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HomeMy WebLinkAboutCAG2021-115 - Insurance Certificate - YMCA - Liability Coverage - 06/01/2021 A CERTIFICATE OF LIABILITY INSURANCE DATE 05/275/27//2021 Y) 2021 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 NAME: Parker,Smith&Feek, Inc. PHONE 425-709-3600 FAX 425-709-7460 2233 112th Avenue NE A/c Ext: AIC No E-MAIL Bellevue,WA 98004 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Great American Insurance Company INSURED INSURER B: YMCA of Greater Seattle 909 4th Avenue INSURER C: Seattle,WA 98104 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 ADDL SUBR POLICY EFF POLICY EXP R LIMITS LTR IN WVD POLICY NUMBER MM/DD/YYYY MM/DD A GENERAL LIABILITY PAC313246702 06/01/2021 06/01/2022 EACH OCCURRENCE $ 1,000,000 >< COMMERCIAL GENERAL LIABILITY General Liability DAMAGE ( RENTED 1,000,000 X X PREMISESS Ea occurrence $ CLAIMS-MADE F)7c OCCUR MED EXP(Any one person) $ 20,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,000 POLICY PR F)7C LOC $ CMINED A AUTOMOBILE LIABILITY CAP313246802 06/01/2021 06/01/2022 EaaccidentSINGLELIMIT 1,000,000 K ANY AUTO Auto BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident A UMBRELLA LIAB OCCUR UMB313246902 06/01/2021 06/01/2022 EACH OCCURRENCE $ 4,000,000 )C EXCESS LIAB CLAIMS-MADE Umbrella AGGREGATE $ 4,000,000 DIED X RETENTION$ NIL $ A WORKERS COMPENSATION PAC313246702 WC LIMITS X T WA Stop Gap Y/N AND EMPLOYERS'LIABILITY 06/01/2021 06/01/2022 ANY PROPRIETOR/PARTNER/EXECUTIVE WA Stop Gap E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A **WA Stop Gap (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) All Operations.City of Kent is an additional insured and coverage is primary and non-contributory on the general liability policy per the attached endorsements/forms.Waiver of subrogation applies on the general liability policy per attached endorsements/forms.$25,000 GL BI/PD Deductible. Notice of Cancellation applies per the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn:Parks, Recreation and Community ACCORDANCE WITH THE POLICY PROVISIONS. Services Director 220 Fourth Ave S AUTHORIZED REPRESENTATIVE Kent,WA 98032 (©1988--2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1 of 8 PAC313246702 indemnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of e.(2) of this endorsement, such payments will not be deemed to be damages for "personal and advertising injury" as described in paragraph e.(2)(c) above and will not reduce the Limits of Insurance. Our obligation to defend an Insured's indemnitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when: 1. we have used up the applicable Limit of Insurance in the payment of judgments or settlements; or 2. the conditions set forth above, or the terms of the agreement described in paragraph 2J. above, are no longer met. S. LIMITED PROPERTY DAMAGE TO PROPERTY OF OTHERS The following is added to paragraph (4) of Exclusion j. Damage To Property of Section I - Coverage A - Bodily Injury And Property Damage Liability: 4. However, this exclusion does not apply to personal property of others while in the temporary care, custody or control of an insured. For the purpose of this coverage extension, loss shall mean damage or destruction but does not include mysterious disappearance or loss of use. In the event of a theft, a police report must be filed. This supplementary payment does not apply if: a. Coverage is otherwise provided by the Property Coverage Part (if any) of this Policy; or b. The loss is covered by any other insurance you have or by any insurance of such person who causes such loss. We will pay up to $5,000 for loss under this coverage extension. These payments will not reduce the Limits of Insurance. T. ADDITIONAL INSURED - ATHLETIC ACTIVITY PARTICIPANTS 1. Section II - Who Is An Insured is amended to include as an additional insured any person representing you while participating in amateur athletic activities that you sponsor. The insurance provided by this provision does not apply to: (a) "Bodily injury" to: (1) another participant, your "volunteer worker" or your "employee"; or (ii) you, or any partner or member, (if you are a partnership or joint venture), or any member (if you are a limited liability company); or (b) "Property damage" to property; (1) owned, occupied or used by; CG 91 23 (Ed. 05/18) (Page 9 of 16) PAC313246702 (ii) rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by: any of your "employees", "volunteer workers", or any partner or member, (if you are a partnership or joint venture), or any member (if you are a limited liability company). U. ADDITIONAL INSURED - MANAGER OR LESSOR OF PREMISES 1. Section II - Who Is An Insured is amended to include as an additional insured any person or organization from whom you lease or rent property and which requires you to add such person or organization as an Additional Insured on this Policy under: (a) a written contract; or (b) an oral agreement or contract where a Certificate of Insurance showing that person or organization as an Additional Insured has been issued; but the written or oral contract or agreement must be an "insured contract", and: (1) currently in effect or become effective during the term of this Policy; and (II) executed prior to the "bodily injury", "property damage", "personal and advertising injury". 2. With respect to the insurance afforded to the additional insured identified in paragraph 1.above, the following additional provisions apply: (a) This insurance applies only with respect to the liability arising out of the ownership, maintenance or use of that part of the premises leased to you. (b) The Limits of Insurance applicable to the additional insured are the lesser of those specified in the written contract or agreement or in the Declarations for this Policy and subject to all the terms, conditions and exclusions for this Policy. The Limits of Insurance applicable to the additional insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. (c) In no event shall the coverages or Limits of Insurance in this Coverage Form be increased by such contract. (d) Coverage provided herein is excess over any other valid and collectible insurance available to the additional insured whether the other insurance is primary, excess, contingent or on any other basis unless a written contractual arrangement specifically requires this insurance to be primary. (e) This insurance applies only to the extent permitted by law. 3. This insurance does not apply to: (a) Any "occurrence" or offense which takes place after you cease to be a tenant in that premises. (b) Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured. CG 91 23 (Ed. 05118) (Page 10 of 16) PAC313246702 V. ADDITIONAL INSURED - FUNDING SOURCES 1. Section II - Who Is An Insured is amended to include as an additional insured any Funding Source which requires you in a written contract to name the Funding Source as an additional insured but only with respect to liability arising out of: a. your premises; or b. "your work" for such additional insured; or c. acts or omissions of such additional insured in connection with the general supervision of .'your work" and only to the extent set forth as follows: a. The Limits of Insurance applicable to the additional insured are the lesser of those specified in the written contract or agreement or in the Declarations for this Policy and subject to all the terms, conditions and exclusions for this Policy. The Limits of Insurance applicable to the additional insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. b. The insurance afforded to the additional insured only applies to the extent permitted by law. c. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. d. In no event shall the coverages or Limits of Insurance in this Coverage Form be increased by such contract. W. ADDITIONAL INSUREDS - BY CONTRACT 1. Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured that are subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the offense resulting in "personal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or b. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or c. The additional insureds financial control of you; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and CG 91 23 (Ed. 05/18) (Page 11 of 16) PAC313246702 2. If coverage provided to the additional insured is required by contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide such additional insured. With respect to paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed for or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to paragraph 1.b. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage" occurs, or prior to when any offense resulting in "personal and advertising injury" is committed. 2. With respect to the insurance provided by this endorsement, the following are added to paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" that occurs prior to your commencing operations at the location where such "bodily injury" or "property damage" occurs. b. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal or advertising injury", involved the rendering of, or failure to render, any professional architectural, engineering or surveying services. c. "Bodily injury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed for or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CG 91 23 (Ed. 05/18) (Page 12 of 16) PAC313246702 (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. d. Any person or organization specifically designated as an additional insured for ongoing operations by a separate additional insured endorsement issued by us and made part of this Policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. X. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this Policy. Condition 4. Other Insurance of Section IV - Commercial General Liability Conditions is amended as follows: As respects any additional insured, this insurance is excess unless: a. the additional insured is a named insured under such other insurance; or b. you have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Y. ADDITIONAL INSUREDS - PROTECTION OF YOUR LIMITS This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this Policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit' under this insurance to us; as soon as practicable; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and CG 91 23 (Ed. 05/18) (Page 13 of 16) PAC313246702 c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit' by the additional insured. Z. BLANKET WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (SUBROGATION) Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Transfer Of Rights Of Recovery Against Others to Us: If required by a written contract or written agreement, we waive any right of recovery we may have against a person or organization because of payment we make for injury or damage arising out of your ongoing operations or "your work" done under a contract for that person or organization and included in the "products-completed operations hazard" provided that the injury or damage occurs subsequent to the execution of the written contract or written agreement. AA. PROPERTY DAMAGE EXTENSION WITH VOLUNTARY PAYMENTS 1. The following is added to paragraph 1. Insuring Agreement of Section I - Coverage A - Bodily Injury And Property Damage Liability: At your request we will pay for "property damage" to property of others caused by your business operations. Such payment will be made without regard to your legal obligation to do so. The "property damage" must occur during the policy period and must take place in the "coverage territory". 2. With respect to the coverage afforded under paragraph 1. above, paragraph 2. Exclusions of Section I - Coverages A - Bodily Injury And Property Damage Liability is amended as follows: Exclusions j.(3), j.(4), j.(5) and j.(6) are deleted. 3. With respect to the coverage afforded under paragraph 1. above, Section III - Limits of Insurance is replaced by the following: 1. Subject to 2. below, the most we will pay for any one incident is $1,000. 2. The most we will pay for the sum of all "property damage" in the policy period is $5,000. This aggregate amount is part of and not in addition to the General Aggregate Limit described in paragraph 2. of Section III - Limits of Insurance. BB. LIMITED FUNGI OR BACTERIA COVERAGE i. The following are added to SECTION III - LIMITS OF INSURANCE: a. Subject to paragraphs 2. and 3. of SECTION III - LIMITS OF INSURANCE, as applicable, a Fungi and Bacteria Liability Aggregate Limit of $30,000 is the most we will pay under Coverage A for all "bodily injury" or "property damage" and Coverage C for Medical Payments arising out of one or more "fungi or bacteria incidents". CG 91 23 (Ed. 05/18) (Page 14 of 16) PAC313246702 CG 24 04 (Ed. 05 09) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Schedule Name of Person or Organization- City of Kent 220 Fourth Ave S Kent, WA 98032 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to paragraph 8. Transfer of Rights of Recovery Against Others to Us of SECTION IV - CONDITIONS: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard." This waiver applies only to the person or organization shown in the Schedule above. Copyright, ISO Properties, Inc., 2008 CG 24 04 (Ed. 05/09) PRO (Page 1 of 1) A� CERTIFICATE OF LIABILITY INSURANCE DAT5/27/2021 Y) 05/27/2021 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 NAME: Parker,Smith&Feek, Inc. PHONE 425-709-3600 FAx 425-709-7460 2233 112th Avenue NE A/c Ext: AIC No E-MAIL Bellevue,WA 98004 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Great American Insurance Company INSURED INSURER B: Nexus Youth and Families c/o YMCA of Greater Seattle INSURER C: 909 4th Avenue INSURER D: Seattle,WA 98104 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN SR WVD POLICY NUMBER MM/DD/YYYY MM/DD A GENERAL LIABILITY PAC313246702 06/01/2021 06/01/2022 EACH OCCURRENCE $ 1,000,000 >< General Liability DAMAGE RENTED COMMERCIAL GENERAL LIABILITY X PREMISESS(Ea occurrence) $ 1,000,000 CLAIMS-MADE F)7c OCCUR MED EXP(Any one person) $ 20,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,000 POLICY PR F)7C LOC $ CMINED A AUTOMOBILE LIABILITY CAP313246802 06/01/2021 06/01/2022 EaaccidentSINGLELIMIT 1,000,000 K ANY AUTO Auto BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ A WORKERS COMPENSATION PAC313246702 WC LIMITS X ER WA Stop Gap Y/N AND EMPLOYERS'LIABILITY 06/01/2021 06/01/2022 ANY PROPRIETOR/PARTNER/EXECUTIVE WA Stop Gap E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A **WA Stop Gap (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Y Social Impact Center City of Kent is an additional insured on the general liability policy per the attached endorsement/form... (See Attached Description) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Clty of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn:Parks, Recreation and Community ACCORDANCE WITH THE POLICY PROVISIONS. Services Director 220 Fourth Ave S AUTHORIZED REPRESENTATIVE Kent,WA 98032 6��_ ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD DESCRIPTIONS (Continued from Page 1 ) Coverage is primary and non-contributory on the general liability policy per the attached endorsement/form. Notice of cancellation for the general liability policy per the attached form. (CA000 PAC313246702 indemnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of e.(2) of this endorsement, such payments will not be deemed to be damages for "personal and advertising injury" as described in paragraph e.(2)(c) above and will not reduce the Limits of Insurance. Our obligation to defend an Insured's indemnitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when: 1. we have used up the applicable Limit of Insurance in the payment of judgments or settlements; or 2. the conditions set forth above, or the terms of the agreement described in paragraph 2J. above, are no longer met. S. LIMITED PROPERTY DAMAGE TO PROPERTY OF OTHERS The following is added to paragraph (4) of Exclusion j. Damage To Property of Section I - Coverage A - Bodily Injury And Property Damage Liability: 4. However, this exclusion does not apply to personal property of others while in the temporary care, custody or control of an insured. For the purpose of this coverage extension, loss shall mean damage or destruction but does not include mysterious disappearance or loss of use. In the event of a theft, a police report must be filed. This supplementary payment does not apply if: a. Coverage is otherwise provided by the Property Coverage Part (if any) of this Policy; or b. The loss is covered by any other insurance you have or by any insurance of such person who causes such loss. We will pay up to $5,000 for loss under this coverage extension. These payments will not reduce the Limits of Insurance. T. ADDITIONAL INSURED - ATHLETIC ACTIVITY PARTICIPANTS 1. Section II - Who Is An Insured is amended to include as an additional insured any person representing you while participating in amateur athletic activities that you sponsor. The insurance provided by this provision does not apply to: (a) "Bodily injury" to: (1) another participant, your "volunteer worker" or your "employee"; or (ii) you, or any partner or member, (if you are a partnership or joint venture), or any member (if you are a limited liability company); or (b) "Property damage" to property; (1) owned, occupied or used by; CG 91 23 (Ed. 05/18) (Page 9 of 16) PAC313246702 (ii) rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by: any of your "employees", "volunteer workers", or any partner or member, (if you are a partnership or joint venture), or any member (if you are a limited liability company). U. ADDITIONAL INSURED - MANAGER OR LESSOR OF PREMISES 1. Section II - Who Is An Insured is amended to include as an additional insured any person or organization from whom you lease or rent property and which requires you to add such person or organization as an Additional Insured on this Policy under: (a) a written contract; or (b) an oral agreement or contract where a Certificate of Insurance showing that person or organization as an Additional Insured has been issued; but the written or oral contract or agreement must be an "insured contract", and: (1) currently in effect or become effective during the term of this Policy; and (II) executed prior to the "bodily injury", "property damage", "personal and advertising injury". 2. With respect to the insurance afforded to the additional insured identified in paragraph 1.above, the following additional provisions apply: (a) This insurance applies only with respect to the liability arising out of the ownership, maintenance or use of that part of the premises leased to you. (b) The Limits of Insurance applicable to the additional insured are the lesser of those specified in the written contract or agreement or in the Declarations for this Policy and subject to all the terms, conditions and exclusions for this Policy. The Limits of Insurance applicable to the additional insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. (c) In no event shall the coverages or Limits of Insurance in this Coverage Form be increased by such contract. (d) Coverage provided herein is excess over any other valid and collectible insurance available to the additional insured whether the other insurance is primary, excess, contingent or on any other basis unless a written contractual arrangement specifically requires this insurance to be primary. (e) This insurance applies only to the extent permitted by law. 3. This insurance does not apply to: (a) Any "occurrence" or offense which takes place after you cease to be a tenant in that premises. (b) Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured. CG 91 23 (Ed. 05118) (Page 10 of 16) PAC313246702 V. ADDITIONAL INSURED - FUNDING SOURCES 1. Section II - Who Is An Insured is amended to include as an additional insured any Funding Source which requires you in a written contract to name the Funding Source as an additional insured but only with respect to liability arising out of: a. your premises; or b. "your work" for such additional insured; or c. acts or omissions of such additional insured in connection with the general supervision of .'your work" and only to the extent set forth as follows: a. The Limits of Insurance applicable to the additional insured are the lesser of those specified in the written contract or agreement or in the Declarations for this Policy and subject to all the terms, conditions and exclusions for this Policy. The Limits of Insurance applicable to the additional insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. b. The insurance afforded to the additional insured only applies to the extent permitted by law. c. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. d. In no event shall the coverages or Limits of Insurance in this Coverage Form be increased by such contract. W. ADDITIONAL INSUREDS - BY CONTRACT 1. Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured that are subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the offense resulting in "personal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or b. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or c. The additional insureds financial control of you; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and CG 91 23 (Ed. 05/18) (Page 11 of 16) PAC313246702 2. If coverage provided to the additional insured is required by contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide such additional insured. With respect to paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed for or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to paragraph 1.b. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage" occurs, or prior to when any offense resulting in "personal and advertising injury" is committed. 2. With respect to the insurance provided by this endorsement, the following are added to paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" that occurs prior to your commencing operations at the location where such "bodily injury" or "property damage" occurs. b. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal or advertising injury", involved the rendering of, or failure to render, any professional architectural, engineering or surveying services. c. "Bodily injury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed for or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CG 91 23 (Ed. 05/18) (Page 12 of 16) PAC313246702 (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. d. Any person or organization specifically designated as an additional insured for ongoing operations by a separate additional insured endorsement issued by us and made part of this Policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. X. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this Policy. Condition 4. Other Insurance of Section IV - Commercial General Liability Conditions is amended as follows: As respects any additional insured, this insurance is excess unless: a. the additional insured is a named insured under such other insurance; or b. you have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Y. ADDITIONAL INSUREDS - PROTECTION OF YOUR LIMITS This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this Policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit' under this insurance to us; as soon as practicable; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and CG 91 23 (Ed. 05/18) (Page 13 of 16) PAC313246702 c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit' by the additional insured. Z. BLANKET WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (SUBROGATION) Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Transfer Of Rights Of Recovery Against Others to Us: If required by a written contract or written agreement, we waive any right of recovery we may have against a person or organization because of payment we make for injury or damage arising out of your ongoing operations or "your work" done under a contract for that person or organization and included in the "products-completed operations hazard" provided that the injury or damage occurs subsequent to the execution of the written contract or written agreement. AA. PROPERTY DAMAGE EXTENSION WITH VOLUNTARY PAYMENTS 1. The following is added to paragraph 1. Insuring Agreement of Section I - Coverage A - Bodily Injury And Property Damage Liability: At your request we will pay for "property damage" to property of others caused by your business operations. Such payment will be made without regard to your legal obligation to do so. The "property damage" must occur during the policy period and must take place in the "coverage territory". 2. With respect to the coverage afforded under paragraph 1. above, paragraph 2. Exclusions of Section I - Coverages A - Bodily Injury And Property Damage Liability is amended as follows: Exclusions j.(3), j.(4), j.(5) and j.(6) are deleted. 3. With respect to the coverage afforded under paragraph 1. above, Section III - Limits of Insurance is replaced by the following: 1. Subject to 2. below, the most we will pay for any one incident is $1,000. 2. The most we will pay for the sum of all "property damage" in the policy period is $5,000. This aggregate amount is part of and not in addition to the General Aggregate Limit described in paragraph 2. of Section III - Limits of Insurance. BB. LIMITED FUNGI OR BACTERIA COVERAGE i. The following are added to SECTION III - LIMITS OF INSURANCE: a. Subject to paragraphs 2. and 3. of SECTION III - LIMITS OF INSURANCE, as applicable, a Fungi and Bacteria Liability Aggregate Limit of $30,000 is the most we will pay under Coverage A for all "bodily injury" or "property damage" and Coverage C for Medical Payments arising out of one or more "fungi or bacteria incidents". CG 91 23 (Ed. 05/18) (Page 14 of 16) C * S1 * PAC-3132467- GREAT AMERICAN INSURANCE CO ORIGINAL COPY 0227047 IL 01 46 (Ed. 08 10) WASHINGTON COMMON POLICY CONDITIONS All Coverage Parts included in this Policy are subject to the following conditions. The conditions in this endorsement replace any made a part of this Policy, by mailing or similar conditions in the Policy that are less fa- delivering to the first Named Insured and vorable to the Insured. the first Named Insured's agent or broker written notice of cancellation at least five A. Cancellation days before the effective date of can- cellation for any structure where two or 1. The first Named Insured shown in the more of the following conditions exist: Declarations may cancel this Policy by no- tifying us or the insurance producer in one a. without reasonable explanation, the of the following ways: structure is unoccupied for more than a. written notice by mail, fax or e-mail; 60 consecutive days, or at least 65%of the rental units are unoccupied for b. surrender of the Policy or binder; or more than 120 consecutive days, un- less the structure is maintained for c. verbal notice. seasonal occupancy or is under con- struction or repair; Upon receipt of such notice, we will can- cel this Policy or any binder issued as b. without reasonable explanation, evidence of coverage, effective on the progress toward completion of per- later of the following: manent repairs to the structure has not a. the date on which notice is received or occurred within 60 days after receiptof funds following satisfactory ad- the Policy or binder is surrendered; or justment or adjudication of loss re- b. the date of cancellation requested by sulting from afire; the first Named Insured. c. because of its physical condition, the 2. We may cancel this Policy by mailing or structure is in danger of collapse; delivering to the first Named Insured and the first Named Insured's agent or broker d. because of its physical condition, a written notice of cancellation, including the vacation or demolition order has been actual reason for the cancellation, to the issued for the structure, or it has been last mailing address known to us, at least: declared unsafe in accordance with applicable law; a. 10 days before the effective date of cancellation if we cancel for nonpay- e. fixed and salvageable items have been ment of premium; or removed from the structure, indicating b. 45 days before the effective date of an intent to vacate the structure; cancellation if we cancel for any other f. without reasonable explanation, heat, reason; water, sewer and electricity are not except as provided in paragraphs 3. and 4. furnished for the structure for 60 below. consecutive days; or 3. We may cancel the Commercial Property g. the structure is not maintained in sub- Coverage Part and the Capital Assets Pro- stantial compliance with fire, safety gram (Output Policy) Coverage Part, if and building codes. Copyright, ISO Properties, Inc., 2010 IL 01 46 (Ed. 08/10) XS (Page 1 of 4) C * S1 " 07/22I20'19 * PAC-3132467-00-01 GREAT AMERICAN INSURANCE CO ORIGINAL COPY 0227047 4. If: paragraph A.3. above, we will mail or de- liver this notice at least 20 days prior to a. you are an individual; the effective date of cancellation. b. a covered auto you own is of the "pri- 6. Notice of cancellation will state the offec- vate passenger type'; and tive date of cancellation. The policy period will end on that date. c. the Policy does not cover garage, automobile sales agency, repair shop, 7. If this Policy is cancelled, we will send the service station or public parking place first Named Insured any premium refund operations hazards; due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, We may cancel the Commercial Auto- the refund will be at least 90% of the pro mobile Coverage Part by mailing or de-livering to the first Named Insured and the rats refund unless the following applies: first Named Insured's agent or broker a. For Division Two - Equipment Break- written notice of cancellation, including the down, if the first Named Insured can- actual reason for cancellation, to the last cels, the refund will be at least 75% of mailing address known to us: the pro rata refund. a. at least 10 days before the effective b. If: date of cancellation if we cancel for nonpayment of premium; or (1) you are an individual; b. at least 10 days before the effective date of cancellation for any other rea- {2) a covered auto you own is of the. son if the Policy is in effect less than private passenger type"; 30 days; or (3) the Policy does not cover garage, c. at least 20 days before the effective automobile sales agency, repair date of cancellation for other than shop, service station or public nonpayment if the Policy is in effect parking place operations hazards; 3.0 days or more; or and d. at least 20 days before the effective (4) the first Named Insured cancels; date of cancellation if the Policy is in effect for 60 days or more or is a the refund will be not less than 90% of renewal or continuation policy, and the any unearned portion not exceeding reason for cancellation is that your $100, plus 95% of any unearned por- driver's license or that of any driver tion over $100 but not exceeding who customarily uses a covered 'auto' $500, and not less than 97% of any has been suspended or revoked during unearned portion in excess of $500. policy period. The cancellation will be effective even if 5. We will also mail or deliver to any most- we have not made or offered a refund. gage holder, pledgee or other person shown in this Policy to have an interest in 8. If notice is mailed, proof of mailing will be any loss which may occur under this Poli- sufficient proof of notice. cy, at their last mailing address known to us, written notice of cancellation, prior to B. Changes the effective date of cancellation. If can- cellation is for reasons other than those The Policy contains all the agreements be- contained in paragraph A.3. above, this tween you and us concerning the insurance notice will be the same as that mailed or afforded. The first Named Insured shown in delivered to the first Named Insured. If the Declarations is authorized to make cancellation is for a reason contained in changes in the terms of this Policy with our Copyright, ISO Properties, Inc., 20,10 IL 01 46 (Ed. 08/10) X5 (Page 2 of 4) THIS PAGE INTENTIONALLY LEFT BLANK