HomeMy WebLinkAboutIT17-293 - Insurance Certificate - Computlink Management Center, Inc dba Laserfiche - Insurance Certificate - page 1 of 9
03/15/2024
McGriff Insurance Services
PO Box 819
Wilson NC 27894-0819
5400 H
City of Kent
220 Fourth Avenue South
Kent,WA 98032
279
page 2 of 9
Client#:1258425 305COM PU M GM
ACORDTM CERTIFICATE OF LIABILITY INSURANCE FDAT.(MM/DD/YYYY)
3/14/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW,THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER,
IMPORTANT:If the certlficate holder Is an ADDITIONAL INSURED,the policy(€ea}must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on
this certificate does not confer 11r1y rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CO ACT
NA E: Aide Rad111a
McGriff Insurance Services LLC P144NE - - - FAX
vc,N.,�l 714 941-2850 {Aic,Not, 877-297-9245
130 Theory Ste 200 a, llg: arad-il.la@mcgrlff.com
Irvine, CA 92617 -. --714 941-2800 -
#NSUREA(S)•AFFORDING COVERAGE NAIC#
INSURER A:StarNet Insurance Company 40M
INSURED INSURER B:Allmerlca Financial Benefits 41840 _
Compulink Mgmt Center Inc INSURER C:Berkley National Insurance Company 38911
dba Laserfiche
3443 Long Beach Blvd. INSURER D;
Long Beach, CA 90807-4432 INSURER E:
_ INSURER F.
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
_ TYPE OF INSURANCE jga`sua POLICY f4UMDER POLICY EFF. POLLICY EX p..
tMdVOD1YYYY} {MMIDDIYYYY LIMITS
A X COMMERCIAL GENERAL LIABILITY TCP701616014 3113/2024 03/13/20 EACH OCCURRENCE $1 000000
ppAq qq 7
CLAIMS-MADE JOCCUR .pR[FAsS acc n9e„.rl¢e $1,=000
MEDEXP Ihiy one peirwon) s15i000
PERSONAL&ADV INJURY $1 00D 000
GEN'L AGGREGATE LIMIT APPLIES PER: GENER
PRO- AL AGGREGATE $2,000,ODO
��
POLICY F�JECT I n I LOG PRODUCTS-COMPIOP AGG $Z
OTH ER:
C. AUTOMOBILE LIABILITY TCA702211711 D3M 3/2024 03/1=02d-OMOINED SiNOLE:t_IMIr 1,000,000
Xl ANY AUTO BODILY INJURY(Per person) $
OWNED L
ULED
AUTOS ONLY BODILY INJURY(Per accident) $
HIRED WNED
XAUTOS ONLY X ONLY PROPERTY ar DAMACE $
A X UMBRELLA LIAB CUR TCP701616014
0113/2024 O3/1312 EACH OCCURRENCE $�Q O00 fl00
EXCESS LIAB IMS•MADE AGGREGATE _$20�000,000
DED RETENTIONS Personal 4 Adv In u _ s20,000 p00
B WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY W23H44370103 /01/2024 01/0112025;X PER oTrl.
Y'1 N. bT�u- — -
ANY PIIOPRIET'OWPARTNERIEXECUTIVE
OFFICEEWMEMHE'R EXCLUD✓D? J N/A E.L.EAGF#pOEiOENT 1,000 O00
(Mer[da[ory In NH)4 E.L.DISEA-SE ' $ L00..-0-,000YE
HI7OOFOPERATIONS below _ _ E.L.DISEASE-POLCY LIMIT_ $`1 G]�_OOO
"SEE BELOW FOR ""SEE BELOW FOR
ADDITIONAL ADDITIONAL
COVERAGES" COVERAGES—
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
Certificate is subject to policy limits,conditions and exclusions.
ADDITIONAL COVERAGE/POLICY INFORMATION:
(See Attached Descriptions)
CERTIFICATE HOLDER CANCELLATION
City of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
220 Fourth Avenue South ACCORDANCE WITH THE POLICY PROVISIONS.
Kent,WA 98032-0000
AUTHORRED REPRESENTATIVE
0 1 988-201 5 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD
280 #S33958099/M33955623 AFRAD
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. --77771
.:......::...:.......:...................:............
DESCRIPTIONS (Continued from Pa'gel)
C. Insurer: Steadfast Insurance Company(Non Admitted)- NAIC#: 10172
Technology E&O, Cyber, Privacy& Network Security and Media Liability Claims Made Policy
Policy#EOC390488202
Policy Effective: 03/13/2024- Policy Expiration: 03/13/2025
$5,000,000 Each Claim
$5,000,000 Each Aggregate
$100,000 Retention
D. Insurer: Crum&Forster Specialty Insurance Co.(Non Admitted)- NAIC#:44520
Technology E&O, Cyber, Privacy&Network Security and Media Liability Claims Made Policy
Policy#EOL241143
Policy Effective:03/13/2024-Policy Expiration: 03/13/2025
$5,000,000 Each Claim
$5,000,000 Each Aggregate
$100,000 Retention
Excess of underlying$5,000,000 Each Claim/Aggregate Limits
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This Certificate only applies to the operations for which our Insured actually performs work and is
referenced by written contract between the Certificate Holder and our Insured. Certificate Holder Is
included as Additional Insured as respects General Liability as required by written contract.
SAGITTA 25.3(2016/03) 2 of 2W`�
#S33958099/M33955623
281
0 page 4 of 9
link Mgmt Center Inc
TCP701616014 COMMERCIAL GENERAL LIABILITY
CG 83 60 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY EXTENSION FOR TECHNOLOGY
COMPANIES ENDORSEMENT
This Endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
This endorsement broadens coverage, The following schedule of coverage extensions is a general coverage
description only, Limitations and exclusions may apply to these coverages. Read all the provisions of this
endorsement along with your entire policy carefully to determine the extent of coverage afforded.
SCHEDULE OF COVERAGE EXTENSIONS
A. Additional Insured —Lessors of Leased L. Duties in the Event of Occurrence, Offense,
Equipment Claim or Suit
B. Additional Insured —Owners, Managers or M. Expected or Intended Injury or Damage
Lessors of Premises (Property Damage)
C. Additional Insured - Primary and Non- N. Damage to Premises Rented To You
contributor
D. Additional Insured —Vendors O. Medical Payments
E. Additional Insured —Written Contract or P. Non-owned Aircraft
Agreement
F. Aggregate Limit Per Location Q. Non-owned Watercraft
G. Amateur Athletic Participants R. Newly Acquired or Formed Organizations
H. Bodily Injury Definition S. Supplementary Payments
I. Broadened Named Insured T. Unintentional Omission
J. Damage to Property—Borrowed Equipment, U. Waiver of Subrogation -Blanket
Customer Goods, Use of Elevators
K. Good Samaritan Services
A. ADDITIONAL INSURED -LESSORS OF LEASED EQUIPMENT
Under Section II -Who Is An Insured, the following is added:
Any person or organization that is an equipment lessor is an insured, but only with respect to liability for"bodily
injury", "property damage", "personal and advertising injury"caused, in whole or in part, by your acts or
omissions in the maintenance, operation or use by you of equipment leased to you by such equipment lessor.
The insurance provided to such equipment lessor does not apply to any"bodily injury"or"property damage"
caused by an "occurrence"that takes place, or"personal and advertising injury"caused by an offense that is
committed after the equipment lease expires.
B. ADDITIONAL INSURED -OWNERS, MANAGERS OR LESSORS OF PREMISES
Under Section II -Who Is An Insured, the following is added:
Any person or organization that is a premises owner, manager or lessor is an insured, but only with respect to
liability arising out of the ownership, maintenance or use of that part of any premises leased to you.
The insurance provided to such premises owner, manager or lessor does not apply to:
1. Any"bodily injury"or"property damage"caused by an 'occurrence"that takes place, or"personal and
advertising injury"caused by an offense that is committed, after you cease to be a tenant in that premises;
or
2. Structural alterations, new construction or demolition operations performed by or on behalf of such
premises owner, manager or lessor.
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E.
C. ADDITIONAL INSURED -PRIMARY AND NON-CONTRIBUTORY
The following is added to the Other Insurance Condition and supersedes any provision to the contrary:
This insurance is primary to and will not seek contribution from any other insurance available to an additional
insured under your policy provided that:
1. The additional insured is a Named Insured under such other insurance; and
2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not
seek contribution from any other insurance available to the additional insured.
D. ADDITIONAL INSURED -VENDORS
Under Section II -Who Is An Insured,the following is added:
Any person or organization that is a vendor and that you have agreed in a written contract or agreement to
include as an additional insured on this Coverage Part is an insured, but only with respect to liability for"bodily
injury" or"property damage"that:
1. Is caused by an "occurrence"that takes place after you have signed and executed that contract or
agreement; and
2. Arises out of"your products"which are distributed or sold in the regular course of such vendor's business.
The insurance provided to such vendor is subject to the following provisions:
1. The limits of insurance provided to such vendor will be the limits which you agreed to provide in the written
contract or agreement, or the limits shown in the Declarations, whichever are less.
2. The insurance provided to such vendor does not apply to:
a. Any express warranty not authorized by you;
b. Any change in "your products"made by such vendor;
c. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the
substitution of part under instructions from the manufacturer, and then repackaged in the original
container;
d. Any failure to make such inspections, adjustments, tests or servicing as vendors agree to perform or
normally undertake to perform in the regular course of business, in connection with the distribution or
sale of"your products";
e. Demonstration, installation, servicing or repair operations, except such operations performed at such
vendor's premises in connection with the sale of"your products"; or
f. "Your 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 on behalf of such vendor.
Coverage under this provision does not apply to:
1. Any person or organization from whom you have acquired "your products", or any ingredient, part or
container entering into, accompanying or containing such products; or
2. Any vendor for which coverage as an additional insured specifically is scheduled by endorsement.
E. ADDITIONAL INSURED -WRITTEN CONTRACT OR AGREEMENT
Under Section II -Who Is An Insured,the following is added:
Any person or organization that is not otherwise an insured under this Coverage Part and that you have agreed
in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but
only with respect to liability for"bodily injury"or"property damage"that:
1. Is caused by an "occurrence"that takes place after you have signed and executed that contract or
agreement; and
2. Is caused, in whole or in part, by your acts or omissions in performance of your ongoing operations to
which that contract or agreement applies or the acts or omissions of any person or organization performing
such operations on your behalf.
The limits of insurance provided to such insured will be the limits which you agreed to provide in the written
contract or agreement, or the limits shown in the Declarations, whichever are less.
F. AGGREGATE LIMIT PER LOCATION
1. Under Section III -Limits Of Insurance, the following is added:
The General Aggregate Limit applies separately to each of your"locations" owned by or rented or leased to
you.
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2. Under Section V-Definitions, the following is added:
"Location"means premises involving the same or connecting lots, or premises whose connection is
interrupted only by a street, roadway, waterway or right-of-way of a railroad.
G. AMATEUR ATHLETIC PARTICIPANTS
Under Section II -Who Is An Insured, the following is added:
Any person representing you while participating in amateur athletic activities that you sponsor. However, no
such person is an insured for:
1. "Bodily injury"to:
a. A co-participant, your"employee"or"volunteer worker"while participating in amateur athletic activities
that you sponsor; or
b. You, any partner or member(if you are a partnership or joint venture), or any member(if you are a
limited liability company), or any"executive officer" (if you are an organization other than a partnership,
joint venture, or limited liability company); or
2. "Property damage"to property owned by, occupied or used by, rented to, in the care, custody, or control of,
or over which physical control is being exercised for any purpose by:
a. A co-participant,your"employee"or"volunteer worker"; or
b. You, any partner or member (if you are a partnership or joint venture), or any member(if you are a
limited liability company), or any"executive officer" (If you are an organization other than a partnership,
joint venture, or limited liability company).
H. BODILY INJURY
Under Section V-Definitions, the definition of"bodily injury" is deleted and replaced by the following:
"Bodily injury" means physical injury, sickness, or disease sustained by a person, including death resulting from
any of these. "Bodily injury" also means mental injury, mental anguish, humiliation, or shock sustained by a
person, if directly resulting from physical injury, sickness, or disease sustained by that person.
I. BROADENED NAMED INSURED
Under Section II -Who Is Insured, the following is added:
Any person or organization named in the Declarations and any organization you own,newly acquire or form, other
than a partnership,joint venture, or limited liability company, and over which you maintain more than 50% of
the interests entitled to vote generally in the election of the governing body of such organization will qualify as a
Named Insured if there is no other similar insurance available to such organization until the end of the policy
period.
Coverage under this provision does not apply to any person or organization for which coverage is excluded by
endorsement.
J. BROADENED PROPERTY DAMAGE -BORROWED EQUIPMENT,CUSTOMERS' GOODS AND USE OF
ELEVATORS
The insurance for"property damage" liability is subject to the following:
1. Under Section I -Coverages, Coverage A, Bodily Injury and Property Damage Liability, paragraph 2.,
Exclusions, item j., Damage To Property is amended as follows:
a. The exclusion for personal property in the care, custody or control of the insured does not apply to
"property damage"to equipment you borrow while at a job site and provided it is not being used by
anyone to perform operations at the time of loss.
b. The exclusions for:
(1) Property loaned to you;
(2) Personal property in the care, custody or control of the insured; and
(3) That particular part of any property that must be restored, repaired or replaced because"your work"
was incorrectly performed on it;
do not apply to"property damage"to"customers'goods"while on your premises nor do they apply to
"property damage"arising from the use of elevators at premises you own, rent, lease or occupy.
2. Subject to the Each Occurrence Limit, the most we will pay for"property damage"to"customers' goods" is
$25,000 per"occurrence".
3. Under Section V-Definitions, the following is added:
"Customers'goods"means goods of your customer on your premises for the purpose of being:
a. Repaired; or
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b. Used in your manufacturing process.
4. Under Section IV -Commercial General Liability Conditions,the insurance afforded by this provision is
excess over any other valid and collectible property insurance (including any deductible)available to the
insured whether such insurance is primary, excess, contingent or on any other basis. Any payments by us
will follow the Other Insurance- Excess Insurance provisions.
K. GOOD SAMARITAN SERVICES
1. Under Section II -Who Is Insured, paragraph 2., item d., the following is added:
This exclusion does not apply to your employees or volunteer workers, other than an employed or
volunteer physician, rendering"Good Samaritan services".
2. Under Section V-Definitions, the following definition is added:
"Good Samaritan services"means any emergency medical services for which no compensation is
demanded or received.
L. DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
Under Section IV-Commercial General Liability Conditions, paragraph 2., Duties In The Event Of
Occurrence, Claim or Suit is amended to include the following:
1. The requirements that you must:
a. Notify us of an "occurrence"offense, claim or"suit"; and
b. Send us documents concerning a claim or"suit'apply only when such accident claim, "suit' or loss is
known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) An executive officer of the corporation or insurance manager, if you are a corporation; or
(4) A manager, if you are a limited liability company.
2. The requirement that you must notify us as soon as practicable of an "occurrence"or an offense that may
result in a claim does not apply if you report an "occurrence"to your workers compensation insurer which
later develops into a liability claim for which coverage is provided by this policy, However, as soon as you
have definite knowledge that the particular"occurrence"is a liability claim rather than a workers'
compensation claim, you must comply with the Duties In The Event Of Occurrence, Offense, Claim Or Suit
Condition.
M. EXPECTED OR INTENDED INJURY OR DAMAGE (PROPERTY DAMAGE)
Under Section I -Coverages, Coverage A, Bodily Injury And Property Damage Liability, paragraph 2.,
Exclusions, item a., Expected Or Intended Injury, is deleted and replaced by the following:
a. Expected or Intended Injury
"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,
N. DAMAGE TO PREMISES RENTED TO YOU
If damage to premises rented to you is not otherwise excluded from this policy or coverage part, then the
following provisions apply:
1. The last paragraph under 2. Exclusions of Section I -Coverage A-Bodily Injury And Property
Damage Liability is deleted and replaced by the following:
Exclusions c. through n, do not apply to damage by fire, lightning, explosion, "smoke", or leakage from
automatic fire protective systems to premises while rented to you or temporarily occupied by you with the
permission of the owner, including the contents of premises rented to you for a period of seven or fewer
consecutive days.A separate limit of insurance applies to this coverage as described in Section III -Limits
Of Insurance.
2. The paragraph immediately after Sub-paragraph j.(6)of Paragraph 2. Exclusions of Section I -Coverage
A-Bodily Injury And Property Damage Liability is deleted and replaced by the following:
Paragraphs(1), (3)and (4)of this exclusion do not apply to"property damage"(other than damage by fire,
lightning, explosion, "smoke", or leakage from automatic fire protective systems)to premises, including the
contents of such premises, rented to you for a period of seven or fewer consecutive days. A separate limit
of insurance applies to Damage To Premises Rented To You as described in Section III -Limits Of
Insurance.
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3. Paragraph 6. of Section III -Limits Of Insurance is deleted and replaced by the following:
6. Subject to Paragraph 5. above, the greater of:
a. $500,000; or
b. The Damage To Premises Rented To You Limit shown in the Declarations;
is the most we will pay under Coverage A for damages because of"property damage"to premises
while rented to you, or in the case of damage by fire, lightning, explosion, "smoke", or leakage from
automatic fire protective systems, while rented to you or temporarily occupied by you with permission of
the owner, including the contents of such premises rented to you for a period of seven or fewer
consecutive days.
4. Subparagraph b.(1)(a)(ii)of Paragraph 4. Other Insurance of Section IV -Commercial General Liability
Conditions is deleted and replaced by the following:
(ii) That is fire, lightning, explosion, "smoke"or leakage from automatic fire protective systems insurance
for premises rented to you or temporarily occupied by you with permission of the owner, or for personal
property of others in your care, custody or control;
5. Subparagraph a. of Definition 9. "Insured contract'of Section V-Definitions is deleted and replaced by
the following:
a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that
indemnifies any person or organization for damage by fire, lightning, explosion, "smoke" or leakage
from automatic fire protective systems to premises while rented to you or temporarily occupied by you
with permission of the owner is not an "insured contract'.
6. As used in this provision "smoke"does not include smoke from agricultural smudging, industrial operations
or a "hostile fire".
O. MEDICAL PAYMENTS
1. Under Section I -Coverages, Coverage C, Medical Payments, paragraph 1., Insuring Agreement, the
requirement that expenses are incurred and reported to us within one year of the date of the accident is
changed to three years.
2. The Medical Expense Limit is$15,000 per person or the amount shown in the Declarations as the Medical
Expense Limit, whichever is greater.
3. This provision O. does not apply if Coverage C, Medical Payments, is otherwise excluded either by the
provisions of the Coverage Form or by endorsement.
P. NON-OWNED AIRCRAFT
1. Under Section I -Coverages, Coverage A, Bodily Injury and Property Damage Liability, item 2.,
Exclusions, item g., Aircraft, Auto Or Watercraft, does not apply to an aircraft that is:
a. Hired, chartered or loaned with a paid crew; and
b. Not owned by any insured,
2. The insurance afforded by this provision P. is excess over any other valid and collectible insurance
(including any deductible or Self Insured Retention)available to the insured, whether such insurance is
primary, excess, contingent or on any other basis. Any payments by us will follow the Other Insurance -
Excess Insurance provisions in the Commercial General Liability Conditions.
Q. NON-OWNED WATERCRAFT
1. Under Section 11 -Who Is Insured, is amended as follows:
To include as an insured for any watercraft that is covered by this policy, any person who, with your
expressed or implied consent, either uses or is responsible for the use of a watercraft. However, no person
or organization is an insured with respect to:
a. "Bodily injury"to a co-"employee"of the person operating the watercraft; or
b. "Property damage"to property owned by, rented to, in the charge of or occupied by you or the
employer of any person who is an insured under this provision.
2. In the exception to the Aircraft, Auto Or Watercraft exclusion under Coverage A, Bodily Injury And
Property Damage Liability,the limitation on the length of a watercraft is increased to 75 feet.
3. The insurance afforded by this provision Q. is excess over any other valid and collectible insurance
(including any deductible or Self Insured Retention)available to the insured, whether such insurance is
primary, excess, contingent or on any other basis. Any payments by us will follow the Other Insurance -
Excess Insurance provisions in the Commercial General Liability Conditions.
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R. NEWLY ACQUIRED OR FORMED ORGANIZATIONS
Under Section II -Who Is An Insured, item 3.a. is deleted and replaced by the following:
a. Coverage under this provision is afforded only until the end of the current policy period.
S. SUPPLEMENTARY PAYMENTS
Under Section I -Coverages, Supplementary Payments -Coverages A and B is amended as follows:
1. The limit for the cost of bail bonds is amended to$2,500; and
2. The limit for reasonable expenses incurred by the"insured"is amended to$500 a day.
T. UNINTENTIONAL OMISSION
Under Section IV-Commercial General Liability Conditions, paragraph 6., Representations, the following
is added:
The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in
issuing this policy will not prejudice your rights under this insurance, However, this provision does not affect our
right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with
applicable insurance laws or regulations.
U. WAIVER OF SUBROGATION -BLANKET
Under Section IV-Commercial General Liability Conditions, paragraph 8., Transfer of Rights of
Recovery Against Others to Us the following is added:
We will waive any right of recovery we may have against any person or organization because of payments we
make for injury or damage arising out of your ongoing operations done under a written contract or agreement
with that person or organization and included in "your work"or the"products-completed operations hazard".
This waiver applies only to persons or organizations with whom you have a written contract, executed prior to
the"bodily injury"or"property damage", that requires you to waive your rights of recovery.
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