTERIA EXCLUSION CG D2 88 11 03 EMPLOYMENT-RELATED PRACTICES EXCLUSION CG D2 93 11 03 EXCL-CONSTRUCT MANAGE ERRORS & OMISSIONS CG D3 22 01 04 EXCLUSION-SUITS BY ONE NAMED INSURED CG D3 26 10 11 EXCLUSION - UNSOLICITED COMMUNICATION CG D3 56 05 14 MOBILE EQUIP REDEFINED-EXCL OF VEHICLES CG D3 91 .08 13 EXCL-PROD SUBJ TO WRAP-UP-LTD EXCEPTIONS CG D5 46 10 11 EXCL - ARCHITECT/ENG/SURVEY PROF SERV CG D6 18 10 11 EXCL-VIOLATION OF CONSUMER FIN PROT LAWS CG DO 76 06 93 EXCLUSION-LEAD CG D1 42 01 99 EXCLUSION-DISCRIMINATION CG.D1 73 11 03 AMEND-POLL EXCL-INCL LTD COV POLL COSTS CG D2 04 06 01 EXCL-EXTERIOR INSULATION & FINISH SYSTEM CG D2 40 06 01 EXCLUSION - SILICA CG D2 42 01 02- EXCLUSION WAR CG T4 78 02 90 EXCLUSION-ASBESTOS CG T4 81 11 88 EXC-HAZARD-CONNECTED DESIGNATED EXPOSURE CG TO 09 09 93 EMPLOYEE BENEFITS LIAB COV PART DEC CG TO 43 11 88 EMPLOYEE BENEFITS LIAB TABLE OF CONTENTS CG T1 01 07 86 EMPLOYEE BENEFITS LIABILITY COV FORM CG T5 30 06 89 AMENDMENT-EBL CG DO 38 03 95 EXCLUSION-IRC VIOLATIONS CG T4 85 11 88 ADDITIONAL EXCLUSION-EBL CG 32 34 01 05 CALIFORNIA CHANGES IL T8 01 10 93 PAGE: 1 OF 2 TRAVELERS J POLICY NUMBER: DT22-CO-OF027488-TCT-14 EFFECTIVE DATE: 08-21-14 ISSUE DATE: 08-29-14 INTERLINE ENDORSEMENTS IL T3 68 05 10 FEDERAL TERRORISM RISK INS ACT DISCLOSE IL T3 76 10 10 CAP ON LOSSES CERTIFIED ACT OF TERRORISM IL 00 21 09 08 NUCLEAR ENERGY LIAB EXCL END-BROAD FORM IL 02 70 09 12 CALIFORNIA CHANGES - CANC AND NONRENEWAL IL T8 01 10 93 PAGE: 2 OF 2 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions: A. Cancellation during the policy period and up to three years 1. The first Named Insured shown in the Decla- afterward. rations may cancel this policy by mailing or D. Inspections And Surveys delivering to us advance written notice of 1. We have the right to: cancellation. 2. We may cancel this policy or any Coverage a. Make inspections and surveys at any Part -by mailing or delivering to the first time; Named Insured written notice of cancellation b. Give you reports on the conditions we at least:find; and a. 10 days before the effective date of can- c. Recommend changes. cellation if we cancel for nonpayment of 2. We are not obligated to make any inspec- premium; or tions, surveys, reports or recommendations b. 30 days before the effective date of can- and any such actions we do undertake relate cellation if we cancel for any other rea- only to insurability and the premiums to be son. charged. We do not make safety inspections. 3. We will mail or deliver our notice to the first We do not undertake to perform the duty of Named Insured's last mailing address known any person or organization to provide for the health or safety of workers or the public. And to us. we do not warrant that conditions: 4. Notice of cancellation will state the effective a. Are safe or healthful; or date of cancellation. If the policy is cancelled, that date will become the end of the policy b. Comply with laws, regulations, codes or period. If a Coverage Part is cancelled, that standards. date will become the end of the policy period 3. Paragraphs 1. and 2. of this condition apply as respects that Coverage Part only. not only to us, but also to any rating, advi- 5. If this policy or any Coverage Part is can- sory, rate service or similar organization celled, we will send the first Named Insured which makes insurance inspections, surreys, any premium refund due. If we cancel, the re- reports or recommendations. fund will be pro rata. If the first Named In- 4. Paragraph 2. of this condition does not apply sured cancels, the refund may be less than to any inspections, surveys, reports or rec- pro rata. The cancellation will be effective ommendations we may make relative to certi- even if we have not made or offered a re- fication, under state or municipal statutes, or- fund. dinances or regulations, of boilers, pressure 6. If notice is mailed, proof of mailing will be vessels or elevators. sufficient proof of notice. E. Premiums B. Changes 1. The first Named Insured shown in the Decla- This policy contains all the agreements between rations: you and us concerning the insurance afforded.a. Is responsible for the payment of all pre- The first Named Insured shown in the Declara- miums; and tions is authorized to make changes in the terms of this policy with our consent. This policy's terms b. Will be the payee for any return premi- can be amended or waived only by endorsement ums we pay. issued by us as part of this policy. 2. We compute all premiums for this policy in C. Examination Of Your Books And Records accordance with our rules, rates, rating plans, premiums and minimum premiums. The pre- We may examine and audit your books and mium shown in the Declarations was com- records as they relate to this policy at any time puted based on rates and rules in effect at IL TO 01 01 07(Rev.06-09) Includes the copyrighted material of Insurance Services Office,Inc.with its permission. Page 1 of 2 the time the policy was issued. On each re- acting within the scope of duties as your legal newal continuation or anniversary of the ef- representative. Until your legal representative is fective date of this policy, we will compute appointed, anyone having proper temporary cus- the premium in accordance with our rates tody of your property will have your rights and and rules then in effect. duties but only with respect to that property. F. Transfer Of Your Rights And Duties Under This Policy G. Equipment Breakdown Equivalent to Boiler Your rights and duties under this policy may not and Machinery be transferred without our written consent except On the Common Policy Declarations, the term in the case of death of an individual named in- Equipment Breakdown is understood to mean sured. and include Boiler and Machinery and the term If you die, your rights and duties will be trans- Boiler and Machinery is understood to mean and ferred to your legal representative but only while include Equipment Breakdown. This policy consists of the Common Policy Declarations and the Coverage Parts and endorsements listed in that declarations form. In return for payment of the premium, we agree with the Named Insured to provide the insurance afforded by a Coverage Part forming part of this policy. That insurance will be provided by the company indicated as insuring company in the Common Policy Declarations by the abbreviation of its name opposite that Coverage Part. One of the companies listed below (each a stock company) has executed this policy, and this policy is counter- signed by the officers listed below: The Travelers Indemnity Company(IND) The Phoenix Insurance Company(PHX) The Charter Oak Fire Insurance Company(COF) Travelers Property Casualty Company of America (TIL) The Travelers Indemnity Company of Connecticut(TCT) The Travelers Indemnity Company of America (TIA) Travelers Casualty Insurance Company of America (ACJ) Secretary President Page 2 of 2 Includes the copyrighted material of Insurance Services Office,Inc.with its permission. IL TO 01 01 07(Rev.06-09) LOCATION SCHEDULE POLICY NUMBER: DT22-CO-OF027488-TCT-14 This Schedule of Locations and Buildings applies to the Common Policy Declarations for the period 08-21-14 to 08-21-15 . Loc. Bldg. No. No. Address Occupancy 1 1 582 BRAGATO ROAD OFFICER/WAREHOUSE SAN CARLOS, CA 94070 IL TO 03 04 96 Page 1 (END) y r POLICY NUMBER: DT22-CO-OF027488-TCT-14 ISSUE DATE: 08-29-14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALCULATION OF PREMIUM - COMPOSITE RATES A. SCHEDULE 1. This endorsement modifies insurance provided under the following Coverage Part(s): COMMERCIAL GENERAL LIABILITY 2. This endorsement applies to the Declarations from 08-21-14 to 08-21-15 12:01 A.M. Standard Time at your mailing address shown in the Common Policy Declarations. 3. Definition of Premium Base (Bases): PER $1,000 OF EXPOSURE 4. Exceptions (if any) to compositing of premium calculation: 5. Premium Schedule PREMIUM COVERAGE BASE SEE CG TO 07 ESTIMATED ADVANCE EXPOSURE RATE PREMIUM If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) B. PROVISIONS premium shall be computed in accordance with 1. Referring to the Schedule above, the premium the policy and this endorsement. If the earned for the Coverage Parts shown in item 1, except premium thus computed exceeds the estimated with respect to any exceptions shown in item 4, advance premium paid, you shall pay the ex- shall be computed in accordance with the cess to us; if less, we shall return to you the premium base (bases) and rate (rates) desig- unearned paid portion. Rates and premiums nated in item 5. for any subsequent .Declarations Periods shall be determined at the inception date of those 2. The premium for the excepted hazards shall be respective periods and shall be specified in en- computed in accordance with the rates and dorsements to be added to the policy. After rules filed by us or on our behalf. termination of each period,the earned premium 3. The advance premium stated above is an es- shall be computed in accordance with the timated premium for the Declarations Period. policy and this endorsement. Upon termination of this period, the earned IL T3 02 07 86(Rev.12-08) Page 1 of 1 GENERAL LIABILITY CONTRACTORS r TRAVELERS J One Tower Square, Hartford, Connecticut 06183 COMMERCIAL GENERAL LIABILITY CONTRACTORS POLICY NO.: DT22-CO-OF027488-TCT-14 COVERAGE PART DECLARATIONS ISSUE DATE: 08-29-14 INSURING COMPANY: THE TRAVELERS INDEMNITY COMPANY OF CONNECTICUT DECLARATIONS PERIOD: From 08-21-14 to 08-21-15 12:01 A.M. Standard Time at your mailing address shown in the Common Policy Declarations. The Commercial General Liability Coverage Part consists of these Declarations and the Coverage Form shown below. 1. COVERAGE AND LIMITS OF INSURANCE: COMMERCIAL GENERAL LIABILITY COVERAGE FORM LIMITS OF INSURANCE General Aggregate Limit 2,000,000 Other than Products-Completed Operations) Products-Completed Operations Aggregate Limit 2,000,000 Personal &Advertising Injury Limit 1,000,000 Each Occurrence Limit 1,000,000 Damage To=Premises Rented To You Limit(any one premises) 300,000 Medical Expense Limit(any one person) 51000 2. AUDIT PERIOD: ANNUAL 3. FORM OF BUSINESS: CORPORATION . 4. NUMBERS OF FORMS,SCHEDULES AND ENDORSEMENTS FORMING PART OF THIS COVERAGE PART ARE ATTACHED AS A SEPARATE LISTING. COMMERCIAL GENERAL LIABILITY COVERAGE IS SUBJECT TO A GENERAL AGGREGATE LIMIT CG TO 01 11 03 Page 1 of 1 PRODUCER: DORSEY HAZELTINE & WYNNE KE741 OFFICE: WALNUT CREEK 418 f COMMERCIAL GENERAL LIABILITY POLICY NUMBER: DT22-CO-OF027488-TCT-14 ISSUE DATE: 08-29-14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Coverage Amount of Deductible PER OCCURRENCE Property Damage Liability,including Limited Coverage For 5,000 Pollution Costs(if applicable),and associated "allocated loss adjustment expenses", only OR Bodily Injury Liability and Property Damage Liability,including Limited Coverage For Pollution Costs (if applicable),and associated"allocated loss adjustment expenses", combined If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) PROVISIONS b. Under the Limited Coverage For Pollution APPLICATION OF ENDORSEMENT (Enter below, Costs (if applicable) to pay 'limited covered any limitations on the application of this endorsement. pollution costs" and "allocated loss adjust- If no limitation is entered,the deductible applies to: ment expenses"on behalf of the insured; A. Damages for all "property damage" and to all 'lim- applies only to the amount of damages, 'limited ited covered pollution costs" (if applicable); or covered pollution costs" (if applicable) and "allo- B. Damages for all "bodily injury" and "property cated loss adjustment expenses" in excess of any damage" and to all 'limited covered pollution deductible amount stated in the Schedule above costs" (if applicable); as applicable to such coverages. however caused): 2. The deductible amount stated in the Schedule above applies as follows: a. Under Property Damage Liability Coverage, including Limited Coverage For Pollution Costs(if applicable), only,to all: 1) Damages because of"property-damage"; 2) "Limited covered pollution costs" (if appli- cable); and 3) Associated "allocated loss adjustment expenses"; 1. Our obligation: as the result of any one occurrence';or b. Under Bodily Injury Liability and Property a. Under the Bodily Injury Liability and Property Damage Liability Coverage, including Limited Damage Liability Coverages to pay damages Coverage For Pollution Costs if applicable), and "allocated loss adjustment expenses on g combined,to all: behalf of the insured;and 1) Damages because of"bodily injury'; CG D3 05 07 08 2008 The Travelers Companies,Inc. Page 1 of 3 COMMERCIAL GENERAL LIABILITY 2) Damages because of"property damage'; not satisfied by contributions made toward pay- 3) "Limited covered pollution costs" (if appli- ment of any claim or"suit", or any "allocated loss cable); and adjustment expenses" incurred, by other insurers 4) Associated "allocated loss adjustment or any other entity. expenses ;7. If you fail to reimburse us for any amounts as re- quired by this endorsement, we may cancel this as the result of any one"occurrence". policy by mailing or delivering to the first Named 3. The terms of this insurance, including those with Insured written notice of cancellation at least 10 respect to: days before the effective date of cancellation. a. Our right and duty with respect to the defense 8. "Allocated loss adjustment expenses": of"suits'; and a. Means any of the following fees, costs or ex- b. Your duties in the event of an"occurrence", penses which can be directly allocated to a claim, or"suit"; particular claim or"suit": apply irrespective of the application of the de- 1) Fees of attorneys, or other authorized ductible amount. representatives where permitted,for legal 4. The applicable limits of insurance (including ag- services, whether by outside or staff rep- gregates) shall be reduced by the amount of any resentatives; damages (or "limited covered pollution costs", if 2) Court, Alternate Dispute Resolution, and applicable)within the deductible amount. The ap- other specific items of expense, whether plicable limits of insurance (including aggregates) incurred by an outside vendor or by one shall not be reduced by the amount of any "allo- of our employees, including: cated loss adjustment expenses" within the de- a) Medical examinations of a claimant to ductible amount.determine the extent of injury, degree 5. The following is added to the Transfer of Rights of of'permanency, or length of disability; Recovery Against Others To Us Condition: b) Expert medical or other testimony; Any recoveries hereunder shall be applied in the c) Autopsy;following order: a. Any interest (including the insured) that may d) Witnesses and summonses; have paid any amount with respect to liability e) Copies of documents such as birth in excess of the limit of our liability hereunder; and death certificates and medical b. Us for the amount paid hereunder; and treatment records; c. All other interests (including the insured), with f) Arbitration fees; respect to the residue, if any.g) Fees or costs for surveillance or other professional investigations which are When we-have elected to participate in the exer- conducted as part of handling of aciseoftheinsured's right of recovery, reasonable expenses resulting therefrom shall be appor- tioned among all the interests in the ratio of their h) Fees or costs for loss prevention and respective recoveries. engineering personnel, and fees or 6. We may pay any part or all of the deductible costs for rehabilitation nurses or other amount to effect payment of any claim or "suit" nurses, for services which are con- . ducted as part of handling of a claim and you shall promptly reimburse us from your or"suit";and own funds for such part of the deductible amount as we have paid, regardless of any contributions i) Appeal bond costs and appeal filing toward payment of any claim or "suit" made by fees; or other insurers or any other entity, and regardless 3) All Supplementary Payments as de- of any deductibles owed or paid by you to other scribed and included in the applicable insurers for the same"occurrence". Coverage Part. Only payments made by you will satisfy your obli- b. Does not include: gation to reimburse us for payments we make 1) Salaries, overhead and traveling ex-within the deductible amount. Your obligation to penses.of our employees, except for em- reimburse us for-such payments made by us is Page 2 of 3 2008 The Travelers Companies;Inc. CG D3 05 07 08 COMMERCIAL GENERAL LIABILITY ployees while doing activities previously determination can be made of the cause listed as allocated expenses; or or extent of, or responsibility for, the in- 2) Fees paid to independent claims profes- jury, disease or damage, including sionals or attorneys (hired to perform the evaluation and settlement of covered function of claim investigation normally claims. performed by claim adjusters), for devel- oping and investigating a claim so that a CG D3 05 07 08 2008 The Travelers Companies,Inc. Page 3 Of 3 DECLARATIONS PREMIUM SCHEDULE POLICY NUMBER:DT22-CO-OF027488-TCT-14 This Schedule applies to the Declarations for the period of 08-21-14 to 08-21-15 It shows all of your known rating classes as of the effective date. Any exceptions will be so noted. This includes all locations you own, rent or occupy. LOC/ CLASS PREMIUM OPN BLDG DESCRIPT/ BASE/ ADVANCE NO. NO. CODE NO. SUBLINE EXPOSURE RATES PREMIUM MINIMUM PREMIUMS LOB 250 GENERAL LIABILITY COMPOSITE- CONSTRUCTION - SALES/RECEIPTS 69863 COMBINED S 15,000,000 3.016 45,240 COVERAGE PART TOTAL 45,240 This class is subject to the prem/ops transition program. If an "X"is entered in this box,these Declarations are completed on the Premium Schedule Extension CG TO 12. CG TO 07 09 87 PAGE 1 (END) KEY TO DECLARATIONS PREMIUM SCHEDULE ABBREVIATIONS: CLASS DESCRIPT — means CLASS DESCRIPTION LOC/BLDG NO. — means LOCATION/BUILDING NUMBER OPN NO. — means OPERATION NUMBER PREM/OPS — means PREMISES/OPERATIONS PROD/C-OPS — means PRODUCTS/COMPLETED OPERATIONS PREMIUM BASE: Key Letter Premium Base How Rates Apply a Area per 1,000 square feet c Total Cost per$1,000 of total cost M Admissions per 1,000 admissions o Total Operating Expense per$1,000 of total operating expenditures P Payroll per$1,000 of payroll s Gross Sales per$1,000 of gross sales t see note*below)see note*below) u Units per unit Premium base t applies for a number of rarely used premium bases. The specific base and how rates apply are shown with the Class Description on the DECLARATIONS-PREMIUM SCHEDULE. CG TO 08 11 03 Copyright, The Travelers Indemnity Company, 2003 Page 1 of 1 1 1 TABLE OF CONTENTS COMMERCIAL GENERAL LIABILITY COVERAGE FORM CG 00 01 10 01 SECTION I—COVERAGES Beginning on Page Coverage A- Bodily Injury and Property Insuring Agreement ..............................................................1 Damage Liability Exclusions ...........................................................................2 Coverage B- Personal and Advertising Insuring Agreement..............................................................5 Injury Liability Exclusions ...........................................................................5 Coverage C- Medical Payments Insuring Agreement..............................................................7 Exclusions ...........................................................................7 SupplementaryPayments ..................................................................................................... 7 SECTION II—WHO IS AN INSURED ..........................................................................................8 SECTION.III—LIMITS OF INSURANCE ...................................................................................10 SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS .........................................10 Bankruptcy ........................................................................................................................10 Duties in the Event of Occurrence, Claim or Suit ................................................................10 LegalAction Against Us .....................................................................................................11 OtherInsurance .................................................................................................................11 PremiumAudit ...................................................................................................................12 Representations ................................................................................................................12 Separation of Insureds ......................................................................................................12 Transfer of Rights of Recovery Against Others To Us .........................................................12 WhenWe Do Not Renew ....................................................................................................12 SECTIONV—DEFINITIONS ....................................................................................................12 CG TO 34 11 03 i COMMERCIAL GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage.1) The "bodily injury" or "property damage" Read the entire policy carefully to determine rights, is caused by an "occurrence" that takes duties and what is and is not covered. place in the"coverage territory"; Throughout this policy the words "you" and "your"2) The "bodily injury" or "property damage" refer to the Named Insured shown in the Declarations, occurs during the policy period;and and any other person or organization qualifying as a 3) Prior to the policy period, no insured Named Insured under this policy. The words "we", listed under Paragraph 1. of Section II — us" and "our" refer to the company providing this Who Is An Insured and no "employee" insurance. authorized by you to give or receive no- The word "insured" means any person or organization tice of an "occurrence" or claim, knew qualifying as such under Section II — Who Is An that the "bodily injury" or "property dam- Insured. age" had occurred, in whole or in part. If Other words and phrases that appear in quotation such a listed insured or authorized "em- marks have special meaning. Refer to Section V — ployee" knew, prior to the policy period, Definitions. that the "bodily injury" or "property dam- age' occurred, then any continuation, SECTION I—COVERAGES change or resumption of such "bodily in- COVERAGE A BODILY INJURY AND PROPERTY jury" or"property damage" during or after DAMAGE LIABILITY the policy period will be deemed to have 1: Insuring Agreement been known prior to the policy period. c a. We will pay those sums that the insured be- Bodily injury" or "property damage" which occurs during the policy period and was not,comes legally obligated to pay as damages because of "bodily injury" or "property dam- prior to the policy period, known to have oc- curred by any insured listed under Paragraphage" to which this insurance applies. We will have the right and duty to defend the insured 1. of Section II — Who Is An Insured or any against any "suit" seeking those damages.employee" authorized by you to give or re- against notice of an "occurrence" or claim, in- However, we will have no duty to defend the eludes-any continuation, change or resump-insured against any "suit" seeking damages for "bodily injury" or "propeity damage" to tiori of that "bodily injury" or "property which this insurance does not apply.We may, damage"after the end of the policy period. at our discretion, investigate any"occurrence" d. "Bodily injury" or "property damage" will be and settle.any claim or "suit" that may result. deemed to have been known to have oc- But:curred at the earliest time when any insured 1) The amount we will pay for damages is listed under Paragraph 1. of Section II —Who limited as described in Section III—Limits Is An Insured or any "employee" authorized Of Insurance;and by you to give or receive notice of an "occur- rence"or claim: 2) Our right and duty to defend ends when 1) Reports all, or any part, of the "bodily in- we have used up the applicable limit of jury"or insurance in the payment of judgments or property damage to us or any in settlements under Coverages A or B or other insurer; medical expenses under Coverage C. 2) Receives a written or verbal demand or claim for damages because of the "bodily No other obligation or liability to pay sums or perform acts or services is covered unless injury"or"property damage"; or explicitly provided for under Supplementary 3) Becomes aware by any other means that Payments—Coverages A and B. bodily injury" or "property damage" has b. This insurance applies to "bodily injury" and occurred or has begun to occur. property damage"only if: CG 00 01 10 61 0 ISO Properties-Inc., 2000 Page 1 of 16 a COMMERCIAL GENERAL LIABILITY e. Damages because of "bodily injury" include 3) Any statute, ordinance or regulation relat- damages claimed by any person or organiza- ing to the sale, gift, distribution or use of tion for care, loss of services or death result- alcoholic beverages. ing at any time from the"bodily injury".This exclusion applies only if you are in the 2. Exclusions business of manufacturing, distributing, sell- This insurance does not apply to: ing, serving or furnishing alcoholic beverages. a. Expected Or Intended Injury d. Workers'Compensation And Similar Laws Bodily injury" or"property damage" expected Any obligation of the insured under a workers' or intended from the standpoint of the in- compensation, disability benefits or unem- sured. This exclusion does not apply to "bod-ployment compensation law or any similar ily injury" resulting from the use of reasonable law. force to protect persons or property. e. Employer's Liability b. Contractual Liability Bodily injury"to: Bodily injury" or"property damage"for which 1) An "employee" of the insured arising out the insured is obligated to pay damages by of and in the course of: reason of the assumption of liability in a con- a) Employment by the insured; or tract or agreement. This exclusion does not apply to liability for damages:b) Performing duties related to the con- 1) That the insured would have in the ab- duct of the insured's business; or sence of the contract or agreement; or 2) The spouse, child, parent, brother or sis- ter of that "employee" as a consequence 2) Assumed in a contract or agreement that of Paragraph (1)above. is an "insured contract", provided the bodily injury" or "property damage" oc- curs subsequent to the execution of the 1) Whether the insured may be liable as an contract or agreement. Solely for the pur- employer or in any other capacity; and poses of liability assumed in an "insured 2) To any obligation to share damages with contract", reasonable attorney fees and or repay someone else who must pay necessary litigation expenses incurred by damages because of the injury. or for a party other than an insured are deemed to be damages because of"bod- This exclusion does not apply to liability as- ily injury" or"property damage", provided:sumed by the insured under'an "insured con- tract". a) Liability to such party for, or for the cost of, that party's defense has also f. Pollution been assumed in the same "insured 1) "Bodily injury" or "property damage" aris- contract";and ing out of the actual, alleged or threat- b) Such attorney fees and litigation ex- ened discharge, dispersal, seepage, mi- penses are for defense of that party gration, release or escape of"pollutants": against a civil or alternative dispute a) At or from any premises, site or loca- resolution proceeding in which dam- tion which is or was at any time ages to which this insurance applies owned or occupied by, or rented or are alleged. loaned to, any insured. However, this c. Liquor Liability subparagraph does not apply to: Bodily injury" or"property damage"for which i) "Bodily injury" if sustained within any insured may be held liable by reason of:a building and caused by smoke, fumes, vapor or soot from equip- 1) Causing or contributing to the intoxication ment used to heat that building; of any person; ii) "Bodily injury" or "property dam-2) The furnishing of alcoholic beverages to a age" for which you may be held person under the legal drinking age or liable, if you are a contractor and under the influence of alcohol; or the owner or lessee of such Page 2 of 16 ISO Properties Inc., 2000 CG 00 01 10 01 COMMERCIAL GENERAL LIABILITY premises, site or location has bodily injury" or "property dam- been added to your policy as an age" arises out of the intentional additional insured with respect to discharge, dispersal or release of your ongoing operations per- the fuels, lubricants or other op- formed for that additional insured erating fluids, or if such fuels, lu- at that premises, site or location bricants or other operating fluids and such premises, site or loca- are brought on or to the prem- tion is not and never was owned ises, site or location with the in- or occupied by, or rented or tent that they be discharged, dis- loaned to, any insured, other than persed or released as part of the that additional insured; or operations being performed by iii) "Bodily injury" or "property dam- such insured, contractor or sub- age"arising out of heat, smoke or contractor; fumes from a"hostile fire"; ii) "Bodily injury" or "property dam- b) At or from any premises, site or loca- age" sustained within a building tion which is or was at any time used and caused by the release of by or for any insured or others for the gases, fumes or vapors from ma- handling, storage, disposal, process- terials brought into that building in ing or treatment of waste; connection with operations being performed by you or on your be- c) Which are or were at any time trans- half by a contractor or subcon- ported, handled, stored, treated, dis- tractor; or posed of, or processed as waste by or for: iii) "Bodily injury" or "property dam- age" arising out of heat, smoke or i) Any insured; or fumes from a"hostile fire". ii) Any person or organization for e) At or from any premises, site or loca- whom you may be legally re- tion on which any insured or any con- sponsible; or tractors or subcontractors working di- d) At or from any premises, site or loca- rectly or indirectly on any insured's tion on which any insured or any con- behalf are performing operations if tractors or subcontractors working di- the operations are to test for, monitor, rectly or indirectly on any insured's clean up, remove, contain, treat, de- . behalf are performing operations if toxify or neutralize, or in any way re- the "pollutants" are brought on or to spond to, or assess the effects of, the premises, site or location in con- pollutants". nection with such operations by such 2) Any loss, cost or expense arising out of insured, contractor or subcontractor. any: However, this subparagraph does not apply to: a) Request, demand, order or statutory or regulatory requirement that any in- i) "Bodily injury" or "property dam- sured or others test for, monitor, age" arising out of the escape of clean up, remove, contain, treat, de- fuels, lubricants or other operat- toxify or neutralize, or in any way re- ing fluids which are needed to spond to, or assess the effects of, perform the normal electrical, hy- pollutants"; or draulic or mechanical functions necessary for the operation of b) Claim or "suit" by or on behalf of a mobile equipment" or its parts, if governmental authority for damages such fuels, lubricants or other because of testing for, monitoring, cleaning up, removing, containing, operating fluids escape from a vehicle part designed to hold, treating, detoxifying or neutralizing, or store or receive them. This ex- in any way responding to, or assess- ception does not apply if the ing the effects of, "pollutants". CG 00 01 10 01 ISO Properties Inc., 2000 Page 3 of 16 COMMERCIAL GENERAL LIABILITY However, this paragraph does not apply 2) The use of "mobile equipment" in, or to liability for damages because of "prop- while in practice for, or while being pre- erty damage"that the insured would have pared for, any prearranged racing, speed, in the absence of such request, demand, demolition, or stunting activity. order or statutory or regulatory require- i. War ment, or such claim or "suit" by or on be- half of a governmental authority. Bodily injury" or "property damage" due to war, whether or not declared, or any act or g. Aircraft,Auto Or Watercraft condition incident to war. War includes civil Bodily injury" or "property damage" arising war, insurrection, rebellion or revolution. This out of the ownership, maintenance, use or en- exclusion applies only to liability assumed trustment to others of any aircraft, "auto" or under a contract or agreement. watercraft owned or operated by or rented or j, Damage To Property loaned to any insured. Use includes operation and"loading or unloading". Property damage"to: This exclusion applies even if the claims 1) Property you own, rent, or occupy, includ- against any insured allege negligence or ing any costs or expenses incurred by other wrongdoing in the supervision, hiring, you, or any other person, organization or employment, training or monitoring of others entity, for repair, replacement, enhance- by that insured, if the "occurrence" which menta restoration or maintenance of such caused the "bodily injury" or "property dam- property for any reason, including preven- age" involved the ownership, maintenance, tion of injury to a person or damage to use or entrustment to others of any aircraft, another's property; auto" or watercraft that is owned or operated 2) Premises you sell, give away or abandon, by or rented or loaned to any insured. if the "property damage" arises out of any This exclusion does not apply to: part of those premises; 1) A watercraft while ashore on premises 3) Property loaned to you; you own or rent; 4) Personal property in the care, custody or 2) A watercraft you do not own that is: control of the insured; a) Less than 26 feet long; and 5) That particular part of real property on which .you or any contractors or subcon-b) Not being used to carry persons or tractors working directly or indirectly on property for a charge; your behalf are performing operations, if 3) Parking an "auto" on, or on the ways next the"property damage" arises out of those to, premises you own or rent, provided operations; or the "auto" is not owned by or rented or 6) That particular-part of any property thatloanedtoyouortheinsured; must be restored, repaired or replaced 4) Liability assumed under any"insured con- because "your work" was incorrectly per- tract" for the ownership, maintenance or formed on it. use of aircraft or watercraft; or Paragraphs (1), (3) and (4) of this exclusion 5) "Bodily injury" or "property damage" aris- do not apply to "property damage" (other than ing out of the operation of any of the damage by fire) to premises, including the equipment listed in Paragraph f.(2) or contents of such premises, rented to you for a f.(3) of the definition of "mobile equip- period of 7 or fewer consecutive days. A ment". separate limit of insurance applies to Damage h. Mobile Equipment To Premises Rented To You as described in Bodily injury" or "property damage" arising Section III—Limits-Of Insurance. out of: Paragraph (2) of this exclusion does not apply if the premises -are "your work" and were 1) The transportation of "mobile equipment" never occupied, rented or held for rental bybyan "auto" owned or operated by or rented or loaned to any insured; or you. Page 4 of 16 ISO Properties Inc., 2000 CG 00 01 10 01 COMMERCIAL GENERAL LIABILITY Paragraphs (3), (4), (5) and (6) of this exclu- o. Personal And Advertising Injury sion do not apply to liability assumed under a Bodily injury" arising out of "personal and sidetrack agreement. advertising injury". Paragraph (6) of this exclusion does not apply Exclusions c. through n. do not apply to damage to "property damage" included in the "prod- by fire to premises while rented to you or tempo- ucts-completed operations hazard". rarily occupied by you with permission of the k. Damage To Your Product owner. A separate limit of insurance applies to Property damage" to "your product" arising this coverage as described in Section III — Limits out of it or any part of it. Of Insurance. I. Damage To Your Work COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY Property damage" to "your work" arising out of it or any part of it and included in the 1. Insuring Agreement products-completed operations hazard". a. We will pay those sums that the insured be- This exclusion does not apply if the damaged comes legally obligated to pay as damages work or the work out of which the damage because of "personal and advertising injury" arises was performed on your behalf by a to which this insurance applies. We will have subcontractor. the right and duty to defend the insured against any "suit" seeking those damages. m. Damage To Impaired Property Or Property However, we will have no duty to defend the Not Physically Injured insured against any "suit" seeking damages Property damage" to "impaired property" or for "personal and advertising injury" to which property that has not been physically injured, this insurance does not apply.We may, at our arising out of: discretion, investigate any offense and settle 1) A defect, deficiency, inadequacy or dan-any claim or"suit"that may result. But: gerous condition in "your product" or 1) The amount we will pay for damages is your work"; or limited as described in Section III—Limits 2) A delay or failure by you or anyone acting Of Insurance; and on your behalf to perform a contract or 2) Our right and duty to defend end when agreement in accordance with its terms. we have used up the applicable limit of This exclusion does not apply to the loss of insurance in the payment of judgments or use of other property arising out of sudden settlements under Coverages A or B or and accidental physical injury to "your prod- medical expenses under Coverage C. uct" or"your work" after it has been put to its No other obligation or liability to pay sums or intended use. perform acts or services is covered unless n. Recall Of Products, Work Or Impaired explicitly provided for under Supplementary Property Payments—Coverages A and B. Damages claimed for any loss, cost or ex- b. This insurance applies to "personal and ad- pense incurred by you or others for the loss of vertising injury" caused by an offense arising use, withdrawal, recall, inspection, repair, re- out of your business but only if the offense placement, adjustment, removal or disposal was committed in the "coverage territory" dur- ing the policy period.of: 1) "Your product"; 2. Exclusions 2) "Your work"; or This insurance does not apply to: 3) "Impaired property"; a. Knowing Violation Of Rights Of Another if such product, work, or property is withdrawn Personal and advertising injury" caused by or recalled from the market or from use by or at the direction of the insured with the any person or organization because of a knowledge that the act would violate the known or suspected defect, deficiency, in- rights of another and would inflict "personal adequacy or dangerous condition in it. and advertising injury". CG 00 01 10 01 ISO Properties Inc., 2000 Page 5 of 16 J COMMERCIAL GENERAL LIABILITY b. Material Published With Knowledge Of j. Insureds In Media And Internet Type Busi- Falsity nesses Personal and advertising injury" arising out Personal and advertising injury" committed of oral or written publication of material, if by an insured whose business is: done by or at the direction of the insured with 1 Advertising, broadcasting,knowledge of its falsity. 9. g, publishing or telecasting; c. Material Published Prior To Policy Period 2) Designing or determining content of web- Personal and advertising injury" arising out sites for others; or of oral or written publication.of material whose 3) An Internet search, access, content or first publication took place before the begin- service provider. Hing of the policy period. However, this exclusion does not apply tod. Criminal Acts Paragraphs 14.a., b. and c. of"personal and Personal and advertising injury" arising out advertising injury" under the Definitions Sec- of a criminal act committed by or at the direc- tion. tion of the insured. For the purposes of this exclusion,the placing e. Contractual Liability of frames, borders or links, or advertising, for Personal and advertising injury"for which the you or others anywhere on the Internet, is not insured has assumed liability in a contract or by itself, considered the business of advertis- agreement. This exclusion does not apply to ing, broadcasting, publishing or telecasting. liability for damages that the insured would k_. Electronic Chatrooms Or Bulletin Boards have in the absence of the contract or Personal and advertising injury" arising outagreement.of an electronic chatroom or bulletin board the f. Breach Of Contract insured hosts, owns, or over which-the in- Personal and advertising injury" arising out sured exercises control. of a breach of contract, except an implied I. Unauthorized Use Of Another's Name Or contract to use another's advertising idea in Product your"advertisement". Personal and advertising injury" arising out g. Quality Or Performance Of Goods — Fail- of the unauthorized use of another's name or ure To Conform..To Statements product in your e-mail address, domain name Personal and advertising injury" arising out or metatag, or any other similar tactics to mis- of_the failure of goods, products or services to lead another's potential customers. conform with any statement of quality or per- m. Pollution formance made in your"advertisement".Personal and advertising injury" arising out h. Wrong Description Of Prices of the actual, alleged or threatened discharge, Personal and advertising injury" arising out dispersal, seepage, migration, release or es- of the wrong description'of the price of goods,cape of"pollutants"at any time. products or services stated in your "adver- n. Pollution-Related tisement". Any loss, cost or expense arising out of any: I. Infringement Of Copyright, Patent, Trade- 1) Request, demand or order that any in-mark Or Trade Secret sured or others test for, monitor, clean up, Personal and advertising injury" arising out remove, contain,treat, detoxify or neutral- of the infringement of copyright, patent, ize, or in any way respond to, or assess trademark, trade secret or other intellectual the effects of,"pollutants'; or property rights. 2) Claim or suit by or on behalf of.a govern- However, this exclusion does not apply to in- mental authority for damages because of fringement, in your "advertisement", of copy- testing for, monitoring; cleaning up, re- right,trade dress or slogan. moving, containing, treating, detoxifying or neutralizing, or in any way responding Page 6 of 16 0 ISO Properties Inc., 2000 CG 00 01 10 01 COMMERCIAL GENERAL LIABILITY to, or assessing the effects of, "pollut- d. Workers Compensation And Similar ants". Laws COVERAGE C MEDICAL PAYMENTS To a person, whether or not an "em- 1. Insuring Agreement ployee" of any insured, if benefits for the bodily injury" are payable or must be a. We will pay medical expenses as described provided under a workers' compensation below for "bodily injury" caused by an acci- or disability benefits law or a similar law. dent: e. Athletics Activities 1) On premises you own or rent;To a person injured while taking part in 2) On ways next to premises you own or athletics. rent; or f. Products-Completed Operations Haz- 3) Because of your operations; and provided that: Included within the "products-completed 1) The accident takes place in the"coverage operations hazard". territory"and during the policy period; g. Coverage A Exclusions 2) The expenses are incurred and reported Excluded under Coverage A. to us within one year of the date of the accident;and h. War 3) The injured person submits to examina- Due to war, whether or not declared, or tion, at our expense, by physicians of our any act or condition incident to war. War choice as often as we reasonably require. includes civil war, insurrection, rebellion or revolution. b. We will make these payments regardless of fault. These payments will not exceed the ap- SUPPLEMENTARY PAYMENTS — COVERAGES A plicable limit of-insurance. We will pay rea= AND B sonable expenses for: 1. We will pay, with respect to any claim we investi- 1) First aid administered at the time of an gate or settle, or any "suit" against an insured we accident; defend: 2) Necessary medical, surgical, x-ray and a. All expenses we incur. dental services, including prosthetic de- b. Up to $250 for cost of bail bonds required be- vices; and cause of accidents or traffic law violations 3) Necessary ambulance, hospital, profes- arising out of the use of any vehicle to which sional nursing and funeral services. the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Exclusions c. The cost of bonds to release attachments, but We will not pay expenses for"bodily injury": only for bond amounts within the applicable a. Any Insured limit of insurance. We do not have to furnish To any insured, except 'volunteer work- these bonds. ers". d. All reasonable expenses incurred by the in- b. Hired Person sured at our request to assist us in the inves- tigation or defense of the claim or "suit", in- To a person hired to do work for or on cluding actual loss of earnings up to $250 a behalf of any insured or a tenant of any day because of time off from work. insured. e. All costs taxed against the insured in the c. Injury On Normally Occupied Premises suit". To a person injured on that part of prem- f. Prejudgment interest awarded against the in- ises you own or rent that the person nor- sured on that part of the judgment we pay. If malty occupies. we make an offer to pay the applicable limit of insurance, we will not pay any prejudgment CG 00 01 10 01 0 ISO Properties Inc., 2000 Page 7 of 16 COMMERCIAL GENERAL LIABILITY interest based on that period of time after the a) Obtain records and other information offer.related to the"suit"; and g. All interest on the full amount of any judgment b) Conduct and control the defense of that accrues after entry of the judgment and the indemnitee in such"suit". before we have paid, offered to pay, or de- So long as the above conditions are met, attor- posited in court the part of the judgment that neys' fees incurred by us in the defense of thatiswithintheapplicablelimitofinsurance. indemnitee, necessary litigation expenses in- These payments will not reduce the limits of in- curred by us and necessary litigation expenses surance. incurred by the indemnitee at our request will be 2. If we defend an insured against a "suit" and an paid as Supplementary Payments. Notwithstand- indemnitee of the insured is also named as a ing the provisions of Paragraph 2.b.(2) of Section party to the "suit", we will defend that indemnitee I — Coverage A — Bodily Injury And Property if all of the following conditions are met: Damage Liability, such payments will not be deemed to be damages for "bodily injury" and a. The "suit" against the indemnitee seeks dam- property damage" and will not reduce the limits ages for which the insured has assumed the of insurance. liability of the indemnitee in a contract or agreement that is an "insured contract"; Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary liti- b. This insurance applies to such liability as- gation expenses as Supplementary Payments_ sumed by the insured; ends when: c. The obligation to defend, or the cost of the a. We have used up the applicable limit of in-defense of, that indemnitee, has also been surance in the payment of judgments or set- assumed by the insured in the same "insured tlements; or contract"; b. The conditions set forth above, or the terms d. The allegations in the "suit" and-the informa- of the agreement described in Paragraph f. tion we know about the"occurrence"are such above, are no longer met. that no conflict appears to exist between the interests of the insured and the interests of SECTION II—WHO IS AN INSURED the indemnitee; 1. If you are designated in the Declarations as: e. The indemnitee and the insured ask us to a. An individual, you and your spouse are insur- conduct and control the defense of that in- eds, but only with respect to the conduct of a demnitee against such "suit" and agree that business of which you are the sole owner. we can assign the same counsel to defend b. A partnership or joint venture, you are an in- the insured and the indemnitee;and sured. Your members, your partners, and f. The indemnitee: their spouses are also insureds, but only with 1) Agrees in writing to: respect to the conduct of your business. a) Cooperate with us in the investiga- c. A limited liability company, you are an in- tion, settlement or defense of the sured. Your members are also insureds, but suit'; only with respect to the conduct of your busi- ness. Your managers are insureds, but onlyb) Immediately send us copies of any with respect to their duties as your managers. demands, notices, summonses or le- gal papers received in connection d. An organization other than a partnership,joint with the"suit"; venture or limited liability company, you are an insured. Your "executive officers" and di- c) Notify any other insurer whose cov- rectors are insureds, but only with respect to erage is available to the indemnitee; their duties as your officers or directors. Your and stockholders are also insureds,.but only with d) Cooperate with us with respect to co- respect to their liability as stockholders. ordinating other applicable insurance e. A trust, you are an insured. Your trustees are available to the indemnitee; and also insureds, but only with respect to their 2) Provides us with written authorization to: duties as trustees. Page 8 of 16 ISO Properties Inc., 2000 CG 00 01 10 01 l f, COMMERCIAL GENERAL LIABILITY 2. Each of the following is also an insured: b. Any person (other than your "employee" or a. Your "volunteer workers" only while perform- volunteer worker"), or any organization while ing duties related to the conduct of your busi- acting as your real estate manager. ness, or your "employees", other than either c. Any person or organization having proper your"executive officers" (if you are an organi- temporary custody of your property if you die, zation other than a partnership, joint venture but only: or limited liability company) or your managers 1) With respect to liability arising out of the if you are a limited liability company), but maintenance or use of that property; and only for acts within the scope of their em-2) Until your legal representative has beenploymentbyyouorwhileperformingduties related to the conduct of your business. How- appointed. ever, none of these"employees"or"volunteer d. Your legal representative if you die, but only workers"are insureds for: with respect to duties as such.That represen- 1) "Bodily injury" or "personal and advertis- tative will have all your rights and duties un- ing injury": der this Coverage Part. a) To you, to your partners or members 3. With respect to "mobile equipment" registered in if you are a partnership or joint ven- your name under any motor vehicle registration ture), to your members (if you are a law, any person is an insured while driving such limited liability company), to a co- equipment along a public highway with your per- employee" while in the course of his mission. Any other person or organization re- or her employment or performing du- sponsible for the conduct of such person is also ties related to the conduct of your an insured, but only with respect to liability arising business, or to your other "volunteer out of the operation of the equipment, and only if workers" while performing duties re- no other insurance of any kind is available to that lated to the conduct of your business; person or organization for this liability. However, no person or organization is an insured with re- b) To the spouse, child, parent, brother spect to: or sister of that co-"employee" or volunteer worker" as a consequence a. "Bodily injury" to a co-"employee" of the per- of Paragraph (1)(a) above; son driving the equipment;or c) For which there is any obligation to b. "Property damage" to property owned by, share damages with or repay some-rented to, in the charge of or occupied by you one else who must pay damages be- or the employer of any person who is an in cause of the injury described in Para- sured under this provision. graphs (1)(a)or(b) above;or 4. Any organization you newly acquire or form, other d) Arising out of his or her providing or than a partnership,joint venture or limited liability failing to provide professional health company, and over which you maintain ownership care services. or majority interest, will qualify as a Named In- sured if there is no other similar insurance avail- 2) "Property damage"to property:able to that organization. However: a) Owned, occupied or used by, a. Coverage under this provision is afforded only b) Rented to, in the care, custody or until the 90th day after you acquire or form control of, or over which physical con- the organization or the end of the policy pe- trol is being exercised for any pur-riod,whichever is earlier; pose by b. Coverage A does not apply to "bodily injury" you, any of your "employees", "volunteer or "property damage" that occurred before workers", any partner or member (if you you acquired or formed the organization; and are a partnership or joint venture), or any c. Coverage B does not apply to "personal and member (if you are a limited liability com- advertising injury" arising out of an offense pany). committed before you acquired or formed the organization. CG 00 01 10 01 ISO Properties Inc., 2000 Page 9 of 16 i COMMERCIAL GENERAL LIABILITY No person or organization is an insured with respect The Limits of Insurance of this Coverage Part apply to the conduct of any current or past partnership,joint separately to each consecutive annual period and to venture or limited liability company that is not shown any remaining period of less than 12 months, starting as a Named Insured in the Declarations. with the beginning of the policy period shown in the SECTION III—LIMITS OF INSURANCE Declarations, unless the policy period is extended after issuance for an additional period of less than 12 1. The Limits of Insurance shown in the Declarations months. In that case, the additional period will be and the rules below fix the most we will pay re- deemed part of the last preceding period for purposes gardless of the number of: of determining the Limits of Insurance. a. Insureds; SECTION IV—COMMERCIAL GENERAL LIABILITY b. Claims made or"suits" brought; or CONDITIONS c. Persons or organizations making claims or 1. Bankruptcy bringing "suits". Bankruptcy or insolvency of the insured or of the 2. The General Aggregate Limit is the most we will insured's estate will not relieve us of our obliga- pay for the sum of: tions under this Coverage Part. a. Medical expenses under Coverage C;2. Duties In The Event Of Occurrence, Offense, b. Damages under Coverage A, except dam- Claim Or Suit ages because of "bodily injury" or "property a. You must see to it that we are notified as damage" included in the "products-completed soon as practicable of an "occurrence" or an operations hazard'; and offense which may result in a claim. To the c. Damages under Coverage B. extent possible, notice should include: 3. The Products-Completed Operations Aggregate 1) How, when and where the "occurrence" Limit is the most we will 'pay,under Coverage A or offense took place; for damages because of"bodily injury" and "prop- 2) The names and addresses of-any injured erty damage" included in the "products-completed persons and witnesses; and operations hazard". 3) The nature and location of any injury or 4. Subject to 2. above, the Personal and Advertising damage arising out of the "occurrence"or Injury Limit is the most we will pay under Cover- offense. age B for the sum of all damages because of all b. If a claim is made or "suit" is brought against personal and advertising injury"sustained by any any insured, you must: one person or organization. 1) Immediately record the specifics of the 5. Subject to 2. or 3. above, whichever applies, the claim or"suit"and the date received;and Each Occurrence Limit is the most we will pay for the sum of: 2) Notify us as soon as practicable. a. Damages under Coverage A; and You must see to it that we receive written no- tice of the claim or "suit" as soon as practica- b. Medical expenses under Coverage C ble. because of all "bodily injury" and "property dam- c. You and any other involved insured must: age"arising out of any one"occurrence". 1) Immediately send us copies of any de- b. Subject to 5. above, the Damage To Premises mands, notices, summonses or legal pa- Rented To You Limit is the most we will pay un- pers received in con nection.with the claim der Coverage A for damages because of "prop- erty damage" to any one premises, while rented or"suit"; to you, or in the case of damage by fire, while 2) Authorize us to obtain records and other rented to you or temporarily occupied by you with information; permission of the owner. 3) Cooperate with us in the investigation or 7. Subject to 5. above, the Medical Expense Limit is settlement of the claim or defense against the most we will pay under Coverage C for all the"suit"; and medical expenses because of "bodily injury" sus-4) Assist us, upon our request, in the en- tained by any one person.forcement of any right against any person Page 10 of 16 0 ISO Properties Inc.,2000 CG 00 01 10 01 7 C COMMERCIAL GENERAL LIABILITY or organization which may be liable to the c) That is insurance purchased by you insured because of injury or damage to to cover your liability as a tenant for which this insurance may also apply. property damage" to premises d. No insured will, except at that insured's own rented to you or temporarily occupied cost, voluntarily make a payment, assume by you with permission of the owner; any obligation, or incur any expense, other or than for first aid,without our consent. d) If the loss arises out of the mainte- 3. Legal Action Against Us nance or use of aircraft, "autos" or watercraft to the extent not subject to No person or organization has a right under this Exclusion g. of Section I — Coverage Coverage Part: A— Bodily Injury And Property Dam- a. To join us as a party or otherwise bring us age Liability. into a "suit" asking for damages from an in-2) Any other primary insurance available to sured;or you covering liability for damages arising b. To sue us on this Coverage Part unless all of out of the premises or operations for its terms have been fully complied with. which you have been added as an addi- A person or organization may sue us to recover tional insured by attachment of an en- on an agreed settlement or on a final judgment dorsement. against an insured; but we will not be liable for When this insurance is excess, we will have damages that are not payable under the terms of no duty under Coverages A or B to defend this Coverage Part or that are in excess of the the insured against any "suit" if any other in- applicable limit of insurance. An agreed settle- surer has a duty to defend the insured against ment means a settlement and release of liability that "suit". If no other insurer defends, we will signed by us, the insured and the claimant or the undertake to do so, but we will be entitled to claimant's legal representative. the insured's rights against all those other in- 4. Other Insurance surers. If other valid and collectible insurance is available When this insurance is excess over other in- to the insured for a loss we cover under Cover- surance, we will pay only our share of the ages A or B of this Coverage Part, our obligations amount of the loss, if any, that exceeds the are limited as follows: sum of: a. Primary Insurance 1) The total amount that all such other in- surance would pay for the loss in the ab- This insurance is primary except when b. be- sence of this insurance; and low applies. If this insurance is primary, our 2) The total of all deductible and self-insuredobligationsarenotaffectedunlessanyofthe other insurance is also primary. Then, we will amounts under all that other insurance. share with all that other insurance by the We will share the remaining loss, if any, with method described in c. below. any other insurance that is not described in b. Excess Insurance this Excess Insurance provision and was not bought specifically to apply in excess of the This insurance is excess over: Limits of Insurance shown in the Declarations 1) Any of the. other insurance, whether pri- of this Coverage Part. mary, excess, contingent or on any other c. Method Of Sharing basis: If all of the other insurance permits contribu- a) That is Fire, Extended Coverage, tion by equal shares, we will follow this Builder's Risk, Installation Risk or method also. Under this approach each in- similar coverage for"your work"; surer contributes equal amounts until it has b) That is Fire insurance for premises paid its applicable limit of insurance or none rented to you or temporarily occupied of the loss remains,whichever comes first. by you with permission of the owner; If any of the other insurance does not permit contribution by equal shares, we will contrib- CG 00 01 10 01 0 ISO Properties Inc.,2000 Page 11 of 16 COMMERCIAL GENERAL LIABILITY ute by limits. Under this method, each in- 9. When We Do Not Renew surer's share is based on the ratio of its appli- If we decide not to renew this Coverage Part, we cable limit of insurance to the total applicable will mail or deliver to the first Named Insured limits of insurance of all insurers. shown in the Declarations written notice of the 5. Premium Audit nonrenewal not less than 30 days before the expi- a. We will compute all premiums for this Cover- ration date. age Part in accordance with our rules and If notice is mailed, proof of mailing will be suffi- rates. cient proof of notice. b. Premium shown in this Coverage Part as ad- SECTION V—DEFINITIONS vance premium is a deposit premium only. At 1. "Advertisement" means a notice that is broadcast the close .of each audit period we will com- or published to the general public or specific mar- pute the earned premium for that period and ket segments about your goods, products or ser- send notice to the first Named Insured. The vices for the purpose of attracting customers orduedateforauditandretrospectivepremi- supporters. For the purposes of this definition: ums is the date shown as the due date on the bill. If the sum of the advance and audit pre- a. Notices-that are published include material miums paid for the policy period is greater placed on the Internet or on similar electronic than the earned premium, we will return the means of communication; and excess to the first Named Insured. b. Regarding web-sites, only that part of a web- c. The first Named Insured must keep records of site that is about your goods, products or ser- the information we need for premium compu- vices for the purposes of attracting customers tation, and send us copies at such times as or supporters is considered an advertisement. we may request.2. "Auto" means a land motor vehicle, trailer or 6. Representations semitrailer designed for travel on public roads, in- cluding any attached machinery or equipment. By accepting this policy, you agree: But"auto"does not include "mobile equipment". a. The statements in the Declarations are accu- 3. "Bodily injury" means bodily injury, sickness or rate and complete; disease sustained by a person, including death b. Those statements are based upon represen- resulting from any of these at any time. tations you made to.us; and 4. "Coverage territory"means: c. We have issued this policy in reliance upon a. The United States of America (including its your representations. territories and possessions), Puerto Rico and 7. Separation Of Insureds Canada; Except with respect to the Limits of Insurance, b. International waters or airspace, but only if and any rights or duties specifically assigned in the injury or damage occurs in the course of this Coverage Part to the first Named Insured,travel or transportation between any places this insurance applies:included in a.above; or a. As if each Named Insured were the only c. All other parts of the world if the injury or Named Insured; and damage arises out of: b. Separately to each insured against whom 1) Goods or products made or sold by you in claim is made or"suit"is brought. the territory described in a. above; 8. Transfer Of.Rights Of Recovery Against Oth- 2) The activities of a person whose home is ers To Us in the territory described in a. above, but If the insured has rights to recover all or part of is away for a short time on your business; any payment we have made under this Coverage or Part, those rights are transferred to us. The in- 3) "Personal and advertising injury" offenses sured must do nothing after loss to impair them. that take place through the Internet or At our request, the insured will bring "suit" or similar electronic means of communica- transfer those rights to us and help us enforce tion them. Page 12 of 16 ISO Properties Inc., 2000 CG 00 01 10 01 COMMERCIAL GENERAL LIABILITY provided the insured's responsibility to pay dam- damage" to a third person or organization. ages is determined in a "suit" on the merits, in the Tort liability means a liability that would be territory described in a. above or in a settlement imposed by law in the absence of any con- we agree to. tract or agreement. 5. "Employee" includes a "leased worker". "Em- Paragraph f. does not include that part of any ployee"does not include a"temporary worker". contract or agreement: 6. "Executive officer" means a person holding any of 1) That indemnifies a railroad for "bodily in- the officer positions created by your charter, con- jury" or "property damage" arising out of stitution, by-laws or any other similar governing construction or demolition operations, document. within 50 feet of any railroad property and 7. "Hostile fire" means one which becomes uncon- affecting any railroad bridge or trestle, trollable or breaks out from where it was intended tracks, road-beds, tunnel, underpass or to be.crossing; 8. "Impaired property" means tangible property, 2) That indemnifies an architect, engineer or other than "your product" or "your work", that surveyor for injury or damage arising out cannot be used or is less useful because: of: a. It incorporates "your product" or "your work" a) Preparing, approving, or failing to that is known or thought to be defective, defi- prepare or approve, maps, shop cient,inadequate or dangerous; or drawings, opinions, reports, surveys, field orders, change orders or draw- b. You have failed to fulfill the terms of a con- ings and specifications; or tract or agreement; b) Giving directions or instructions,, or if such property can be restored to use by: failing to give them, if that is the Ari- a. The repair, replacement, adjustment or re- mary cause of the injury or damage; moval of"your product"or"your work"; or or b. Your fulfilling the terms of the contract or 3) Under which the insured, if an architect, agreement. engineer or surveyor, assumes liability for 9. "Insured contract" means:an injury or damage arising out of the in- sured's rendering or failure to render pro- a. A contract for a lease of premises. However, fessional services, including those listed that portion of the contract for a lease of in (2) above and supervisory, inspection, premises that indemnifies any person or or- architectural or engineering activities. ganization for damage by fire to premises while rented to you or temporarily occupied 10. "Leased worker" means a person leased to you by you with permission of the owner is not an by a labor leasing firm under an agreement be- insured contract"; tween you and the labor leasing firm, to perform duties related to the conduct of your business. b. A sidetrack agreement; Leased worker" does not include a "temporary c. Any easement or license agreement, except worker". in connection with construction or demolition 11. "Loading or unloading" means the handling of operations on or within 50 feet of a railroad; property: d. An obligation, as required by ordinance, to in- a. After it is moved from the place where it is demnify a municipality, except in connection accepted for movement into or onto an air- with work for a municipality; craft,watercraft or"auto"; e. An elevator maintenance agreement; b. While it is in or on an aircraft, watercraft or f. That part of any other contract or agreement auto'; or pertaining to your business (including an in- c. While it is being moved from.an aircraft, wa- demnification of a municipality in connection tercraft or"auto"to the place whereit is finally with work performed for a municipality) under delivered; which you assume the tort liability of another party to pay for "bodily injury" or "property but "loading or unloading" does not include the movement of property by means of a mechanical CG 00 01 10 01 ISO Properties Inc., 2000 Page 13 of 16 COMMERCIAL GENERAL LIABILITY device, other than a hand truck, that is not at- 13. "Occurrence" means an accident, including tached to the aircraft,watercraft or"auto". continuous or repeated exposure to substantially 12. "Mobile equipment" means any of the following the same general harmful conditions. types of land vehicles, including any attached 14. "Personal and advertising injury" means injury, machinery or equipment:including consequential "bodily injury", arising out a. Bulldozers,farm machinery,forklifts and other of one or more of the following offenses: vehicles designed for use principally off public a. False arrest, detention or imprisonment; roads; b. Malicious prosecution; b. Vehicles maintained for use solely on or next c. The wrongful eviction from, wrongful entrytopremisesyouownorrent; into, or invasion of the right of private occu- c. Vehicles that travel on crawler treads; pancy of a room, dwelling or premises that a d. Vehicles, whether self-propelled or not, main-person occupies, committed by or on behalf tained primarily to provide mobility to perma- of its owner, landlord or lessor; nently mounted: d. Oral or written publication, in any manner, of 1) Power cranes, shovels, loaders, diggers material that slanders or libels a person or or- or drills; or ganization or disparages a person's or or- 2) Road construction or resurfacing equip- ganization's goods, products or services; ment such as graders, scrapers or rollers; e. Oral or written publication, in any manner, of material that violates a person's right of pri- e. Vehicles not described in a., b., c. or d. vacy; above that are not self-propelled and are maintained primarily to provide mobility to f. The use of another's advertising idea in your permanently attached equipment of the fol- advertisement";or lowing types: g. Infringing upon another's copyright, trade 1) Air compressors, pumps and generators,dress or slogan in your"advertisement". including spraying, welding, building_ 15. "Pollutants" mean any solid, liquid, gaseous or cleaning, geophysical exploration, lighting thermal irritant or contaminant, including smoke, and well servicing equipment; or vapor, soot, fumes, acids, alkalis, chemicals and 2) Cherry pickers and similar devices used waste. Waste includes materials to be recycled, to raise or lower workers; reconditioned or reclaimed. f. Vehicles not described in a., b., c. or d. 16. "Products-completed operations hazard": above maintained primarily for purposes other a. Includes all "bodily injury"and "property dam- than the transportation of persons or cargo. age" occurring away from premises you own However, self-propelled vehicles with the fol- or rent and arising out of "your product" or lowing types of permanently attached equip- your work" except: ment are not "mobile equipment" but will be 1) Products that are still in your physical considered "autos"' possession; or 1) Equipment designed primarily for: 2) Work that has not yet been completed or a) Snow removal; abandoned. However, "your work" will be b) Road maintenance, but not construe- deemed completed at the earliest of thefollowingtimes: tion or resurfacing; or c) Street cleaning; a) When all of the work called for in your contract has been completed. 2) Cherry pickers and similar devices b) When all of the work to be done at mounted on automobile or truck chassis the job site has been. completed if and used to raise or lower workers; and your contract calls for work at more 3) Air compressors, pumps and generators, than one job site. including spraying, welding, building c) When that part of the work done at a cleaning, geophysical exploration, lighting job site has been put to its intended and well servicing equipment. Page 14 of 16 0 ISO Properties Inc., 2000 CG 00 01 10 01 COMMERCIAL GENERAL LIABILITY use by any person or organization must submit or does submit with our consent; other than another contractor or sub- or contractor working on the same pro- b. Any other alternative dispute resolution pro- ject. ceeding in which such damages are claimed Work that may need service, mainte- and to which the insured submits with our nance, correction, repair or replacement,consent. but which is otherwise complete, will be 19. "Temporary worker" means a person who is treated as completed. furnished to you to substitute for a permanent b. Does not include "bodily injury" or "property employee"on leave or to meet seasonal or short- damage"arising out of: term workload conditions. 1) The transportation of property, unless the 20. "Volunteer worker" means a person who is not injury or damage arises out of a condition your "employee", and who donates his or her in or on a vehicle not owned or operated work and acts at the direction of and within the by you, and that condition was created by scope of duties determined by you, and is not the "loading or unloading" of that vehicle paid a fee, salary or other compensation by you by any insured; or anyone else for their work performed for you. 2) The existence of tools, uninstalled 21. "Your product": equipment or abandoned or unused ma- a. Means: terials; or 1) Any goods or products, other than real 3) Products or operations for which the clas- property, manufactured, sold, handled, sification, listed in the Declarations or in a distributed or disposed of by: policy schedule, states that products- completed operations are subject to the a) You; General Aggregate Limit.b) Others trading under your name; or 17. "Property damage"means: c)-A person or organization whose busi- a. Physical injury to tangible property, including ness or assets you have acquired; all resulting loss of use of that property. All and such loss of use shall be deemed to.occur at 2) Containers (other than vehicles), materi- the time of the physical injury that caused it; als; parts or equipment furnished in con- or nection with such goods or products. b. Loss of use of tangible property that is not b. Includes: physically injured. All such loss of use shall 1) Warranties or representations made at be deemed to occur at the time of the"occur- any time with respect to the fitness, qual- rence"that caused it. ity, durability, performance or use of"your For the purposes of this insurance, electronic product"; and data is not tangible property. 2) The providing of or failure to provide As used in this definition, electronic data means warnings or instructions. information, facts or programs stored as or on, c. Does not include vending machines or other created or used on, or transmitted to or from property rented to or located for the use of computer software, including systems and appli- others but not sold. cations software, hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or 22. "Your work": any other media which are used with electroni- a. Means: cally controlled equipment.1) Work or operations performed by you or 18. "Suit" means a civil proceeding in which damages on your behalf; and because of "bodily injury", "property damage" or personal and advertising injury" to which this in- 2) Materials, parts or equipment furnished in surance applies are alleged."Suit"includes: connection with such work or operations. a. An arbitration proceeding in which such dam- ages are claimed and to which the insured CG 00 01 10 01 ISO Properties Inc., 2000 Page 15 of 16 3 COMMERCIAL GENERAL LIABILITY b. Includes: ity, durability, performance or use of"your 1) Warranties or representations made at work", and any time with respect to the fitness, qual- 2) The providing of or failure to provide warnings or instructions. Page 16 of 16 ISO Properties Inc., 2000 CG 00 01 10 01 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT - OTHER INSURANCE CONDITION AND MEANING OF OTHER INSURANCE, OTHER INSURER AND INSURER This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS sion to not buy insurance, for any reason, in 1. The following replaces the part of the first para- which case the insured will be deemed to be graph of Paragraph 4., Other Insurance, of the provider of other insurance; or SECTION IV — COMMERCIAL GENERAL LI- v) Any similar risk transfer or risk management ABILITY CONDITIONS that precedes Paragraph method. a•: Other insurance does not include umbrella insur- If valid and collectible other insurance is available ance, or excess insurance, that was bought spe- to the insured for a loss we-cover under Cover- cifically to apply in excess of the Limits of Insur- ages A or B of this Coverage Part, our obligations ance shown in the Declarations of this Coverage are limited as described in Paragraphs a. and b. Part. below.As used_ anywhere in this Coverage Part, other As used anywhere in this Coverage Part, other insurer means a provider of other insurance. As insurance means insurance, or the funding of used in Paragraph c. below, insurer means a pro- losses, that is provided by, through or on behalf vider of insurance. - of: i) Another insurance company; 2. The first Subparagraph (2) of Paragraph 4.b., Ex- i) Insurance, of SECTION IV — COMMER- ii) Us or any of our affiliated insurance compa- CIAL GENERAL LIABILITY CONDITIONS re- nies, except when the Non cumulation of garding any other primary insurance available to Each Occurrence Limit provision of Para- you is deleted. graph 5. of Section III — Limits Of Insurance or the Non cumulation of Personal and Adver- 3. The following is added to Paragraph 4.b., Excess tising Injury Limit provision of Paragraph 4. of Insurance, of SECTION IV — COMMERCIAL Section III — Limits of Insurance applies be- GENERAL LIABILITY CONDITIONS: cause the Amendment - Non Cumulation Of This insurance is excess over any of the other Each Occurrence Limit Of Liability and Non insurance, whether primary, excess, contingent or Cumulation Of Personal and Advertising In- on any other basis, that is available to.the insured jury Limit endorsement is included in this pol- when the insured is added as an additional in icy; sured under any other policy, including any um- iii)Any risk retention group; brella or excess policy. iv)Any self-insurance method or program, in- cluding any failure to buy insurance, or deck CG D4 20 07 08 The Travelers Companies,Inc. Page 1 of 1 Y COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF COVERAGE B - PERSONAL AND ADVERTISING INJURY LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS 2. The following replaces the third sentence of A. AMENDMENT OF DEFINITION OF PERSONAL Paragraph 2. of SUPPLEMENTARY PAY- AND ADVERTISING INJURY MENTS—COVERAGES A AND B: The following replaces the definition of "personal Notwithstanding the provisions of Paragraph and advertising injury" in the DEFINITIONS Sec- 2.b.(2) of Section I—Coverage A—Bodily In- tion:- jury And Property Damage Liability or Para- graph 2.e. of'Section I — Coverage B — Per- Personal and advertising injury"means"personal sonal and Advertising Injury Liability, such injury"or"advertising injury".payments will-not be deemed to be damages B. AMENDMENT OF CONTRACTUAL LIABILITY because of "bodily injury", "property damage" EXCLUSION — EXCEPTION FOR DAMAGES or "personal injury", and will not reduce the BECAUSE OF PERSONAL INJURY ASSUMED limits of insurance. BY NAMED INSURED IN AN INSURED CON- 3. The following replaces the first paragraph-of TRACT Paragraph f. of the definition of "insured con- t. The following is added to Exclusion e., Con- tract"in the DEFINITIONS Section: tractual Liability, in Paragraph 2. of SEC- f. That part of any other contract or agree- TION I — COVERAGES — COVERAGE B ment pertaining to your business (includ- PERSONAL AND ADVERTISING INJURY ing an indemnification of a municipality in LIABILITY: connection. with work performed for a This exclusion also does not apply to liability municipality)under which you assume the w for damages because of "personal injury".as- tort liability of another party to pay for sumed by you in;a contract or agreement that bodily injury", "property damage"or"per- is an "insured' contract", provided that the sonal injury" to a third party or organiza- personal injury" .is caused by an offense tion. Tort liability means a liability that committed subsequent to the execution of the would be imposed by law in the absence contract or agreement. Solely for the pur- of any contract or agreement. poses of liability assumed by you in an "in- C. AMENDMENT OF OTHER EXCLUSIONS sured contract", reasonable attorney fees and 1. The following replaces Exclusion b., Material necessary litigation expenses incurred by or Published With Knowledge Of Falsity, inforapartyotherthananinsuredwillbeParagraph2. of SECTION I — COVERAGES deemed to be damages because of"personal. COVERAGE B PERSONAL AND'ADVER- injury", provided that: TISING INJURY LIABILITY: 1) Liability to such party for, or for the cost b. Material Published With Knowledge Ofof, that party's defense has also been as-Falsitysumedbyyouinthesame "insured con- tract'; and Personal injury" or "advertising injury" 2) Such attorney fees and litigation ex-arising out of oral or written publication, penses are for defense of that party including publication by electronic means, of material, if done by or at the direction _against a civil or alternative dispute reso- of the insured with knowledge of its fal-lution proceeding in which damages to sity.which this insurance applies are alleged. 2. The following replaces Exclusion c., Material Published Prior To Policy Period, in Para- CG D4 71 02 09 2009 The Travelers Companies,Inc. Page 1 of 4 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY graph 2. of SECTION I — COVERAGES — PERSONAL AND ADVERTISING INJURY COVERAGE B PERSONAL AND ADVER-LIABILITY: TISING INJURY LIABILITY: i. Intellectual Property c. Material Published Or Used Prior To Personal injury" or "advertising injury" Policy Period arising out of any actual or alleged in- 1) "Personal injury" or "advertising in- fringement or violation of any of the fol- jury" arising out of oral or written pub- lowing rights or laws, or any other "per- lication, including publication by elec- sonal injury"or"advertising injury"alleged tronic means, of material whose first in any claim or"suit"that also alleges any publication took place before the be- such infringement or violation: ginning of the policy period; or 1) Copyright; 2) "Advertising injury" arising out of in- 2) Patent; fringement of copyright, "title" or "slo- gan" in your "advertisement" whose 3) Trade dress; first infringement in your "advertise- 4) Trade name; ment" was committed before the be- 5) Trademark; ginning of the policy period.6) Trade secret; or 3. The following replaces Exclusion f., Breach Of Contract, in Paragraph 2. of SECTION I— 7) Other intellectual property rights or COVERAGES — COVERAGE B PERSONAL laws. AND ADVERTISING INJURY LIABILITY: This exclusion does not apply to: f. Breach Of Contract 1) "Advertising injury" arising out of any Advertising injury" arising out of a breach actual or alleged infringement or vio- of contract. lation of another's copyright, "title" or slogan" in your"advertisement"; or 4. The following replaces Exclusion g., Quality Or Performance of Goods — Failure To 2) Any other "personal injury" or "adver- Conform To Statements, in Paragraph 2. of tising injury" alleged in any claim or SECTION I—COVERAGES—COVERAGE B suit" that also alleges any such in- PERSONAL AND ADVERTISING INJURY fringement or violation of another's LIABILITY: copyright, "title" or "slogan" in your advertisement". g. Quality Or Performance Of Goods — Failure To Conform To Statements 7.. The following replaces Exclusion j., Insureds In Media And Internet Type Businesses, in Advertising injury" arising out of the fail-Paragraph 2. of-SECTION I — COVERAGES ure of goods, products or services to con- COVERAGE B PERSONAL AND ADVER- form with any statement of quality or per- TISING INJURY LIABILITY: formance made in your"advertisement". j. Insureds In Media And Internet Type 5. The following replaces Exclusion h., Wrong Businesses Description Of Prices, in Paragraph 2. of SECTION I—COVERAGES—COVERAGE B Personal injury" or "advertising injury" PERSONAL AND ADVERTISING INJURY arising out of an offense committed by an LIABILITY: insured whose business is: h. Wrong Description Of Prices 1) Advertising, "broadcasting" or pub- Advertising injury" arising out of the lishing; wrong description of the price of goods, 2) Designing or determining content of products or services stated in your "ad- web-sites for others; or vertisement". 3) An Internet search, access, content 6. The following replaces Exclusion i., In- or service provider. fringement Of Copyright, Patent, Trade- This exclusion does not apply to Para- mark, Or Trade Secret, in Paragraph 2. of graphs a.(1), (2.) and (3) of the definition SECTION I—COVERAGES—COVERAGE B of"personal injury". For the purposes of this exclusion: Page 2 Of 4 2009 The Travelers Companies,Inc. CG D4 71 02 09 Includes copyrighted material of Insurance Services Office,Inc.with its permission. 7 L COMMERCIAL GENERAL LIABILITY 1) Creating and producing correspon- person or organization that claims to have dence written in the conduct of your been slandered or libeled, or that claims business, bulletins, financial or an- to have had its goods, products or ser- nual reports, or newsletters about vices disparaged; your goods, products or services will 2) Oral or written publication, including pub- not be considered the business of lication by electronic means, of material in publishing; and your"advertisement"that: 2) The placing of frames, borders or a) Appropriates a person's name, voice, links, or advertising, for you or others photograph or likeness; anywhere on the Internet will not, by itself, be considered the business of b) Unreasonably places a person in a advertising, "broadcasting"or publish- false light; or ing. c) Discloses information about a per- 8. The following replaces Paragraph (2) of Ex- son's private life; or clusion n., Pollution-Related, in Paragraph 3) Infringement of copyright, "title" or "slo- t. of SECTION I — COVERAGES — COVER- gan" in your "advertisement", provided AGE B PERSONAL AND ADVERTISING that the claim is made or the "suit" is INJURY LIABILITY: brought by a person or organization that 2) Claim or suit by or on behalf of a govern- claims ownership of such copyright, "title" mental authority because of testing for, or"slogan". monitoring, cleaning up, removing, con- b. Includes "bodily injury" caused by one or taining, treating, detoxifying or neutraliz- more of the offenses described in Paragraph ing, or in any way responding to, or as- a. above. sessing the effects of, "pollutants". Broadcasting" means transmitting any audio or D. AMENDMENT OF WHO IS AN INSURED visual material for any purpose: The following replaces the introductory phrase of a. By radio or television; or Paragraph 2.a.(1) of SECTION II — WHO IS AN b. In, by or with any other electronic means ofINSURED: communication, such as the Internet, if that 1) "Bodily injury"or"personal injury": material is part of: E. AMENDMENT OF LIMITS OF INSURANCE 1) Radio or television programming being The following replaces Paragraph 4. of SECTION transmitted; III—LIMITS OF INSURANCE: 2) Other entertainment, educational, instruc- Subject to 2. above, the Personal and Advertising tional, music or news programming being Injury Limit is the most we will pay under Cover- transmitted; or age B for the sum of all damages because of all 3) Advertising transmitted with any of such personal injury" and "advertising injury" sus- programming. tained by any one person or organization. Personal injury": F. ADDITIONAL DEFINITIONS a. Means injury, other than "advertising injury", The following is added to the DEFINITIONS Sec- caused by one or more of the following of- tion: fenses: Advertising injury": 1) False arrest, detention or imprisonment; a. Means injury, other than "personal injury",2) Malicious prosecution; caused by one or more of the following of- 3) The wrongful eviction from,wrongful entry fenses: into, or invasion of the right of private oc- 1) Oral or written publication, including pub- cupancy of a room, dwelling or premises lication by electronic means, of material in that a person occupies, provided that the your "advertisement" that slanders or li- wrongful eviction, wrongful entry or inva- bels a person or organization or dispar- sion of the right of private occupancy is ages a person's or organization's goods, committed by or on behalf of the owner, products or services, provided that the landlord or lessor of that room, dwelling claim is made or the"suit" is brought by a or premises; CG D4 71 02 09 2009 The Travelers Companies,Inc. Page 3 of 4 Includes copyrighted material of Insurance Services Office,Inc.with its permission. 1 COMMERCIAL GENERAL LIABILITY 4) Oral or written publication, including pub- c) Discloses information about a per- lication by electronic means, of material son's private life. that slanders or libels a person or organi- b. Includes "bodily injury" caused by one or zation or disparages a person's or or-more of the offenses described in Paragraph ganization's goods, products or services,a.above. provided that the claim is made or the suit" is brought by a person or organiza- tion that claims to have been slandered or a. Means a phrase that others use for the pur- libeled, or that claims to have had its pose of attracting attention in their advertis- goods, products or services disparaged;ing. or b. Does not include a phrase used as, or in, the 5) Oral or written publication, including pub-name of: lication by electronic means, of material 1) Any person or organization, other than that:you; or a) Appropriates a person's name, voice,2) Any business, or any of the premises, photograph or likeness; goods, products, services or work, of any b) Unreasonably places a person in a person or organization, other than you. false light; or Title"means a name of a literary or artistic work. Page 4 Of 4 2009 The Travelers Companies,Inc. CG D4 71 02 09 Includes copyrighted material of Insurance Services Office,Inc.with its permission. f COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART . LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY If aggregate insured losses attributable to terrorist ant to the federal Terrorism Risk Insurance Act. The acts certified under the federal Terrorism Risk Insur- criteria contained in the Terrorism Risk Insurance Act ance Act exceed $100 billion in a Program Year for a"certified act of terrorism"include the following: January 1 through December 31) and we have met 1. The act resulted in insured losses in excess of$5 our insurer deductible under the Terrorism Risk Insur- million in the aggregate, attributable to all types of ance Act,we shall not be liable for the payment of any insurance subject to the Terrorism Risk Insuranceportionoftheamountofsuchlossesthatexceeds - 100 billion, and in such case insured losses up to Act-,and that amount are subject to pro rata allocation in ac- 2. The act is a violent act or an act that is dangerous cordance with procedures established by the Secre- to human life, property or infrastructure and is tary of the Treasury. committed by an individual or individuals as part Certified act of terrorism" means an act that is certi- of an effort to coerce the civilian population of the fied by the Secretary of the Treasury, in concurrence United States or to influence the policy or affect with the Secretary of State and the Attorney General the conduct of the United States.Government by of the United States, to be an act of terrorism pursu- coercion. CG 2170 01. 08 ISO Properties, Inc.,2007. Page 1 of 1 t COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT — NON CUMULATION OF EACH OCCURRENCE LIMIT OF LIABILITY and NON CUMULATION OF PERSONAL and ADVERTISING INJURY LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Paragraph 5 of SECTION III— LIMITS OF INSUR- 2. Paragraph 4 of SECTION III—LIMITS OF INSUR- ANCE,,is amended to include the following: ANCE, is amended to include the following: Non cumulation of Each Occurrence Limit—If one Non cumulation of Personal and Advertising Limit occurrence" causes "bodily injury" and/or "prop- If "personal injury" and/or "advertising injury" is erty damage" during the policy period and during sustained by any one person or organization dur- the policy period of one or more prior and/or future ing the policy period and during the policy period policies that include a commercial general liability of one or more prior and/or future policies that coverage part for the insured issued by us or any include a commercial general liability coverage affiliated insurance company, the amount we will part for the insured issued by us or any affiliated pay is limited.This policy's Each Occurrence Limit insurance company, the amount we will pay is will be reduced by the amount of each payment limited.This policy's Personal Injury and Advertis- made by us and any affiliated insurance company ing Injury Limit will be reduced by the amount of under the other policies because of such "occur- each payment made by us and any affiliated in- rence"'. surance company under the other policies be- cause of such"personal injury"and/or"advertising injury". CG D2 03 12 97 Copyright,Travelers Indemnity Company, 1997 Page 1 of 1