HomeMy WebLinkAboutCAG2020-351 - Amendment - #2 - GeoEngineers, Inc. - McCoy Levee Repair Design Review Services - 12/12/2022Ap
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Originator:Department:
Date Sent:Date Required:
Director or Designee to Sign.
Interlocal Agreement Uploaded to Website
Date of Council Approval:
Grant? Yes No
Type:
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Date Routed to the City Clerk’s Office:
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Vendor Name:Category:
Vendor Number:Sub-Category:
Project Name:
Project Details:
Agreement Amount:
Start Date:
Basis for Selection of Contractor:
Termination Date:
Local Business? Yes No*
Business License Verification: Yes In-Process Exempt (KCC 5.01.045)
If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace.
Notice required prior to disclosure?
Yes No
Contract Number:
Agreement Routing Form
For Approvals, Signatures and Records Management
This form combines & replaces the Request for Mayor’s Signature and Contract Cover
Sheet forms.
Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20
Budget Account Number:
Budget? Yes No
Dir Asst:
Sup/Mgr:
Dir/Dep:
rev. 20210513
FOR CITY OF KENT OFFICIAL USE ONLY
(Optional)
* Memo to Mayor must be attached
CAG2020-351
AMENDMENT - 1 OF 2
AMENDMENT NO. 2
NAME OF CONSULTANT OR VENDOR: GeoEngineers, Inc.
CONTRACT NAME & PROJECT NUMBER: McCoy Levee
ORIGINAL AGREEMENT DATE: October 30, 2020
This Amendment is made between the City and the above-referenced Consultant or
Vendor and amends the original Agreement and all prior Amendments. All other provisions of
the original Agreement or prior Amendments not inconsistent with this Amendment shall remain
in full force and effect. For valuable consideration and by mutual consent of the parties,
Consultant or Vendor’s work is modified as follows:
1. Section I of the Agreement, entitled “Description of Work,” is hereby modified to
add additional work or revise existing work as follows:
In addition to work required under the original Agreement and any
prior Amendments, the Consultant or Vendor shall:
No change to the scope of work, however an amendment is
needed to extend the time of completion to December 31, 2024
due to delays caused by the PSE right-of-way acquisition.
2. The contract amount and time for performance provisions of Section II “Time of
Completion,” and Section III, “Compensation,” are modified as follows:
Original Contract Sum,
including applicable WSST
$18,352
Net Change by Previous Amendments
including applicable WSST
$0
Current Contract Amount
including all previous amendments
$18,352
Current Amendment Sum $0
Applicable WSST Tax on this
Amendment
$0
Revised Contract Sum $18,352
Original Time for Completion
12/31/21
(insert date)
Revised Time for Completion under
12/31/22
prior Amendments
(insert date)
Add] Days Required (f) for this
730 calendar days
Amendment
Revised Time for Completion
12/31/24
(insert date)
The Consultant or Vendor accepts all requirements of this Amendment by signing below,
by its signature waives any protest or claim it may have regarding this Amendment, and
acknowledges and accepts that this Amendment constitutes full payment and final settlement of
all claims of any kind or nature arising from or connected with any work either covered or
affected by this Amendment, including, without limitation, claims related to contract time,
contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless
otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the
guarantee and warranty provisions of the original Agreement.
All acts consistent with the authority of the Agreement, previous Amendments (if any),
and this Amendment, prior to the effective date of this Amendment, are hereby ratified and
affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment
shall be deemed to have applied.
The parties whose names appear below swear under penalty of perjury that they are
authorized to enter into this Amendment, which is binding on the parties of this contract.
IN WITNESS, the parties below have executed this Amendment, which will
become effective on the last date written below.
CONSULTANT/VENDOR:
CITY OF KENT:
By:
By: 0a E4�2z
(signature)
(signature)
Print Name: Lyle 1. Stone, PE
Print Name: Carla Maloney, P.E.
Its Associate
Its Design Engineering Manager
(title)
DATE: December 12, 2022
DATE: [2
(title)
J 7,(
ATTEST:
APPROVED AS TO FORM:
(applicable if Mayor's signature required)
Kent City Clerk
Kent Law Department
GeoEngineers - McCoy Levee Amd 2/1-incoln
AMENDMENT - 2 OF 2
Client#: 3261 19 GEOENINC2
ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
6t23t2022
TqIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS.TTIFICATE
DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
-cLOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: ll the certilicate holder is an ADDITIONAL INSUHED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed
ll SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsemenl. A statement on
this certilicate does not conler any rights to the certificate holder in lieu ol such endorsement(s).
PRODUCER
USI lnsurance Services NW CL
601 Union Street, Suite 1000
Seattle, WA 98101
ftXilii'' Please See Below:
l'fiS,\oo. e,o, 206 441 -6300 610-362-8530
Seattle.PLCert m
INSURER(S) AFFORDING COVERAGE NAIC #
tNsuBER 4 . Hartlord Fire lnsurance Company 1 9682
INSURED
GeoEngineers, lnc.
17425 NE Union Hill Road, Suite 250
Redmond, WA 98052
tNsuREB s . Hartlord Casualty lnsurance Company 29424
TNSUBER c . Hartlord - WC Multiple lssuing Cos 00914
INSURER D ;
INSUFER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:REVISION NUMBER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVEBEEN ISSUED TOTHE INSURED NAI\4EDABOVE FORTHE POLICYPERIOD
INDICATED. NOTWITHSTANDING ANY REOUIBEMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUN4ENT 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
LTR TYPE OF INSUHANCE INSR POLICY NUMBER
POLICY EFF.MM/Df}/YYVY\POLICY EXP LIMITS
A X COMMERCIAL GENEFAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER
,o,", filSFSi LOC
b AutoMogtLg LraetLrtv
x ANY AUTO
OWNED
AUTOS ONLY
HIRED
AUTOS ONLY
SCHEDULED
AUTOS
NON.OWNED
AUTOS ONLYXx
X
X X 52UUNOLs662 )6130t2022 06t30t202i EACH OCCURRENCE $1.000.000
$300.000
l\,lED EXP (AnV one person)$10.000
PEBSONAL & ADV INJURY s 1.000.000
GENERAL AGGREGATE $2.000.000
PHODUCTS. COMP/OP AGG s2,000,000
$
X x 52UENOL5663 )6t30t2022 06t30t202i s1,000,000
BODILY INJURY (Per person)$
BODILY INJURY (Per accidenl)$
$
$
B X UMERELLA LIAB
EXCESS LIAB
X OCCUF
CLAIMS.MADE
x X 52XHUOL5664
(Follow Form)
)6t30t2022 06t30t202i EACH OCCURRENCE $5.000.000
AGGREGATE $5,000,000
DED X nererrlor.: s10000 $
c WORKERS COMPENSATION
AND EMPLOYERS'LtABtLtTY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVET-oFF|cER/MEMBEREXCLUDED? I Nl
(Mandatory in NH)
lf yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
X 52WEOL6H8D
lncludes:
StopGap/MEL/USL&H
)6t30t2022 06t30t2023 X PER OTH-
E.L. EACH ACCIDENT $1.000.000
E.L. DISEASE . FA FMPI OYFF s'1.000.000
E.L, DISEASE - POLICY LIMIT s1.000.000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 1 01, Additional Remarks Schedule, may be attached if more space is required)**Please Note: The limits shown above may not represent the lull limits of coverage carried by the Named
lnsured, but are shown as evidence that coverage is carried with the limits at least as high as is required
by contract,**
RE: GeoEngineers Project No:0410-172-13, Project: McCoy Levee Repairs, Kent, Washington. The General
Liability and Automobile Liability policies include an automatic Additional lnsured endorsement that
(See Attached Descriptions)
FICATE H
ACORD 25 (2016/03) 1 ol 2
#s36389386/M363501 29
O 1988-2015 ACORD CORPORATION. Alt rights reserved.
The ACORD name and logo are registered marks of ACORD
DYGZP
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPTRATTON DATE THEREOF, NOTTCE W|LL BE DELTVEBED tN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Kent
c/o Alex Murillo
220 Fourth Avenue South
Kent, WA 98032-0000
*,*a, Pj*^*_
AUTHORIZED BEPBESENTATIVE
provides Additional Insured status to the certilicate holder, only when there is a written contract that
requires such status, and only with regard to work perlormed on behall ol the named insured. The General
Liabilily and Automobile Liability policies contain a speciat endorsement with primary and Noncontributory
wording, when requlred by written contract. The General Liability, Automoblle Liablllty and Workers
Compensation policies provide a Waiver ol Subrogation when required by written contract. The General
Liability, Automobile Liability and Workers Compensation policies include an endorsement providing that 30
days notice of cancellation will be given to the Certificate Holder by the lnsurance Carrier. The General
Liabllity policy includes General Aggregate Limit Per Project Endorsement, when required by written
contract' The Umbrella Liability policy follows form ol undertying liability. General Llability Includes WA
Stop Gap.
SAGITTA 25.3 (2016/03) 2 ol2
fs36389386/M363501 29
POLICY NUMBER: 52 UUN 0L5662 COMMERCIAL GENERAL LIABILITY
cG 20 10 10 01
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
ADDITIONAL INSURED _ O!['NERS, LESSEES OR
CONTRACTOR$ - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifics in$urance provided under the following;
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or 0rganization:
AS RSQUIRED BY WRITTEN CONTRACT
(lf no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
l
A. Section ll * Who ls An lnsured is arnended lo
include as an insured the person or organieation
shown in the $chedule, but only with respect to
liability arising out of your ongoing operations
performed for that insured.
B. With respect to the insurance afforded to these
additional insureds. the following exclusion is
added:
2. Exclusions
This insurance does not apply to "bodily in"
jury" or "property damage" occurring after:
{1} All work, including materials, parts or
equipment furnished in connection with
such work, on the project {other tl'ran
service, maintenance or repairs) to be
perforrned by or on behalf of the addi-
tional insured(s) at the sito of the cov-
ered operations has been completed;
0r
{?} That portion of "your work" out of
which the injury or damage arises has
been put to its intended use by any
person or organization other than an-
other contractor or subcontractor en-
gaged in performing operations for a
principal a$ a part of the same pro,ieci.
GG 20 10 10 01 Copyright, lnsurance Sorvices Offics, lnc., 2000 Page 1 of 1
POLICY: 52UUNOL5662
Al.PNC.WOS,Sl.OngOps.CO
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
Various provisions in this policy restrict coverage.
Read the entire policy carefully to determine rights,
duties and what is and is not covered.
Throughout this policy the words "you" and "your"
refer lo the Named lnsured shown in the
Declarations, and any other person or organizalion
qualifying as a Named lnsured under this policy. The
words "we", "us" and "our" refer to the stock
insurance company member of The Hartford
providing this insurance.
The word "insured" means any person or
organization qualifying as such under $ection ll *
Who ls An lnsured.
Other words and phrases that appear in quolation
marks have $pecial meaning. Refer to Section V -
Definitions^
SECTION I* COVERAGES
COVERAGE A BODILY INJURY AND PROPERTY
DAMAGE LIABILITY
1. lnsuring Agreement
a. We will pay those sums that the insured
becomes legally obligated to pay as damages
because of "bodily injury" or "property
damage" to which this insurance applies. We
will have the right and duty to defend the
insured against any "suit" seeking those
damages. However, we will have no duty to
defend the insured against any "suit" seeking
damages for "bodily injury" or "property
damage" to which this insurance does not
apply. We may, al our discretion, investigate
any "occurrence" and settle any claim or "suit"
thal may result. Bui:
(1) The amount we will pay for damages is
limited as described in Section lll - Limits
Of lnsurance; and
(2) Our right and duty to defend ends when
we have used up the applicable limit of
insuranse in the payment of judgments or
settlements under Coverages A or B or
medical expen$es under Coverage C.
No other obligation or liability to pay sums or
perform acts or services is covered unless
explicitly providecl for under Supplementary
Payments - Coverages A and B,
b. This insurance applies to "bodily injury" and
"property damage" only if:
{1) The "bodily injury" or "property damage" is
caused by an "occunence" that takes
place in the "coverage territory";
{2} The "bodily injury" or "property danrage"
occurs during the policy period; and
{3} Prior to the policy period, no insured tisted
under Paragraph 1. of $ection ll - Who ls
An lnsured and no "amployee" authorized
by you to give or receive notice of an
"occurrence" or claim, knew that the
"bodily injury" or "property damage" had
occurred, in whole or in part. lf such a
listed irrsured or authorized "employee"
knew, prior to the policy period, that the
"bodily injury" or "prope(y darnage"
occurred, then any continuation, change
or resunrption of such "bodily injury" or
"property damage" during or after the
policy period will be deemed to have been
known prior to the policy period.
c. "Bodily injury" or "property damage" will be
deemed to have been known to have
occurred at the earliest time when any
insured lisled under Paragraph 1. of Section ll
- Who ls An lnsured or any "employee"
authorized by you to give or receive notice of
an "eccurrence" or claim:
{1} Reports all, or any part, of the "bodily
injury" or "properly damage" to us or any
other insurer;
{2} Receives a written or verbal demand or
claim for damages because of the "bodily
in.iury" or "property damage"; or
(3) Becomes aware by any other means that
"bodily injury" or "property danrage" has
occurred or has begun to occur,
d. Damages because of -bodily injury" include
damages claimed by any person ot
organization for care, loss of services or
death resuliing at any time from the "bodily
injury".
e. lncidental Medical Malpractice And Good
Samaritan Coverage
"Bodily injury" arising out of the rendering of
or failure to render the following health care
service$ by any "employee" or "vulunteer
wsrk€r" shall be deemed to be caused by an
"occurrence" for:
HG 00 01 09 16 page 1 of21
Q 2016 The Hartford
(lncludes copyrighted material of lnsurance Services Office, lnc. with its permission")
{1) Professional health care services such a$:
(a) Medical, surgical, dental, laboratory, x-
ray ar nursing services or treatn'lent,
advice or instruction, or the related
furnishing of food or beverages;
{b) Any health or therapeutic service,
treatment, advice or instruction; or
(c) The furnishing or dispensing of drugs
or medical, dental, or surgical supplies
or appliances; or
{2) First aid services, which include:
{a} Cardiopulnronary resuscitation,
whelher performed manually or with a
defibrillatori or
(b) Services performed as a Good
Sanaritan.
For the purpose of deiermining the limits of
insurance, any act or omission together with
all related acts or omissions in the furnishing
of these services to any one person will be
considered one "occurrence".
However, this lncidental Medical Malpractice
And Good Samaritan Coverage provision
applies only if you are not engaged in the
business or occupation of prcviding any of the
services described in this provision.
2. Exclusions
This insurance does not apply to:
a. Expected Or lntended lnjury
"Bodily injury" or "property damage" expected
or intended from the standpoint of the
insured. This exclusion does not apply to
"bodily injury" or "property damage" resulting
from the use of reasonable force to protect
persons or property.
b. Contractual Liability
"Bodily injury" or "property damage" for which
the insured is obliSated to pay damages by
reason of the assumplion of liability in a
contract or agreement. This exclusion does
nct apply to liability for damages:
{1} That the insured would have in the
absence af the contract or agteement; or
(2) Assumed in a ccntract or agreement that
is an "insured contract". provided the
"bodily injury" or "property damage"
occurs subsequent to the execution of the
conlract or agre€msnt. Solely for the
purposes of liability assunled in an
"insured contract", reasonable attorney
fees and necessary litigation expense$
incurred by or for a party other than an
insured are deemed to be damages
because of "bodily injury" or "property
damage", provided:
(a) Liability to such party for, or for the
cost of, that party's defense has also
been assumed in the same "insured
contract"; and
{b) Such attorney fees and litigation
expenses are for defense of that party
against a civil or alternative dispute
resolution proceeding in which
damages to which this insurance
applies are alleged.
c. Liquor Liability
"Bodily injury" ol' "property damage" for which
any insured may be held liable by reason of:
{1} Causing sr contributing to the intoxication
of any person;
{2} The furnishing of alcohalic beverages to a
person under the legal drinking age or
under the influence of alcohol; or
{3} Any statute, ordinance or regulation
relating to the sale, gift, distribution or use
of alcoholic beverages.
This exclusion applies even if the elaims
againsi any insured allege negligence or
other wrongdoing in:
{a) The supervision, hiring, ernployment,
training or nronitoring of others by that
insured; or
{b} Providing or failing to provide
transportation with respect to any
per$on that may be under the influence
of alcohol;
if lhe "occurrence" which caused the 'bodily
injury" or "property damage", involved lhat
whicfi is described in Paragraph {1}, {2} or (3}
above.
However, this exclusion applies only if you
are in lhe business of manufacturing,
distributing, selling, serving or furnishirig
alcoholic beverages. For the purposes of this
exclusion, permitting a per$on to bring
alcoholic beverages on your premises, for
con*umption on your premises, whether or
not a fee is charged or a license is required
for such activity, is not by itself considered the
business of selling, serving or furnishing
alcoholic beverages.
d. Workers' Compensation And Similar Laws
Any obligation of the insured under a workers'
compensation, disability benefits er
unemployment compensation law or any
similar law.
e. Employer's Liability
"Bodily injury" to:
(1) An "employee" of the insurecl arising out of
and in the course of:
Page 2 of 21 HG 00 01 09 16
{a} Employment by the insured; or
(b) Performing duties retaled to the
conduct of the insured's business; or
{2} The spou$e. child, parent, brother or sister
of that "employee" as a consequence of
Paragraph {1} above.
This exclusion applies:
(1) Whether the insured may be liabte as an
employer or in any other capacity; and
{2) To any obligation to share damages with
or repay someone else who must pay
damages because of the injury.
This exclusion does not apply to liability
assumed by the insured under an ,'insured
conlract".
f. Pollution
(1) "Bodily injury" or "property damage"
arising out of the actual, alleged or
threatened discharge, dispersal, seepage,
migraiion, release or escape of
"pollutants":
(a) At or from any premises, site or
location which is or was at any time
owned or occupied by, or rented or
loaned to, any insured" However, this
subparagraph does not apply to:
(i) "Bodily injury" if sustained within a
building and caused by smoke,
funres, vapor or soot produced by
or originating from equipment that
is used to heat, cool or dehumidify
the building, or equipment that is
used to heat water for personal
use, by the building's occupants or
tlreir guests;
(ii) "Bodily injury" or "property damage"
for which you may be held liable, if
you are a contractor and the owner
or lessee of such premises, site or
location has been added to your
policy as an additional insured with
respect to your ongoing operations
performed for that additional
insured at that premises, site or
locaiion and such premises, site or
location is ngt and never was
owned or occupied by, or rented or
loaned to, any insured, other than
that additional insured; or
{iii) "Bodily injury" or "prope(y damage,'
arising oul rrf heat, smoke or funres
from a "hostile fire";
{b) At or from any premises, site or
location which is or was at any time
used by or for any insured or others for
lhe handling, storage, disposal,
processing or treatment of waste;
{c} Which are or were at any time
transported, handled, stored, treated,
disposed of, or processed as waste by
or for:
(i) Any insured; or
(ii) Any p€rson or organization for
whom you may be legally
responsible;
{d} At 0r from any premises, site or
location on which any insured or any
contraetors or subcontractors working
directly or indirectly on any insured's
behalf are performing operations if the
"pollutants" are brought on or to the
premises, site or location in connection
with such operations by such insured.
contractor or subcontractor. However,
this subparagraph does not apply to:
(i) "Bodily injury" or "property damage"
arising sut of the escaBe of fuels,
lubricants or other operating flr"rids
which are needed to perform the
normal electrical, hydraulic or
mechanical functions necessary for
the operation of "mobile equipment"
or its parts, if such fuels, lubricants
or other operating fluids escape
from a vehicle part designed to
hold, store or receive them. This
exception does not apply if the
"bodily injury" or "property damage"
arises out of the intentional
discharge, dispersal or release ofthe fuels, lubricants or other
operating fluids, or if such fuels,
lubricants or other operating fluids
are brought on or to the premises,
site or location with the intent that
they be diseharged, dispersed or
released as part of the operations
being performed by such insured,
contractor or subcontractor;
{ii} "Eodily injury" or "property damage"
sustained within a building and
caused by the release of gases,
furnas or vapors from materials
brought into that building in
connection with operations heing
performed by you or on your behalf
by a eontractor or subcontractor; or
(iii) "Bodily injury" or "property dnmogc"
arising out of heat, smoke or fumes
from a "hostile fire"; or
{e) At 0r from any premises, site 0r
location on which any insured or any
contractors or subcontractors working
HG 00 0't 09 16 Page 3 of 21
directly or indirectly on any insured's
behalf are perfornring operations if the
operations are lo test for, monitor,
clean up, remove, contain, treat,
detoxify or neutralize, or in any way
respond t0, or assess the effects of,
"pollutants",
(2) Any foss, cast or expense arising out of
any:
(a) Request, demand, order or statutory or
regulatory requiremerrt that any
insured or others test for, monitor,
clean uB, remove, contain, treat,
detoxify or neutralize, or in any way
respond t0, or assess the effects of,
"pollutants"; or
(b) Claim or suit by or on behalf of a
governmental authority for damages
beeause of testing for, monitoring,
cleaning up, removing, containing,
treating, detoxifying or neutralizing, or
in any way responding to, or assessing
the effects of, "pollutanls",
However, this paragraph does not appfy to
liability for damages because of "property
damage" that the insured would have in
the absence of such request, demand,
order or statutory or regulatory
requiremenl, or such claim or "suit" by or
on behalf of a govornmental ailthority,
g. Aircraft, Auto 0r Watercraft
"Bodily injury" or "properly danrage" arisirrg
out of the ownership, maintenanc€, use or
entrustment to others of any aircraft, "auto" or
watercraft owned or operated by or rented or
loaned to any insured, Use includes operation
and "loading or unloading".
This exclusion applies even if the claims
against any insured allege negligence or
other wrongdoing in the supervision, hiring,
employment, training or nronitoring of others
by that insured, if the "occurrence" which
caused the "bodily injury" or "prcperty
damage" involved the ownership,
maintenance, use or entrustment to others of
any aircraft, "auto" or wat€rcraft that is owned
or operated by or rented or loaned to any
insured.
This exclusion does not apply to:
(1) A watercraft while ashore on premises you
own or rent;
(2) A watercraft you do not own that is:
(e) Less than 51 feet long; and
{b) Not being uaed to carry persons for a
charge;
{3) Parking an "auto" on, or on the ways next
to, premises you own or rent. provided the
"auto" is nol 0wned by or rented or loaned
to you or the insured;
{4) Liability assumed under any "insured
contract" for the ownership, mainlenance
or use sf aircrafl or watercraftl
(5) "Bodily injury" ar "property damage"
arising out of:
(a) The operation of machinery or
equipment that is attached to, or part
of, a land vehicle that would qualify
under the definition of "mobile
equipment" if it were not $ubject to a
compulsory sr financial responsibility
law or other motor vehicle insurance
{aw where it is licensed or principally
garaged: or
{b} The operatlon of any of the machinery
or equipment listed in Paragraph f.{?}
or f.{3} of the definiiion of "mobile
equipnrent"; or
(6) An aircraft that is not owned by any
insured and is hired, chartered or loaned
with a paid crew. However, this exeeption
does not apply if the insured has any other
insuranco for such "bodily injury" er
"property damage", whether the other
insurance is primary, excess, contingent
or on any other basis.
h. Mobile Equipment
"Bodily injury" or "property damage" arising
out of:
(1) The transportation of "mobile equipment"
by an "auto" ownecl or aperated by or
rented or ioaned to any insured; or
(2) The use of "mobile equiprnent" in, or while
in practice for, or while being prepared for,any prearranged racing, speed,
demolition, or stunting activity,
i. War
"Bodily injury" or "property damage", however
caused, arising, directly or indirectly, out of:
{1} War, including undeclared or civilwar;
{2} Warlike action by a military force, including
action in hindering or defending against an
actual ot expected attack, by any
government, sovereign or other authority
using military personnel or other agents;
or
{3) lnsurrection, rebellion, revolution, usurped
power, or aetion taken by governmental
authority in hindering or defending against
any of these.
j. Damage To Property
"Properly damage" to:
Page 4 of 21 HG 00 01 09 16
{1) Property you own, rent, or occupy,
including any co$ts or expen$es incurred
by you, or any other person, organizationor entity, for repair, replacement,
enhancement, restoration sr maintenance
of such property for any reason, inctuding
prevention of injury to a person or danrage
to another's property;
(2) Premises you $ell, give away or abandon,
if the "property damage" arises out of any
part of those premises;
(3) Property loaned to you;
(4) Pereonal property in lhe care, custody or
control of the insured;
(5) That particular parl of real property on
which you 0r any contraclors or
subcontractors
working directly or indirectly on your behatf
are performing operations, if the "property
danrage" arises out of those operations; or
{6) That particular parl of any property that
must be restored, repaired or replaced
because "your work" was incorrecily
performed on it.
Paragraphs (1), (3) and {4} of this exclusion
do not apply to "property damage" (other than
damage by fire) to premises, including the
contents of such premises, rented to you for a
period of seven or fewer consecutive days. A
$eparate limit of insurance applies to Damage
To Premises Rented To You as described in
Seclion lll - Limits Of lnsurance.
Paragraph (2) of this exclusion does not apply
if the premise$ are "your work" and were
never oceupied, rented or held for rental by
yOu.
Paragraphs (3) and (4) of this exclusion do
not apply to "properly damage" arising from
the use of elevators.
Paragraphs {3}, (4), (5) and (6} of this
exclusion do not apply to liability a$sumed
under a sidelrack agreement.
Paragraphs (3) and (4) of this exclusion do
not apply to "property damage" to borrowed
equipment while not being used to perform
operations at the iob site.
Paragraph (6) of this exclusion does not applyto "property damage" included in the
"products-completed operations hazard".
k. Damage To Your Product
"Property damage" to "your product" arising
out of it tlr alry parl uf it.
l. Damage To Your Work
"Property damage" to "your work" arising out
of it or any part of it and included in the
"proclucls-completed operations hazard".
This exclusion does not apply if the damaged
work or the work out of whieh the damage
arises was performed on your behalf by a
subcontractor.
m. Damage To lmpaired Property Or Property
Not Physically lnjured
"Froperty damage" to "impaired property" or
property that has not been physicatly injured,
arising out of:
{1} A defect, deficiency, inadequacy or
dangerous condition in "your product" or
"your work"; or
{2) A delay or failure by you or anyone acting
on your behalf to perform a contract or
agreemenl in accordance with its terms.
This exclusion does not apply to the loss of
use of other property arising out of sudden
and accidental physical injury to "your
product" or "your work" after it has been put
to its intended use.
n. Recall Of Products, Work Or lmpaired
Property
Damages claimed for any lcss, cosl or
expense incurred by you or oth€rs for the loss
of use, withdrawal, recall, inspection, repair.
replacement, adjustment, removal or disposal
of:
(1) "Your product";
(2) "Your work"; or
{3} "lmpaired property";
if such product, work, or property is withdrawn
or recalled from the market or from use by
any person or organizalion because of a
known or suspected defect, deficiency,
inadequacy or dangerous condition in it.
o. PersonalAnd Advertising lnjury
"Bodily injury" arising out of "personal and
adverti$ing injury".
p" Access or Disclosure Of Confidential Or
Personal lnformation And Data.related
Liability
Damages arising out of:
(1) Any access to ar disclosure of any
person's or organization's confidenlial or
personal information, including patent$,
trade secrets, processing melhods,
customer lists, financial information, credit
card information, health information or any
other type of nonpublic information; or
{2} The loss of, loss sf use of, damage to,
coffuptlon of, inability tu a$r;s$s, ot
inability to manipulate electronic data.
This exclusion applies even if damages are
claimed for notification costs, credit
monitoring expenses, forensic expenries,
HG 00 01 09 16 Page 5 of 21
public relations expenses or any other loss,
cost or expense incurred by you or olhers
arising out of that which is described in
Paragraph {1) or {2} above.
However, unless Paragraph (1) above
applies, this exclusion does not apply to
damages because of "bodily injury".
As used in this exclusion, electronic data
means information, facts or programs stored
as or on, created or used on, or transmitted to
or from computer software, including systerns
and applications software, hard or floppy
disks, CD-ROMS, taBes, drives, cell$, data
processing devices or any other media which
are used with electronically controlled
equipment.
q, Employment-Related Practices
"Bodily injurf'to:
(l) A person arising out of any "employment-
related practices": or
(2) The spouse, child, parent, brother or sister
of that person as a consequence of "bodily
injury" to that percon at whom any
"employmenl-related practices" are
directed.
This exclusion applies:
(1) Wheiher the injury-causing event
described in the definition of "employment-
related practices" occurs before
employment. during employrnent or after
employment of that personi
(2) Whether the in$ured nray be liable as an
employer or in any other capacity; and
(3) To any obligation to share damages with
or repay someone else who must pay
damages because of the injury.
r. Asbestos
(1) "Bodily injury" or "property damage"
arising out of the "asbestos hazard".
(2) Any danrages, judgments, settlements,
loss, costs or expenses lhal:
{a} May be awarded or incurred by reason
of any claim or suil atleging actual or
threatened injury or damage of any
nature or kind to persons or property
which wor:ld not have occurred in
whole or in parl but for the "asbestos
hazard"i
(b) Arise out of any request, demand,
order or statutory or regulatory
requirement that any insured or others
test for, monitor, clean up, remove,
encapsufate, contain. treat, detoxify or
neutralize or in any way respond to or
assess the effects of an "asbestos
hazard"; or
{c} Arise out of any clainr or suit for
damages because of testing for,
monitoring, cleaning up, removing,
encapsulating, containing, treating,
detoxifying or neutralizing or in any
way responding to or assessing the
effects of an "asbestos hazard".
s. Recording And Distribution Of Material Or
lnformaticn ln Violation 0f Law
"Bodily injury" or "properly damage" arising
directly or indirectly out of any action or
omission that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendmertt of or
addition to such law;
(2) The CAN-SFAM Acr of 2003, including
any amendment of or addition to such law;
(3) The Fair Credit Reporting Act (FCRA), and
any amendment of or addition to such law,
including the Fair and Accurate Credit
Transaction Act (FACTA); or
{4) Any federal, state or local statute,
ordinance or regulation, other than the
TCPA or CAN-SPAM Act of 2OO3 or FCRA
and their anrendmenls and additions, that
addresses, prohibits or limits the printing,
dissemination, disposal, collecting,
recording, sending, transmitting,
comnrunicating or distribution of material
or information.
Damage To Premises Rented To You
Exception For Damage By Fire, Lightning Or
Explosion
Exclusions c. through h. and j. through n. do not
af:ply to damage by fire, lightning or explosion to
premises while rented to you or temporarily
occupied by you with permission sf the owner. A
separate limit of insuranee applies to this
coverage as described in Section lll * Limits Of
lnsurance.
COVERAGE B PERSONAL AND ADVERTISING
INJURY LIABILITY
1, lnsuring Agreement
a. We will pay those sunrs that the insured
becomes legally obligated to pay as damages
because of "personal and advertising injury"
to which this insurance applies. We will have
the right and duty to defend the insured
against any "suit" seeking those damages.
However. we will have no duty ts defend the
insured against any "suit" seeking damages
for "persorral and advertising injury" to which
this insurance does not apply. We may, at our
Page 6 of 21 HG 00 01 09 16
discretion, investigate any offense and setile
any claim or "suit" that may result. Bul:
(1) The amounl we will pay for damages is
limited as described in $ection lll - Limits
Of Insurance; and
(2) Our right and duty to defend end when we
have used up the applicable linrit of
insurance in the paymerrt of judgnrents or
settlements under Coverages A or B or
medical expenses under Coverage C,
No other obligation or liability to pay sums or
perform acts or services is covered unless
explicitly provided for under Supplementary
Payments - Coverages A and B.
b. This insurance applies to "personal and
advertising injury" caused by an offense
arising out of your business but only if the
offense was committed in the "coverage
territory" during the policy period.
2" Exclusions
This insurance does not apply to;
a. Knowing Violatlon Of Rights Of Another
"Personal and advertising injury" arising out of
an offense committed by, at the direction or
with the consent or acquiescence of the
insured with the expectation of inflicting
"personat and advertising injury".
b. Material Publiehed Wlth Knowtedge Of
Falsity
"Personal and advertising injury" arising out of
oral, written or electronic publication, in any
manner, of malerial, if done by or at the
direction of lhe insured with knowledge cf its
falsity.
c. Material Published Prior To Policy Period
"Personal and advertising injury" arising or"rt of
oral, written or electronic publication, in any
manner, of material whase first publication
took place before the beginning of the policy
pericd.
d. CriminalActs
"Personal and advertising injury" arising out of
a criminalacl committed by or at the direction
of the insured.
e" Contractual Liability
"Personal and advertising injury" for which the
insured has assumed liability in a conlract or
agreement. This exclusion does not apply to
liability for damages that the insured would
have in the absence of the contract or
^A
cn
^.* ^
6tqgr 9g! | rer ir,
f. Breach 0f Contract
"Personal and advertising injury'' arising out of a
breach of contract, except an implied contract to
use anotheFs "advertising idea" in your
"advertisement".
g. Quality Or Performance Of Goods
Failure To Conform To Statements
"Personal and advertising injury" arising out of
the failure of goods, products or services to
conform with sny statemeni of quality or
performance made in your "advertisement".
h. Wrong Description Of Prices
"Personal and advertising injury" arising out of
the wrong description of the price of goods,
prodltcts or services.
i. lnfringement Of lntellectual Property
Rights
{1} "Personal and advertising injury" arising
out of any actual or alleged infringement
or violation of any intellectual property
rights such as copyright, patent,
trademark, trade name, trade secret, trade
dress, service mark or other designation
of origin or authenticity; or
(2) Any injury or damage alleged in any ctam
or "$uit" lhat also alleges an infringement
or violalion of any intellectuaf property
right, whether such allegation of
infringement or violation is made by you or
by any other party involved in the claim or
"suit", regardless sf whether this
insurance would othenruise apply.
However, this exclusion does not apply if the
only allegation in the claim or "suit" involving
any intellectual property right is limited to:
('t) lnfringement, in your "advertisenrent", of:
{a} Copyright;
{b} Slogan;or
{c} Title of any literary or artistic work; or
{2} Copying, in your "adverti$ement", a
person'$ or organization's "advertising
idea" or style of "advertisement".
j. lnsureds ln Media And lnternet Type
Businesses
"Personal and advertising injury" committed
by an insured whose business is:
(1) Advertising, broadcasting, publishing or
telecasting;
{2} Designing or determining content of web
sites for othersi or
(3) An lnternet search, access, content or
service provider.
!!ng_rgr_rg1 lhie ovnlrrcinn dncq nnl *nnltr tn
Paragraphs a., b. and c. of the definition of
"personal and advertising injury" under the
Definitions Section.
HG 00 01 09 16 PageT ot21
For the purposes of this exclusion, the placing
of frames, borders or links, or advertising, for
you or others any,vhere on the lnternet, is notby itself, considered the business of
a<ivertising, broadcasting, publishing or
telecasting.
k. Electronic Chatrooms Or Bulletin Boards
"Personal and advertising injury" arising out of
an electronic chatroom or bullelin board the
insured hosls, owns, or over which the
insured exercises conlrol.
l. Unauthorized Use Of Another's Name Or
Product
"Personal and advertising injury" arising out of
the unauthorized use ol another's name or
product in your e-mail address, domain name
or metatags, or any other simitar tactics to
mislead another's potential ouslomers.
m. Pollution
"Personal and advertising irrjury" arising out of
the actual, alleged or threatened discharge,
dispersal, seepage, migration, release or
escaBe of "pollutants" at any time.
n. Pollution-Related
Any loss, cost or expense arising out of any:
{1) Request, demand. order or statutory or
regulatory requirement that any insured or
others test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize, or in
any way respond to, or assess the effects
of, "pollutants"i or
(?) Claim or suit by or on behalf of a
governmental authority for damag*s
because of testing for, monitoring,
cleaning up, removing, containing,
treating, detoxifying or neutralizing, or in
any way responding to, or assessing the
effects of, "pollutants".
o. War
"Personal and advertising injury'', however
caused, arising, directly or indirectly, out of:
(1) War, including undeclared or civil war,
(2) Warlike action by a military force, including
action in hindering or defending against an
actual or expecled attack, by any
government, sovereign or other authority
using military porsonnel or other agents;
or
(3) lnsunection, rebellion, revolulion, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.
p. lnternet Advertisements And Gontent Of
Others
"Personal and advertising injury" arising out
of;
{1} An "advertisement" for others on your web
site;
{2} Placing a link to a web site of others on
your web site;
(3) Content, including information, sounds,
text, graphics, or images from a web site
of others displayed within a frame or
border 0n your web sitei or
(4) Computer code, software or programming
used to enable:
{a} Your web site; or
(b) The pre$entation or functionality of an
"advertisement" or other content on
your web site.
q. Right Of Privacy Created By Statute
"Personal and advertising injury" arising out of
the violation of a person's right of privacy
created by any state or federal act.
However, this exclusion does not apply to
liability for damages thai the insured wauld
have in the absence of such state or federal
act.
r. Violation Of Anti-Trust law
"Personal and advertising injury" arising out of
a violation of any anti-trust law.
s. $ecurities
"Personal and advertising injury" arising out of
the fluctuaiion in price or value of any stocks.
bonds or other securities,
t. Recording And Distribution Of Material Or
lnformation ln Violation Of Law
"Personal and adverti$ing injury" arising
directly or indirectly out of any action or
omission that violates or is alleged to violate;
{1} The Telephone Consumer Protection Act
(TCPA), including any amendment ol or
addition to such [aw;
(?) The CAN-SPAM Act of 2003, including
any amendment of or addition to such law;
(3) The Fair Credit Reporting Act (FCRA), and
any amendment of or addition to such law,
including the Fair and Accurate Credit
Transaction Act {FACTA)l or
{4} Any federal, state or local statute,
ordinance or regulation, other tlian the
TCPA or CAN-SPAM Act of 2003 or FCRA
and their amendments and additions, that
addresses, prohibits or limits the printing,
dissernination, disposal, collecting,recarding, sending, transmilting,
communicating or distribution of matedal
or information"
Page 8 of 21 HG 00 01 09 16
u. Employment-Related Practices
"Personal and advertising injury" to:
(1) A person arising out of any "employment-
relaled practices"; or
(2) The spouse, child, parent, brother or sister0f that person as a consequence of
"personal and advertising injury" to that
person at whom any "employment-related
practices" are directed.
This exclusion applies:
{1} Whether the injury-causing event
described in the definition of "employment-
related praciices" occurs before
employmerrt. during employment or after
enrployment of that personi
(2) Whelher the insured may be liable as an
employer or in any other capacity; and
(3) To any obligation lo share damages with
or repay someone else who must pay
damages because of the injury"
v. Asbestos
(1) "Personal and advertising injury" arising
out of the "asbestos hazard".
(2) Any damages, judgments, setilements,
loss, costs or expenses that:
(a) May be awarded or incurred by reason
of any el€im or suit alleging actual or
threatened injury or damage of any
nature or kind to persons or property
which would not havo occurred in
whole or in part but for the "asbestos
hazard";
(b) Arise out of any request, demand,
order or statutory or regulatory
requirernent that any insured or others
test for, monitor, clean up, remove,
encapsulate, contain, treat, detoxify or
neutralize or in any way respond to or
assess the effects of an "asbestos
hazard"; or
(c) Arise out of any claim or suit for
damages because of testing for,
monitoring, cleaning up, removing,
encap*ulating, conta;ning, treating,
detoxifying or neuiralizing or in any
way responding to or assessing the
effects of an "asbestos hazard".
w. Access Or Disclosure Of Confidential Or
Personal lnformation
"Personal and advertising injury" arisirrg out of
anv access to or disclosure of any person's or
organization's confidential or personal
information, including patents. trade sscrets,
processing methods, custonler lists, financial
information. credil card information, lrealth
inforrnation or any other type of nonpublic
inforrnation.
This exclusion applies even if damages areclaimed for notification costs, credit
monitoring expenses, forensic expenses,
public relations expenses or any other los$,
cost or expense incurred by you or others
arising out of any acc€ss to or disclosure of
any person's or organization's confidential or
personal information.
COVERAGE C MEDICAL PAYMENTS
1, lnsuring Agreement
a. We will pay medical expen$es as described
below for "bodily injury" caused by an
accident:
{1} 0n premises you own or rent;
{2) On ways nexi io premises you own or
renti or
{3} Because of your operations;
provided that:
(1) The accident takes place in the "coverage
territory" and during the policy period;
{2) The expenses are ineurrsd and reported
to us within three years of the date of the
accident; and
{3} The injured person submits to
examination, at our expense, by
physicians of our choice as oft€n as we
reasonably require.
b. We will make these payments regardless of
fault. These payments will not exceed the
applicable limit of insurance. We will pay
reasonable expenses for:
(1) First aid administered at the time of an
accident;
(2) Necessary medical, surgical, X-ray and
dental seryices, including prosthetic
devices; and
{3) Necessary ambulance, hospital,
professional nursing and funeral services,
2. Exclusions
We will not pay expenses for "bodily injury";
a. Any lnsured
To any insured, except "volunteer workers".
b. Hired Person
To a person hired to do work for or on behalf
of any insured or a tenant of any insured.
c. lnjury On Normally Occupied Premises
To a person injured on that part of premises
you own or renl that the person normally
occupies.
d. Workers Compensation And Similar Laws
To a person, whether or not an "employee" of
HG 00 01 09 16 Page 9 of 21
any insured, if benefits for the "bodily injury" are
payable or must be provided under a workers'
compensation or disability benefits law or a
similar law.
e. Athletics Activities
To a p*rson injured while practicing,
instructing or partioipating in any physical
exercises or games, sports, or athlelic
contesls.
f. Products-Completed Operations Hazard
lncluded within the "products-completed
operations hazard".
g. Coverage A Exclusions
Excluded under Cov€rage A.
SUPPLEMENTARY PAYMENTS - COVERAGES
AANDB
1. We will pay, with respect to any claim we
investigate or settle, or any "suit" against an
insured we defend:
a. All expenses we incur.
b. Up to $1.000 for cost of bail bonds required
because of accidents or traffic law violations
arising out of the use of any vehicle to which
the Bodily lnjury Liability Coverage applies.
We do not have to furnish these bclnds,
c. The cost of appeal bonds or bonds to release
attachments, but anly for bond amounts
within the applicable limit of insurance. We do
not have to furnish these bonds.
d, All reasonable expenses incurred by tlre
insured at our requ€st to assist us in the
investigation or defense of the claim or "$uit".
including actuat loss of earnings up to $500 a
day because of time otf fronr work.
e. All court costs taxed against the insured in
the "suit". However, such costs do not
include attorneys' fees, attorneys' €xpenses,
witness or expert fees, or any other expenses
of a party taxed to the insured"
f. Prejudgment interest awarded against the
insured on that part of the judgment we pay. lf
we make an offer to pay the applicable limit of
insurance, we will not pay any prejudgment
interest based on that Boriod of time after the
offer.
g. All interest on the full amount of any judgment
that accrues after entry of the judgment and
before we have paid, offered lo pay, or
deposited in court the pai"t of the judgment
that is within the applicable limit of insurance.
These payment$ will not reduce the limits of
insurance.
2. lf we defend an insured against a "suit" and an
indemnitee of the insured is also named as a
party to the "suit", we will defend that indemnitee
if all of the following conditions are met:
a. The "$uit" against the indemnitee seeks
damages for which the insured has assumed
the liability of the indemnitee in a contract or
agreement that is an "insured contract";
b. This insurance applies to such liability
assumed by the insured:
c. The obligation to defend, or the cost of the
defense of, that indemnitee, has also been
assumed by the insured in the same "insured
contract";
d. The allegations in the "$Lrit" and the
information we know about the "occurrence"
are such that no conflict appears to exist
between the interests of the insured and the
interests of the indemnitee;
e. The indernnitee and ihe insured ask us to
canduct and contrsl lhe defense of that
indemnitee against such "suit" and agree that
we can assign the same counsel to defend
the insured and the indemnitee: and
f. The indemnitee;
{1i Agrees in writing to:
(a) Cooperate with us in the investigaiion,
settlement or defense of the "suii";
(b) lmrnediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
"suit";
{c} Notify any olher insurer whose
coverage i$ available t0 the
indemnitee; and
(d) Cooperate with us with respect to
coordinating other applicable
insurance available to the indemnitee;
and
(2) Provides us with written authorization to;
{a} Obtain records and other information
relaled to the "suit", and
{b} Conduct ancl control the defense of the
indemnitee in such "sult",
So long as the above conditions are met,
attorneys' fees incurred by us in the defense ofthat indemnitee,
necessary litigation expensos incurred by us and
necessary litigation expenses incurred by the
indemnitee at our request will be paid as
Supplementary Payments. Notwithstanding the
provisions of Paragraph 2.b.(2) of Section I -
Coverage A Bodily lnjury And Property
Damage Liability, such payments will not be
deenred to be damages for "bodily injury" and
"property damage" and will not reduce the limits
of insurance.
Page 10 of 21 HG 00 01 09 16
Our obligation to defend an insured's indemnitee
and to pay for aitorneys' fees and necessary
litigation expenses as Supplementary Payments
ends when:
a. We have used up the applicable limit of
insurance in the payment of judgments or
settlements, or
b. The condilions set forth above, or the terms of
the agreement described in Paragraph f.
above, are no longer met.
SSCTION II- WHO IS AN INSURFD
t. lf you are designated in the Declarations as:
a" An individual, you and your spouse are
insureds, but only with respect to the conduct
of a business of which you are the sole
owner-
b. A partnership or joint venture, you are an
insured. Your members, your partners, and
their spouses are also insureds, but only with
respect to the conduct of your business.
c. A limited liability company, you are an
insured. Your members are also insureds, br.rt
only wiih respect to the conducl of your
business. Your managers are insureds, but
only with respect to their duties as your
managers.
d. An organization other than a partnorship, joint
venture or limited liabilily company, you are
an insured. Your "executive officers" and
directors are insureds, but only with respect to
their duties as your officers or directors. Your
stockholders are also insureds, but only with
respect to their liability as stockholders.
e. A trust, you are an insured. Your trustees are
also insureds, but only with respect to their
duties as trustees,
2. Each of the following ls also an insured:
a. Employees And Volunteer Workers
Your "volunteer workers" only while
performing duties related to the conduct of
your busine$$, or your "employees", other
than either your "executive officers" (if you are
an organization other than a partnership, joint
veniure or limited liability company) or your
managers (if you are a limiled liability
company), but only for acts within the scopeof their employment by you or while
performing duties related to the conduct of
your business.
However, none of these "employees" or
"volunteer workers" are insureds for:
(1) "Bodily injury" or "personal and adver{ising
injury":
{a} To you, to your partners or members (if
you are a partnership or joint venture),
to your members (if you are a limited
liability company), to a co-"employee"
while in the course o{ his or her
employment or performing duties
related to the conduct of your
business, or to yaur other "volunteer
workers" while performing duties
related to the conduct of your
business;
{b) To the spouse, child, parent, brother or
sister of that co-"employee" or that
"volunteer worker" as a consequence
of Paragraph (1)(a) above;
{c} For which there is any obligation to
share damages with or repay someone
else wlro must pay damages becauso
of the injury described in Paragraphs
{1}(a) or {1}{b) above: or
{d} Arising out of his or her providing or
failing to provide professional heatth
care services.
lf you are not in the business of providing
professional health care services:
{a) Subparagraphs {1)(a}, {1)(n} and (1)(c}
above do not apply to any "employee"
or "volunieer worker" providing first aid
services: and
{b} Subparagraph (1}{d) above does not
apply to any nurse, emergency medical
technician or paramedie employed by
you to provide such services,
(2) "Property damage" to property;
{a} Owned, occupied or used by,
(b) Rented to, in the care, custody or
control of , or over which physical
control is being exercised for any
purpose by
you, any of your "employees", "volunteer
workers", any partner or member {if you
are a partnership or joint venture), or any
member (if you ar€ a limited liability
company).
b. Real Estate Manager
Any person {olher than your "employe6" or
"volunteer worker"), or any organization while
acting as your real sstate manager.
c. Temporary Custodians Of Your Property
Any person or organization having proper
temporary custody of your property if you die,
but only:
{1} With respect to liability arising out of the
maintenance or use of that property; and
(2) Until your legal representative has been
appointed,
d. Legal Representative lf You Die
Your legal representative if you die, but only
HG 00 01 09 16 Page11of21
with resp€ct to dulies a$ sueh. Thal
representative will have all ycur rights and
duties under this Coverage Part.
e. Unnamed Subsidiary
Any subsidiary, and subsidiary thereof, of
yours which is a legally incorporated entity of
which you own a financial interest of more
than 50% of the voting stock on the effective
date of the Coverage Part.
The insurance afforded herein for any
subsidiary not named in this Coverage Part
as a named insured does not app{y to injury
or damage with respect to which such insured
is also a named insured under another policy
or would be a named insured under suclr
policy but for its termination or the exhaustion
of its limits of insurance.
3. Newly Acquired Or Formed Organization
Any organization you newly acquire or form,
other than a partnership. jaint venture or linrited
liability cornpany, and over wlrich you maintain
finansial interest o{ more than 50% of the voting
$tock, will qualify as a Named lnsured if there is
no other similar insurance available to that
organization. However:
a. Coverage under this provision is afforded only
until the 1BOth day after you acquire or form
the organization or the end of the policy
period, whichever is earliel
b. Coverage A does not apply to "bodily injury"
or "propeily damage" that occurred before
you acquired or formed the organizaiion; and
c. Coverage B does not apply tc "persorral and
advertising injury" arisirrg out of an offense
committed before you acquired or formed the
organizaticn.
4. Nonowned Watercraft
With respect to watercraft you do not own that is
less than 51 feet long and is not being used to
carry Bersons for a charge, any person is an
insured while operating such watercraft with your
pernrission. Any other person or organization
responsible for the conduct of such person is
also an insured, but only with respecl to liability
arising out of the operation of the watercraft, and
only if no otlrer insurance of any kind is available
to that person or organization for this liabilily.
However, no person or organizalion is an insured
with respect to:
a. "Bodily injury" to a co-"enrployee" of the
person operating the watercrafti or
b. "Froperty damage" to property owned by,
rented to, in the charge of or occupied by you
or the enrployer of any person who is an
insured under this provision.
5. Additional lnsureds When Required By
Writtan Contract, Written Agreement Or
Permlt
The following person(s) or organization{s) are an
additional insured when you have agreed, in a
written contract, written agreement or because of
a permit issued by a state or political subdivision,
that such person or organization be added as an
additional insured an your policy, provided the
injury cr damage occurs subsequont to the
execution of the contract or agreement.
A person or organization is an additional insured
under this provision only for that period of time
required by the contract or agreement.
However, no such person or organization is an
insured under this provision if such person or
organization is included as an insured by an
endorsement issued by us and made a part of
this Coverage Part.
a. Vendors
Any person(s) or organization{s) (referred to
below as vendor), but only with respect to
"bodily injury" or "property damage' arising
out of "your products" which are distributed or
sold in the regular course of the vendor's
business and only if this Coverage Part
providos coverage for "bodily injury" or
"property damage" included within the
"products-completed operations hazard".
(1) The insurance afforded the vendor is
subject to the following additional
exclusions:
This insurance does not apply to:
(a) "Bodily injury" or "property damage" for
which the vendor is obtigated to pay
damages by reason of the assumption
of liability in a contract or agreement.
This exclusion does not apply to
liability for damages that the vendor
would have in the absence of the
contracl or agreement;
{b) Any express warraRty unauthorized by
you;
{c) Any physical or chemical change in the
product made intentionally by the
vendor;
{d} Repackaging, except when unpacked
solely for the purpose of inapection,
demonstration, testing, or the
substitution of parts under instructions
from the manufacturer, and then
repackaged in the original container,
(e) Any failure to make such inspections,
adjustnrents, tesls or servicing as the
vendor has agreed to make or normally
Page 12 of 21 HG 00 01 09 16
undertakes to make in the usual
course of business, in connection with
the dislribution or sale of the products;
(f) Demonstration, installation, servicingor repair operations, except such
operations perfonned at the vendols
premises in connection with the sale of
the product;
(g) Products which, after distribution or
sale by you, have been labeled or
relabeled or used as a container, part
or ingredient of any other thing or
substance by or for the vendor; or
(h) 'Bodily injury" or "property damage"
arising out of the sole negligence of the
vendor for its own acts or omissions or
those of it$ employees or anyono else
acting on its behalf, However, this
exclusisn does not apply to:
(i) The exceptions contained in Sub-
paragraphs (d) or (f); or
{ii) Such inspections, adjustments,
tests or servicing as the vendor has
agreed to make or nornrally
undertakes to make in the usual
course of business, in connection
with the distribution or sale of the
produets.
(2) This insurance does not apply to any
in$ured person ar organization, from
whom you have acquired such products,
or any ingredient, part or container,
entering into, accompanying or containing
such products,
b. Lessors Of Equipment
(1) Any person(s) cr orgenization{s) from
whom you lease equipment: but only with
respect to their liability for "bodily injury',
"property damagen or "personal and
advertising injury" caused, in whole or in
part, by your maintenance, operation or
use of eguipment leased to you by such
porson(s) or organization(s).
(2) Wilh respect to the insurance afforded to
these additional insureds this insurance
does not apply to any "occurrence" which
takes place after the equipmeni lease
expires.
c. Lessors Of Land Or Premises
Any person or organization fronr whom you
lease land or premises, but only with reepectto liability arising out of the ownership,
maintenance or use of that part of the land or
premises leased to you.
With respect to the insurance afforded these
additional insureds the following additional
exclusions apply:
This insurance does not apply to:
1. Any "occunence" which takes place after
you cease to lease that land; or
2. Structural alterations, nsw con$truction or
elemolition operaiions performed by or on
behalf of such person or crganization.
d. Architects, Engineers Or Surveyors
Any architect, engineer, or survsysr, but only
with respect to tiability for "bodily injury",
"property damage" or "personal and
adverlising injury" caused, in whote or in part,
by your acts or omissions or the acts or
omissions of those acting on your behalf:
(1) ln connection with your premises; cr
(2) ln the performance of your ongoing
operations performed by you or on your
behalf.
Wilh respect to the insurance afforded these
additional insureds, the following additional
exclusion applies:
This insurance does not apply to "bodily
injury", "property damage" or "personal and
advertising injury" arising out of the rendering
of or the failure to render any professional
services by or for you, including:
1. The preparing, approving, ar failing to
preparo 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 and advertising injur/, involved the
rendering of or the failure to render any
professional services by or for you.
e. Permits lssued By $tate Or Political
Subdivisions
Any state or political subdivision, but only with
respect to operations performed by you or on
your behalf for which the state or political
subdivision has issued a permit.
With respeet to the insurance afforded these
additional insureds, this insurance does not
apply to:
(1) "Bodily injurf, "property damage' or
"personal and advertising injury" arising
out of operatians performed for the state
or munieipalitp or
HG 00 01 09 16 Page 13 of 21
(2) "Bodily injury" or "property damage"
included within the "products-compleled
operations hazard".
f. Any Other Party
Any other per$on or organization who is not
an additional insured under Paragraphs a.
through e. above, but only with respect to
liability for "bodily injury", 'proporty damage"
or "personal and advertising injury" caused, in
whole or in part, by your acts or omissions or
the acts or omissions of those acting on your
behalf :
(1) ln the performance of your ongoing
operations;
(2) ln connection with your premises owned
by or rented to you; or
(3) ln connection with 'your work" and
included within the "products-completed
operations hazard", but only if
(a) The written contract or agreement
requires you to provide such coverage
to such additional insured; and
(b) This Coverage Part provides covsrage
for "bodily injury' or "property damage"
ineluded within the "products-
completed operations hazard".
However:
(1) The insurance afforded to such additional
insured only applies to the extent
permitted by law; and
(2) lf coverage provided to the additionel
insured i$ 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 contractor agreement to provide for such
additional insured.
With respect to the insurance afforded to
these additional insureds, this insurance dces
not apply to:
"Bodily injury", "property damage" or
"personal and advertising injury" arising out of
the rendering of, or the failuro to render, any
professional architectural, engineering or
surveying services, including :
(1) The preparing, approving, or faiting 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 and advertising injury'', involved the
rendering of or the failure to render any
professional services by or for you,
The limits of insurance that apply to additional
insureds is described in Section lll - Limits Of
lnsurance.
How this insurance applies when other insurance
is available to the additional insured is described
in the Other lnsurance Condition in Section lV -
Commercial General Liability Conditions,
No person or organization is an insured with respect
to the conduct of any current or past partnership,
joint venture ar timited liability company that is not
shown as a Named lnsured in the Declarations.
SECTION III* LIMITS OF INSURANCE
1. The Most We Will Pay
The Limits of lnsurance shown in ttre
Declarations and the rules below fix the most we
will pay regardless of the number of;
a. lnsureds;
b. Claims made or "suits" broughi.; or
c. Fersons or organizations making clalms or
bringing "suits".
2. General Aggregate Limit
The General Aggregate Limit is the most we will
pay for the sum of:
a" Medical expenses under Coverage C;
b. Damages under Coverage A, excepl
damages because of "boclily injury" or
"property damage" included in the "products-
completed operations hazard"i and
c. Damages under Ccverage B.
3. Froducts-Completed Operations Aggregate
Limit
The Products-Completed Operations Aggregate
Limit is the mosl we wilt pay under Coverage A
for damages because of "bodily injury" and
"property damage" included in the "products*
completed operations hazard",
4. PersonalAnd Advertising lnjury Limit
Subject to 2, above, the Personal and
Adv€rtising lnjury Linrit is the most we will pay
under Coverage B for ihe sum of all damages
because of all "personal and adverlising injury"
sustained by any one person or organization.
5. Each Occurrence Limit
Subject to 2. or 3. above, wirichever applies, lhe
Each Occurrence Limit is the most we will pay for
the sum of:
a. Damages under Coverage A; and
Page 14 of 21 HG 00 01 09 16
b. Medical expense$ under Coverage C
beeause of all "bodily injury" and "property
damage" arising out of any one "occurrence".
6. Damage To Prernises Rented To You Limit
Subject to 5. above, the Damage To Fremises
Rented To You Limit is the most w* wilt pay
under Coverage A for darnages because of
"property damage" to any one premises, while
rented to you, or in the case of damage by fire,
lightning or explosion, while rented to you or
temporarily occupied by you with permission of
the owner.
ln the case of damage by fire, lightning or
explosion, the Damage to Premises Renled To
You Limit applies io all damage proximately
caused by the same event, wheilrer such
damage results from fire, lightning or explosion
or any combination of lhese.
7. Msdical Expensa Limit
Subject to 5. above, the Medical Expense Limit is
the most we will pay under Coverage C for all
medical expenses because of "bodily injury"
sustained by any one person.
8. How Limits Apply To Additional lnsureds
lf you have agreed in a writterr contract or written
agreement that another per$on or crganization
be
added as an additianal insured on your policy,
the most we will pay on behal{ of such additional
insured is the lesser of:
a. The limits of insurance specified in the written
contract or written agreement; or
b. The Limits of lnsurance slrown in the
Declarations,
Such amount shall be a part of and not in
addition to Limits of lnsurance shown in the
Declarations and described in this $ection.
The Limits of lnsurance of this Coverage Part apply
separately to each consecutive annual period and to
any remaining period of less than 12 months,
starting with the beginning of the policy period
shown in the Declarations, unless the policy period
is extended after issuance for an additional period of
less than 12 months, ln that case, the additional
period will be deemed part of the last preceding
period for purposes of determining the Limits of
lnsurance.
SECTION IV - COMMERCIAL GENERAL
LIABILITY CONDITIONS
1" Bankruptcy
Bankruptcy or insolvency of the insured or of the
insured's estate will not relieve us of our
obligations under this Coverage Part.
2. Duties ln The Event Of Occurrence, Offense,
Claim 0r Suit
a. Notice Of Occurrence Or Offense
You or any additional insured rnust see to it
that we are notified as soon as practicable of
an "cccurrence" or an offense which may
result in a claim. To the extent possible,
notice should include;
{1} How, when and where the "occurrenca" or
offerrse took pface;
(2) The names and addresses of any injured
persons and witnesses; and
(3) The nature and location of any injury or
damage arising out of the "eccurence" ot
offense.
b. Notice Of Claim
lf a claim is made or "suit" is brought against
any insured, you or any additional insured
must:
(1) lmmediately record the specifics of the
claim or "suit" and the date received; ancl
(2) Notify us as soon as practicable.
You or any additional insured must see to it
that we receive written notice of the claim or
"suit" a$ soon as practicabte.
c. Assistance And Cooperation OJ The
lnsured
You and any other involved insured must:
(1) lmmediately send us copies o{ any
d6mands, notice$, summon$es or legal
papers received in connection with the
claim or "suit",
{2} Authorize us to obtain records and other
information;
(3) Cooperate with u$ in the investigation or
settlement of the claim or defense against
the "suit"; and
{4} Assist us, upon our request, in the
enforcement of any right against any person
or organization which may be liable to the
insured because of injury or damage to
which this insurance may also appty.
d. Obligations At The lnsureds Own Cost
No insured will, except at that insured's own
cost, voluntarily make a payment, assume
any obligalion, or incur any 6xpense, other
than for first aid, without our consent.
e. Additional lnsureds Other lnsurance
lf we cover a claim or "suit" under tfris
Coverage Part that may also be covered by
qthgr irlgllrnnee avaitahle to an adclitional
insured. such additional insured must submit
such claim or "suil" to the other insurer for
defense and indemnity.
However, this provision does not apply to the
extent that you have agreed in a written
HG 00 01 09 't6 Page 15 of 21
contract or written agreement that this
insurance is primary and non-contributory
with the additional irrsured's own insurance.
f. Knowledge Of An Occurrence, Offense,
Claim Or Suit
Paragraphs a. and b. apply to you or to any
additional insured only when such
"occurrence", of{ense, clainr or "suit" is knowrr
to:
(1) You or any additional insured that is an
individual;
{2} Any partner. if you or the additional
insured is a partnership;
{3} Any manager, if you or the additional
insured is a lintited liability company;
(4) Any "executive officer" or insurance
nanager, if you or the additional insured is
a corporation;
(5) Any trustee, if you or the additisnal
insured is a trust; cJr
(6) Any elected or appointed official, if you or
the additional insured is a political
subdivision or public entity.
This duty applies separalely to you and any
additional insured.
3. LegalAction Against Us
No person or organization has a right under this
Coverage Part:
a. To join us as a party or otherwise bring us
into a "suit" asking for damages from an
insured; or
b. To sue us on this Coverage Part unless all of
its terms have been fully complierl with.
A person or organization ntay sue us to recover
on an agreed seltlement or on a {rnal judgment
against an insuredi but we will not be liable for
damages that are not payable under the terms of
this Coverage Part 0r
that are in excess of the applicable limit of
insurance. An agreed settlement means a
settlement and release of liability signed by us,
the insured and the claimant or the claimant's
legal representative.
4. Other lnsurance
lf other valid and collectible insurance is
available to the insured for a loss we cover under
Coverages A or B of this Coverage Part, our
obligations are limrted as follows:
a. Primary lnsurance
This insurance is primary except when b.
below applies. lf other insurance is also
primary, we will share with all that other
insurance by the method described in c.
below.
b. Excess lnsurance
This insurance is excess over any of the other
insurance, whether primary, excess,
contingenl or on any otlrer basis:
(1) Your Work
That is Fire, Extended Coverage, Builder's
Risk, lnstallation Risk or *imilar coverage
for "your work";
{2} Premises Rented To You
That is fire, lightning or explosion
insurance for premises rented to you or
temporarily occupied by you with
permission of the owner;
(3) Tenant Liability
That is insurance purchased by you to
cover your liability as a tenant for
"properiy damage" io premises rented to
you or temporarily occupied by you with
permission of the owner;
(4) Aircraft, Auto Or Watercraft
lf the foss arises out of the maintenance or
use of aircraft, "autos" or watercraft to the
extenl nol subject to Fxclusion g. of
Section I * Coverage A - Bodily Injury
And Property Damage Liability;
(5) Property Damage To Borrowed
Equipment Or Use Of Elevaiors
lf the loss arises oui of "property damage"
to borrowed equiprnent or the use of
elevators to the extenl not subject tc
Hxclusion j" of $ection I - Coverage A -
Bodily lnjury And Property Damage
Liability;
{6} When You Are Added As An Additional
lnsured To Other lnsurance
Any other insurance available to you
covering liabilily fcr danrages arising out
of the premises or operations, or producls
and completed operations, for which you
have been added as an additional insured
by lhat insurance, or
(7) When You Add Others As An
Additional lnsured To This lnsurance
Any other insurance available to an
additional insured.
However, the following provisions apply to
other insurance availabla to any person or
organization who is an additional insured
under this coverage part.
(a) Primary lnsurance When Required
By Contract
This insurance is primary if you have
agreed in a written contract or written
agreemenl that this insurance be
prinrary. lf other insurance is also
Page 16 of 21 HG 00 01 09 16
primary, we will share with all that
other insurance by the method
described in c. below.
{b) Prlmary And Non-Contributory To
Other lnsurance When Required By
Contract
lf you have agreed in a written
conlract, written agreemenl, or permit
thal this insurance is primary and non-
contributcry with the additional
insured's own insurance, this insuranceis primary and we will not seek
contribution from that other insurance.
Paragraphs (a) and (b) do not appty ro
other insurance to which the additional
insured has been added as an additional
insured.
When this insurance is excess, rne will have
no duty under Coverages A or B to defend
the insured against any "suit" if any other
insurer has a duty to defend the insured
against that "suit". lf no other insurer defends,
we will undertake to do so, but we will be
entitled to the insured's rights against all
those other insurers.
When this insurance is excess over other
insurance, we will pay only our share of the
amount of the loss, if any, that exceeds the
sum of:
(1) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
{2) The total of all deductible and seltinsured
amounts under all that other insurance.
We will share the remaining loss, if any, with
any other insurance that is not described in
this Excess lnsurance provision and was not
bought specifically to apply in excess of the
Limits of lnsurance shown in the Declarations
of this Coverage Part.
c. Method Of Sharing
lf all of the other insurance pernrits
contribution by equal shares, we will follow
this method also. Under this approach each
insurer contributes equal amounts until it has
paid its applicable lirnii of insurance or none
clf the loss remains, whichever comes first.
lf any of the other insurance does not permit
contribution by equal shares, we will
contribute by limits. Under" this method, each
insurer's share is based on tlre ratio of its
applicable limit of insurance to lhe total
applicable limits ot rnsurance ot all Insurers.
5. Premiunr Audit
a. We will cornpute all premiums for this
Coverage Part in accordance with our rules
and rates.
b. Premir"rm shown in this Coverage Part as
advance premium is a deposit prernium only.
At the close of each audit period we wilt
compute the earned prenrium for tlrat period
and send notice to the first Named lnsured.
The due date for audit and retrospective
premiums is the date shown as the due date
on the bill. lf the sunt of the advance and
audit premiums paid for the policy period is
greater than the earned premium, we will
return the excess to the first Named lnsured.
c. The first Named lnsured musl keep records ofthe information we need for prenrium
computation, and send us copies at suclr
times as we may requesl.
6. Representations
a. When You Accept This Policy
By accepting this policy, yoll agree:
{1) The statements in the Declarations are
accurate and conrplete;
(2) Those statements are based upon
repre$entation$ you made to us; and
(3) We have issued this policy in reliance
upon your representations.
b. Unintentional Failure To Disclose Haaards
lf unintontionally you should fail to disclose all
haeards relating to the conduct of your
business that exist at the inception date of
this Coverage F6rt, we shall not deny
coverage under this Coverage Part because
of such failure"
7. Separation Of lnsurecls
Except with respect to th€ Limit$ of lnsuranee,
and any rights or duties speciflcally assigned in
this Coverage Part to the first Nanred lnsured,
this insurance applies:
a. As if each Named lnsured were the only
Named lnsured; and
b. Separately to each insured against whom
claim is made or "suit" is brought.
8. Transfer Of Rights Of Recovery Against
Others To Us
a. Transfer Of Rights Of Recovery
lf the insured has rights to recov€r all or part
of any payment, including Supplementary
Payments, we have made under this
Coverage Part, those rights are transferred to
us. The insured must do nothing after loss to
HG 00 01 0s 16 Page 17 of 21
impair them. At our request, the insured wifl
bring "suit" or transfer those right$ to us and
help us enforce them.
b. Walvsr Of Righta Ol Rocovery {Waiver Of
$ubrogation)
lf the insured has waived any rights of
recovery against any person or organieetion
for atl or part of any paymsnl, including
Supplamentary Payment$, we have made
under this Coverage Part, we also waive that
right, provided the insured waived their rightsof recovery against such peftion or
organization in a contraet, agreemenl or
permit that was executad prior to the injury or
damage.
9. When We Do Not Renew
lf we decide not to renew tlris Coverage Part, we
will mail or deliver to ihe first Named lnsured
shown in the D€clarations written notice of the
nonrenewal not less than 30 days before the
expiration date.
lf notice is mailed, proof of mailing will be
sufficient proof of notice.
SECTION V _ DEFINITIONS
1. "Advertisement" means the wide$pread public
dissemination of information or images that has
the purpose of inducing the sale of goods,
products or services through:
a. {1) Radio:
(2) Television;
(3) Billboard;
{4} Magazine:
(5) Newspaper; or
b. Any other publication that is given widespread
public distribution.
However, "advertisement" does not include:
a. The design, printed material, information or
images contained in, 0n 0r upon the
packaging or labeling of any goods cr
products; or
b. An interactive conversation between or
among persons through a compuler nelwork.
2. "Advertising idea" means any idea for an
"advertisemenl""
3. "Asbestos hazard" mean$ an exposure or
threat of exposure to the actual or alleged
properties of asbestos and includes the mere
presenee of asbestos in any form.
4. "Auto" means:
a. A land motor vehicle, trailer or semitrailer
designed for travel on public roads, including
any attached machinery or equipment; or
b, Any other land velricle that is subject to a
compulsory or financial responsibility law or
other motor vehicle insurance law where it is
licensed or principally garaged.
However, "auto" does not include "mobile
equipment".
5. "Bodily injury" mean6 physical:
a. lnjury;
b. Sickness; or
c. Disease
sustained by a persorr and, if arising out of the
above, mental anguish or death at any tlme.
6. "Coverage territory" means:
a. The United States of America (including its
territories and possessions), Fuerto Rico and
Canada;
b. lnternational waters or airspaee, but only if
the ifljury or damage occurs in the course of
travel or lransportation between any places
included in a. above; or
c. All other parts of the world if the injury or
damage arlse$ out 0f:
('l) Goods or products made sr sold by you in
the lerritory described in a. above;
{2} The activities of a person whose home is
in the territory described in a. above, but is
away for a short time on your business; or
(3) "Personal and advertising injury" offenses
that take place through the lnternet or
similar electronic msans of communication
provided the insured's responsibility io pay
damages is determined in the United States of
America {includlng its territories and possessions},
Puerto Rico or Canada, in a "suit" on the merits
according to the substanlive law In such lerrilory or
in a settlement we agree to.
7. "Employee" includes a "leased worker".
"Employee" does not include a "temporary
w0rker".
S. "Employment-Related Fractices" means:
a. Refusalio enploy that person;
b. Termination of that person's ernployment; or
c. Employment-related practices, policies, acts
or omissions, such as coercion, demstion,
evaluation, reassignmenl, discipline,
defamation, harassment, humiliation,
discrimination or malicious prosecution
directed at that person.
9. "Executive officer" ffieans a person holding any
of the officer positions created by your charter,
constitution, by-laws or any other similar
governing document.
10."Hostile fire" m€ans one which becomes
uncontrollable or breaks out from where it was
intended to be.
Page 18 of 21 HG 00 01 09 16
11,"lmpaired property" means tangible property,
other than "your product" or "your work", that
cannot be used or is less useful because:
a. ll incorporates "your product" or "your work"
that is known or thought to be defective,
deficient, inadequate or dangerous; or
b. You have failed tc fulfill lhe tenns of a
contract or agreement;
if such property can be reslored to use by the
repair, replacernent, acljustnrenl or removal of
"your product" or "your work", or your fLrlfilling the
terms of the contract or agreenent.
12. "lnsured contract" means:
a. A contract far a lease of prenrises. However,
that portion of the coniraci for a lease of
premises that indemnifies any person or
organization for damage by fire, lightning or
explosion to premises while rented to you or
temporarily occupieci by you with pernrission
of lhe owner is subject to the Damage to
Premises Rented To You Limit described in
Section lll * Limits of lnsurance;
b. A sidetrack agreement;
c. Any easement or license agreer"nent,
includirrg an easement or license agreenrent
in connectiorr with construction or ejemolition
operations on or within 50 feet of a railroad:
d. An obligation, as required by ordinance, to
indemnify a municipality, except in connection
with work for a munlcipality;
e. An elevator maintenance agreement;
f. That part of any other conlract or agreement
pertaining to your business (includirrg an
indemnification of a municipality in connection
wilh work performed for a municipality) under
which you as$ume the tort liability of another
party to pay for "bodily injury" or "property
damage" to a third person or organization,
provided the "bodily injury" or "property
damage" is cau$ed, in whole or in part, by
yclu or by those acting on your behalf. Tort
liability menns a liability that would be
imposed by law in the absence of any
contract 0r agreemet'tt.
Paragraph f. includes that part of any contract
or agreemsnt that indemnifies a railroad for
"bodily injury" or "property damage' ansing
out of construclion or demolition operations,
within 50 feet of any railroad property and
affecting any railroad bridge or trestle, tracks,
road-beds, tunnel, underpass or crossing.
Hnwevor, Psr4graph f dne.e not inr:hrcla that
part ol any contracl or agreement:
(1) Th6t indemnifies an architect, engineer or
surveyor for injury or damage arising out
of;
(a) Preparing, apprcving, or failing to
prepare 0r approvs, maps, shop
drawings, opinions, reports, surveys,
fietd orders, change orders or drawings
and specifications: or
{b} Giving directions or instructions, or
failirrg to give them, if that is the
primary cause of the iniury or danrage;
0r
(2) Under wlrich the insured, if an architect,
engineer or surveyor, a$sumes liability for
an injury or darnage arising out o{ the
insured's rendering or failure to render
professional services, including lhose listecl
in {1) above and supervisory, inspection,
architectr:ral or engineering activities.
13."Leased worker" means a person leased to you
by a labor leasing firm under an agreemefit
b'etween you and the labor leasing firm, to
perform duties related to the condr.rct of your
business. "Leased worker" does not include a
"temporary worker".
14."Loading or unloading" illeans tlre handling of
pr0perty:
a. After it is movecj from the place where il is
accepted for movement into or onto an
aircraft, watercraft or "auto",
b. While it is in or on an aircraft, watercraft or
"auto"; or
c. While it is lreing moved from an aircraft,
watercraft or "auto" to the place where it is
finally delivered;
but "loading or unloading" does not include the
movement of property by means of a mechanical
device, ottier lhan a hand truck, that is not
attached to the aircraft, watercraft or "auto",
15."Mobile equipment" means any of the following
types of land vehicles, inch"rding any attached
machinery or equipment:
a. Bulldczers, farm nrachinery, forklifts and other
vehicles designed for use principally off public
roads;
b. Vehicles maintained for use solely on or next
to prenrises you own or rent;
c. Vehicles that travel on crawler treadsi
d. Vehicles, whether self-propelled or not,
maintained primarily to provide mobility to
permanently m0untedi
{1} Power cranes, $hovels, loaders, diggers or
drills; or
{2! Roacl construclion or resurfacing
equipment such as graders, scrapers or
rollers;
e. Vehicles nol described in a., b., c. or d. above
that are not self-propelled and are maintained
HG 00 01 09 16 Page 19 of 21
primarily to provide mobility to permanently
attached equipment of the fCIllowing 1yp6$:
(1) Air compressor$, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment; or
(2) Cherry pickers and similar devices used to
raise or lower workers;
f. Vehicles not described in a., b., c. or d. above
maintained primarily for purposes other than
the transportation of persons or cargo.
Howev€r, selt-propelled vehicles with the
following types of permanenlly attached
equipment are not "mobile equipment" but will
be considered "autos":
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not
con$truction or resurfaeing; or
(c) Street cleaning;
(2) Cherry pickers and similar devices
mounted on aulomobile or truck chassis
and used to raise or lower workers; and
(3) Air comprsssors, purnps and generators,
inctuding spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment.
However, "mobile equipment" doe$ not include
any land vehicle that is subject to a compulsory
or financial responsibility law or olher motor
vehicle insurance law where it is licensed or
principally garaged. tand vehicles subject lo a
compulsory or financial responsibility law or other
motor vehicle insurance law are considered
"autos".
16."Occurrence" means an accident, including
continuous or repeated expo$ure to substantially
the same general harmful conditions.
17. "Per6onal and advertising injury" rneans
injury, including consequential "bodily injury",
arising out of one or more of the following
offenses:
a. False arest, detention or irnprisonment;
b. Maficious prosecution;
c. The wrongful eviction from, wrongful entry
into, or invasion of the right of privale
occupancy of a room, dwelling or prernises
that a person or organization occupi*s,
committed by or on behalf sf its owner,
landlord 0r lessori
d. Oral, written or electronic publication, in any
manner, of material that slanders or libels a
person or organization or disparages a
per$on's or organization's goods, products or
services;
e. Oral, written or electronic publioation, in any
manner, of material that violales a person's
right of privacy;
f. Copying, in your "advertisement", a person'$
or organization's "advertising idea" or $tyle of
"advertisement"; or
g. lnfringement of copyright, slogan, or title of
any literary or artistic work, in your
"advertisement".
18."Pollutants" mean any solid, liquid, gaseous or
thermal irritant or contaminant, including smoke,
vapor, soot, fumes" aeids, alkalis, ehemicals and
wasls, Waste ineludes materials to be recyelad,
reconditioned or reclaimed.
1 9. "Products-corn pleted operations hazard":
a. lncludes all "bodily injury" and "property
damage" occurring away from premises you
own or rent and arising out of "your produci"
or "your work" except:
{1} Products tl'lat are still in your physical
possession; or
(2) Work that has not yet been completed or
abandoned. However, "your work" will be
deemed completed al the earliest of the
following times:
{a} When all of the work called for in your
contract has been cornpleted.
(b) When all of the work lo be done at the
job site has been completed if your
contrdct calts for work at more than
one job site.
(c) When thai part of the work done at a
job site lras been put to its intended
use by aily person or organizalion
other than another contractor or
subcontractor working on the same
project.
Work that may need service,
maintenance, correction, repair or
replacement, but which is otherwise
complete. will be treated as completed.
b. Does not include "bodily injury" or "property
damage" arising out of;
(1) The tranrportation of property, unless the
injury or damage atises out of a condition
in or on a vehicle not owned or operated
by you, and that condition was created by
the "loading or unloading" of that vehiele
by any insured;
{2} The existence of lools, uninstalled
equipment or abandoned or unused
materials; or
{3) Products or operations for which the
classification, li*ted in the Declarations or
in a policy Schedule, state$ that products-
Page 20 of 21 HG 00 01 09 16
completed operations are subjeet to the
General Aggregate Limit.
20. "Property damage" msans:
a. Physical injury to tangible praperty, including
all resulting loss of use of thai property. All
such loss of use shall be deemed to oeeur at
the time of the physical injury that caused it;
0r
b. Loss of use of tangible property thal is not
physically injured. All such loss of use shall
be deemed to occur at the time of the
"occurr€nce" that caused it.
As used in lhis definilion, computerieed or
electronically slored data, programs or software
are not tangible properly. Electronic data means
information, facts or programs;
a. Stored as or on;
b. Created or used on: or
c. Transmitted to or from;
computer software, including systems and
applications software, hard or floppy disks, CD-
ROMS, tapes, drives, cells, data processing
devices or any olher media which are used wiih
electronica lly controlled equipment.
21. "Suit" nleans a civil proceeding in which
damages because of "boclily injury", "propsrty
damage" or "personal and advertising injury" to
which tlris insurance applies are alleged. ',Suit',
includes;
a. An arbitration proceeding in which such
damages are claimed and to which the
insured must submit or does subnrit with our
consent; 0r
b. Any otlrer alternative dispute resolution
proceeding in which such darnages are
clajmed and to which the insured sutrmits with
our consent.
22."Temporary worker" means a person who is
furnished to you to substitute for a permanent
"employee" on leave or to tneel seasonal or
shorl-term workload cond itions.
23. "Volunteer worker" means a person who
a. ls not your "employee";
b. Donates his or her work;
c. Acts at the direction of and within the scope
of duties determined by you; and
d. ls not paid a fee, salary or otlrer
compensation by you or anyone else for their
work performed for you.
24. "Your product":
a. Means:
{1) Any goods or products, other than real
property, manufactured, sold, handled,
clistributed or disposed of by:
{a) You;
(b) Others trading under your name; or
{c} A person or organization whose
business or assets you have acquired;
and
{2} Containers {other tl'}an vehicles),
materials, parts or equipment furnislrod in
ccnnection with such goods or products.
b. lncludes
{1 } Warranties or representations made at
any tin're with respect to the fitness,
quality, durability, performance or use of
"your product"; and
(2) The providing of or failure lo provide
warnings clr instruction$_
c. Does not incluele vending machines or other
property rented to or located for the use of
oihers but not sold,
25. "Your work":
a. Means:
(1) Work or operations performed by you or
on your behalf; and
(2) Materials, parts or equipment furnished in
connection with such work or operations.
b, lncludes
{1) Warranties or representations made at
any tirrie with respect to the fitness,
qualiiy, durability, performance or use of
"your work", and
{2} The providing of or failure to provide
warnings or irrstructions.
HG 00 01 09 16 Page 21 of 21
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL AUTOMOBILE BROAD FOHM
ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
To the extent that the provisions ol this endorsement provide brsader benefits to the "insured" than other
provisions of the Coverage Form, the provisions of this endorsement apply.
POLICY; 52UENOL5663
AI,PNC.WOS
1. BROAD FORM INSUfrED
A. Subsidiaries and Newly Acquired or
Formed Organizations
The Named lnsured shown in the
Declarations is amended to include:
(1) Any legal business entity other than a
partnership or joint venture, formed as a
subsidiary in which you have an
ownership interest ol more than 50% on
lhe effective date of the Coverage Form.
However, the Named lnsured does nol
includo any subsidiary that is an
"insured" under any olher automobile
policy or would be an "insured" under
such a poticy but for ils terminatian or
the exhaustion of its Limit of lnsurance.
{2) Any organizalion that is acquired or
formed by you and over which you
maintain majority ownership. However,
the Named lnsured does not include any
newly formed or acquired organization:
(a) That is a partnership 0r joint
venture,
(b) Thal i$ an "insured" under any other
polioy,
(c) That has exhausted its Limit of
lnsurance under any other policy. or
td) 180 days or more after its
acquisition or formation by you,
unless you have given us notice of
the acquisition or forrnation.
Coverage does not apply to "bodily
in,iury" or "properly damage" that results
from an "accident" that oceurred before
you formed or acquired the organization.
B. Employees as lnsureds
Paragraph A.1. - WHO lS AN INSURED - of
SECTION ll - LIABILITY COVEAAGE is
amended to add:
COMMEHCIAL AUTOMOBILE
HA 99 16 03 12
d. Any "employee" of yours while using a
covered "auto" you don't own, hire or
borrow in your business or your
personal affairs,
C. Lessors as lnsureds
Paragraph A.1. - WHO lS AN INSURED - of
Sectiorr ll - Liability Coverage is amended to
add:
e. The lessor of a covered '!aulo" while lhe
"auto" is leased to you under a written
agreemerrl il:
(1) The agroement requires you to
provide direct primary insurance for
the lessor and
(2) The "auto" is leased without a driver.
Such a leased "auto" will be considered a
covered "auto" you own and not a covered
"auto" you hire.
D. Additional lnsured il Fequired by Contract
(1) Paragraph A,1. - !\rHO lS AN INSURED
- of Section ll - Liability Coverage is
amended to add:
f. When you have agreed, in a written
contract or written agreemenl, that a
person or organization be added asan additional insured on your
business auto policy, such perscn or
organieation is an "insured", but onlyto the extent such person or
organization is liable tor "bodily
injury" or "property damage" caused
by the conduct of an "insured" under
paragraphs a. or b. of Who ls An
lnsured with regard to the
ownership, maintenance or use of a
covered "auto."
(r) 2011, The Hartford (lnctudes copyrighted material
of tSO Properties, lnc., with its permission.)Form HA 99 16 03 12 Page 1 of 5
The insurance afforded to any such
additional insured applies only if the
"bodily iniury" or "property damage,'
0ccurs:
{1) During the policy period, and
(2) Subsequent to the execution ol such
written contract, and
(3) Prior to the expiration o{ the period
of time that the written conlract
requires such insurance be provided
to the additional insured.
(2) How Limits Apply
lf you have agreed in a written contractor wrillen agreemenl that another
person or organization be added as an
additional insured on your policy, the
most we will pay on behalf of such
additional insured is the lesser ol:
{a) The limits of insurance specilied inihe written contract or written
sgreement; or
{b) The Limits of lnsurance shown in
the Declaralions.
Such amount shall be a part r:f and not
in addition to Limits ol lnsurance shown
in the Declaratlons and described in this
Section.
(3) Additional lnsureds Other lnsurance
lf we cover a claim or "suit" under this
Coverage Part that may also be covered
by other insurance available 10 an
additional insured, such additional
insured must submit such claim or "$uit"
to the other insurer tor defense and
indemnity.
However, this provision does not apply
to the extent that yau have agreed in a
wriffen contract or written agr€emant
that this insurance is prirnary and non-
contributory with the additional insured's
own insurance.
{4) Duties in The Event Of Accident, Clairn,
Suit or Loss
lf you have agreed in a written contractor written agrsement that another
person or organization be added as an
additional insured on your policy, the
additional insured shall bo required to
comply with the provisions in LO$S
CONDITIONS 2, . DUTIES IN THE
EVENTOF ACCIDENT, CLAIM , SUIT
OF LOSS _ OF SECTION IV
BUSINESS AUTO CONDTTIONS, in the
same manner as the Named lnsured.
E. Primary and Non-Contributory it
Bequired by Contract
Only with respeet to insurance provided to
an additional insured in 1.D, - Additional
lnsured lf Required by Contract, the
following provisions apply:
{3} Primary lnsurance When Requireel By
Contract
This insurance is prirnary if you have
agreed in a wrilten contract or wrillen
agreement thal thi$ insurance be
primary. lf other insurance is also
primary, we will share witlr all that other
insurance by the method deseribed in
Other lnsurance 5.d.
(4) Primary And Non-Contributory To Other
lnsurance When Ftequired By Contracl
lf you have agreed in a written contract
or written agreernent that this insurance
is primary and non-contributory with the
additional insured'$ own insurance, thi$
insurance is primary and we will not
seek contribr,ltion from that olher
insurance.
Paragraphs (3) and (4) do nol apply to other
insurance to which the additional insured
has been added as an additional insured.
When this insurance is exsess, we will have no
duty to defend ihe insured against any "suit" il
any other insurer has a duty to defend the
insured against lhat "$uit". lf no other insurer
defends, we will undertake to do so, but we will
be entitled to the insured's rights against all
those other insurers.
When this insurance is excess over other
insurance, we will pay only our share of the
amount of the loss, if any, that exceeds the sum
ol:
(1) The tolal amount that all such other
insurance would pay for the loss in the
absence o{ this insurance; and
(2) The total of all deductibte and setf-insured
arnounts under all lhat other insurance.
We will share the remaining loss, if any, by the
melhod described in Other lnsurance 5.d.
2. AUTOS RENTED BY EMPLOYEES
Any "auto" hired or renled by your '*employee"
on your behatf and at your direction will be
considered an "aulo" you hire.
The OTHER INSURANCE Condition is amended
by adding the following:
G)2A11, The Hartford (lncludes copyrighted material
of tSO Properlies, lnc., with its permission,)Form HA Sg 16 03 12 Page 2 of 5
ll an "employee's" personal in$urance also
applies on an excess basis to a covered "auto"
hired or rented by your "employee" on your
behalf and at your direction, this insurance will
be primary to the "emplcyee's" personal
insurance.
3. AMENDEO FELLOW EMPLOYEE EXCLUSION
EXCLUSION 5. - FELL0W EMPLOYEE " of
SECTION ll - LIABILITY COVERAGE does not
apply if you have workers' compensation
insurance in-force covering all of your
"employees",
Coverage is excess over any olher collectible
insurance.
4. HIRED AUTO PHYSICAL DAMAGE COVERAGE
lf hired "auto$" are covered "autos" for Liability
Coverage and if Comprehensive, Specilied
Causes of Loss, or Collision coverages are
provided under this Coverage Form for any
"auto" you own, then the Physical Damage
Coverages provided are extended to "auto$" you
hire or borrow, subject to the following limit.
The most we will pay for "loss" to any hired
"autot'is:
(1) $1oo,ooo;
(2) The actual cash value oi the damaged or
stolen prcperty al the tirne of the "loss"; or
{3) The cosl of repairing or replacing the
damaged or stolen property,
whichever is smallest, minus a deductible. The
deductible will be equal to the largest deductible
applicable to any owned "auto" for that
coverage. No deductible applies to "loss" caused
by fire or lightning, Hired Autr Physical Damage
eovsrage is excess over any other collectible
insurance. Subject to the above limit, deductible
and excess provisions, we will provide coverage
equal to the broadest coverage applicable to any
covered "auto" you own,
We will also cover loss ol use of the hired "auto"
if it results irom an "accident", you are legally
liable and the lessor incurs an actual financial
loss, subject to a maximum of $1000 per
"accident".
This extension of coverage does not apply to
any "auto" you hire or borrow from any of your
"employees", partners (if you are a parlnership),
members (if you are a limited liability company),
or rnernbers of their households,
5. PHYSICAL DAMAGE - ADDITIONAL
TEMPORARY TRANSPORTATION EXPENSE
COVERAGE
Paragraph A.4.a. of SECTION lll - PHY$ICAL
DAMAGE COVERAGE is amended to provide a
limit of 950 per day and a maximum limit of
$1,000.
6" LOAN/LEASE GAP COVERAGE
Under SECTION lll - PHYSICAL DAMAGE
COVERAGE. in the event of a total "loss" to a
covered "auto", we will pay your additional legal
obligalion for any difference between lho actual
cash value of the "auto" at the time of the "los$"
and the "outstanding balanee" ol the loanilease.
"Oulstanding balance" moan$ the amounl you
owe on the loanllease at the time of "loss" le$$
any amounts representing taxes; overdue
payments; penalties, interesl or charges
resulting trom overdue paymentsi additional
mileage chargesl exces$ wear and tear charges;
lease termination fees; $ecurity deposits not
returned by the lessor; costs lor exlended
warranties, credit lite lnsurance, health, accident
or disability insurance purchased with the loan or
lease; and carry-over balances from previous
loans or leases"
7. AIRBAG COVEHAGE
Under Paragraph B, EXCLUSIONS " of
SECTION III PHYSICAL DAMAGE
COVERAGE. the following is added:
The exclusion relating to mechanical breakdown
does not apply to the accidental discharge of an
airbag,
8. ELECTRONIC EQUIPMENT . BROADFNED
COVERAGE
a. The exceptions to Paragraphs 8.4
EXCLUSION$ - of SECTION ltl- PHYSICAL
DAMAGE COVEHAGE are replaced by the
following:
Exclusions 4.c. and 4.d. do not apply to
equipment designed to be operated solely
by use oi lhe power from lhe "aulo's"
electrical system that, at the time of "loss",
is:
(1) Permanently installed in or upon
the covered "auto";
(2) Removable from a housing unit
which is permanently installed in
or upon the covered "auto";
(3) An integral part of the same unithousing any electronic
equipment described in
Paragraphs {1 ) and (Z) above; or
t-O 2011, The Hartford (lncludes copyrighled material
of ISO Properties, lnc., with its permission.)Form HA 99 16 03 12 Page 3 ol 5
(4) Necessary for the normal
operation of the covered "auto" or
the monitoring of the covered
"aulo's" operating system.
b.Section lll * Version CA 00 01 03 10 of the
Business Auto Coverage Form, physieal
Damage Coverage, Limit of ln$urance,
Paragraph C.2 and Version CA 00 01 10 01 of
the Business Auto Coverage Fcrm, Physical
Danrage Coverage, Limit af lnsurance,
Paragraph C are each amended to add the
following:
$1 ,500 is the most we will pay for "loss" in
any one "accidenl,' to all electronic
equipment (other than equipmenl desigried
solely tor lhe reproduction of sound, and
accessories used with such equipment)
that reproduces, receives or transrnits
audio, visual or data signals which, at the
time o{ "loss", is:
('li Permanently installed in or upon
the covered "auto" in a housing,
opening or other location that is not
normally used by lhe ,'auto"
manulacturer for the installation o{
such equipment;
(2) Removable from a permanently
installed housing unit as described
in Paragraph 2.a. above or is an
integral part of that equipment: or
(3) An integral part of such equipment.
c. For each covered "auto", should loss be limited
to eleetronic equipmenl only, our obligation to
pay for, repair, return or replace damaged or
stolen electronic equipmerrt will be reducecl by
the applicable deductible shown in the
Declarations, or $250, whichever deductible is
less.
9. EXTRA EXPENSE . BROADENEO
COVEBAGE
Under Paragraph A. - COVERAGE - of SECTTON
lll - PHYSICAL DAMAGE COVERAGE, we wiil
pay lor the expense ol returning a stolen covereclt'auto" t0 you.
10. GLASS REPAIR. WAIVER OF DEDUCTIBLE
Under Paragraph D, - DEDUCTIBLE - ot SECTTONIII PHYSICAL DAMAGE COVERAGE, thE
following is added:
No deductible applies to glass damage if the
glass is repaired rather than replaced.
11. TWO OR MOBE DEDUCTIBLES
Under Paragraph D. - DEDUCTIBLE - of SECTTONlll PHYSICAL DAMAGE COVERAGE, rhe
following is added:
lf another Harllord Financial $ervices Group,
lnc. company policy or coverage form that is not
an automobile policy or coverage form appties to
the same "accidenl", the following applies:
(1) lf the deductible under this Business Auto
Ccverage Form is the smalfer (or smallest)
deductible, it will be waived;
(2) lf the daductible under this Business Auto
Coverage Form is nol the srnaller {or
smallest) deductible, it wilt be reduced by
the amount ol lhe smaller (or srnallest)
deductible.
12. AMENOED DUTIES IN THE EVENT OF
ACCIDENT, CLAIM, SUIT OR LOSS
The requirernent in LOSS CONDITIONS 2.a. -
DUTIES IN THE EVENT OF ACCIDENT,CLAIM,
SUIT OR LOSS - ol SECTION lV . BUSTNESS
AUTO CONDITIONS that you must notify us of
an "accidenl" applies only when lhe "accident" is
known to:
{1) You, if yor"l are an individual;
i2) A partner, if you are a partnership;
{3) A member, if you are a timited tiabitity
company; or
(4) An executive off icer or insurance manager, it
you are a corporation.
13. UNINTENTIONAL FAILURE TO OISCLOSE
HAZARDS
lf you unintenlionally fail to disclose any hazarcls
existing at the inception date ol your policy, we
will not deny coverage under this Coverage
Form because of such failure"
,I4. HIRED AUTO. COVERAGE TERRITORY
Paragraph e. of GENERAL CONDITION$ Z. -
POLICY FERIOD, COVERAGE TERRITCIRY .
of SECTION IV BUSINESS AUTO
CONDITIONS is replaced by the following:
e. For short-term hired "autos", the coverage
territory with respsct to Liability Coverage is
anywhere in lhe world provided that it the
"insured's" responsibility to pay damages for
"bodily injury" or "propsrty damage" is
delermined in a "suit," the "suit" is brought in
the United States of America, the territories
and possessions ol tho Unitod States of
America, Puerlo Rico or Oanada or in a
settlement we agree to.
15. WAIVER OF SUBROGATION
TRANSFER OF RIGHT$ OF RECOVEFY
AGAINST OTHERS TO US - of SECTION IV .
BUSINESS AUTO CONDITION$ is amended by
adding the following;
{- 2011, The Hartford (lncludes copyrighted material
of ISO Properties, lnc., with its permission.)Form HA 99 16 03 12 Fage 4 of 5
We waive any right of recovery we may have
against any person or organizatign with whom
you have a written contract that requires such
waiver because of payments we make for
damages under this Coverage Form.
16. RESULTANT MENTAL ANGUISH COVERAGE
The definition of "bodily injury" in SECTION V-
DEFINITIONS is replaceei by the following:
"Bodily injury" means bodily injury, sickness or
disea$e sustained by any person, including
menial anguish or death resulting from any of
these.
17. EXTENDED CANCELLATION CONDITION
Paragraph 2. of the COMMON POLICY
CONDITIONS CANCELLATION - applies
except as follows:
lf we cancel for any reason other than
nonpayment ol premium, we will mail or deliver
to the first Named lnsured written nolice ol
cancellation at least 60 days belore the eflective
dale of cancellation.
18. HYBRID, ELECTRIC, OB NATURAL GAS
VEHICLE PAYM€NT COVERAGE
ln the event of a total loss to a "non-hybrid" auto
for which Comprehensive, Specified Causes ol
Loss, or Collision covetages are provided under
this Ooverage Form, then such Physicai
Damage Coverages are amended as follows:
a.l{ the auto is replaced with a "hybrid" auto or
an auto powered solely by electricity or natural
gas, we will pay an additional 10o/", to a
maximum of $2,500. ol the "non-hybrid" auto's
actual cash value or replacernenl cost,
whichever is less,
b.The auto must be replaced and a copy of a bill
of sale or nsw lease agreement received by us
within 60 calendar days of the dale ol "loss,"
c. Regardless of the nunber of autos deemed a
total loss, {he most we will pay under this
Hybrid, Electric, or Natural Gas Vehicle
Payment Coverage provision for any one
"loss" is $10,000,
For the purposes of the coverage provision,
a.A "non-hybrid" aulo is delined as an auto that
uses only an internal combustion engine to
move the aulo but does not include autos
powered solely by electricity or natural gas,
b.A "hybrid" auto i$ defined as an auto with an
iniernal combustion engine and one or more
electric motors; and that uses the internal
combustion engine and one or rrore electric
motors to move the auto, or the internal
combustion engine to charge one or mors
eleetric motors, which move the auto.
19. VEHICLE WHAP COVERAGE
ln the event ol a total loss to an "auto" for which
Comprehensive, Specified Causes of Loss, or
Collision coverag6s are provided under this
Coverago Form, then such Physical Damage
Coverages are amended to add the following:
ln addition to the actual cash value ol the "aulo",
we will pay ilp to $1,000 for vinyl vehicle wraps
which are displayed sn lhe covered "auto" at the
time of total loss. Regardless of the number of
autos deemed a total loss, the most we will pay
under lhis Vehicle Wrap Coverage provision for
any one "loss" is $5,000. For purposes of this
coverage provision, signs or other graphics
painted or magneiically affixed to tlre vehicle are
not considered vehicle wraps,
I
6i 2011, The Hartford (lncludes copyrighled material
of ISO Properties, lnc., with its permission.)Form HA 99 16 03 12 Page 5 ol 5
We have the right to recover our payrnents from anyone liable for an injury covered by this policy, We will not eniorce our
right against the person or organieation named in the Schedule,
This agreement slrall not operaie directly or indirectly to benelit anyone not named in the Schedule.
SCHEDULE
lny person or organization for whom you are required by contract or agreement to obtain this waiver from usEndorsement is not applicable in KY, NH, NJ or for any Mo construction risk
THIS ENDOHSEMENT CHANGES THE POLICY. PLEASE READ IT CAHEFULLY.
WAIVER OF OUR RIGHT TO RECOVER
FROM OTHERS ENDORSEMENT
Policy Number: 52 WE OL6HBD Endorsement Number:
Effeclive Date: a6ft012022 Effective hour is the same as $tated on the lnformation Fage of the policy
Named lnsured and Address: GFOENGINEERS tNC
8410 154TH AVE NE
REDMOND WA 98052
Authorized Representative
Form WC 00 0313 Prinred in U.S.A.
ProcessDate: 063alzaz2
Countersigned by
Policy Expiration Date: a6aan0z3
POLICY NUMBER: sz UUbr CILs662
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAHEFULLY.
PER LOCATION AND PER PROJECT. AMENDMENT OF
GENERAL AGGREGATE SUBJECT TO MAXIMUM ANNUAL
AGGREGATE LIMIT
This endorsement modifies insurance provided under the folfowing
COMMERCIAL GENEFIAL LIABILITY COVERAGE PART
SCHEDULE
tr
Each Occurrence Limit
Personal and Advertising lnjury Limit
Damage to Premises Rented to You - Any One Premises
Medical Expense Limit - Any One Person
General Aggregate Limit
Location General Aggregate Limit
Projecl General Aggregate Limit
Maximum Annual Aggregate Limit
Products-Completed Operations Aggregate Limit
See Declarations Page
See Declatalj'o"s Page
@@"
s
$
$
$
$
$
$
$
$See Declarations Page
ln return for the payment ol the premium when due and subject to all the terms of lhe Commercial General Liability
Coverage Parl not expressly moditied herein, we agree with you as follows
A. The LIMITS oF INSUHANCE (SECTION lll) is
deleted in its entirety and replaced with the
following:
1. The Most We Will Pay
The Lirnits ol lnsurance shown in the above
Schedule and the rules below fix the most we
will pay regardless ol the number ol:
a. lnsureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims
or bringing "suits".
2. Maximum Annual Aggregate
The Maximum Annual Aggregate Limit is the
most we will pay for ihe sum of :
a. Damages under the General Aggregate
Limit;and
b, Damages under:
(1) Any one or more Location General
Aggregate Limit{s), as described in
paragraph 4. below; or
{2) Any one or more Project General
Aqgregate Limit(s), as described in
paragraph 5. below.
3. GeneralAggregale Limit
Subject to 2. above, the General Aggregate
Limil is the most we will pay for the sum o{;
a. Damages under Coverage B Personal
and Advertising lnjury Liability; and
b. Damages under Coverage C Medieal
Payments, and Coverage A Bodily
lnjury and Property Damage Liability,
with the following exceptions:
(1) "Bodily injury" or "property damage"
included in the "products-completed
operations hazard";
Form HS 25 42 06 08
O 2008, The Hartford
(lncludes copyrighted materialof lnsurance Services Oftice, lnc. with its permission.)
Page 1 ol 3
(2) "Bodily injury" or "property damage,,
attributed solely to ongoing operations
at a $ingle "location"; or
{3) "Bodily injury" or "property clamage,,
attributed solely io ongoing operations
at a single "project".
a. "Property damage" included as Damage
to Premises Rented to You.
4. Locallon Aggregate Limit
Subject to 2. above:
a. A separate Location General Aggregate
Limit applies to each single "location", in
liou of and not in addilion to, the General
Aggregate. Such Location General
Aggregate is the most we will pay for alt
damages under Coverage A Bodily
lnjury and property Oamage Liabillty,
or Coverage C Medical Payments, with
the following sxceptions:
(1) "Bodily injury" or "property damage"
included in the "products-completed
operalions haz&rd"; or
(2) "Property damage" included in the
Damage to Premises Rented to You
cov€rage;0r
{3) "Bodily injury", "property damage", or
medical expenses under Coverage G,
which cannot be attributed solely to
the ongoing operations at a single
"localion", Such damages will erode
lhe General Aggregate Limit as
provided in paragraph 3. above.
b- The Location GeneralAggregate Limit:
{1) Applies only to "occurrences"
attributed solely to ongoing operaiions
al a single "localion"; and
(2) Does not include damages for
Coverage B Personal and
Advertising lnjury Liability, no
matt€r where or in how many
"locations" the offense or otfenses
may be committed. Such damages
will erode the General Aggregate
Limit as provided in paragraph 3.
above.
c. Any payments made undor this paragraph
4., for damages for "bodily injury",
"property damage", or rnedical expenses
under Coverage C, shall reduce the
M41im1rm Annrral Annrenate Limil and the
Location General Aggregate for that
"location". Such payments shall not
reduce the General Aggregate Lirnit or the
Products-Completed Operations
Aggregate Limit nor shall they reduce any
other Locafion General Aggregate Limit.
5. Proiect Aggregare Limit
Subject to 2. above:
ll a wrjtten contracl or written agreement or
permit requires a separate "project" general
aggregate limil, the lollowing will apply:
a. A separate Project General Aggregate
Limit applies to each single "projecl", in
lieu of and not in addition lo, th€ General
Aggregate. Such Project General
Aggregate is the most we will pay for alt
damages under Coverage A Bodily
lniury and Property Damage Liability,
or Coverage C Medical Paymenls, with
the folfowing exceptions:
(1) "Bodily injury" or "property damage"
included in the "products-completed
operations hazard"; or
(2) "Property damage" included in lhe
Darnage lo Premises Rented to You
coverage; or
{3) "Bodily injury", "property damage", or
medical expenso$ under Coverage C,
which cannot be attributed solely to
the ongoing operations at a single
"proieet". $uch damages will erodo
the General Aggregate Limit as
provided in paragraph 3. above.
b. The Project GeneralAggregate Limit:
{1) Applies only t0 "occurrences"
aitributed solely to ongoing operations
at a single "projecl"; and
(2) Does not include damages for
Coverage B Personal and
Advertlsing lnjury Liability, no
matter where or in how many
"projects" the offense or ollenses may
bo committed. Such damages will
erode the General Aggregate Limit as
provided in paragraph 3. above.
c. Any payments made under this paragraph
5., lor damages for "bo<lily injury",
"property darnage", or medical expenses
under Coverage C, shall reduce the
Maximum Annual Aggregate Limit and the
Project General Aggregate for that
"project". Such payments shall not
reduce the General Aggregate Limit or the
Products-Completed Operations
Aggregate Limit nor shall they reduce any
other Projecl General Aggregate Limit.
Form HS 25 42 06 08 Page 2 ol 3
6. Products-Completed Operations
Aggregate Limit
The Products-Completed Operations
Aggregate Limit is the most we will pay for
damages because of "bodily injury" and
"property damage" included in the "products-
completed operations hazard".
7. Personal And Advertising lnlury Llmit
Subjecl to 3. above, the Personal and
Advertising lnjury Limit is the most wo will pay
under Coverage B Personal and
Advertising lnjury Liability for the sum of all
damages because of all "personal and
advertising injury" sustained by any one
person or organization.
L Occurrence Llmit
Subject to 3., 4., 5., or 6. above, whichever
applies, the Each Occurrence Limit is the
mosl. we will pay for damages under "bodily
injury" or "proper$ damage" arising out of any
one "occurrenoe".
9. Damages To Premlses Rented To You
Llmit
Subject to 8. above, the Damage to Prernises
Rented lo You Limil is the most we will pay for
damages because of "property damage" to
any one premises, while rentod to you, or in
ths case of damage by fire, lighlning or
explosion, while rented lo you or temporarily
occupied by you with permission of the owner.
ln the case of damage by fire, lightning or
explosion, the Damage io Premises Flented to
You Limit applies to all darnage proximately
caused by the same event, whether such
damage results from fire, lightning or
explosion or any combination o{ these.
The Damage to Premises Rented to You
Coverage is not subject lo any Location
General Aggregate Limit or any PrCIject
General Aggregatg Limit, but will erode the
General Aggregate Limit.
10. Medical Expense Limit
$ubject to 3,, 4., or 5. above, whichever
applies, the Medical Expense Any One
Person Limit is ih€ most we will pay under
Coverage C Medical Payments lor all
medical expenses because of "bodily injury"
sustained by any one person.
Such Medical Payments Coverage is subject
to either the Localion General Aggregate
Limit, Project General Aggregate Limil or the
General Aggregate Limit as provided in
paragraphs 3., 4., or 5. above.
'11. How Limits Apply To Additional lnsureds
lf you have agreed in a written conlract or
written agreement that another person or
organization be added as an additional
insured on your policy, the most we will pay
on behalf of such additional insured is lhe
lesser ol:
(1) The limils of insurance specified in the
written contract or written agreement; or
{2) The Limits ol lnsurance shown in the
Declarations.
Such amount shall be a parl of and not in
addition to Limits ol lnsurance shown in the
Declarations and described in this $ection.
12. lf More Than One Limit ol lnsurance
Applies
It more than one limit ol insurance under this
Coverage Part and any endorsements
attachod thereto appties to any claim or "suit",
lhe most we will pay under this Coverage Part
and such endsrsemenls is the single highest
limit ol liability of all coverages applicable to
such clainr 0r "suit".
However, this paragraph 12. does not apply to
the Medical Expense Limit for Coverage C.
The Limits o{ lnsurance of this Coverage Part apply
separately to each consecutive annual period and to
any remaining period of less than 12 months, starting
with the beginning of the policy period shown in the
Declarations, unless the policy period is extended
after issuance {or an additional period of le$s than 12
months" ln that case, the additionat period will be
deemed part of the last preceding period for purposes
o{ determining ihe Limits of lnsuranco.
B. For the purpo$es of this endorsemenl, the
Definitions Section is amended by the addition of
the following definilions :
"Location" means premises involving the same or
connecting lots, or premises whose connection is
interrupted cnly by a street, roadway, waterway or
right ol way o{ a railroad,
"Project" means a jobsite including premises
involving the same or connecling lots, or premises
whose connection is interrupled only by a street,
roadway, waterway or righl ol way o{ a railroad. lf
a "project" has been abandoned and then
restarted, or if the authorized contracting parties
deviate lrom plans, blueprints, designs,
specifications or timetables, the project will still be
deemed as the same proiect.
Form HS 25 42 06 08 Page 3 ol 3
POLICY NUMBER: g2tiUN0LS66Z
THI$ ENDORSEMENT CHANGES THE POLICY. PLEASE HEAD IT CAHEFULLY,
NOTICE OF CANCELLATION
TO DTSIGNATED CERTIFICATE HOLDER
tr
SCHEDULE
Number of Days Notice:
Part A; *fl____
part B: _ 10_ _
Part C: 30
Name of Certilicate Holder:
ANY PERSON OR ORGANIZATION TO WHOM
YCIU HAVE AGREED IN A WRITTEN CONTRACT.
Mailing Address:
THE AI}DRESS FOR THAT PERSON OR ORGANIZATION
INCLUDED IN SUCH WRITTEN CONTRACT,
This policy is subject to the foltowing additionat
Conditions when a number of days are shown in the
Schedule for any of the above Parts.
A. ll this policy is cancetled by the Company, other
than tor nonpaymenl of premium, notice of such
cancellation will be provided to the certilicate
holder in the Schedule, at least the number of
days in advance ol the cancellation ef{ective date,
as shown in Part A.
B. lf this policy is cancefled by the Company for
nonpayr*ent of premium, notice o{ such
cancellalion will be provided to the certificate
holder in the Schedule within the number of days
notice of the cancellation effective date, as shown
in Part B.
C. lt this policy is cancelled by the insured, notice of
such cancellation will be provided to the certificate
holder in the Schedule, wilhin the number of days
notice of the canceflation eflective date, as shown
in Part C.
lf notice is mailed, proo{ ol mailing notice to the
certiiicate holder's mailing address as shown in
the Schedule will be sufficient proof ol notice. lf
the number of days notice in lhe schedule for any
Part is left blank or is shown as zero, no notice will
be provided to the $cheduled certi{icate holder
under that Par{.
Any notification rights provided by this
endorsernent apply only to active certiticate
holde(s) who were issued a certificate of
insurance applicable to this poliey's terrn
Failure to provide such notice to the certiticate
holder(s) will not amend or extend the date the
cancellation becomes effective. nor will it negate
cancellation of the policy. Faifure to send notice
shall impose no liability of any kind upon the
Company or ils agents or representatives.
Form lH 03 15 06 11
€) 2011, The Hartford
Fage 1 ol 1
POLICY NUMBER: 52UENOL5663
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE HEAD IT CAREFULLY.
NOTICE OF CANCELLATION
TO DESIGNATED CERTIFICATE HOLDER
SCHEDULE
Number of Oays Notice:
Part A: - ".10--- -
Name of Certilicate Holder:
ANY PERSON OR ORGANTZATION TO WHOM
YOU HAVE AGREED IN A WRITTEN CONTRACT.
Mailing Address:
TIIE ADDRE$S FOR THAT PERSON OR ORGANIZATION
INCLUDEO IN SUCH WRITTEN CONTRACT,
Part B:'t0
Part C: -.1..9--""" ""-".
This policy is subject to the following additional
Conditions when a number of days are shown in the
Schedule for any of the above Parts.
A. lf this policy is cancelled by the Company, other
than for nonpayment of prenrium, notice of such
cancellation will be provided to the certificate
holder in the Schedule, at least the number of
days in advance of the cancellation elfective date,
as shown in Part A.
B. lf this policy is cancelled by the Company lor
nonpayment of premium, notice o{ such
cancellation will be provided to the certificate
lrolder in the Schedule within the number of days
notice of the cancellation efiective date, as shown
in Part B.
C. lf this policy is cancelled by the insured, notice ot
such cancellation will be provided to the cerlificate
holder in the Schedule, within the number of days
notice of the cancellation eflective date, as shown
in Part C.
lf notice is mailed, prco{ o{ mailing notice to the
certificate holder's mailing address as shown in
the Schedul€ will be su{ficient proof ol notice. l{
the number of days notice in the schedul€ for any
Part is teft blank or is shown as zero, no notice will
be provided to the Scheduled certificate holder
under that Part.
Any notification rights provided by this
endorsement apply only to active certificate
holder(s) who were issued a certilicate of
insurance applicable io this policy's term
Failure io provide such notice to the certifieate
holder(s) will not amend or extend the date the
cancellation becomes effective, nor will ii negate
cancellation ol the poticy, Faiture to send notice
shall impose no liability of any kind upon the
Company or its agenB or representatives.
Form lH 03 15 06 11
O 20'11, The Hartford
Fage 1 ol 1
THIS ENDOR$EMENT CHANGES THE FOLICY. PLEASE READ IT CAREFULLY.
NOTTGE OF CANCELLATTON TO CERTTFTCATE HOLDER(S)
ANY PERSON OR ORGANIZATTON TO WHOM YOU HAVE AGREED IN A WRITTEN AGREEMENT OR CO}.ITRACT
Policy Number: 52VtlE0L6HBD
Eflective Date: 06130/2011
Named lnsured and Address:
This policy is subject to the following additional
Conditions:
A. lf lhis policy is cancetled by the Company, other
than for non-payment of premium, nolice of such
cancellalion will be provided at least thirty {30)days in advance ot the cancellation effective
date to the certificate holder(s) with mailing
addresses on file with the agent of record or the
Company,
B. l{ this policy is cancelled by the Company for
non-payment of premium, CIr by the insured,
notice of such cancellation will be provided
within ten {10) days of the cancellation elfective
date to the certificate holderts) with mailing
addresses on lile with the agent of record or the
Company.
Form WC Sg 03 94 Printed in U.S.A.
Process Date: 06/3012022
Endorsement Number: "
Effective hour is the same as stated on the lnformalion Page of the policy
il notice is mailed, proof of mailing to the last known
mailing address of the cerlificate holder(s) on fite
with the agent ot record or lhe Company will be
sufficient proof of notice.
Any notification rights provided by this endorsement
apply only to active certificate holde(s) who were
issued a certificate ol insurance applicable to this
policy's term.
Failure to provide such notice to the certificate
holder(s) will not amend or extend the date the
cancellation becomes effective, nor will it negate
cancellation of the policy. Failure to send nolico
shall impose no liability of any kind upon the
Company or ils agents or representatives.
@2011, The Hartford
Policy Expiration Date: 0613012023
wos.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WORKERS' COMPENSATION BROAD FORM ENDOR$EMENT
EXTENDED OPTIONS
Policy Number: 52WEOL6H8D
Effective Date: 95y3912922
Named lnsured and Address:
Endorsement Number:
Effective hour is the same as stated on the lnformation Page of the policy.
ANY PERSON OR ORGANIZATTOI.I TO WHOM YOU HAVE AGREED IN A WRITTEN AGREEMENT OR CONTRACT.
Section I of this endorsement expands coverage provided under WC 00 00 00.
Section ll of this endorsement provides additional coverags usually only provided by endorsernent.
Section lll of this endorsement is a Sohedule of Covered State$.
You may use the index to locate these coverage fealures quickly;
INDEX
SUBJECT PAGE $vBJECT PAC,,H
sEcTroN r
PARTS ONE and TWO
01 We WillAlso Pay
PART . THREE
02 How This lnsurance Works
PART. SIX
03 Transfer of Your Rights and Duties
04 Cancellation
05 Liberalization
sEcTroN il
VOLUNTARY COMPENSATION
INSURANCE
06 Voluntary Compensation lnsurance
A. How This lnsurance Appties
B. We WillPay
C- Exclusions
D. Before We Pay
E. Recovery From OthersF. Employers' Liability lnsurance
EMPLOYERS' LIABILITY STOP GAP
ENDORSEMENT
07 Employers' Liability Stop Gap
Coverage
A, Stop Gap Coverage Limited to
Montana, North Dakota, Ohio,
Washington, West Virginia and
Wyoming
Form WC 99 03 01 B Printed in U.S.A. (Ed.8i00)
O 2000, The Hartford
B. Part One Does Not Apply
C. Application of Coverage
D. Additional Exclusions
E. West Virginia
EXTENDED OPTIONS
01 Employers' Liability Insurance
02 Unintentional Failure to Disclose
Haeards
03 Waiver of Our Righl to Recover from
Others
04 Foreign Voluntary Compensation
A. How This Reimbursement Applies
B. We WillReimburse
C. Exclusions
D. Before We Pay
E. Recovery From Others
F. Reimbursement For Actual Loss
SusLained
G. Repatriation
H. Endemic Disease
05 Longshore and Harbor Workers'
Compensation Act Caverage
Endorsement
sEcTloN Ht
01 Schedule of Covered States
2
2
2
2
2
I
2
2
2
2
L
2
z
3
J
J
3
3
3
3
J
J
3
3
3
.+
4
4
q
.+
4
4
4
q
5
5
5
5
5
6
6
Page 1 of 6
PARTS ONE and TWO
1. WE WILL ALSO PAY
D" Vire Will Also Pay of Part One (WORKFR$'
COMPEN$ATION TNSURANCE); and
E. We Will Also Pay of part Two
(EMpLOyERS', LtABtLtTy |N$URANCE) is
replaced by the foltowing:
We WillAlso Pay
We wilt also pay these eosts, in addition to
other amounts payable under this insurance,
as part of any claim, proceeding, or suit we
defend:
1. reasonable expen$es incurred at our
requesl, INCLUDING loss of earningsi
2. premiums for bonds to release
attachments and for appeal bonds in
bond amounts up to the limit of our
liability under this insurance;
3. litigation costs taxed against you;
4. interest on a judgment as required by
law until we offer the amount due under
this law: and
5. expenses we incur.
PART THREE
2, How This lnsurance Applies
Paragraph 4, a{ A. How Thls lnsurance
Applies sf Part 3 (Other $tates tnsurance) is
replaced by the following:
4. lf you have work on ihe effeetive date of this
policy in any state not listed in ltem 3.A. of
the lnformation Page, coverage will not be
afforded for that state unless we are notified
within slxty days.
PART SIX
3. Transfer Of Your Rights and Duties
C. Transfer Of Your Rights and Duties of
Part 6 (Conditions) is reptaced by the
following:
Your rights or duties under this policy maynot be transferred without our written
consenl.
lf you die and we receive notice within $ixty
days after your death, we will cover your
legal representative as insured.
4, Cancellation
Paragraph 2. of D" Cancellation of Part 6
(Conditions) is replaced by the foftowing:
2. We may cancel this policy. We musl mail or
deliver to you not less than 15 days advance
written notice stating when the cancellation
is to take effect. Mailing that notice to you at
your mailing address shown in ltem 1 of the
lnformation Page will be sufficient to prove
notice.
5. Llberalization
lf we adopt a change in this form that would
broaden the coverage of this form without extra
charge, the broader coverage will apply to tlris
policy. lt witl apply when the change becomes
effective in your state.
2, The bodily injury must arise out of and in
the course of employment or incidental
to work in a state shown in ltem 3.A. of
the lnformation Page.
3. The badily lnjury must occur in the
United States of America, its territories
or possessions, ot Canada, and may
occur elsewhere if the enrployee is a
United States or Canadian citizen, or
otherwise legal resident, and legally
employed, in the United States or
Canada and temporarily away {rom
those places.
sEcTtoN r
sEcTroN u
VOLUNTARY COMPENSATION AND
EMPLOYERS' LIABILITY COVERAGE
6. VoluntaryCcmpensation lnsurance
A. How This lnsurance Appliee
This insurance applies to bodily injury by
accident or bodily injury by disease. Bodily
injury includes resulting death.
1" The bodily injury must be sustained by
any officer or employee not subject to
the workers' compensation law of any
state shown in llem 3 A of the
lnformation Page.
Forrn WC 99 CI3 01 B Frinted in U.S.A. {8d.8100}Page 2 of 6
4. Bodily injury by accident must occur
during the policy period"
5. Bodily injury by disease must be caused
or aggravated by the conditions of the
officer's or employee's employment.
The officer's or employee's last day of
last exposure to the conditions cau*ing
or aggravating such bodily injury by
disease rnust occur during the policy
period.
B. We Will Pay
We will pay an amount equal to the benefits
thet would be required of you as if you and
your employees were subject to the workers'
conrpensation law of any state shown in ltem
3.A. of the lnformation Page. We will pay
those amounts to the p€rsons who would be
entitled to thenr under the law.
C. Excluslon
This insurance does not cover:
1. any obligation imposed by workers'
ccmpensation or occupational disease
law or any similar law.
2. bodily injury intentionally causeeJ ar
aggravated by you,
3. officers or employees who have elected
not to be subject to the state workers'
compensation law.
4. partners or sole proprietors not covered
under the Standard Sole Proprietors,
Partner$, Officers and Others Coverage
Endorsement,
D. Before We Pay
Before we pay benefits to the persons
entitled to them, they must:
1. Release you and us, in writing, of all
responsibility for the injury or death,
2. Transfer to us their right to recover from
others who may be responsible for the
injury or death.
3. Cooperate with us and do everything
necessary to enable us to enforce the
right to recover from others.
lf the persons entitled to the benefits of this
insurance fail to do those things, our duty to
pay ends at once. lf they claim damages
from you or from us for the injury or death,
our duty to pay encls at once.
E. Recovery From Others
lf we make a recovery fronr others, we will
keep an amouni equal to our expenses o{
recovery and the benefits we paid. We will
pay the balance to the persons entitled to it.
lf the persons entitled to the benefits of this
insurance make a rocovery from others, they
must reimbur$e us for lhe benefits we paid
ihem.
F. Employers' Liability lnsurance
Part Two (Employers' Liability lnsurancei
applies to bodily injury covered by this
endcrsement as though the State of
Employrnent was shown in ltem 3.A. of the
lnformation Page.
This provision 6. does not apply in New Jersey or
Wisconsin.
EMPLOYERS' LIABILITY STOP GAP COVERAGE
7, Employers'Liability Stop Gap Coverage
A. This coverage only applies in Montana,
North Dakota, Ohio, Washington, West
Virginia and Wyoming.
B. Part One (Workers' ComBensatlon
lnsurance) doe* not apply to work in states
shown in Paragraph A above.
C, Part Two (Employers' Liability lnsurance)
applies in the states, $hown in Paragraph A.,
as lhough they were shown in ltem 3.A. of
the lnformation Page.
D. Part Two, Seciion C, Exclusions is changed
by adding these exclusions,
This insurance does not cover;
5. bodily injury intenlionally caused or
aggravated by you or in Ohio bodily
injury resulting from an act which is
determined by an Ohio court cf law to
have been commitled by you with the
belief than an injury is substantially
certain lo occur. However, the cost of
defending such claims or suits in Ohio is
covered.
13. bodily injury sustained by any member of
ihe flying crew of any aircraft.
'14. any claim for bodily injury with respect to
which you are deprived of any defense
or defenses or are otherwise subject to
penalty because of default in premium
under the provisions of the workers'
cornpensation law or laws of a state
shown in Paragraph A.
E. This insurance applies to damages for which
you are liable under West Virginia Code
Annot. g 23-4-2.
Form WC Sg 03 01 B Printed in U.S.A. (Ed. Bl00)Page 3 of 6
1. Employers' Liability lnsurance
Item 3.8, of the lnformation Page is replaced
by the following;
B. Employers' Liahilitylnsurance:
1. Part Two of the policy applies to work in
each siate listed in ltem 3.A.
The Limits of Liability under Part Two
are lhe higher of:
Bodily lnjury
by Accident $500,000 Each Accident
Bodily lnjury
by Disease $500,000 Policy Limit
EXTENDED OPTIONS
-$i9
q' 999""-."-Es-sl .Fsrle.yse
4, Foreign Voluntary Componsation and
Employers' Liability Reimbursement
A, How This Reimbursement Applies
This reimbursement provision applies to
bodily injury by accident or bodity injury by
disease. Bodily injury includes resutting
death.
1. The bodily injury must be sustained by
an officer or employee.
2. The bodily injury must occur in lhe
course of employment nece$sary or
incidental to work in a country not listed
in Exclusion e.1^ of this provision.
3. Bodily injury by accident must occur
during the policy period.
4. Bodily injury by disease must be caused
or aggravated by the conditions of your
employment. The officer or employee's
last exposure to those conditions of your
employment must occur during the
policy period.
B. We WillReirnburse
We will reimburse you for all amounts paid
by you whether such amounts are:
1. voluntary payments for the benefits that
would be required of you if you and your
officers or employees were subject to
any workers' compensation law of the
state of hire of the individualemployee,
2. sums to which Part Two (Employers'
Liability lnsurance) would apply if the
Country of Employment were shown in
Item 3.A. of the lnformation Page.
C, Exclusions
This insurance dses not cover;
1. any occurrences in the United $tates,
Canada, and any country or jurisdiction
which is the subject of trade or
economi0 sanctions imposed by the
laws or regulations of the United States
of America in effect as of the inception
date of this policy.
2. any obligation imposed by a workers'
compensalion or occupational disease
law, or similar law.
3. bodily injury intentionally caused or
aggravaiulj by you.
Bodily lnjury
by Disease
OR
2. The amount shown in the lnformation
page.
This provision 1 of EXTENDED OPTION$ does
not apply in New York because the Limits Of Our
Liability are unlimited,
ln this provision the limits are changed from
$500,000 to $1,000,000 in Catifornia.
2. Unintentional Failure to Disclose Hazards
lf you unintentionally shoulcl fail to disclose all
existing hazards at the inception clale of your
policy, we shall not deny coverage under this
policy because of such failure.
3. Waiver of Our Right To Recover From Others
A. We have the right to recover our payments
from anyone tiable for an injury covered by
this policy. We will not enforce our right
against any person or organization for whom
you perform work under a written contract
lhat requires you to obtain this agreement
frorn us.
This agreement shall not operate direcfly or
indirectly to benefil anyone not named in the
agreement.
B. This provision 3. dses not apply in the states
of Pennsylvania and Ulah.
Form WC 99 03 01 B Printed in U.S.A. (Ed.8100)Page 4 of 6
4. liability for any con$equenc€, whether
direct or indirect, of war, invasion, act of
Foreign enemy, hoslilities {whether war
be declared or not), civil war, rebellion,
revolution, insurrection or military or
usurped power. No endorsement now
or subsequently attached to this policy
shall be conslrued as oveniding or
waiving this limitation unless specific
reference is made thereto.
0. Before We Pay
Before we reimburse you for the benefits to
the persons entitled to them. you must have
them:
1. release you and us, in writing, of all
responsibility for the injury or death,
2. transfer to us their right to recover from
others who may be responsible for their
injury or death,
3. cooperate with us and do everything
necessary to enable us to enforce the
right to recover from others.
lf the persons entitted to the benefits paid fail
to do these things, our duty lo reimburse
ends at once. lf they claim damages from
us for the injury or death, our duty to
reimburso ands at once.
E. Recovery From Others
lf we make a recovery from others, we will
keep an amount equal to our expenses of
recovery and the benefits we reimbursed.
We will pay the balance to the per$ons
entitled to it. lf persons entitled to the
benefits make a recovery from others, they
must repay us for the amounts that we have
reimbursed you.
F. Reimbursement for Actual Loss
Sustained
This endorsement provides only for
reimbursement for the lsss you actually
sustairr. ln order for you to recover loss or
expenses under this reimbursement you
must:
1. actually sustain and pay the loss r:r
expense in money after trial, or
2. secure our consent for the paymenl of
the loss or expensa.
G. Repatriation
Our reimbursemenl includes the additional
expenses of repatriation to the United States
of America necessarily incurred as a direct
result of bodily injury.
Our reirnbursement shall be limiled as
follows:
1" to the amount by which such expenses
exceed the normal cost of returning the
officer or employee if in good healih, or
2. in the event of death, to the amount by
whiclr such expenses exceed the normal
cost of returning the officer or employee
if alive and in goad health.
ln no event shall our reimbursement exceed
the bodily injury by accident limit shown in
Item 3.8. of the lnformation Page as
respects any one such officer or employee
whether dead or alive,
H. Endemic Dlsease
The word "disease" includes any endenric
diseases.
The coverage appties as if endemic
disease* were included in the provisions of
the workers' compensation law,
5. Longshore and Harbor Workers'
Compensation Act Coverage
General Section C. Workers' Compensation
Law is replaced by the following:
C. Workers' Compensation Law
Workers' Compensation Law means the
workers or workers' compensation law and
occupational disease law of each state or
territory named in ltem 3.A. of the
lnformation Page and the Longshore and
Harbor Workers' Compensation Act {33
USC Sections 901-950). lt includes any
amendments to those laws that are in effect
during the policy period. lt does not include
any other federal workers or workers'
compensation law, other federal
occupational disease iaw or the provisions of
any f aw that provide nonoccupational
disability bene{ils.
Parl Two (Employers' Liability lnsurance), C"
Exclusions, exclusion 8, does not apply to
work subject to the Longshore and Harbor
Workers' Compensation Act.
This coverage does not apply to work
subject to the Defense Base Act, the Outer
Continental $helf Lands Act, 0r the
Nonappropriated Fund lnstrumentalities Act.
Form WC 99 03 01 B Printed in U.S.A. (Ed. 8/00)Page 5 of 6
sEcTtoN ilt
1. SCHEDULE OF COVERED STATES
A. This endorsement only applies in ths etates
listed in this Schedule bf CbvereO States.
C. $chedule of Covered Stales:
Countersigned by
g, lf a state, shovrnr in ltem 3"A, of thelnfonnatlrn Page, spprove$ this
endcrsement after the effective date of this
policy- this endorsernent will apply to {his
policy, The coverage will apply in the new
otate on the effective date of the stata
appraval.
Authorized Representative
Form WC 9S 03 01 B Printod in U.$.A. {Ed. el00}Page 6 of 6
I TERRA
INSURANCE COMPANYTerra lnsurance Company
(A Risk Retention Group)
Two Fifer Avenue, Suite I O0
Corte Madera, CA 94925
DATE
0y0r/22 CERTIFICATE OF INSURANCE
CERTIFICATE HOLDER
City of Kent
Attn: Chad Bieren, PE
220Fourt Avenue South
Kent, WA 968032
This certifies that the "claims made" insurance policy (described below by policy number) written on forms in
use by the Company has been issued. This certificate is not a policy or a binder of insurance and is issued as a
matter of information only, and confers no rights upon the certificate holder, This certificate does not alter,
amend or extend the coverage afforded by this policy,
The policy of insurance listed below has 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 policy described herein is
subject to all the terms, exclusions and conditions of such policy. Aggregate limits shown may have been
reduced by paid claims.
TYPE OF INSURANCE Professional Liability
POLICY NUMBER
222019
EFFECTIVE DATE
ot/0U22
EXPIRATION DATE
l2l3U22
LIMITS OF LIABILITY $3,000,000
$3,000,000
EACH CLAIM
ANNUAL AGGREGATE
PROJECT DESCRIPTION
McCoy Levee Repair, City of Kent. GeoEngineers No. 0410-172-13
CANCELLATION: lf the described policy is cancelled by the Company before its expiration date,
the Company will mail written notice to the certificate holder thirty (30) days in advance, or ten
(lO) days in advance for non-payment of premium. lf the described policy is cancelled by the
insured before its expiration date, the Company will mail written notice to the certificate holder
within thirty (30) days of the notice to the Company from the insured.
NAME AND ADDRESS OF INSURED ISSUING COMPANY:
TERRA INSURANCE COMPANY
(A Risk Retention Group)GeoEngineers, Inc.
1101 S. Fawcett Avenue, Suite 200
Tacoma, WA 98402 fu;otg
President