CERTIFICATE OF LIABILITY INSURANCE (613)i � � �S �
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'4�!�O� CERTIFICATE OF LIABILITY INSURANCE DATE�MM/DD/YWY)
3/19/2016 3/11/2015
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 �%�y �
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED O�• �C `
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. F
IMPORTANT: If the certifcate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, su ct to O
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer ri��-t� the 1 h. ��1�
certificate holder in lieu of such endorsement(s�. � /
PRODUCER Lockton Insurance Brokers, LLC NA e: �
License #OF15767 ac No EXt : ac No : � F
4275 Executive Square, Suite 600 E-MAII
La Jolla CA 92037 ADDR
(858) 587-3100 IN R AF RDIN C VERA E AIC #
iNSURER A: National Fire lnsurance Co of Hartford �nd�u
INSURED IPS Group, Inc.
1377909 5601 Oberlin Drive, Ste.100
San Diego CA 92121
Indian Harbor
A
COVERAGES IPSGROI CERTIFICATE NUMBER: 12814051 REVISION NUMBER: XXXX3�XX
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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE IN D POLICY NUMBER M/DD MM/ /YYYY LIMITS
A COMMERCIAL GENERAL LIABILITY
X 1' ]�j 4034952942 3/19/2015 3/19/2016 EACH OCCURRENCE 1 000 000
CLAIMS-MADE � OCCUR PREMISES Ea oNccTurrence SOO OOO
MED EXP An one erson I S ���
PERSONAL & ADV INJURY $ 1 OOO OOO
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 OOO OOO
POLICY� �E � ❑ LOC PRODUCTS - COMP/OP AGG $ 2 OOO OOO
OTHER
$
$ AUTOMOBILE LIABILITY Y r] 6013847F372 3/19/2015 3/19/2016 EO aBl aeDtSINGLE LIMIT $ 1 000 000
X ANY AUTO BODILY INJURY (Per person) $�{}{XX���
ALL OWNED SCHEDULED � XXXXX��X
AUTOS AUTOS BODILY INJURY Per accident $
X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE
AUTOS Per accident $ XX����X
$ ��x��x�ci'�
C X UMBRELLA LIAB X OCCUR N N 4034952990 3/19/2015 3/19/2016 EACH OCCURRENCE $ 5 �00 �00
EXCESS LIAB CLAIMS-MADE AGGREGATE $ S OOO OOO
DED X RETENTION $10,000 g XXX��XXX
WORKERS COMPENSATION
BAND EMPLOYERS' LIABIUTY Y � N N 5093308451 (CA) 3/19/2015 3/19/2016 X STATUTE OTH-
ANYPROPRIETOR/PARTNER/EXECUTIVE 5�933�8496 �A�S� 3/19/2015 3/19/2016 1
OFFICER/MEMBER EXCLUDED? N❑ N� A E.L. EACH ACCIDENT $ 1 OOO OOO
(ManAatory in NH) E.L. DISEASE - EA EMPLOYEE 1 OOO OOO
If yes, tlescribe under t
DESCRIPTION OF OPER4TIONS Delow E.L. DISEASE - POLICY LIMIT 1 OOO OOO
D Tech E&0 / Network / N N MTP9032003 3/19/2015 3/19/2016 Each Occ. 5,000,000;
Privacy / Media A S,OOQ000;
g .:
De .: ]OQ000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: Engineering of Pazking Meters. City of Clearwater is named as additional insured as respects General Liability and Auto Liability per attached.
CERTIFICATE HOLDER CANCELLATION See Attachments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITN TNE POLICY PROVISIONS.
12814051 AUTHORIZED REPRESENTATIVE
City of Clearwater
P.O. Box 4748
Clearwater FL 33758
� �
ACORD 25 (2014/01) O 014 ACORD P ION. All riqhts reserved
The ACORD name and logo are registered marks of ACORD
CNA
G-144294-C99
(Ed.12/06)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
TECHNOLOGY GENERAL LIABILITY EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LL�BILITY COVERAUE PAR1'
Coverage afforded under this extension of coverage endorsement does not apply to any person or organizarion covered
as an addirional insured on any other endorsement now or hereafter attached to this Coverage Part.
1. ADDITIONAL. INSURED - BLANKET VENDORS
WI IO IS AN INSURED (Secrion II) is amended to include as
an additional insured any person or organizarion (referred to
below as vendor) with whom you agreed, because of a written
contract or agreement to provide insurance, but only with
xespect to "bodily injury" or "properly damage" arising out of
"your products" which are distributed or sold in the regular
course of the vendors business, subject to the following
additional exclusions:
1. The insurance afforded the vendor does not apply to:
a. 'Bodily injury" or "property damage" for which the vendor is
obligated to pay damages by reason of the assumption of liability
in a contract or agreement This exclusion does not apply to
liability for damages that the vendor would have in the absence
of the contract or agreement;
b. Any express warranty unauthorized by you;
c. Any physical or chemical change in the product made
intentionally by the vendor;
d. Repackaging, except when unpacked solely for the purpose of
inspection, demonstration, testing, or the substitution of parts
under instructions from the manufacturer, and then repackaged
in the original container;
e. Any failure to make such inspecrions, adjustments, tests or
servicing as the vendor has agreed to make or normally
undertakes to make in the usual course of business, in
connecrion with the distriburion or sale of the products;
£ Demonstration, installation, servicing or repair operations,
except such operations performed at the vendors premises in
connection with the sale of the product;
g. Products which, after distriburion or sale by you, have been
labeled or relabeled or used as a container, part or ingredient of
any other thing or substance by or for the vendor; or
persons or organizations are additional insureds under this
endorsement and coverage provided to such additional insureds
is limited as provided herein:
a. Additional Insured - °Your Work"
That person or organization for whom you do work is an
additional insured solely for liabilit�� due to your negligence
specifically resulting from "your work" for the additional
insured which is the subject of the written contract or written
agreement. No coverage applies to liability resulting from the
Miscellaneous Attachment : M495240
Master ID: 1377909, Certificate ID: 12814051
h. "Bodily injury" or "property damage" arising out of the sole
negligence of the vendor for its own acts ox omissions or those
of its employees or anyone else acting on its behalf. However,
this exclusion does not apply to:
(1) The excepuons contained in Subparagraphs d. or £; or
(2) Such inspecrions, adjustments, tests or servicing as the vendor
has agreed to make or normally undertakes to make in the usual
course of business, in connection with the distribution or sale of
the products.
2. This insurance does not apply to any insured person or
organization, from whom you have acquired such products, or
any ingredient, part or container, entering into, accompanying or
containing such products.
3. This provision 1. does not appl}� to any vendor included as an
insured by an endorsement issued by us and made a part of this
Coverage Part.
4. This provision 1. does not apply if "bodily injury" or "property
damage" included within the "pzoducts-completed operations
hazazd" is excluded either by the provisions of the Coverage Part
or by endorsement.
2. MISC�LI.ANEOUS ADDITIONAL INSUREDS
WHO IS AN INSURITD (Section II) is amended to include as
an insured any person or organization (called additional insured)
described in paragraphs 2.a. through 2.h. below whom you are
required to add as an addirional insured on this policy under a
written contract or agreement but the written contract or
agreement must be:
1. Currendy in effect or becoming effective during the term of
this policy; and
2. Executed prior to the "bodily injury," "property damage" or
"personal injury and advertising injury," but only the following
with premises you own, rent, or control and to which the
insurance applies:
(a) The existence, maintenance, repau, construction, erecrion, or
removal of advertising signs, awnings, canopies, cellar
entrances, coal holes, driveways, manholes, marquees,
hoistaway openings, sidewalk vaults, street banners, or
decorations and similar exposures; or
(b) The construction, erection, or removal of elevators; or
sole negligence of the additional insured.
The insurance provided to the additional insured is limited as
follows:
(l) The Lunits of Insurance applicable to the additional
insured are those specified in the written contract or written
agreement or in the Declarations of this policy, whichever is
less. These l.i:nits of Insurance are inclusive of, and not in
addition to, the Lunits of Insurance shown in the
Declarations.
(2) The coverage provided to the addirional insured by this
paragraph. 2.a., does not apply to "bodily injury" or "property
damage" arising out of the "products-completed operations
hazard" unless:
(a) It is required by the written contract or written
agreement; and
(b) "Bodily injury" or "property damage" included within the
"products-completed operations hazard" is not excluded
either by the provisions of the Coverage Pazt or by
endorsement.
(3) The insurance provided to the additional insured does
not apply to "bociily injury," "property damage," or "personal
and advertising injury" arising out of the rendering or failure
to render any professional services.
b. State or Political Subdivisions
A state or political subdivision subject to the following
provisions:
(1) This insurance applies only with respect to the following
hazards for which the state or political subdivision has
issued a pernut in connection
e. Mortgagee, Assignee or Receivex
A mortgagee, assignec or receivez but onl}' with respect to their
liability as mortgagee, assignee, or receiver and arising out of the
ownership, maintenance, or use of a premises by you.
1'his insuzance does not apply to stmctuxal alterations, new
construction or demolition operations performed by or for such
additional insured.
(2) This insurance applies only with respect to opefations
performed by you or on your behalf for which the state or
poliucal subdivision has issued a permit.
This insurance does not apply to "bodily injury," "property
damage" or "personal and advertising injury" arising out of
operations performed for the state or municipality.
c. Controlling Interest
Any persons or organizarions with a controlling interest in you
but only with respect to their ability arising out of:
(1) Theu financia] control of you; or
(2) Premises they own, maintain or control while you lease or
occupy these premises.
This insurance does not apply to structural alterations, new
construcrion and demolition operarions performed by or for
such additional insured.
d. Managers or Lessors of Premises
A manager or lessor of premises but only with respect to liability
arising out of the ownership, maintenance or use of that specific
part of the premises leased to you and subject to the following
additional exclusions:
This insurance does not apply to:
(1) Any "occurrence" which takes place after you cease or be a
tenant in that premises; or
(2) Structural alterarions, new construction or demolition
operations performed by or on bchalf of such additional insured.
Any insurance provided to an addirional in,ured designated
under paragraph, b. through h. above does not apply to "bociil}�
injury" or "property damage" included within the "products-
completed operarions hazard."
As respects the coverage provided undet this endorsement,
Paragraph 4.b. SI?,CTION IV -
COMMERCIAL GENERr1L LIA73ILITY CONDIITONS is
deleted and replaced with the following:
£ Ownexs/Other Interests - T,and is Leased
An owner or othex interest from whom land has been leased by 4•
you but only with mspect to liability arising out of the ownership, b
maintenance or use of that specific part of the land leased to you
Othcr Insurancc
Lxcess Insurance
and subject to the following additional exclusions: This insurance is excess over:
This insurance does not apply to:
(1) Any "occurrence" which takes place aftex you cease to lease
that land; or
(2) Structural alterations, new construction or demolition
operations performed by or on behalf of such additional
insured.
g. Co-owner of In,ured Premises
Miscellaneous Attachment : M495240
Master ID: 1377909, Certificate ID: 12814051
�iny other insurance naming thc additional insured as an insured
whetber primary, excess, contingent or on any other basis unless
a written contract or agreement specifically re9uires that this
insurancc be either prunary or primary and noncontribuUng.
Where required by written contract or agxeement, we will
consider any other insuxance maintained by d�e addirional
insuxed for injury or damage covcred by this endorsement to be
excess and noncontriburing with this insurance.
3. NEWLY FORMLD OR ACQUIRF,ll OIZGANIGATIONS
Paragraph 3.a. of Secrion II- Who Is An In,ured is deleted and
mplaced by the following:
Coverage under this provision is afforded only until the end of
A co-owner of a premises co-owned by you and covemd under
this insuzance but only with respect to the co-ownefs liability as
co-owner of sucl� premises.
h. Lessor of Equipment
Any person or organvaUOn from whom you lease equipment.
Such person or organization are insureds only with respect to
their liability arising out of the maintenance, operation or use by
you of equipment leased to }�ou by such person or organizarion.
A person's ox organization's status as an insured under this
endorsement ends when their written contract or agreement with
you for such leased eyuipment ends.
With respect to thc insurance afforded these additional insureds,
the following adciirional exclusions apply:
This insurance does not apply:
(9) To any "occurrence" which takes place aftex the equipment
lease expires; or
(2) To "bodily injury," "property damage;' or "per,onal and
advertising injury" arising out of the sole negligence of such
additional insured.
B. The last paragraph of Section II - Who Is An Insured is
deleted and replaced by the following:
Except as provided in 4. above, no person or organization is an
insured with respect to the conduct of any current or past
parmership, joint venture or limited liability company that is not
shown as a Named Insured in the Declarations.
5. PARTNERSHIP OR)OINT VENTURES
Paragraph l.b. of Section II - Who Is An Insured is deleted and
replaced by the following.
b. A parmership (including a limited liability parmership) or joint
venture, you are an insured. Your members, your partners, and
theu spouses are also insureds, but only with respect to the
conduct of youz business.
6. EMPLOYEES AS INSUREDS - HEr1LT1-I CARE
SERVICES
the policy period or the next anniversary of this policy's effective
date after you acquire or form the organizarion, whichever is
earlier.
4. JOINT VENTURES / PARINERSHIP / LI'�IITEll
LIABILITY COMP�iNY COV�RriG�
A. 'The following is added to Section 11 - Who Is .�n
Insured:
4. You are an insuxed when you had an interest in a joint
venture, partnership ot lunited liability company which
terminated or ended prior to or during this policy period but
only to the cxtent of your intexest in such joint venture,
partnership or limited IiabIlity company. 'This covecage does
not apply:
a. Prior to the terminarion date of any joint venture,
partnership or limited liability company; or
b. If there is other valid and collectible insurance purchased
specifically to insure the partnership, joint venture or limited
liability company.
h. Discriminarion or humiliation that results in injur}� to the
feelings or reputation of a natural person, but only if such
discrunination or humiliation is:
(1) Not done intenrionally by or at the d'uection of:
(a) The insured; or
(b) riny "executive officer," director, stockholder, partner,
member or manager (if you are a limited liability company) of the
insured; and
(2) Not direcdy or indirecdy related to the employment,
prospective employment, past employment or termination of
employment of any person or persons by any insured.
B. Exclusions of Secrion I- Coverage B- Personal and
�dvertising Injury Liability is amended to include the following.
p. lliscrii7iination Relating To Room, Dwelling or Premises
For other than a physician, paragraph 2.a.(1)(d) of Caused by discruxunation direcdy or indirecd}� related to the sale,
Section II - Who Is An Insured does not apply with respect to rental, lease or sub-lease or prospective sale, rental, lease or sub-
professional health care services provided in the course of lease of any room, dwelling or premises by or at the direction of
employment by you. any insured.
7. PROPERTY DAMAGE - PATTERNS, MOLDS AND
DIES
Paragraphs (3) and (4) of Exclusion j. Damage to Property of
SrCTION I- EXCLUSIONS do not apply to pattems, molds
or dies in the care, custody or control of the insured if the
patterns, molds or dies are not being used to perform operations
at the time of loss. A limit of insurance of �25,000 per policy
period applies to PROPERTY DAM;1GE - PAT'TERNS,
MOLDS AND DIES and is included within the General
Aggregate I,unit as described in SECTION III - LIMITS OF
Miscellaneous Attachment : M495240
Master ID: 1377909, Certificate ID: 12814051
q. Fines Or Penalties
P'ines or penalties levied or unposed by a governmental entity
because of discruninarion.
C. This provision 9. (EXPANDED PERSONAL AND
ADVERTISING INJURY COVERAG�) does not apply to
discrimination or huiniliation committed in the states of New
York or Ohio. Also, EXPANDED
P�RSONAL AND ADV�RTISING INJURY COVERAGE
INSURANCE.
The insurance afforded by this provision 7. is excess ovei any
valid and collectible property insurance (including any
deductible) available to the insured, and the Other Insurance
Condition is changed accordingly.
8. BODILY INJURY
Secrion V- Defuvtions, the definition of "bodily injury" is
changed to read:
"Bodily injury" means bodily injury, sickness or disease snstained
by a person, including death, humiliation, shock, mental anguish
or mental injury by that person at any time which results as a
consequence of the bodily injury, sickness or disease.
9. EXPANDED PERSONAI, AND ADVERI'ISING INJURY
A. The following is added to Section V- Definitions, the
definition of "personal and adverrising injury":
for all medical expenses because of "bodily injury" sustained by
any one person. The Medica] Expense Lunit is the greater of:
(1) $15,000; or
does not apply to policies issued in the states of New York or
Ohio.
D. This provision 9. (EXPANDED PERSONAL AND
ADVERTISING INJURY COVERAGE) does not apply if
Section I- Coverage B- Personal And Advertising Injury
Liability is excluded either by the provisions of the Coverage Part
or by endorsement.
10. MEDICAI. PAYMENTS
A. Paragraph 7. Medical Expense I.iinit, of Section Ill - Lunits of
Insurance is deleted and replaced by the following:
7. Subject to 5. above (the Each Occurrence I.irnit), the Medical
Expense Lunit is the most we will pay under Secrion - I-
Coverage C
(3) Property loaned to you;
(4) Personal property in the care, custody or control of the
insured;
(2) T'he amount shown in the Declarations for Medical Expense (5) That particular part of real property on which you or any
Lunit. contractors or subcontractors working direcdy or indirecdy on
your behalf are performing operations, if the "property damage"
B. This provision 10. (Medical Payments) does not apply if arises out of those operations; or
Secrion I- Coverage C Medical Payments is excluded eithez by
the provisions of the Coverage Part or by endorsement.
C. Paragraph l.a.(3)(2) of Section I- Coverage C- Medical
Payments, is replaced by the following:
The expenses are incurred and reported to us within three years
of the date of the accident; and
11. SUPPLEMENTARY PAYMENTS
A. Under Section I- Supplementary Payments - Coverages A and
B, Paragraph 1.b., the limit of �250 shown for the cost of bail
bonds is replaced by �2,500:
B. In Paragraph l.d., the limit of �250 shown for daily loss of
earnings is replaced by $1,000.
12. PROPERTY DAMAGE - �LEVATORS
(6) That particular part of any property that must be restored,
repaired or replaced because "your wark" was incorrecdy
performed on it.
Paragraph (2) of this exclusion does not apply if the premises are
"your work" and were never occupied, rented or held for rental
by you.
Paragraphs (1), (3) and (4) of this exclusion do not apply to
"property damage° (other than damage by fire, lightning,
explosion, smoke, or leakage from automatic fire protective
systems) to premises including the contents of such premises,
rented to you for a period of 7 or fewer consecutive days.
A separate limit of insurance applies to Damage To Premises
Rented To You as described in Secrion III - L'units Of
Insurance.
Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to
With respect to Exclusions of Section I- Coverage A, paragraphs liability assumed under a sidetrack agreement.
(3), (4) and (6) of Exclusion j. and Exclusion k. do not apply to Paragraph (6) of this exclusion does not apply to "property
the use of elevators. damage" included in the "products-completed operations
hazazd."
The insurance afforded by this provision 12. is excess over any
valid and collectible property insurance (including any
deducrible) available to the insured, and the Othet Insurance
Condition is changed accordingly.
13. LEGAL LI�'�BILITY - DAMAGE TO PR�MISES
A. Under Secrion I- Coverage A- Bodily Injury and Property
Damage 2. �xclusions, �xclusion j. is replaced by the following.
Miscellaneous Attachment : M495240
Master ID: 1377909, Certiiicate ID: 12814051
B. Under Secrion I- Coverage A- Bodily Injury and Property
Damage the last paragraph of 2. Exclusions is deleted and
replaced by the following.
Exclusions c. through n. do not apply to damage by fire,
lightning, explosion, smoke, or leakage from automatic fire
protecrive systems to premises wbile rented to you or
tempozarily occupied by you with permission of the owner.
"Property damage" to:
(1) Property you own, rent, or occupy, including any costs or
expenses incurred by you, or any other person, organization or
entity, for repair, replacement, enhancement, restorauon or
maintenance of such property for any reason, including
prevention of injury to a person or damage to another's property;
(2) Premises you sell, give away or abandon, if the "property
damage" arises out of any part of those premises;
6. Subject to 5. above, the Damage To Premises Rented To You
Lunit is the most we will pay under Coverage A for damages
because of "property damage" to any one premises while rented
to you or in the case of damage by fue, lightning, explosion,
smoke, or leakage from automaric fue protective s5�stems, while
rented to you or temporarily occupied by you with the
pernussion of the owner. The Damage To Premises Rented To
You Lunit is the greater of:
a. $500,000; or
A separate limit of insurance applies to this coverage as described
in Secrion III - Limits Of Insurance.
C. Paragraph 6. Damage To Premises Rented To You Lunit of
Secrion III - Lunits Of Insurance is replaced by the following:
16. BROAD KNOWLEDGF OF OCCURRF.NCE
You must give us or our authorized representative norice of an
'bccurrence;' offense, claun, or "suit" only when the
"occurrence," offense, claun or "suit" is known to :
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) An execurive officer or the employee designated by you to
give such notice, if you are a corporation; or
b. The Damage To Premises Rented To You Limit shown in the
Declarauons. (4) A manager, if you are a limited liabilit�� company.
D. Paragraph 4.b.(1)(b) of Secrion N- Commercial General
Liability Condirions is deleted and replaced by the following:
(b) That is property insurance for premises rented to you or
temporarily occupied by you with the permission of the owner;
or
E. This provision 13. (LEGAL LIABILITY - DAMAGE TO
PREMISES) does not apply if Damage To Premises Rented To
You Liability under Section I- Coverage A is excluded either by
the provisions of the Coverage Part or by endorsement.
14. NON-OWNED WATERCRAFT
Under Section I- Coverage A- Bodily Injury and Property
Damage, Exclusion 2.g., subparagraph (2) is deleted and replaced
by the following.
(2) A watercraft you do not own that is:
(a) Less than 55 feet lon� and
(b) Not being used to carry persons or property for a charge.
15. NON-OWNED AIRCRAFT
Exclusion 2.g. of Secrion I- Covexage A- Bodily Injury and
Property Damage, does not apply to an aucraft you do not own,
provided that:
]. The pilot in command holds a currendy effecrive certificate
issued by the duly consrituted authority of the United States of
America or Canada, designaung that person as a commercial or
airline transport pilot;
2. It is rented with a trained, paid crew; and
3. It does not transport persons or cargo for a charge.
Miscellaneous Attachment : M495240
Master ID: 1377909, Certificate ID: 12814051
17. NOTIC� OF OCCURRENCE
The following is added to paragraph 2. of Section IV -
Commercial General Liability Conditions - Duties in The Event
of Occurrence, Offense Claim or Suit:
Your rights under this Coverage Part will not be prejudiced if
you fail to give us norice of an "occurrence," offense, claun or
"suit" and that failure is solely due to your reasonable belief that
the "bodily injury" or "property damage" is not covered under
this Coverage Part. However, you shall give written norice of this
"occurrence," offense, claun or "suit" to us as soon as you are
aware that this insurance may apply to such "occurrence,"
offense claun or "suit."
18. UNINT'ENTIONAL FAILURE TO DISCLOSE
HAZARDS
Based on our reliance on your representations as to existing
hazards, if unintentionally you should fail to disclose all such
hazards at the inception date of your policy, we will not deny
coverage under this Coverage Part because of such failure.
19. EXPECTED OR INTFNDED INJURY
Exclusion a. of Secrion I- Coverage A- Bodily Injury and
Property Damage Liability is replaced by the following.
a. "Bodily injury" or "property damage" expected or intended
fxom the standpoint of the insured. This exclusion does not
apply to "bodily injury" or "property damage" resulring from the
use of reasonable force to protect persons or property.
20. LIBLRALIZATION CLAUSF.
If we adopt a change in our forms or rules which would broaden
coverage provided under this endorsement without an addirional
premium chazge, your policy will automatically provide the
additional coverages as of the date the revision is effective in
your state.
Miscellaneous Attachment : M495240
Master ID: 1377909, Certificate ID: 12814051
POLICY NUMBER
6013847872
POLICY CHANGES
CA 2048 DESIGNATED INSURED
INSURED NAME AND ADDRESS
IPS GROUP, INC
5601 OBERLIN DRNE
SUITE 100
SAN DIEGO, CA 92121
This Change Endorsement changes the Policy. Please read it carefully.
This Change Endorsement is a part of your Policy and takes effect on the effective date of
your Policy, unless another effecrive date is shown.
The following Form has been added:
Form #: CA2048 Tide: Designated Insured
Any person or organization you have agreed in a written contract or
written agreement to add as an addiuonal insured on this Coverage Part,
provided the written contract or written agreement was executed
prior to:
a. The "bodily injury" or "property damage' ; or
b. The offense that caused the "personal and advertising injury
for which the additional insured seeks coverage under this Coverage Part.
The written contract or written agreement must pertain to your ongoing operarions for the addirional
insured, and must specifically require additional insured status according to the provisions of CG 20
48.
But notvvithstanding the above, no person or organization is an
addirional insured for professional architectural or engineering
services provided at or for the Locarion(s) of Covered Operations.
G-56015-B (ED. 11/91)
Attachment Code : D495275
Certificate ID : 12814051