CERTIFICATE OF LIABILITY INSURANCE - RFQ 26-19 (11) page 1 of 21
08/212019
McGriff fnsurance Services
PO Box 819
Olson NC 27894-0819
,A00 H
City ofClearwater Engineering,
RFQ#26-19
P 0 Box 4748
Clearwater,FL 33758
Vi
page of 21
ol
Client#: 216019 2 PrMC IMCRE
ACORD� CERTIFICATE OF LIABILITY INSURANCE' MATE IMiGfYYYY¢
8/23(2019.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANIS CONFERS NO RIGHTS UPON THE CERTIFICATE HOLIER,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.
$MPORTANTit the certiiicats holder is an AD-DITIO IAL INSURED,tIhe p llcy(ies)must have AbbltIdhAL INtUREb-provisions or be endorsed.
H 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 any rights to the,certificate holder in lieu of such endors rnent(s),
Prti3ollGER
NAME: Brittany Yardley
McCriff Insurance Services PHGNEPAX
(A/C,Noe Exl) 919 281-4500 (AJC.No): 8887468763.
Frost Office Box 13941 E-MAIL yar�le
Durham, NC 277179 ADDnEss y MC rifflnsurance.ccrrl
INSURER(S)APPORDINC COVERAGENAIL�
818 281-4500 INSURED A Charter Oak Fire Insurance Company _ 25615
INSURED INSUAEH B Travelers Property Casualty Co of Amer 25674
McKim and Creed Inc
INSURER c Travelers Casualty&Surety Company 19038
1730 Varsity lir Ste SBU
Raleigh,NC 27606-2689 INSURER
'..IN6LaRER E: '
INSURED F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
I HIS IS To CC:RTIrY THAT THE POLICIES OF INSURANCE I..IS`TED BELOW HAVE BEEN ISSUED To'TI-IE INSURED NAMED ABOVE FOR THE POLICY PLR'IC3D
INDICATED NOTWITHSTANDING ANY IREDUIREMEN'T TERM OR CONDII]ON 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 alBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE. BEEN REDUCED BY PAID CLAIMS.
"ADd_1L SU[3'A,., _ --_ PO41CY EFF`. POLICy EIIP ... _ _.
LTR TYPE OF INSURANCE ... INSA,WVD Pt�LICY NUMBER ;EARAtDL'�dv`FY'P}.{pA.t�lf'pp1YYv1+� _. LIMITS
A Gomm nCIAL GENERAL LIABILITY 6302GO91871 C 9/05/2019 091051202Q EACH QCCJJqRENCE $1,000,000
rC a
c:A0,1wADE X�OCCUR �R,0t M I s
r MED EXP(Any ooe pemo,,) 1-110,000 _
PF `_)NAz K ACV INJURY ;x1'000,000
C;FNIL
AGGRE F t.WlP APPI ES PER _ AGGREGATE_
_ �'LntEFAI (s2, ,DDG
PRa PROD_C CG;xf PLOP AGC 2
P4)t i�...r 7=G f � i EJC, y ....
01 PIER
A AUTOMOBILE LBILITY 810 N4432 4fi 09/0W201 g 09106/2020 COMBINED SINGLE DMIT
rcrzlentr_.._. .._.. $1,Uf ,000,..
ANY AUTOHC,tDI f INAJ R`r IPCr L.ems n) =S
i
AUTOS ONLY Aka'C)S
Hl?EC NONE OWNED PROPERYYb Wcic&
AU 10,9 ON Ce .All rOS ONLYIb>�nr,x,ide"r)..._. b
UMBRELLA LIAO XOCCUR CU SJ8991491 9/0-5/2019 08/05/2020 EACH OCCURRENCE _. N.10,000,OW
E%CESS r..IAB CLAIMSWACR AGGREGATE $10x.
L7€;EI X RE EN'TION$10 000 � � ..
C WORKERS COMPENSATION s _. LJ .17176131 _. 97 201 t�'I�J'C1�5J202U Ili_.P r'
AND EMPLOYE RSL LIA RILMY Y J N ..u„AT L<il:... ER , ... __.
ANY PREIP+R ,CFVPARTNER EXECUTIVE k:L
EACH ACCEN7
�I=E(C�IMEt €ER�Y(L.JED7 NfA '$1,0t
(Mandatory In N......H) r'-.:.NJ 3l A..=E_.EA EMPLOYEE�x$1,000, 00.... ...
I Y l nbe U iia .. _
DIwS<k7Vr TiC1fa1 C.7 Ctr'N`Fir+HIC.7VS i7ai�)va - L L DISEASE,POLICY LIMI r $1,000,000
'.:
DESCITIPTION OF OPERATIONS J LOCATIONS I VEHICLES(ACOFID tqt.Addrtlonal Remarks Schedule,may be satachod it mase space Is requirbcl)
Re: A FO#26-19
City of Clearwater is named as Additional Insured under the General Liability„Auto Liability, and Umbrella
Liability It required by contract,before a loss on a prin ary&non-contributory basis,Thi (30)days
notice of cancellation except for non-payment of premium applies on the General Liability,
Auto Liability,and Workers Compensation policies if required by contract,
CERTIFICATE HOLDER CANCELLATION
CIS of ClearwaterEngineering, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES DE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
RF'tQ#26x^18 ACCORDANCE WITH THE POLICY PROVISION'S.
P O Box 4746
Clearwater, FI. 33758 AUTHORVED REPRESENTATIVE
x
1988-2015 ADDED CORPORATION,All rights reserved.
i
ACORD 25(201 03) 1 of 1 The ACORD name and logo are registered masks of ACORD
.3 24206050/M24206689 BFY
mpage 3 of 21
This page has been left blank ii-itentionally.
page 4 of 21
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ARCHITECTS, ENGINEERS AND SURVEYORS
INDUSTRYEDGE5m 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 he 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 exclusion--; may apply to these coverages. Read all the provisions of this en-
dorserneut and the rest of your policy carefully to determine rights, duties, and what is and is not Covered.
A. Broadened Named Insured W Who Is An Insured - Newly Acquired Or
B. Incidental Medical Malpractice Formed Organizations
C. Reasonable Force - Bodily injury Or Property N. Injury To Co-Employees And Co-Volunteer
Damage Workers
D. Non-Owned Watercraft - Increased To Up To 0. Medical Payments Limit
75 feet P. Knowledge And Notice Of Occurrence Or
E. Aircraft Chartered With Pilot Offense
P. Extension Of Coverage - Damage To Q. Other Insurance Condition
Premises Rented To You R, Unintentional Omission
GPersonal Injury-Assumed by Contract S. Waiver, Of Transfer Of Rights Of Recovery
H. Increased Supplementary Payments Against Others To Us When Required By
1, Additional Insured - Owner, Manager Or Contract
Lessor Of Promises T. Amended Bodily Injury Definition
J. Additional Insured - Lessor Of Leased Ecjuip- U• Amended Insured Contract Definition - Rail-
ment road Easement
K. Additional Insured - State Or Pole cat V. Additional Definition - Written Contract Re-
Subdivisions- Permfts, Relating To Premises quiring insurance
L, Additional Insured - State Or, Political
Subdivisions- Permits Relating To Operations
PROVISIONS ever, coverage for any such additional organiza-
A. BROADENED NAMED INSURED - UNNAMED tion will cease as of the date, if any, during the
S
policy period, that you no longer are the sole
UBSIDIARIES
owner of, or maintain the majority ownership in_
The Named Insured in Item 1, of the Declarations forest in, such organization.
is amended as follows,
B. INCIDENTAL MEDICAL MALPRACTICE
The person or organization named in Item 1. of 1� The following is added to the definition of 'oc-
the Declarations and any organization, other than currence' in the DEFINITIONS Section.-
a partnership, joint venture, limited liability com-
pany or trust, of which you are the sole owner or Unless you are in the husiness, or occupation
in which you maintain the majority ownership in- of providing professional health care services,
terest on the effective date of the policy. How- "occutrence' also means an act or ornission
C G D4 15 05 08(Rev.1 0-08� (0 2008 The Travelers companies, Inc Page 1 of 8
324
page 5 of -91
COMMERCIAL GENERAL LIABILITY
committed by any of your 'employees' who is for 'bodily injury" that arises out of providing
employed by you as a registered nurse, li- or failing to provide 'incidental medical ser-
censed practical nurse, emergency medical vices' or "Good Samaritan services", except
technician or paramedic. in providing or failing for insurance purchased specifically by you to
to provide "Incidental medical services' or apply in excess of the Limits of Insurance
"Good Samaritan services"to a person, shown in the Declarations for this Coverage
2. The following is added to the DEFINITIONS Pail,
Section: & The toflowirig is added to Paragraph 5. of
a. "Incidental medical services" means SECTION III —LIMITS OF INSURANCE:
medical, surgical, dental, laboratory, x-ray For the purposes of determining the applica-
or nursing service, treatment, advice or bip Each Occurrence Limit, all related acts or
instruction: the related furnishing of food omissions committed by any of your "employ-
or beverages; the furnishing or dispenis- eps" in providing or failing to provide "inciden-
ing of drugs or medical supplies or appli- tat medical services' or 'Good Samaritan ser-
ances; or first aid. vices' to any one person will be deemed to be
b, "Good Samaritan services" means those one "occurrence".
medical services rendered or provided in C. REASONABLE FORCE PROPERTY DAMAGE —
an emergency and for which no remu- EXCEPTION TO EXPECTED OR INTENDED IN-
neration is demanded or received, JURY EXCLUSION
1 The following is added to Paragraph 2.a.(1) The following replaces Exclusion a., Expected Cr
of SECTION 11 —' FIC IS AN INSURED
Intended injury, in Paragraph 2. of SECTION I —
Paragraphs (1) (a), (b), (C) and (d) above do COVERAGES — COVERAGE A BODILY IN-
not apply to any of your "employees" who are JURY AND PROPERTY DAMAGE LIABILITY:
employed by you as a registered nurse, lis Expected Cr Intended Injury Cr Damage
ceased practical nurse, emergency medical
technician or paramedic but only while per- "Bodily injury' or "property damage" expected
forming the services described in Paragraph or intended from the standpoint of the in-
1., above and while acting within the scope of surpd. This exclusion does not apply to "bod-
their employment by you. Any such "employ- ity injury" or "property damage" resulting from
ees" rendering "incidental medical services' the use of reasonable force to protect any
or "Good Samaritan services" will be deemed person or properly.
to be acting within the scope of their employ- D. NON-OWNED WATERCRAFT — INCREASED
ment by YOU. TO UP TO 75 FEET
C The following exclusion is added to Para- 1. The following replaces Paragraph (2) of Ex.
graph 2. Exclusions of SECTION I — COV- clusion g., Aircraft, Auto Cr, W'atercr,aft, in
ERAGE S — COVERAGE A BODILY INJURY Paragraph 2. of SECTION I — COVERAGES
AND PROPERTY DAMAGE LIAEIILITY: _. COVERAGE Al BODILY INJURY AND
Sale of Pharmaceuticals PROPERTY DAMAGE LIABILITY:
"Bodily injury" or 'property damage" arising (2} ria watercraft you do not own that is:
out of the willful violation of a penal statute or (a) Less than 75 feet long; and
ordinance relating to the sale of pharmaceutic (b) Not being used to carry any person or
cals, committed by or with the knowledge or property for a charge,
consent of the insured.
2� Tire following is added to SECTION 11 —WHO
5, The following is added to Paragraph 4.b., Ex- IS AN INSURED:
cess Insurance, of SECTION IV — COM- Any person who, with your expressed or im-
MERCIAL GENERAL LIABILITY CONDI- plied consent, either uses or is responsible for
TIONS: the use of a nonowned watercraft that is less
This insurance is excess over any valid and than 75, teet and not being used to carry per-
collectible 'other insurance', whether primary, son or property for a charge is included as an
excess, contingent or on any other basis, that insured Linder this Coverage Part.
is available to you or any of your "employees'
Page 2 of 8 0 2008 r Trave*&Comp atiies,Im. CG D4 15 05 08(Hev. ic)-oii)
32b
page 6 of 21
COMMERCIAL GENERAL LIABILITY
E. AIRCRAFT CHARTERED WITH PILOT of the owner, caused by: fire; explosion; light®
The following is added to Exclusion g., Aircraft, ping; smoke resulting from such fire, e plo
Auto t r'Watercraft, in Paragraph . cat RECTION sion, or lightning; or water. The Damage To
I ® COVERAGES — COVERAGE A BODILY IN- Premises Rented To You Limit will apply to all
JURY ANIS PROPERTY DAMAGE LIABILITY: "property damage" proximately caused by the
same 'occurrence", whether such damage
This exclusion does not apply to an aircraft that results front: fire; explosion; lightning; smoke
is: resulting frorn such fire, explosion, or light.
(a) Chartered with a pilot to any insured; and ming; or waster; or any combination of any of
(b) Not owned by any insured. these causes,
F. EXTENSION OF COVERAGE — DAMAGE TO The Damage To Premises Rented To You
PREMISES RENTED TO YO:U Lirnil will be the higher of:
t. The fallowing replaces the last paragraph of a, $300,000: or
SECTION ICOVERAGES—COVERAGE A b. The amount shown fret- the Damage To
BODILY INJURY' AND PROPERTY DAMm Premises Rented To You Limit in the
ASE LIABILITY: Declarations for this Coverage Part..
Exclusions c. through rt-. do not apply to dam- 4. The following replaces Paragraph a. of the
age to premises while rented to you, or terra definition of "insured contract" in the DEFIN1-
porarily occupied by you with permission of TIONS Section:
the owner, cau=sed by: a. A contract for a lease of premises. Now_
a. Fire, ever, that portion of the contract for a
b, Explosion; lease of premises that indemnifies any
person or organization Isar damage to
c. Lightning; premises while rented to you, or tempo-
d. Smoke resulting from such tire, explosion, racily occupied by you with permission of
or lightning; or the owner, caused by: fire; explosion,
e. lightning; smoke resulting from such fire,
Water. explosion, or lightning, or water is not are
separate limit of insurance applies to this "insured contract%
coverage as described in SECTION III — LITS_ G. PERSONAL INJURY ASSUMED BY CON-
ITS OF INSURANCE TRACT
The insurance under this Provision F. sloes The following replaces Exclusion a., Contractual
not apply to damage to premises while rented Liability in Paragraph 2. of SECTION I — COV-
to you, or temporarily occupied by you with ERA ES — COVERAGE S PERSONAL AND
permission of the owner, caused by: ADVERTISING INJURY LIABILITY
a. Rupture, bursting, or operation of pres- "Advertising injurer" for which the insured has as-
sure relief devices; sumed liability in a contract or agreement. This
b. Rupture or bursting due to expansion or exclusion aloes not apply to liability for darnages
swelling of the contents of any building or that the insured would have in the absence of the
structure, caused by or resulting from wa- contract or agreement.
ter; or H. INCREASED SUPPLEMENTARY PAYMENTS
c. Explosion of steam boilers, steam pipes,
Stearn anginas, or steam turbines. 1. The following replaces Paragraph 1.b. of ,
SUPPLEMENTARY PAYMENTS ® COVER-
3. The following replaces Paragraph 6. of SED- AGES A AND R of SECTION I — COVER-
TION III_ LIMITS OF INSURANCE AGES:
Subject to 5. above, the Damage To Prem- b, ftp to $2,500 for cost of bail bonds se-
ises Rented To You Limit is the most we will uired because of accidents or traffic law
pay under Coverage A for the sum of all violations arising out of the use of any
damages because of "property damage" to vehicle to which the Bodily Injury Liability
any one premises while rented to you, or Coverage applies. We do not have to fur-
temporarily occupied by you with permission nish these bonds.
15 05 08(Rev. 10-o ) 2008 The Tr velars companies,Inc. Page 3 of
326
page 7 of 21
COMMERCIAL GENERAL LIABILITY
Z The following replaces Paragraph l.d, of performed by or on behalf of such
SUPPLEMENTARY PAYMENTS - COVER- additional insured; or
AGES A AND, B of SECTION I - COVER= (3) Any premises for which coverage is
AE excluded by another endorsement to
d. All reasonable expenses incurred by the this Coverage Part.
insured at our request to assist us in the 3, This Provision 1. does not apply on any basts
investigation or defense of the claim or to any person or, organization for which cov-
"suit", including actual loss of earnings tip erage as an additional insurer] specifically is
to $500 a day because of time off from added by another endorsement to this Cover
work. age Part.
1. ADDITIONAL INSURED - OWNER, MANAGER J. ADDITIONAL INSURED - LESSOR OF LEASED
OR LESSOR OF PREMISES EQUIPMENT
1. The following is added to SECTION 11 -WHO 1. The following is added to SECTION 11 -WHO
IS ANNS
IURED: IS AN INSURED:
Any person or organization that you have Any person or organization that you have
agreed in a "written contract requiring i�nsur-
ance" to include as an additional insured on ante" to iagreed in a 'written contract requiring Insur-
this Coverage Part is an insured, but: include as an additional insured on
this Coverage Part is an insured, but:
a. Only with respect to liability for "bodily in- a. Only with respect to liability for "bodily in
jury" or "property damage" that occurs, or jury" or "property damage" that occurs, or
personal injury' caused by an offense "personal injury" caused by an offense
committed, after you have entered into committed, after you have entered into
that "written contract requiring insurance": that"written contract requiring insurance':
and and
b. Only if the 'bodily injury", "property dam- b. Only if the 'bodily injury', 'property dam-
age" or "personal injury' is caused, in age" or. "personal injury" is caused, in
whole or in part, by acts or omissions of
you or any person or organization per- whale or in part, by acts or ornissions of
you or any person or organization per
operations on your behalf, and
arises out of the ownership, maintenance forming operations on your behalf, in the
or use of that part of any premises leased maintenance, operation or use of equip-
you under that 'written contract requir- rnent leased to You by such additional in-
toing insurance'. sured.
2. The insurance provided to such additional in- 2. The insurance provided to such additional in-
sured under this Provision J, is subject to the
surf under this Provision I. is subject to the
f
following provisions: following provisions*
& The limits of insurance afforded to such a® The limits of insurance afforded to such
additional insured shall be the limits additional insured shall be the limits
"IT
which you agreed to provide in the "writ- which you agreed to provide in the -Writ-
ten contract requiring insurance". or the
ten contract requiring insurance', or the firnits shown in the Declarations for this
limits shown in the Declarations for this Coverage Pail, whichever are less; and
Coverage Pail, whichever are less; and la. The insurance afforded to such additional
b. The insurance afforded to such additional insured does not apply;.
insured does not apply to: (1) To any "bodily injury" or "property
(1) Any 'bodily injury' or 'property dam- damage" y
that occurs,.or 'personal in-
age" that occurs, or "personal injury" jury' caused by an offense commit-
caused by an offense committed, af- ted, after the equipment lease ex-
ter you cease to be a tenant in that
pires; or
premises', (2) If the equipment is leased with an
(2) Any structural alterations, new con- operator,
struction or demolition operations
Page 4 of a2008 The Travelers Companies, Inc, CG D4 15 05 08(Rev.10-081
321
page 8 of 21
COMMERCIAL GENERAL LIABILITY
o This Provision J. does not apply on any basis clod, whichever is earlier. Any such newly ac-
to any person or organization for which cov= Lluired or formed organization that you report
erage as an additional insured specifically is in writing to us within 180 days after you ac-
added by another endorsement to this Cover- quire or form the organization will be covered
age Part. under this provision until the end of the policy
K, ADDITIONAL INSURE - STATE OR POLIT'I- period, even if there are more than 180 days
CAL SUBDIVISIONS -PERMITS RELATING TO remaining until the end of the policy period.
PREMISES N. INJURY TO CO-EMPLOYEES AND CO-
The following is added to SECTION It -WHO IS VOLUNTEER WORKERS
Aid INSURED- The following is added to SECTION ll - WHO I
Any state or political subdivision that has issued,a AN INSURED.
permit in connection with premises owned or oc- 1. Your "employees" are insureds with respect
cupied by, or rented or loaned to, you, is an in- to "bodily injury" to a co-"ernployee" in the
sured, but only with respect to "bodily injury", course of the co-"employee's" employment by
"property damage" „personal injury" or "adverbs- you, or to your "volunteer workers" while per-
ing injury" arising out of the existence, ownership, forming duties related to the conduct of your
use, maintenances repair, construction, erection business, provided that this coverage for your
or removal of advertising signs, awnings, cano- "employees" does not apply to acts outside
piers, cellar entrances, coal holes., driveways, the scope of their employment by you or while
manholes, marquees, hoist away openings, side- performing duties unrelated to the conduct of
walk vaults, elevators, street banners or decora- your business.
tions for which that state or political subdivision , Your "VOILintper° workers" are insureds with
has issued such permit. respect to "bodily injury" to a co-"volunteer
L, ADDITIONAL I SURED - STATE OR P LITI- worker" while performing duties related to the
CAL SUBDIVISIONS-PERMITS RELATING TO conduct of your business, or to your "employ-
OPERATIONS ees" in the course of the "employee's' em-
The following is added to SECTION 11 - WHO IS ployment by you, provided that this coverage
Ah! ILI I E : for your. "volunteer workers" does not apply
while performing duties unrelated to the cones
Any state or political subdivision that has issued a duct of your business.
pert-nit is an insured, but only with respect to"boi
ify injury', ""property damage', '"personal injury" or subparagraphs Fa.(1j(aj, �bj and i(c) and.
°advertising injury" arising out of operations per- •a" of SECTIO It - WHO IS AN INSURE
formed by you or on your behalf for which that do not apply to "bodily{ injury" for which insure
.state or political subdivision has issued such ante is provided by paragraph 1. or 2. above,
permit. However, no such state or political subdi- 0. MEDICAL PAYMENTS LIMIT
vision is an insured for: The following replaces paragraph 7. of SECTION
1. "Bodily injury," "property damage", "personal III -LIMITS F INSURANCE:
injury" or "advertising injury" arising out of rap- Subject to 5. above, the Medical Expense Limit is
erations performed for that stale or political the most we will pay under Coverage E for all
subdivision; or medical expenses because of "bodily injury" sus-
2. 'Bodily injury" or "property damage" included twined by any one person, and will be the higher
within the "products - completed operations of:
hazard", a. 10.000: or
WHO IS AN INSURE - NEWLY ACQUIRED b. The amount shown on the Declarations
OR FORMED R A I ATI N for Medical Expense Limit,
The following replaces Paragraph 4.a, of REE® P. KNOWLEDGE AND NOTICE OF UR-
TIT 11 -WHO IS AN INSURED: REN E OR OFFENSE
a. Coverage Linder this provision is afforded only The following is added to Paragraph 2, Duties In
until the 180th day after you acquire or form The Event of Occurrence, Offense, Claim �r
the organization or the end of the policy pe-
CG D4
1 (Rev.Ira-ram) ria 20OB The Travelers Com pan ies.Inc, Page 5 of
Ttt
page 9 of 21
COMMERCIAL GENERAL LIABILITY
Suit of SECTION IV — COMMERCIAL GENERAL ante" by the method described in c.
LIABILITY CONDITIONS: below.
Notice of an "occurrence" or of an offense which b. Excess Insurance
may result in a claim must be given as soon as This insurance is excess over any of
practicable after knowledge of the "occurrence' or the "other insurance', whether pri-
offense has been reported to you, one of your teary, excess, contingent or on any
"executive officers" (if you are a corporation), one other basis:
of your partners who is an individual (if you are a (1) That is Fire, Extended Coverage,
partnership), one of your managers (if you are a Builder's Risk, Installation Risk,
limited liability company), one of your trustees or similar coverage for "your
who is an individual (if you are a trust), or art work":
"employee" (such as an insurance, loss control or (2) That is Fire insurance for prern-
risk manager or administrator) designated by you
to give such notice. ises rented to you or temporarily
occupied by you with permission
Knowledge by any other "employee"' of an 'OCCLir- of the owner;
rence" or offense does not imply that you also (3) That is insurance purchased by
have such knowledge. you to cover your liability as a
Notice of an "occurrence," or of an offense whrrh tenant for 'property damage" to
may result in a claim will be deemed to be given premises rented to you or tempo-
as soon as practicable to LIS 0 it is given in good rarity occupied by you with pert
faith as soon as practicable to your workers' corn- mission of the owner: or
pensation, accident, or health insurer. This ap- (4) R the loss arises out of the mains
plies only if you subsequently give notice of the tenance or use of aircraft,
"occurrence"" or offense to us as soon as practi- "autos", or watercraft to the ex-
cable after you, one of your "executive officers" (if tent not subject to Exclusion g. of
you are a corporation), one of your partners wt Section I — Coverage A — Bodily
is an individual (if you are a partnership), one of Injury And Property Damage Li-
your managers (if you are a limited liability com- ability-, or
pany), one of your trustees who is an individual (if (5) That is available to the insured
you are a trust), or an "employee" (such as an in- when the insured is an additional
surance, loss control or risk manager or adminis- insured under any other policy,
trator) designated by you to give such notice or,%- including any umbrella or excess
covers that the "occurrenceld or offense may in- policy.
Verve this policy. When this insurance is excess, we
Q® OTHER INSURANCE CONDITION will have no duty under Coverages A
1. The following replaces Paragraph 4., Other or B to defend the insured against
Insurance of SECTION IV — COMMERCIAL any 'suit" if any provider of "other in-
GENERAL LIABILITY' CCN DITIONS: surance" has a duty to defend the in-
sured against that "suit". If no pro-
4, Other Insurance eider of, "other insurance" defends,
It valid and collectible 'other insurance' is we will undertake to do so, but we will
available to the insured for a loss we he entitled to the insured's rights
cover under Coverages A or B of this against all those providers of "other
Coverage Part, our obligations are limited insurance".
as follows: When this insurance is excess over
a. Primary Insurance other insurance", we will pay only
This insurance is primary except our share of the amount of the loss, if
when b. below applies. If this insur- any, that exceeds the sum of:
ante is primary, our obligations are (1) The total amount that all such
not affected unless any of the 'other "other insurance" would pay for
insurance" is also primary. Then, we the loss in the absence of this in-
will sharp with all that "other insur- surance; and
Page 6 of 8 0'24o8 The Travelers Companies, Inc C! D4 15 05 0:8(Rev 1 o.w
329
page 10 of 21'
N1
COMMERCIAL GENERAL LIABILITY
( ) The total of all deductible and Insurance shown on the Declarations of
self-insured amounts under that this Coverage Pay.
"other insurance". A. UNINTENTIONAL OMISSION
We will share the remaining loss, if 1. The following i added to Paragraph . Rep-
any,
with any "other insurance" that is resentatioans of SECTION I — OM MER-
not described in this Excess Insur- IAL GENERAL LIABILITY CONDITIONS:
ance provision.
c. Method Of Sharing The unintentional omission at. or uninten-
tional error in, any information provided by
If all of the "other insurance" permits you which we relied upon in issuing this policy
contribution by equal shares, we will shall not prejudice your rights ander this inn
follow this method also. Under this surance.
approach each provider of insurance
contributes equal amounts until it has 1 This Provision R. doses not affect our right to
paid its applicable limit of insurance collect additional premium or to exercise our
or none of the loss remains, which- right of cancellation or nonrenewal in accor_
ever Corn es first. dance with applicable insurance laws or regu-
If any of the "other insurance" does latioa s.
not permit contribution by equal S. WAIVER ER F TRANSFER OF RIGHT F RE-
shares, we will contribute by limits. COVERY AGAINST OTHERS TO US WHEN
Linder this method, the share of each REQUIRED BY CONTRACT
provider of insurance is torsed on the The following is added to Paragraph 8. Transfer
ratio of its applicable limit of insur- of Rights of Recovery Against Others to Us of
ance to the total applicable limits of RECTION IV COMMERCIAL GENERAL LI-
insurance of all providers of insur- ABILITYCONDITIONS:
ante.
.. The following definition is added to SECTION We waive any rights of recovery we may have
W" 6 DEFINITIONS:: against any person or organization because of
payments. we make for "bodily injury" ""property
"Other insurance': damage", "personal injury' or 'advertising injury"
a. Means insurance.. or the funding of arising out of:
losses, that is provided by, through or ori
behalf of: 1. Premises owned by you, temporarily caccu-
pied by you with permission of the owner, or
(1) Another insurance company; leased or rented to you;
( ) Us or any of our affiliated insurance 2, Ongoing operations performed by you, or on
companies., except when the plan your behalf, under a contract or agreement
cumulation of Each Occurrence Limit with that person or organization;
section of Paragraph 5. of LIMITS OF
INSURANCE (Section III) or the Nora Your work"; or
curnulation of Personal and Adverfis- 4, "Your products".
ing Injury lini t sections of Paragraph e waive these rights only where you have
. of LIMITS OF INSURANCE (Sec- agreed to do so as part of a "written contract re-
tion III) applies;
quiring insurance" entered into by you before, and
( ) Any risk, retention group; in effect when, the "bodily injury" or "property
( ) Any self-insurance method or pro,- damage" occurs, or the "personal injury" offense
gram, other than any funded by you or "advertising injury"offense is committed.
and over which this Coverage Part T. ,AMENDED BODILY INJURY DEFINITION
applies; or
The following replaces the definition of "bodily
(5) Any similar risk transfer or risk man- injury" in the DEFINITION n:
Sectio
agement method. I �,"
Does not include umbrella insurance.. or "Bodily injury"' means bodily injury., mental an-
b.
insurance, that you bought spe- uisl�, meatal injury, shock, fright, disability, hu-
cifically to apply in excess of the Limits of miliation, sicker s or disease sustained by a per
CG i
D4 15 05 08(Rev. 10-0 8) 2208 The Travefers Companies,Inc. Page 7 of
330
i
page 11 of 21
COMMERCIAL ERAL LIABILITY
son, including death resulting Prom any of these at "Written contract requiring insurance" means that
any time. part of any written contract or mitten agreement
U, AMENDED INSURED CONTRACT DEFINITION under which you are required to include a person
RAILROAD T or organization as an additional insured on this
Coverage Part, provided that the "bodily injury`"
7. subparagraph . of the definition of "insuredarrd "property damage" occur, and the '"personal
placconted
b in the DEFINITIONS I 1� Section i re- injury" i caused by an offense committed:
placed by the following:
Any easement or license agreement:
Atter the signing and execration of the contract
or agreement by you;
. Subparagraph f,(1) of the definition of "in- b, While that part of the contract or agreement i
cured contract" in the DEFINITIONS Section in effect; and
is deleted.
, ADDITIONAL DEFINITION— WRITTEN CON. c. Before the end of the pohicy period.
TRACT REQUIRING INSURANCE
The following definition is add=ed to the DEFINI-
TIONS Section:
Page 8 of 8 9 2008 The TraveIers Companies,Inc 15 05 08(Rev.1G-08)
31
page 12 of 21
mi
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - WRITTEN
CONTRACTS (ARCHITECTS, ENGINEERS AND
This endorsement modifies Insurance provided rancher the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1. The following is added to SECTION ll — WHO IS plies only to such "bodily injury" or "property
AIS INSURED: damage" that occurs before the end of the pe-
Any person or organizatOn that you agree in a riod of time for which the "written contract re-
"written contract requiring insurance" to include as quiring insurance" requires you to provide
an additional insured can this Coverage Part, first: such coverage or the end of the policy period,:
whichever is earlier.
& Only with respect to liability for "bodily injury".
"property damage' or "personal Injury", and . The following is added to Paragraph Ona, of SEC-
TION I COMMERCIAL GENERAL LIABILITY
b. 11, and only to the extent that, the injury or CONDITIONS:
damage is caused by acts or omissions of
you or your subcontractor in the performance The insurance provided to the additional insured
of "your work" to which the "written contract is excess over any valid and collectible "other in-
requiring insurance' applies. The person or surance", whether primary, excess, contingent or
organization does not qualify as an additional on any other basis, that is available to the addL
insured with respect to the independent acts tlonal insured for a joss we cover, However, if you
or omissions of such person or organization. specifically agree in the "written contract requiring
insurance" that this insurance provided to the ad-
The insurance provided to such additional insured ditional insured under this Coverage Part must
is limited as follows: apply on a primary basis or a primary arra non-
e, In the event that the Limits of Insurance of contributory basis, this insurance is primary to
this Coverage Fart -shown in the Declarations "other insurance" available to the additional in-
exceed the limits of liability required by the sured which covers that person or organization as
"written contract requiring insurance", the in. a named insured for such loss, and we will not
surance provided to the additional insured share with that "other insurance But this instar-
shall be limited to the limits of liability required ince provided to the additional insured ;Mill is ex
by that "written contract requiring insurance'. cess over any valid and collectible "other insur-
This endorsement shall not increase the limits ance"' whether, primary, excess, contingent or can
of insurance described in Section III — Limits any other basis; that is available to the additional
Of Insurance. insured when that person or organization is an
d. This insurance does not apply to the render- additional insured under any "other insurance
ing of or failure to render any "professional 3, The following is added to SECTION 1 — OM-
servioes" or construction management errors M R IAL GENERAL LIABILITY CONDITION&
or omissions. Duties Of An Additional Insured
e. This insurance does not apply to "bodily in- As a condition of coverage providedto the ad&
jury" or "properly damage" caused by "your tional insured:
work" and included in the "products- a.
completed operations hazard" unless the
The additional insured merit give us written
written contract requiring insurance" sprfi-
notice as soon as practicable of an "occur_
cally requires you to provide such coverage rence" or an offense which may result in
for that additional insured, and then the insr.rr- claim. To the extent possible, such notice
ante provided to the additional insured ap- should include:
CG 4 14 04 08 0 2008 etre Travelers Companies, Inc. Page t of
I
3 32
I
page 13 of 21
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
ii. The nares and addresses of any injured cover. However, this condition does not affect
persons and witnesses: and w ethei this insurance provided to the d i-
iii. The nature and location of any injury or tional rostered is primary to that other incur-
damage arising out of the "occurrence" or ante available to the additional insured which.
offense. covers that person or organization as a
named insured.
b, df a claire is made or `,suit' is brought against
the additional insured, the additional insured 4• The following is added to the DEFINITIONS Sec-
must: tion:
L Immediately record the specifics of the "'written contract requiring insurance" means that
claim or "snit" and the date received, and part of any written contract or agreement under
ii.. C otity us as soon as practicable. which you are required to include a person or or-
ganization as an additional insured on this over-
The additional insured must see to it that we age pad,, provided that the "bodily injury' and
receive writfen notice of the claim or "suit" as "property damage" occurs and the "personal in-
soon as practicable. jury" is caused by an offense committed;
c.. The additional insured must immediately send a. after the signing and execution of the contract
tis copies of all legal papers received in con, or agreement by you;
nection with the claim Or „suit", cooperate with b, While that part of the contract or agreement i
us in the investigation or settlement of the
claim or defense against the "suit", and oth-
erwise comply with all policy conditions, c. Before the end of the policy period.
d. The additional insured must tender the dee
fense and indemnity of any claim or 'suit' to
Page 2 of 2 0 2708 The Travelers Companies, inc. CG D4 94 04 0
331
page 14 of 21
McKim and creed Inc
6302GO91871C
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
OTHER INSURANCE - ADDITIONAL INSUREDS
This endorsement modifies insurance provided tinder rho following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS b. The"personal injury"or"advertising injury"for
COMMERCIAL GENERAL LIABILITY CONDITIONS which coverage is sought arises out of an of-
(Section IV), Paragraph 4. (Other Insurance), is fense committed
amended as follows'. subsequent to the signing and execution of that
1. The following is added to Paragraph a. Primary contract or agreement by you.
Insurance: 2. The first Subparagraph (2): of Paragraph b. Ex-
However, if you specifically agree in a written con- cess Insurance regarding any other primary in-
tract or written agreement that the insurance pro- surance available to you is clelete<J,
vided to an additional insured tinder this 3. The following is added to Paragraph b. Excess
Coverage Part must apply on a primary basis, or Insurance, as an additional subparagraph Linder
a primary and non-contributory basis, this insur. Subparagraph (1):
ance is primary to other insurance that is avaik That is available to the insured when the insured
able to such additional insured which covers such is added as an additional insured under any other
additional insured as a named insured, and we policy,including any umbrella or excess policy.
will not share with that other insurance, provided
that:
a. The "bindily injury" or "property damage" for
which coverage is sought occurs; and
CG DO 37 04 05 Copyright 2005 The St. Paul Travelers Companies, Inc.All rights reserved. Page I of 1
334
E, page 15 of 21
This page has been left blank nitentional ly
33b
El page 16 of 21
COMMERCIAL AUTO
THIS ENDORSEMENT GEST POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - PRIMARY AND
NON-CONTRIBUTORY WITH OTHER INSURANCE
This endorsernent modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
PROVISIONS 2. The following is added to Paragraph B.5,, Other
1 The following is Added to Paragraph A.I.c., Who Insurance of SECTION IV — BUSINESS AUTO
Is An Insured, of SECTION 11 — COVERED CONDITIONS:
AUTOS LIABILITY COVERAGE! Regardless of the provisions of paragraph a. and
Any person or organization who is required under paragraph d. of this part 5.Other insurance,this
A written contract or agreement between you And insurance is primary to And non-contributory with
that person or organization. that is signed and applicable other insuranCo Linder which an addi-
executed by you before the "bodily injury" or tional insured person or organization is the first
"property damage" occurs and that is in effect named insured when the whiten contract or
during the policy period, to be named as an addi- agreement between you and that person or or-
tional insured is an "insured" for Covered Autos ganization, that is signed and executed by you
Liability Coverage,but only for damages to which before the "bodily injury"' or "property damage"
this insurance applies and only to the extent that
person or organization qualifies as an "insured" occurs and that is in effect during the policy pe-
hod, requires this insurance to be primary and
tinder the Who Is An Insured provision contained
in SECTION 11. non-contributory.
CA T4 74 02 15 @ 2015'rhe Travelers Indemnity Corripa)y Ali right,reserved. Page 1 of 1
VIC!Udeq copynghled rnarsriai of Insurance servicas(Yflrer Inu Min iro permission
M. page 17 of 21
This page has been left bank iritentionally.
3,11
6_1 page 18 of 21
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
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 the 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 an-
dorsement and the rest at your policy carefully to determine rights,duties,and what is and is not covered.
& BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE— LOSS OF
B. BLANKET ADDITIONAL INSURED USE—INCREASED LIMIT
C. EMPLOYEE HIRED AUTO 1, PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES—INCREASED LIMIT
D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY
E. SUPPLEMENTARY PAYMENTS— INCREASED K, AIRBAGS
LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
F. HIRED AUTO — LIMITED WORLDWIDE COV- LOSS
ERAGE—INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION
GWAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS
PROVISIONS
A. BROAD FORM NAMED INSURED this insurance applies and only to the extent that
The following is added to Paragraph A.1,,Who Is person or organ!7alion qualifies as an "insured"
An Insured,of SECTION It—COVERED AUTOS tinder the Who Is An Insured provision contained
LIABILITY COVERAGE: in Section 11,
Any organization you newly acquire or form dur- C° EMPLOYEE HIRED AUTO
in the policy period over which you maintain t. The faflowing is added to Paragraph A.I.,
50% or more ownership interest and that is not Who Is An Insured, of SECTION 11 — COV-
separately insured for Business Auto Coverage. ERED AUTOS LIABILITY COVERAGE:
Coverage under this provision is afforded only un- An "employee" of yours is an "insured" while
fit the 180th day after yoga acquire or form the or- operating an "auto" hired or rented under a
ganization or the end of the policy period, which contract or agreement in an "employee's'
ever is earlier. name, with your permission, while perfon-ning
duties related to the conduct of your bust-
Bi BLANKET ADDITIONAL INSURED cess.
The following is added to Paragraph c. in A.1 2. The following replaces Paragraph b. in B.S.,
Who Is An Insured, of SECTION 11 —COVERED Other Insurance, of SECTION IV — BUSI-
AUTOS LIABILITY COVERAGE: NESS AUTO CONDITION&
Any person or organization who is required under b. For Hired Auto Physical Damage Cover-
a written contract or agreement between you and age, the following are deemed to be cov-
that person or organization, that is signed and ered"autos"you own:
executed by you before the "bodily injury" or (1) Any covered "auto" you lease, hire,
.property damage" occurs and that is in affect rent or borrow:and
during the policy period, to be named as an addi- (2): Any covered "auto' hired or rented by
tional insured is an 'Insured" for Covered Autos your "employee" tinder a contract in
Liability Coverage, but only for damages to which nn "employee's" name, with your
CA T3 53 02 15 (612asl i The Travelers indemnity Compaq.All rights reserved. Page 1 of 4
ITICILKIB5 copy0ghted materia of Insuranom RarVicps office.Inc w0h its permission
338
page 19 of 21
COMMERCIAL AUTO
Permission, while performing duties (a) With respect to any claim made or "suit"
related to the conduct of your bust- brought outside the United States of
ness. America, the territories and possessions
However, any "auto" that is leased, hired, of the United States of America. Puerto
rented or borrowed with a driver is not a Rico and Canada:
covered "auto". (I) You must arrange to defend the "In=
D, EMPLOYEES AS INSURED sured`against,and investigate orset-
tie any such claire or'suit" and keep
The following is added to Paragraph A.I., Who Is us advised of all proceedings and ac-
An Insured,of SECTION II—COVERED AUTOS tions.
LIABILITY COVERAGE:
Any"employee"of yours is an "Insured"while us-
(II) Neither you nor any other involved
"insured" will make any settlement
in a covered "auto"you don't own,hire or borrow without our consent.
in your business or your personal affairs, (Hi) We may, at our discretion, participate
E. SUPPLEMENTARY PAYMENTS— INCREASED in defending the "insur'ld" against, or
LIMITS in the settlement of, any claim or
1i The following replaces, Paragraph A2.a.(2), suit",
of SECTION 11—COVERED AUTOS LIABIL- (N) We will reimburse the "insured" for
ITY COVERAGE: sums that the "insured" legally must
(2) Up to $3,000 for cost of Wait bonds (in- pay as damages because of "bodily
eluding bonds for related traffic law viola- injury"or"property damage" to which
tions) required because of An "accident" this insurance applies, that the "in-
we cover, We do not have to furnish cured"" pays with our consent, but
these bonds. only up to the limit described in Para-
2. The following replaces Paragraph A2,a,(4), graph C., Limits Of Insurance, of
of SECTION It—COVERED AUTOS LIABIL- SECTION Il — COVERED AUTOS
ITY COVERAGE: LIABILITY COVERAGE.
(4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for
"insured" at our request, including actual the reasonable expenses incurred
loss of earnings up to $500 a day be- with our consent for your investiga-
cause of time off from work, tion of such claims and your defense
of the "insured" against any such
F. HIRED AUTO — LIMITED WORLDWIDE COV- sun', but only up to and included
ERAGE—INDEMNITY BASIS within the limit described in Para-
The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of
graph B.7.,, Policy Period, Coverage Territory, SECTION 11 — COVERED AUTOS
of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in
TIONS: addition to such limit. Our duty to
($) Anywhere in the world, except any country or make such payments ends when we
jurisdiction while any trade sanction, em- have used up the applicable limit of
baro, or similar regulation imposed by the Insurance in payments for damages,
United States of America applies to and pro- settlements or defense expenses.
hibits the transaction of business with or (b) This insurance is excess over any valid
within such country or jurisdiction. for Cov- and collectible other insurance available
erect Autos Liability Coverage for any covered to the "insured" whether primary, excess,
"auto" that you lease, hire, rent or borrow contingent or on any other basis.
without a driver for a period of 30 days or less (c) This insurance is not a :substitute for re-
and that is not an "auto" YOU lease, hire, rent quired or compulsory insurance in any
or borrow from Any of your "employees', country outside the United States, its ter-
partners (if you are a partnership), members ritories and possessions, Puerto Rico and
(if you are a limited liability company) or Canada,
members of their households,
Page 2 of 4 0 2016 The Travears Imernnity Compmy.All rtghls reserved. CA T3 53 02 15
Includes oopyrighted rnweriar of Insorance Services Office.Inc.with its purryowon.
3,0
page 20 of 21
COMMERCIAL AUTO
You agree to maintain all required or (2) In or on your covered "auto".
compulsory insurance in any such coun- This coverage applies only in the event of a total
try up to the minimum limits required by theft of your covered"auto".
local law. Your Failure to comply with No deductibles apply to this Personal Property
compulsory insurance requirements will coverage,
not invalidate the coverage afforded by
this policy, but we will only be liable to the K. AIRBAGS
same extent we would have been liable The following is added to Paragraph B.3, Exclu-
had you complied with the compulsory In- dons. of SECTION III — PHYSICAL DAMAGE
SUrnnce requirements. COVERAGE:
(d) it is understood that WE., are not an admit- Exclusion 3.a. does not apply to "loss" to one or
ted or authorized insurer outside the more airbags in a covered "auto" you own that in-
United States of America, its territories Hate due to a cause other than a catj%, of "loss"
and possessions, Puerto Rico and Can- set forth in Paragraphs A.I.b. and A.l.c., but
ada. We assume no responsibility for the only:
furnishing of certificates of insurance, or a. If that "auto" is a covered "auto" for Compre-
for compliance in any way with the laws hensive Coverage under this policy;
of other countries relating to insurance, b. The airbags are not covered under any war-
G, WAIVER OF DEDUCTIBLE—GLASS ranty:and
The following is added to Paragraph D., Deducti- c. The airbags were not intentionally inflated.
ble, of SECTION III — PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any
COVERAGE: one "loss".
No deductible for a covered "auto" will apply to La NOTICE AND KNOWLEDGE OF ACCIDENT OR
glass damage if the glass is repaired rather than LOSS
replaced, The following is added to Paragraph A2.a., of
W HIRED AUTO PHYSICAL DAMAGE—LOSS OF SECTION IV—BUSINESS AUTO CONDITIONS:
USE—INCREASED LIMIT Your duty 10 give US,or our authorized representa-
The following replaces the last sentence of Para- tive prompt notice of the "accident" or "loss" ap-
graph A.4.b., Loss Of Use Expenses, of SEC- plies only when the "accident" or "loss" is known
TION III—PHYSICAL DAMAGE COVERAGE, to:
However, the most we will pay for any expenses (a) You (if you are an individual);
for loss of use is $65 per day, to a maximum of (b) A partner(if you are a partnership);
750 For any one"accident", (c) A member (if you are a limited Iiabifity, coria-
L PHYSICAL DAMAGE — TRANSPORTATION pany);
EXPENSES—INCREASED LIMIT (d) An executive officer, director or insurance
The following replaces the first sentence in Para- manager(if you are a corporation or other or-
graph AA.a., Transportation Expenses, of ganization) or
SECTION III — PHYSICAL DAMAGE COVER- (e) Any "employee'"authorized, by you to give no-
AGE: lice of the"accident"or"loss".
We will pay up to $50 per day to a mAxImurn of M. BLANKET WAIVER OF SUBROGATION
$1,500 for temporary transportation expense in- The following replace,; Paragraph A.5., Transfer
curred by you because of the total theft of a cov- Of Rights Of Recovery Against Others To Us,
ered"auto"of the private passenger type. of SECTION IV — BUSINESS AUTO CONDI-
J, PERSONAL PROPERTY TIONS:
The following is added to Paragraph A.4., Cover- 5. Transfer Of Rights Of Recovery Against
age Extensions, of SECTION III — PHYSICAL Others To Us
DAMAGE COVERAGE: We waive any right of recovery we may have
Personal Property against any person or organization to the ex-
tent required of you by a written contract
We will pay up to $400 for "'loss" to wearing ap- signed and executed prior to any "accident'
parel and other personal property which is: or'loss", provided that the "accident"or"loss"
(1) Owned by an"insured" and arises out of operations contemplated by
CA T3 53 02 15 ( 201 S I hr, rravrpjars Iodpmnity CompWy,All rights,4isserved, Page 3 of 4
Incindes copyrghteri rnaier]W of inq�uranra sarvices,office Inc.wtin its Permission
34 0
page 21 of 21
COMMERCIAL ALITO
such contract. The waiver applies only to the The unintentional omission of, or unintentional
person or organization designated in such error in, any information given by you shalt not
contract. prejudice your rights Under this insurance, How-
N. UNINTENTIONAL ERRORS OR OMISSIONS ever this,provision does not affect Our right to col-
'The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of
ceallment, Misrepresentation, Or Fraud, of cancellation or non-renewal,
SECTION IV—BUSINESS AUTO CONDITIONS:
Page 4 of 4 01 2015 The Travelers Inaemnity Cornpa'ty,All nghis reserved, CA T3 53 02 15
Includes copyrighted material of Ill Servlcf,3s,office,Inc.witi rs.perrnls%lon.
.` 12019page2 of 3
Client#:292011 '35MCKIMCRB
ACORD. CERTIFICATE OF LIABILITY- INS.URAbE oATE(MMlDDIYYYY)
9/04/2019
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:It the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on
this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
McGriff-Insurance Services NAME:
HaNE
2108 W.Laburnum Ave Suite 300 A>C.No EMI:804 359-0044 arc,No: 8887513010
ADDARESS: certifleatesvawv@mcgrifflnsurance.com
Richmond,
Box 17370 INSURER(S)AFFORDING COVERAGE NAIL#
Richmond,VA 23227 INSURER A:XL Specialty Insurance Company 37885
INSURED
McKim&Creed Inc. INSURERS:
1730 Varsity.Drive#500 INSURERC:
-Raleigh,NC 27606 INSURER D:
INSURER E:
INSURER F.
COVERAGES CERTIFICATE NUMBER: REVISION NUMBEH:_
—THIS-IS-TO CERTIFY TFFAT-TH5-POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED.NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUEO 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.
LTAR TYPE OF INSURANCE !NSR 1 p POLICY NUMBER POLICY
CfYEF POLICYEXPLIMITS
COMMERCIAL GENERAL LIABILITY pUEAAACHgqOCCCTURpARENCE S
CLAIMS-MADE D OCCUR PREMISOSOEaEoNccurraise S
MED EXP(Any one person) S
PERSONAL&ADV INJJRY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S
POLICY
PROJECT- LOC PRODUCTS-COMPIOPAGG S
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea accident
ANY AUTO BODILY INJURY(Per person) S
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY(Per aecidenQ S
HIRED NON-OWNED PROPERTY DAMAGE $
AVTOSONLY AUTOS ONLY Peraccident
5
UMBRELLA'LUIBOCCUR EACH OCCURRENCE S
EXCESS LIAR CLAIMS-MADE AGGREGATE S
DED I i RETENTIONS 1 S
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILnY
ANY PROPRIETORIPARTNERMXECUTIVE
OFFICERIMEMBEREXCLUDED? �Y I N NIA EL.EACH ACCIDENT S
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $
!f es.describounder
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
A Professional DPR9948365 9/05/2019 89/05/202 '$5;000,000 Per Claim-- - --
Liability $7;008,000 Aggregate — -
$500K1$1 M Deductibles
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,AddlUonal Remarks Schedule,may be attached If more space Is required)
In the event the Company cancels this policy for any reason other than non-payment of premium,thirty(30)
days notice of cancellation will be provided when agreed In written contract or agreement
CERTIFICATE HOLDER CANCELLATION
City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Engineering,RFO#26.19 ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 4748
Clearwater, FL 33759-4748 AUTHORIZED REP RESENTATIVE
O 1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016109) 1 of 1 The ACORD name and logo are registered marks of ACORD
,1846 #S242677261M24267205 TLS