17-059.04 Strata: On-Call Geotech Services itl.#\1446
*Wane
400010; ky• 10210 E Sprague Avenue♦ Spokane Valley WA 99206
Phone: (509)720-5000 ♦Fax:(509)720-5075 •www.spokanevalley.org
Email:cityhall@spokanevalley.org
November 18,2019
Contract No. 17-059.04
James P. Murphy, C.E.O.
STRATA
10020 E. Knox Avenue, Suite 200
Spokane Valley, WA 99206
Re: Implementation of 2020 option year, Agreement for Geotech Engineering and
Material Testing Services, #17-059, executed May 11, 2017
Dear Mr. Murphy:
The City executed an Agreement for provision of Geotech Engineering and Material
Testing Services on May 11, 2017 by and between the City of Spokane Valley,
hereinafter "City", and S IRATA, hereinafter "Contractor" and jointly referred to as
"Parties."
The original Agreement states that it was for one year, with three optional one-year terms
possible if the parties mutually agree to exercise the options each year. This is the third
of three possible option years that can be exercised and runs through December 31, 2020.
The City would like to exercise the 2020 option year of the Agreement. The
Compensation includes the labor and material cost negotiated and shall not exceed
$9,191.00. The history of the annual renewals, including dollar amounts, is set forth as •
follows:
Original contract amount $40,000.00
2018 Renewal $33,844.00 (remaining funds)
2019 Renewal ...$22,081.50 (remaining funds)
Agreement Amendment No. 1 —add'l funds ..$72,081.50 (remaining funds)
2020 Renewal ..$..9,191.00 (remaining funds)
All of the other contract provisions contained in the original Agreement shall remain in
place and remain unchanged in exercising this option year.
If you are in agreement with exercising the 2020 option year, please sign below to
acknowledge the receipt and concurrence to perform the 2020 option year. Please return
two copies to the City for execution, along with current insurance information. A fully
executed original copy will be mailed to you for your files.
CITY OF SPOKANE VALLEY STRATA
Mark Calhoun, City Manager /-?= a/J James P. Murphy Paxton K. Anderson,P.E.
CEO Director
Title •
ATTEST.
hristine Bainbri ge, rty Clerk
APPROVED AS TO FORM:
r`�
Offic. 6f the Ci ttorne
Y
DOCUMENTS REQUIRING THIRD-PARTY NOTIFICATION
PRIOR TO PUBLIC DISCLOSURE
This page has been inserted in place of the page(s) entitled "Schedule of Fees" of a contract
document which sets forth the rates charged by the contracting entity. Pursuant to the
Washington Public Records Act (RCW 42.56), the City has determined that this record may be
available for disclosure upon request for review by a third party. However, pursuant to RCW
42.56.520 and RCW 42.56.540, the City has determined it is appropriate to provide the
contracting entity notification of any request for this record to allow them time to determine if
they wish to seek to obtain a court order requiring the record to be withheld.
Please contact the City Public Records Officer at (509) 720-5000 or visit our website at
www.spokanevalley.org to complete a Public Record Request to receive a copy of this record.
/ TERRA
Terra Insurance Company .„/
(A Risk Retention Group)
Two Fifer Avenue, Suite 100 INSURANCE COMPANY
Corte Madera, CA 94925
DATE CERTIFICATE OF INSURANCE
12/13/19
CERTIFICATE HOLDER
City of Spokane Valley
City Manager,Mark Calhoun
10210 E. Sprague Avenue
Spokane Valley, WA 99206
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 EFFECTIVE DATE EXPIRATION DATE
219082 01/01/19 12/31/19
LIMITS OF LIABILITY $1,000,000 EACH CLAIM
$1,000,000 ANNUAL AGGREGATE
PROJECT DESCRIPTION
2020 Engineering and Testing Services, Contract No. 17-059.04.
CANCELLATION: If 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
(10)days in advance for non-payment of premium. If 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.
ISSUING COMPANY:
NAME AND ADDRESS OF INSURED TERRA INSURANCE COMPANY
(A Risk Retention Group)
Strata,Inc.
8653 West Hackamore Drive
Boise,ID 83709 Aijanaea--
President
12/13/2019 STRATA INC
4 ..f
STATE OF WASHINGTON
Department of Labor& Industries
Certificate of Workers' Compensation Coverage
December 13, 2019
WA UBI No. 601 187 858
L&I Account ID 564,395-00
Legal Business Name STRATA INC
Doing Business As STRATA GEOTECHNICAL ENGRG
Workers' Comp Premium Status: Account is current.
Estimated Workers Reported 'Quarter 3 of Year 2019"31 to 50 Workers"
(See Description Below)
Account Representative Employer Services Help Line, (360)902.4817
Licensed Contractor? ! No
What does "Estimated Workers Reported"
mean?
Estimated workers reported represents the number of
full time position requiring at least 480 hours of work
per calendar quarter. A single 480 hour position may
be filled by one person, or several part time workers.
Industrial Insurance Information
Employers report and pay premiums each quarter
based on hours of employee work already performed,
and are liable for premiums found later to be due.
Industrial insurance accounts have no policy
periods, cancellation dates, limitations of coverage
or waiver of subrogation (See RCW 51.12.050 and
51.16.190).
https://secure.lni.wa.gov/verify/Details/IiabilityCertificate.aspx?UBI=601187858&LIC=&VIO=&SAW=false&ACCT=56439500 1/1
Client#:10148 STRATAINC
ACORD,, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYI)12/18/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT:if the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on
this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME: Linda Hansen
Moreton&Company-Idaho PHONE 208 321-9300 FAX 208-321-0101
A/C,No,Ext): (A/C,No):
P.O.Box 191030 E-MAIL Ihansen@moreton.com
ADDRESS:
Boise,ID 83719 INSURER(S)AFFORDING COVERAGE NAIC#
208 321-9300 Cincinnati Insurance Company 10677
INSURER A: P Y
INSURED INSURER B:
Strata,Inc. INSURER C:
10020 E Knox Ave,Ste 200
INSURER D:
Spokane Valley,WA 99206
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.
LTR TYPE OF INSURANCE ADDL SUBR POLICCYy EFF POLICY EXP LIMITS
WVD POLICY NUMBER (MM!DDJYYYY) (MM/DD/YYYY)
A X COMMERCIAL GENERAL LIABILITY EPP0432268 05/01/2019 05/01/2020 EACH OCCURRENCE $1,000,000
CLAIMS-MADE X OCCUR PREMISES(Ea nmEinDence) $500,000
X PD Ded:500 MED EXP(Any one person) $10,000
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE UMITAPPUES PER: X X Form GA233 02/07 GENERAL AGGREGATE $2,000,000
POLICY X JECTT LOC • PRODUCTS-COMP/OP AGG $2,000,000
OTHER: $
A _ —- .._ .Epp0432268. - -05I0 F/201=9 U5/01a2020 c eDeNGLE LIMIT -A000;000 —_—
X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
_ PROPERTY DAMAGE
X AUTOS ONLY X AUT AUTOS X X Form AA288 01/16 (Peraccident)
— $
A X UMBRELLA UAB )( OCCUR EPP0432268 05/01/2019 05/01/2020 EACH OCCURRENCE $5,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000
DED RETENTION$ $
WORKERS COMPENSATION OTH-
AND EMPLOYERS'LIABILITY STATUTE ER
A ANY OFFIMED?PROPRIETOR/PARTNER/EXECUTIVE Y/N N/'A EPP0432268 05/01/2019 05/01/202q E.L EACH ACCIDENT $1,000,000
(Mandatory In NH) Washington EL DISEASE-GA EMPLOYEE $1,000,000
If yes,describe under
DESCRIPTION OF OPERATIONS below Stop Gap E.L DISEASE-POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is required)
Ref:2020 Engineering and Testing Services,Contract No.17-059.04
CERTIFICATE HOLDER CANCELLATION
of$ okane ValleySHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City p THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
10210 E Sprague Ave ACCORDANCE WITH THE POLICY PROVISIONS.
Spokane,WA 99206
AUTHORIZEDI REPRESENTATIVE
/HO
®1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S1235886/M1151489 LINHA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTORS' COMMERCIAL GENERAL LIABILITY
BROADENED ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A, Endorsement-Table of Contents:
Coverage: Begins on Page:
1. Employee Benefit Liability Coverage 2
2. Unintentional Failure to Disclose Hazards 7
3. Damage to Premises Rented to You 8
4. Supplementary Payments 9
5. Medical Payments 9
6. Voluntary Property Damage (Coverage a.)and Care, Custody or Control
Liability Coverage(Coverage b.) 9
7. 180 Day Coverage for Newly Formed or Acquired Organizations 10
8. Waiver of Subrogation 10
9. Automatic Additional Insured-Specified Relationships: 10
• Managers or Lessors of Premises;
• Lessor of Leased Equipment;
• Vendors;
• State or Political Subdivisions-Permits Relating to Premises;
• • State or Political Subdivisions-Permits;and
• Contractors'Operations
10. Broadened Contractual Liability-Work Within 50'of Railroad Property 14
11. Property Damage to Borrowed Equipment 14
12. Employees as Insureds -Specified Health Care Services: 14
• Nurses;
• Emergency Medical Technicians;and
• Paramedics •
13. Broadened Notice of Occurrence 14
B. Limits of Insurance:
The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse-
ment, except as provided below:
1. Employee Benefit Liability Coverage
Each Employee Limit: $ 1,000,000
Aggregate Limit: $ 3,000,000
Deductible: $ 1,000
3. Damage to Premises Rented to You
The lesser of:
a. The Each Occurrence Limit shown in the Declarations;or
b. $500,000 unless otherwise stated$
4. Supplementary Payments
a. Bail bonds: $ 1,000
b. Loss of earnings: $ 350
5. Medical Payments
Medical Expense Limit: $ 10,000
Includes copyrighted material of Insurance
GA 233 02 07 Services Office,Inc.,with its permission. Page 1 of 15
6. Voluntary Property Damage (Coverage a.)and Care, Custody or Control Liability Coverage
(Coverage b.)
Limits of Insurance (Each Occurrence)
Coverage a.$1,000
Coverage b.$5,000 unless otherwise stated $
Deductibles(Each Occurrence)
Coverage a.$250
Coverage b.$250 unless otherwise stated $
COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM
(a) Area (For Limits in Excess of (For Limits in Excess of
(b) Payroll $5,000) $5,000)
(c) Gross Sales
(d) Units
(e) Other
b. Care, Custody $
or Control
TOTAL ANNUAL PREMIUM $
11. Property Damage to Borrowed Equipment
Each Occurrence Limit: $ 10,000
Deductible: $ 250
C. Coverages. have used up the ap-
plicable limit of insur-
1. Employee Benefit LiabilityCoverage ance in the payment of
a. The following is added to SECTION I judgments or settle-
- COVERAGES: Employee Benefit ments.
Liability Coverage. No other obligation or liabil-
(1) Insuring Agreement ity to pay sums or perform
acts or services is covered
(a) We will pay those sums that unless explicitly provided for
••
the insured becomes legally under Supplementary Pay-
obligated to pay as dam- ments.
ages caused by any act, er- (b) This insurance applies to
ror or omission of the in- damages only if the act, er-
sured, or of any other per- ror or omission, is negli-
son for whose acts the in-
gently. committed in the
sated is legally liable, to "administration" of your
which this insurance ap-
plies. We will have the right "employee
gram";
and duty to defend the in-
sured against any "suit" 1) Occurs during the poi-
seeking those damages. icy period;or
However, we will have no •
duty to defend against any 2) Occurred prior to the
"suit" seeking damages to effective date of this
which this insurance does endorsement provided:
not apply. We may, at our
discretion, investigate any a) You did not have
report of an act, error or knowledge of a
omission and settle any claim or "suit" on
claim or "suit" that may re- or before the ef-
suit. But: fective date of this
endorsement.
1) The amount we will pay
for damages is limited You will be
as described in SEC.. deemed to have
TION Ill - LIMITS OF knowledge of a
INSURANCE;and claim or "suit"
when any
2) Our right and duty to "authorized repre-
defend ends when we sentative";
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc.,with its permission. Page 2 of 15
•
i) Reports all, or formance of investment
any part,of the vehicles;or
act, error oro 3)to us Advicegiven to any
orni anyon other person ith respect to
that person's decision
insurer; to participate or not to
ii) Receives a participate in any plan
written or ver- included in the 'em-
bal demand or ployee benefit pro-
claim for dam- gram".
ages because
of the act, er- (f) Workers' Compensation
ror or orris- and Similar Laws
sion;and Any claim arising out of
b) There is no other your failure to comply with
applicable incur- the mandatory provisions of
ance. any workers' compensation,
unemployment compensa-
(2) Exclusions ton insurance, social secu-
rity or disability benefits law
This insurance does not apply or any similar law.
to:
•
(a) Bodily injury, Property
(g) ERISA
Damage or Personal and Damages for which any in-
Advertising Injury sured is liable because of
liability imposed on a fiduci-
Bodily injury", "property ary by the Employee Re-
damage" or "personal and tirement Income Security
advertising injury". Act of 1974, as now or
(b) Dishonest, Fraudulent, hereafter amended, or by
Criminal or Malicious Act any similar federal, state or
local laws.
Damages arising out of any Available Benefits
intentional, dishonest, (h)
fraudulent, criminal or mall- Any claim for benefits to the
cious act, error or omission, extent that such benefits
committed by any insured, are available, with reason-
including the willful or reck- able effort and cooperation
less violation of any statute. of the insured, from the ap-
(c) Failure to Perform a Con- plicable funds accrued or
tract other collectible insurance.
Damages arising out of fail-
ure (1) Taxes, Fines or Penalties
of performance of con- Taxes, fines or penalties,
tract by any insurer. including those imposed
(d) Insufficiency of Funds under the Internal Revenue
Code or any similar state or
Damages arising out of an local law.
insufficiency of funds to Employment-Related
meet any obligations under (j)
any plan included in the
"employee benefit pro- Any liability arising out of
gram".
any:
(e) Inadequacy of Perform- (1) Refusal to employ;
ance of Investment / Ad-
vice Given With Respect (2) Termination of em-
to Participation ployment;
Any claim based upon: (3) Coercion, demotion,
1) Failure of any invest- evaluation, reassign-
ment, discipline, defa-
ment to perform; mation, harassment,
2) Errors in providing in- humiliation, discrimina-
formation on past per- tion or other employ-
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc.,with its permission. Page 3 of 15
ment-related practices, (e) A trust, you are an insured.
acts or omissions;or Your trustees are also in-
sureds, but only with re-
(4) Consequential liability spect to their duties as
as a result of(1), (2) or trustees.
(3)above.
This exclusion applies (2) Each of the following is also an
PP insured:
whether the insured may be
held liable as an employer (a) Each of your "employees"
or in any other capacity and who is or was authorized to
to any obligation to share administer your "employee
damages with or repay benefit program".
someone else who must
pay damages because of (b) Any persons, organizations
the injury, or "employees" having
proper temporary authori-
(3) Supplementary Payments zation to administer your
SECTION I - COVERAGES, "employee benefit program"
SUPPLEMENTARY PAY- if you die, but only until your
MENTS - COVERAGES A AND legal representative is ap-
B also apply to this Coverage. . pointed.
b. Who is an Insured (c) Your legal representative if
you die, but only with re-
As respects Employee Benefit Liabil- spect to duties as such.
ity Coverage, SECTION II - WHO IS That representative will
AN INSURED is deleted in its en- have all your rights and du-
tirety and replaced-by the following: ties under this Coverage
Part.
(1) If you are designated in the (3) Any organization you newly ac-
Declarations as: quire or form, other than a part-
(a) An individual, you and your nership, joint venture or limited
spouse are insureds, but liability company, and over
only with respect to the which you maintain ownership
conduct of a business of or majority interest, will qualify
which you are the sole as a Named Insured if no other
owner. similar insurance applies to that
organization. However, cover-
(b) A partnership or joint ven- age under this provision:
ture, you are an insured.
Your members, your part- (a) Is afforded only until the
ners, and their spouses are 180th day after you acquire
also insureds but only with or form the organization or
respect to the conduct of the end of the policy period,
your business. whichever is earlier,and
(c) A limited liability company, (b) Does not apply to any act,
you are an insured. Your error or omission that was
members are also insureds, committed before you ac-
but only with respect.to the quired or formed the or-
conduct of your business. ganization.
Your managers are in- c. Limits of Insurance
sureds, but only with re-
spect to their duties as your As respects Employee Benefit Liabil-
managers. ity Coverage, SECTION III - LIMITS
(d) An organization other than OF INSURANCE is deleted in its en-
a partnership, joint venture tirety and replaced by the following:
or limited liability company, (1) The Limits of Insurance shown
you are an insured. Your in Section B. Limits of Insur-
"executive officers" and di- ance, 1, Employee Benefit Li-
rectors are insureds, but ability Coverage and the rules
only with respect to their below fix the most we will pay
duties as your officers or di- regardless of the number of:
rectors. Your stockholders
are also insureds, but only (a) Insureds;
with respect to their liability
as stockholders.
Includes copyrighted material of Insurance
GA 233 02 07 Services Office,Inc.,with its permissioh. Page 4 of 15
•
(b) Claims made or "suits" (b) The deductible amount
brought; stated in the Declarations
applies to all damages
(c) Persons or organizations sustained by any one "em-
making claims or bringing ployee", including such
"suits"; 'employee's" dependents
(d) Acts,errors or omissions;or and beneficiaries, because
of all acts, errors or omis-
(e) Benefits included in your sions to which this insur-
"employee benefit pro- ance applies.
gram". (c) The terms of this insurance,
(2) The Aggregate Limit shown in including those with respect
Section B, Limits of insurance, to:
1. Employee Benefit Liability Our ri ht and dutyt
Coverage of this endorsement 1) g o
is the most we will pay for all defend the insured
damages because of acts, er- against any "suits"
rors or omissions negligently seeking those dam-
committed in the "administra- ages; and
tion" of your "employee benefit 2) Your duties, and the
program". duties of any other in-
(3) Subject to the limit described in volved insured, in the
(2) above, the Each Employee event of an act, error or
Limit shown in Section B. Limits omission, or claim,
of Insurance, 1. Employee apply irrespective of the
Benefit Liability Coverage of application of the deductible
this endorsement is the most we . amount
will pay for all damages sus-
tained by any one "employee", (d) We may pay any part or all
including damages sustained by of the deductible amount to
such "employee's" dependents . .effect settlement of any
and beneficiaries,as a result of: claim or "suit" and, upon
notification of the action
(a) An act,error or omission;or taken, you shall promptly
(b) A series of related acts, er- reimburse us for such part
rors or omissions, regard of the deductible amount as
less of the amount of time we have paid.
that lapses between such d. Additional Conditions
acts,errors or omissions,
As respects Employee Benefit Li-
negligently committed in the ability Coverage, SECTION IV -
"administration" of your "em- COMMERCIAL GENERAL LIABIL-
ployee benefit program". iTY CONDITIONS is amended as
However, the amount paid un- follows:
der this endorsement shall not (1) Item 2. Duties in the Event of
exceed, and will be subject to Occurrence, Offense, Claim or
the limits and restrictions that Suit is deleted in its entirety and
apply to the payment of benefits replaced by the following:
in'any plan included in the "em-
ployee benefit program". 2, Duties in the Event of an Act, Error or
(4) deductible Amount Omission,or Claim or Suit
a. You must see to it that we are noti-
(a) Our obligation to pay dam- fled as soon as practicable of an act,
ages on behalf of the in- error or omission which may result in
sured applies only to the a claim. To the extent possible, no-
amount of damages in ex- tics should include:
cess of the deductible
amount stated in the Decla- (1) What the act, error or omission
rations as applicable to was and when it occurred;and
Each Employee. The limits
of insurance shall not be (2) The names and addresses of
reduced by the amount of anyone who may suffer dam-
this deductible. ages as a result of the act, error
or omission.
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc.,with its permission. Page 5 of 15
•
b. If a claim is made or"suit" is brought b. Method of Sharing
against any insured,you must:
If all of the other insur-
(1) Immediately record the specifics ance permits contribu-
of the claim or "suit" and the tion by equal shares,
date received;and we will follow this
(2) Notifyus as soon aspracticable. method also.ch eachUn in-
this approach in-
You must see to it that we receive surer contributes equal
amounts until it has
written notice of the claim or"suit"as
soon as practicable. paid its applicable limit
of insurance or none of
c. You and any other involved insured the loss remains,
must: whichever comes first.
(1) Immediately send us copies of If any of the other in-
any demands, notices, sum- surance does not per-
menses or legal papers re- mit contribution by
ceived in connection with the equal shares, we will
claim or"suit"; contribute by limits.
Under method,
(2) Authorize us to obtain records each insurethisr's share is
and other information; based on the ratio of its
in-
(3) Cooperate with us in the invest[- applicable limit of gation or settlement of the claim surance to the total insur-
or -
defense against the "suit'; ancecable limits of and of all insurers.
(4) Assist us, upon our request, in c. No Coverage
the enforcement of any right . This insurance shall not
against any person or organize- cover any loss for
tion which may be liable to the which the insured is
insured because of an act, error entitled to recovery un-
or omission to which this insur- der any other insur-
ance may also apply. ance in force previous '
to the effective date of
d. No insured will, except at that in- this Coverage Park
sured's own cost, voluntarily make a
payment, assume any obligation, or a, Additional Definitions
incur any expense without our con-
sent. As respects Employee Benefit Li-
ability Coverage, SECTION V -
(2) Item 5. Other Insurance is de- DEFINITIONS is amended as fol-
leted in its entirety and replaced lows:
by the following:
(1) The following definitions are
5. Other Insurance • added:
If other valid and collectible 1. "Administration"means:
insurance is available to the
insured for a loss we cover a. Providing information to
under this Coverage Part, "employees", including
our obligations are limited their dependents and
as follows: beneficiaries, with re-
spect to eligibility for or
a. Primary Insurance scope of "employee
This insurance is pri- benefit programs";
mary except when c, b. Interpreting the "em-
below applies, If this ployee benefit pro-
insurance is primary, grams";
our obligations are not
affected unless any of c. Handling records in
the other insurance is connection with the
also primary. Then,we "employee benefit pro-
wlll share with all that grams"; or
other insurance by the
method described in b. d. Effecting, continuing or
terminating any be{ow, "em-
ployee's" participation
Includes copyrighted material of Insurance
GA 233 02 07 Services Office,Inc.,with its permission. Page 6 of 15
in any benefit included benefits, workers' corn-
in the "employee bene- pensation and disability
fit program", benefits;and
•
However, "administration" d. Vacation plans, includ-
does not include: ing buy and sell pro-
grams; leave of ab-
a. Handling payroll de- sence programs, in-
ductions;or eluding military, mater-
b. The failure to effect or nity, family, and civil
maintain any insurance leave; tuition assis-
or adequate limits of tance plans; alth cor-
coverage of insurance, tation and health club
including but not limited subsidies,
to unemployment in- (2) The following definitions are
surance, social security deleted in their entirety and re-
benefits, workers' corn- placed by the following:
pensation and disability
• benefits. 21. "Suit" means a civil pro-
ceeding in which money
2. "Cafeteria plans" means damages because of an
plan authorized by applica- act error or omission to
•
ble law to allow "employ- which this insurance applies
ees"
to elect to pay for cer- are alleged. "Suit"includes:
tain benefits with pre-tax
dollars, a. An arbitration pro-
ceeding in which such
3, "Employee benefit pro- damages are claimed
grams" means a program and to which the in-
providing some or all of the sured must submit or
following benefits to "em- does submit with our
ployees", whether provided consent;
through a"cafeteria plan" or
otherwise: b. Any other alternative
dispute resolution pro-
a. Group life insurance; ceeding in which such
group accident or damages are claimed
health insurance; den- and to which the in-
fa!, vision and hearing sured submits with our
plans; and flexible consent; or
spending accounts;
provided that no one c. An appeal of a civil
other than an "em- proceeding.
ployee" may subscribe
to such benefits and 8. "Employee" means a per-
such benefits are made son actively employed, for-
generally available to merly employed, on leave
those "employees"who of absence or disabled, or
satisfy the plan's eligi- retired_ "Employee" in-
bility requirements; eludes a "leased worker",
q "Employee" does not in-
b. Profit sharing plans, dude a"temporary worker".
employee savings
plans, employee stock 2. Unintentional Failure to Disclose Haz-
ownership plans, pen- ards
sion plans and stock SECTION IV- COMMERCIAL GENERAL
subscription plans, LIABILITY CONDITIONS, 7. Represen-
provided that no one Cations is hereby amended by the addi-
other than an "em- tion of the following:
ployee" may subscribe
to such benefits and Based on our dependence upon your
such benefits are made representations as to existing hazards, if
generally available to unintentionally you should fail to disclose
all "employees" who all such hazards at the inception date of
are eligible under the your policy, we will not reject coverage
plan for such benefits; under this Coverage Part based solely on
c. Unemployment insur- such failure.
ance, social security
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, inc.,with its permission. Page 7 of 15
3. Damage to Premises Rented to You e) Settling, cracking,
a. The last Subparagraph of Paragraph p n or ex-
2. SECTION I - COVERAGES, penssion; or
COVERAGE A. - BODILY INJURY f) Nesting or infesta-
AND PROPERTY DAMAGE, 2. LI- tion, or discharge
ABILITY Exclusions is hereby de- or release of
leted and replaced by the following: waste products or
in-
Exclusions •c.throughdo not apply secretions, ,9 q. PP Y sects, birds, ro-
to damage by fire, explosion, light- dents or other
ping, smoke or soot to premises animals.
while rented to you or temporarily
occupied by you with permission of (b) Loss caused directly or indi-
the owner. rectly by any of the follow-
ing:
b. The insurance provided under SEC- •
TION I - COVERAGES, COVERAGE 1) Earthquake, volcanic
A. BODILY INJURY AND PROP- eruption, landslide or
ERTY DAMAGE LIABILITY applies any other earth move-
to "property damage" arising out of ment;
water damage to premises that are at backs
both rented to and occupied by you. 2)
Water er that
from up or
a
(1) As respects Water Damage Le- sewer,drain or sump;
gal Liability, as provided in
Paragraph 3.b.above: 3) Water under the
ground surface press-
The exclusions under SECTION ing on, or flowing or
- COVERAGES, COVERAGE seeping through:
A. BODILY INJURY AND PROPERTY DAMAGE LIABIL- a) Foundations,
•ITY, 2. Exclusions, other than I. wails, floors or
War and the Nuclear Energy paved surfaces;
Liability Exclusion, are deleted b) Basements,
and the following are added: whether paved or
This insurance does not apply not;or
to: c) Doors, windows or
(a) "Property damage": - other openings.
1) Assumed in any con- (c) Loss caused by or resulting
tract;or from water that leaks or
flows from plumbing, heat-
2) Loss caused by or re- ing, air conditioning, or fire
suiting from any of the protection systems caused
following: by or resulting from freez-
ing,unless:
a) Wear and tear;
1) You did your best to
b) Rust, corrosion, maintain heat in the
fungus, decay, building or structure;or
deterioration, hid-
den or latent de- 2) You drained the
feet or any quality equipment and shut off
in property that the water supply if the
causes it to dam- heat was not main-
age or destroy it- tained.
self; (d) Loss to or damage to:
c) Smog;
1) Plumbing, heating, air
d) Mechanical conditioning, fire pro-
breakdown in- tection systems, or
cluding rupture or other equipment or ap-
bursting caused pliances;or
bycentrifugal
force;
2) The interior of any
building or structure, or
to personal property in
the building or structure
Includes copyrighted material of Insurance
GA 233 02 07 Services Office,Inc.,with its permission. Page 8 of 15
•
caused by or resulting 5. Medical Payments
fror
rain, snow,e sleet The Medical Expense Limit of AnyOne
by ice, whether driven Person as stated in the Declaratins is
by wind or not. amended to the limit shown in Section B.
c. Limit of Insurance Limits of Insurance, 5. Medical Pay-
The Damage to Premises Rented to
ments of this endorsement.
You Limit as shown in the Declare- 6. Voluntary Property Damage and Care,
tions is amended as follows: Custody or Control Liability Coverage
(2) Paragraph 6. of SECTION iII - a. Voluntary Property Damage Cov-
LiMITS OF INSURANCE is erage
hereby deleted and replaced by We will payfor"property damage"to
the following: property of others arisingout of op-
6. Subject to 5. above, the erations incidental to the insured's
Damage to Premises business when:
Rented to You Limit is the
most we will pay under (1) Damage is caused by the in-
COVERAGE A. BODILY cured; or
INJURY AND PROPERTY (2) Damage occurs while in the in-
DAMAGE LIABILITY, for sured's possession. •
damages because of
"property damage" to With your consent, we will make
premises while rented to these payments regardless of fault.
you or temporarily occupied
by you with permission of b. Care, Custody or Control Liability
the owner, arising out of Coverage
any one "occurrence" to SECTION I - COVERAGES, COV-
which this insurance ap- ERAGE A. BODILY INJURY AND
plies. PROPERTY DAMAGE LIABILITY, 2.
(3) The amount we will pay is Um- Exclusions,j. Damage to Property,
ited as described in Section B. Subparagraphs (3), (4) and (5) do
Limits of Insurance, 3. Dam- not apply to "property damage" to
age to Premises Rented to the property of others described
You of this endorsement. therein.
4. Supplementary Payments With respect to the insurance provided by
this section of the endorsement, the fol-
Under SECTION I - COVERAGE, SUP- lowing additional provisions apply:
PLEMENTARY PAYMENTS - COVER-
AGES A AND B: a. The Limits of Insurance shown in the
Declarations are replaced by the lim-
a. Paragraph 2. is replaced by the fol- its designated in Section B. Limits of
lowing: insurance, 6. Voluntary Property
Up to the limit shown in Section B. Damage and Care, Custody or
Control Liability Coverage of this
Limits of Insurance, 4.a. Bail Bonds
endorsement with respect to cover-
• of this endorsement for cost of bail
bonds required because of accidents age provided by this endorsement.
or traffic law violations arising out of inThese limitsio are inclusive limits bf and re-
the -
use of any vehicle to which the pl addition Theo the o Insurance Bodily Injury Liability Coverage ap- shown Limits of
plies. We do not have to furnish in Section B. Limits of Insur-
these bonds. ance, 6. Voluntary Property Dam-
age and Care, Custody or Control
b. Paragraph 4. Is replaced by the fol- Liability Coverage of this endorse-
lowing: ment fix the most we will pay in any
one "occurrence" regardless of the
All reasonable expenses incurred by number of:
the insured at our request to assist
us in the investigation or defense of (1) Insureds;
the claim or "suit", including actual (2) Claims made or "suits" brought;
loss of earnings up to the limit shown or
in Section B. Limits of Insurance,
4.13. Loss of Earnings of this en- (3) Persons or organizations mak-
dorsement per day because of time ing claims or bringing"suits".
off from work.
Includes copyrighted material of Insurance
GA 233 02 07 Services Office,Inc.,with its permission. Page 9 of 15
b. Deductible Clause 9. Automatic Additional Insured - Speci-
(1) Our obligation to pay damages
fled Relationships
on your behalf applies only to a. The following is hereby added to
the amount of damages for each SECTION II-WHO IS AN INSURED:
"occurrence" which are in ex-
cess of the deductible amount (1) Any person or organization de-
stated in Section B. Limits of scribed In Paragraph 9.a.(2)
Insurance, 6. Voluntary Prop- below (hereinafter referred to as
erty Damage and Care, Cus- additional insured) whom you
• tody or Control Liability Cov- • are required to add as an addi-
erage of this endorsement. The tional insured under this CoVer-
limits of insurance will not be re- age Part by reason of:
duced by the application of such (a) A written contract or
deductible amount. agreement;or
' (2) Condition 2. Duties in the Event (b) An oral agreement or con-
of Occurrence, Offense, Claim tract where a certificate of
or Suit, applies to each claim or insurance showing that per-
"suit"irrespective of the amount son or organization as an
(3) We may pay any part or all of additional insured has been
the deductible amount to effect issued,
settlement of any claim or "suit" is an insured, provided:
and, upon notification of the ac-
tion taken, you shall promptly (a) The written or oral contract
reimburse us for such part of the or agreement is:
deductible amount as has been
paid by us. 1) Currently in effect or
becomes effective
7. 180 Day Coverage for Newly Formed or during the policy pe-
Acquired Organizations riod;and
SECTION II - WHO IS AN INSURED is 2) Executed prior to an
amended as follows: "occurrence" or offense
to which this insurance
Subparagraph a. of Paragraph 4. 1s would apply;and
hereby deleted and replaced by the fol-
lowing: (b) They are not specifically
a. Insurance under this provision is af- named as an additional in-
forded only until the 180th day after sured under any other pro-
you acquire or form the organization vision of, or endorsement
added to, this Coverage
or the end of the policy period, Part.
whichever is earlier;
8. Waiver of Subrogation (2) Only the following persons or
organizations are additional in-
•
SECTION IV-COMMERCIAL GENERAL sureds under this endorsement,
LIABILITY CONDITIONS, 9. Transfer of and insurance coverage pro-
. Rights of Recovery Against Others to vided to such additional in-
Us is hereby amended by the addition of sureds is limited as provided .
•
the following: herein:
We waive any right of recovery we may (a) The manager or lessor of a
have because of payments we make for premises leased to you with
injury or damage arising out of your on- whom you have agreed per
going operations or"your work" done un- Paragraph 9.a.(1) above to
der a written contract requiring such provide insurance, but only
waiver with that person or organization with respect to liability aris-
and included in the "products-completed ing out of the ownership,
operations hazard": However, our rights maintenance or use of that
may only be waived prior to the "occur- part of a premises leased to
rence"giving rise to the injury or damage you, subject to the following
for which we make payment under this additional exclusions:
Coverage Part. The insured must do This insurance does not
nothing after a loss to impair our rights.
At our request,the insured will bring "suit" apply to:
or transfer those rights to us and help us 1) Any "occurrence"
enforce those rights. which takes place after
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc.,with its permission. Page 10 of 15
•
you cease to be a ten- c) Any physical or
ant in that premises. chemical change
in the product
2) Structural alterations, made intentionally
new construction or by the vendor,
demolition operations
performed by or on be- d) Repackaging, un-
half of such additional less unpacked
insured, solely for the pur-
pose of inspection,
(b) Any person or organization demonstration,
from which you lease testing, or the
equipment with whom you substitution of
have agreed per Paragraph parts under in-
9.a.(1) above to provide in- structions from the
surance. Such person(s) or manufacturer, and
organizations)are insureds then repackaged
solely with respect to their in the original
liability arising out of the container;
maintenance, operation or
use by you of equipment e) Any failure to
leased to you by such per- make such in-
son(s) or organizations(s). spections, adjust-
However, this insurance ments, tests or
does not apply to any "oc- servicing as the
currence"which takes place vendor has
after the equipment lease agreed to make or
expires. normally under-
(c) Any person or organization takes to make in
the usual course
(referred to below as van- of business, in
dor) with whom you have connection with
agreed per Paragraph the distribution or
9.a.(1) above to provide in- sale of the prod-
surance, but only with re- ucts;
spect to "bodily injury" or
"property damage" arising f) Demonstration, in-
out of"your products"which stallation, servic-
are distributed or sold in the ing or repair op-
regular course of the von- erations, except
dor's business, subject to such operations
the following additional ex- performed at the
clusions: vendor's premises
in connection with
1) The insurance afforded the pale of the
the vendor does not product;
apply to:
g) Products which,
a) "Bodily injury" or after distribution or
"property damage" sale by you, have
for which the yen- been labeled or
dor is obligated to relabeled or used
pay damages by as a container,
reason of the as- part or ingredient
sumption of.liabil- of any other thing
ity in a contract or or substance by or
agreement. This for the vendor.
exclusion does not
. apply to liability for 2) This insurance does
damages that the not apply to any in-
vendor would sured person or or-
have in the ab- ganization:
sence of the con-
tract or agree- a) From whom you
ment; have acquired
such products, or
b) Any express war- any ingredient,
ranty unauthorized part or container,
by you; entering into, ac-
includes copyrighted material of Insurance
GA 233 02 07 Services Office,Inc.,with its permission. Page 11 of 15
•
companying or 2) This insurance does
containing such not apply to "bodily in-
products; or jury", "property dam-
age"When liabilityin- or "personal and
b)
advertising injury" aris-
cluded within the ing out of operations
"products- performed for the state
completed opera- or political subdivision,
tions hazard" has
been excluded (f) Any person or organization
under this Cover- with which you have agreed
age Part with re- per Paragraph 9.a.(1)
spect to such above to provide insurance,
products. but only with respect to li-
ability(d) Anystate orpolitical subdi- arising out of "your
work" performed for that
vision with which you have additional insured by you or
agreed per Paragraph on your behalf. A person or
9.a.(1) above to provide in- organization's status as an
surance, subject to the fol- insured under this provision
lowing additional provision: of this endorsement contin-
This insurance applies only ues for only the period of
with respect to the following time required by the written
hazards for which the state contract or agreement, but
or political subdivision has in no event beyond the ex-
issued a permit in connec- piration date of this Cover-
tion with premises you own, age Part. if there is no
rent or control and to which written contract or agree-
this insurance applies: ment, or if no period of time
is required by the written
1) The existence, mainte- contract or agreement, a
nance, repair, con- person or organization's
struction, erection, or status as an insured under
removal of advertising this endorsement ends
signs, awnings, cano- when your operations for
pies, cellar entrances, that insured are completed.
coal holes, driveways, (3) Any insurance provided to an
manholes, marquees, additional insured designated
hoist away openings,sidewalk vaults, street under Paragraph 9.a.(2):
banners, or decora- (a) Subparagraphs (e) and (f)
tions and similar expo- does not apply to "bodily
sures;or injury"or"property damage"
2) The construction, erec- included within the "prod-
tion, or removal of ele- ucts-completed operations
vators; or hazard ,
3) The ownership, main- (b) Subparagraphs (a), (b), (d),
tenance, or use of any (e) and (f) does not apply to
elevators covered by "bodily injury", "property
this insurance. damage" or "personal and
advertising injury" arising
(e) Any state or political subdi- out of the sole negligence
vision with which you have or willful misconduct of the
agreed per Paragraph additional insured or their
9.a.(1) above to provide in- agents, "employees" or any
surance, subject to the fol- other representative of the
lowing provisions: additional insured; or
1) This insurance applies (c) Subparagraph (f) does not
only with respect to op- apply to "bodily injury",
erations performed by "property damage" or "per-
you or on your behalf sonal and advertising injury"
for which the state or arising out of:
political subdivision has 1) Defects in design fur-
issued a permit nished by or on behalf
Includes copyrighted material of insurance
GA 233 02 07 Services Office, Inc.,with its permission. Page 12 of 15
of the additional in- spects any other insurance
sured;or policy issued to the addi-
tional insured, and such
2) The rendering of, or other insurance policy shall
failure to render, any be excess and /or noncon-
professional architec- tributing, whichever applies,
tural, engineering or with this insurance.
surveying services, in-
cluding: (b) Any insurance provided by
a) The preparing, this endorsement shall be
approving or fail-g, primary to other insurance
PP 9available to the additional
ing to prepare or insured except:
approve maps,
shop drawings, 1) As otherwise provided
opinions, reports, in SECTION IV -
. surveys, field or- COMMERCIAL GEN.
ders, change or- ERAL LIABILITY
ders or drawings CONDITIONS, 5, Other
and specifications; Insurance, b. Excess
and Insurance;or
b) Supervisory, in- 2) For any other valid and
spection, archi- collectible insurance
tectural or engi- available to the addi-
nearing activities. tionai insured as an
additional insured by
3) "Your work"for which a attachment of an en-
consolidated (wrap-up) dorsement to another
insurance program has insurance policy that is
been provided by the written on an excess
primecontractor-project basis. In such case,
manager or owner of the coverage provided
the construction project under this endorse •
-
in which you are in- merit shall also be ex-
volved.
cess.
b. Only with regard to insurance pro- (2) Condition 11. Conformance to
vided to an additional insured desig- Specific Written Contract or
nated under Paragraph 9.a.(2) Sub-
paragraph (f) above, SECTION IIi - Agreement is hereby added:
LIMITS OF INSURANCE is amended 11. Conformance to Specific
to include: Written Contract or
The limits applicable to the additional Agreement
insured are those specified in the With respect to additional
written contract or agreement or in insureds described in Para-
the Declarations Of this Coverage graph 9.a.(2)(f) above only:
Part,whichever are less. If no limits If a written contract or
are specified in the written contract Iagreementa cotryou
or agreement, or if there is no written and the i between ou
contract or agreement, the limits ap-
plicable to the additional insured are specifies that coverage for
those specified in the Declarations of the additional insured:
this Coverage Part. The limits of in- a. Be provided by the In-
surance are inclusive of and not in surance Services Of-
addition to the limits of insurance fice additional insured
shown in the Declarations, form number CG 20 10
c. SECTION IV - COMMERCIAL GEN- or CG 20 37 (where
ERAL LIABILITY CONDITIONS is edition specified);or
hereby amended as follows: b. Include coverage for
(1) Condition 5, Other Insurance is completed operations;
amended to include: or
(a) Where required by a written c. include coverage for
contract or agreement, this "your work";
insurance is primary and / and where the limits or cov-
or noncontributory as re- erage provided to the addi-
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc„with its permission. Page 13 of 15
tional insured is more re- 11. of this endorsement fix the
strictive than was specifi- most we will pay in any one "oc-
cally required in that written currence" regardless of the
contract or agreement, the number of:
terms of Paragraphs (a) Insureds;
9.a.(3)(a), 9.a.(3)(b) or 9.b.
above, or any combination (b) Claims made or "suits"
thereof, shall be interpreted brought;or
as providing the limits or .
coverage required by the (c) Persons or organizations
terms of the written contract making claims or bring
or agreement, but only to "suits".
the extent that such limits or
coverage is included within (2) Deductible Clause
the terms of the Coverage (a) Our obligation to pay dam-
Part to which this endorse- ages on your behalf applies
ment is attached. If, how- only to the amount of dam-
ever, the written contract or ages for each "occurrence"
agreement specifies the In- which are in excess of the
surance Services Office Deductible amount stated in
additional insured form Section B. Limits of Insur-
number CG 20 10 but does ance, 11, of this endorse-
not specify which edition, or ment. The limits of insur-
specifies an edition that ance will not be reduced by
does not exist, Paragraphs the application of such De-
9.a.(3)(a) and 9,a.(3)(b) of
this endorsement shall not
ductible amount.
apply and Paragraph 9.b, of (b) Condition 2. Duties in the
this endorsement shall ap- Event of Occurrence, Of
PIY- fense, Claim or Suit, ap-
10. Broadened Contractual Liability-Work plies to each claim or "suit"
Within 50'of Railroad Property irrespective of the amount.
It is hereby agreed that Paragraph f.(1) of (c) We may pay any part or all
Definition 12. "insured contract" (SEC- of the deductible amount to
TION V-DEFINITIONS)is deleted. effect settlement of any
claim or "suit" and, upon
11. Property Damage Ito Borrowed Equip- notification of the action
ment taken, you shall promptly
reimburse us for such part
a. The following is hereby added to Ex- of the deductible amount as
elusion j. Damage to Property of has been paid by us.
Paragraph 2., Exclusions of SEC •
-
TiON I- COVERAGES, COVERAGE 12. Employees as Insureds - Specified
A. BODILY INJURY AND PROP- Health Care Services
ERTY DAMAGE LIABILITY: It is hereby agreed that Paragraph
Paragraphs (3) and (4) of this exclu- 2.a.(1)(d) of SECTION II - WHO iS AN
sion do not apply to tools or equip- INSURED, does not apply to your "em-
ment loaned to you, provided they pfoyees"who provide professional health
are not being used to perform opera- care services on your behalf as duly Ii-
tions at the time of loss. censed:
b. With respect to the insurance pro- a. Nurses;
vided by this section of the en- b. Emergency Medical Technicians; or
dorsement, the following additional
provisions apply: c. Paramedics,
(1) The Limits of Insurance shown in the jurisdiction where an "occurrence"
in the Declarations are replaced or offense to which this insurance applies
by the limits designated in Sec- takes place,
tion B. Limits of Insurance, 11.
of this endorsement with respect 13. Broadened Notice of Occurrence
to coverage provided by this
endorsement. These limits are Paragraph a. of Condition 2, Duties in
inclusive of and not in addition to the Event of Occurrence, Offense,
the limits being replaced. The Claim or Suit (SECTION IV- COMMER-
Limits of Insurance shown in CIAL GENERAL LIABILITY CONDI-
Section B. Limits of Insurance,
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc.,with its permission. Page 14 of 15
•
TIONS) is hereby deleted and replaced (2) The names and addresses of
by the following: any injured persons and wit
a. You must see to it that we are noti- nesses; and
fied as soon as practicable of an (3) The nature and location of any
"occurrence" or an offense which injury or damage arising out of
may result in a claim. To the extent the"occurrence" or offense.
possible, notice should include:
This requirement applies only when
(1) How, when and where the "oc- the"occurrence"or offense is known
currence"or offense took place; to an "authorized representative".
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc.,with its permission. Page 15 of 15
Named Insured: strata,Inc.
Policy Number: EPP0432268
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CinciPlus®'
BUSINESS AUTO XC+®
(EXPANDED COVERAGE PLUS)
ENDORSEMENT
This endorsement modifies insurance provided by the following:
BUSINESS AUTO COVERAGE FORM
With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless
modified by this endorsement.
A. Blanket Waiver of Subrogation This provision does not apply unless the valid
written contract has been:
SECTION IV - BUSINESS AUTO CONDI-
TIONS, A. Loss Conditions, 5. Transfer of 1. Exectited prior to the accident causing
Right$of Recovery Against Others to Us is "bodily injury" or"property damage";and
amended by the addition of the following:
2. Is still in force at the time of the "accident"
We waive any right of recovery we may have causing "bodily injury" or "property dam-
against any person or organization because of age".
payments we make for "bodily injury" or
"property damage" arising out of the operation D. Employee Hired Auto
of a covered "auto" when you have assumed 1. Changes in Liability Coverage
liability for such bodily injury" or "property
damage" under an "insured contract", provid- The following is added to the Section II -
ed the "bodily injury' or"property damage° oc- Liability Coverage, A. Coverage, 1.
curs subsequent to the execution or the "In- Who is an Insured:
sured contract".
An "employee" of yours is an "insured"
B. Noncontributory Insurance while operating an "auto" hired or rented
SECTION IV - BUSINESS AUTO CONDI- under a contract or agreement in that
TIONS, B. General Conditions, 5. Other In- "employee's" name, with your permission,
while performing duties related to the
surance c. Is replaced by the following: conduct of your business.
c. Regardless of the provisions of Par- 2. Changes in General Conditions
agraph a. above, this Coverage
Form's Liability Coverage is primary SECTION IV - BUSINESS AUTO CON-
and we will not seek contribution DITIONS, B. General Conditions, 5.
from any other insurance for any lia- Other Insurance is amended by replac-
bility assumed under an "insured ing Paragraph 5.b.with the following:
contract" that requires liability to be
assumed on a primary noncontributo- b. For Hired Auto Physical Damage
ry basis. Coverage the following are deemed
to be covered "autos"you own:
C. Additional Insured by Contract
(1) Any covered "auto" you lease,
SECTION II - LIABILITY COVERAGE, A. hire, rent or borrow; and
Coverage, I. Who is an Insured is amended
to include as an insured any person or organi- (2) Any covered "auto" hired or
zation with which you have agreed in a valid rented by your"employee" under
written contract to provide insurance as is af- a contract in that individual "em-
forded by this policy. ployee's" name, with your per-
mission, while performing duties
This provision is limited to the scope of the related to the conduct of your
valid written contract. business.
Includes copyrighted material of ISO
AA 288 01 16 Properties, Inc..with its permission. Page 1 of 4
However, any "auto" that is leased, a. Is effective on the date of acquisition
hired, rented or borrowed with a driver or formation, and is afforded for 180
is not a covered "auto". days after such date;
E. Audio, Visual and Data Electronic Equip- b. Does not apply to "bodily injury" or
ment "property damage" resulting from an
SECTION III - PHYSICAL DAMAGE COV- "accident" that occurred before you
ERAGE, C. Limit of Insurance is amended
acquired or formed the organization;
by adding the following: c. Does not apply to any newly acquired
4. The most we will pay for all "loss" to au- or formed organization that is a joint
venture or partnership;and
dio. visual or data electronic equipment
and any accessories used with this d. Does not apply to an insured under
equipment as a result of any one "acci- any other automobile liability policy,
dent"is the lesser of: or would be an insured under such a
policy but for the termination of such
a. The actual cash value of the dam- policy or the exhaustion of such poll-
aged or stolen property as of the time cy's limits of insurance.
of the "accident";
3. Any of your "employees" while using a
b. The cost of repairing or replacing the covered "auto" in your business or your
damaged or stolen property with oth- personal affairs. provided you do not own,
er property of like kind and quality; or hire or borrow that "auto".
c. $2,500. G. Liability Coverage Extensions - Supple-
Provided the equipment, at the time of the mentary Payments- Higher Limits
"loss"is: SECTION II - LIABILITY COVERAGE, A.
a. Permanently installed In or upon the Coverage, 2. Coverage Extensions, a. Sup-
covered "auto" in a housing, opening plementary Payments is amended by:
or other location that is not normally 1. Replacing the 52,000 Limit of Insurance
used by the "auto" manufacturer for for bail bonds with$4,000 in(2); and
the installation of such equipment;
b. Removable from a permanently in- 2. Replacing the S250 Limit of Insurance for
stalled housing unit as described in reasonable expenses with $500 in(4).
Paragraph 2.a.above; or H. Amended Fellow Employee Exclusion
c. An integral part of such equipment. SECTION II - LIABILITY COVERAGE, B. Ex-
clusions, 5. Fellow Employee is modified as
F. Who is an Insured-Amended follows:
SECTION II - LIABILITY COVERAGE, A. Exclusion 5. Fellow Employee is deleted.
Coverage, 1. Who Is an Insured is amended
by adding the following: L Hired Auto-Physical Damage
The following are Insureds": If hired "autos"are covered "autos" for Liability
Coverage, then Comprehensive and Collision
1. Any subsidiary which is a legally incorpo- Physical Damage Coverages as provided un-
rated entity of which you own a financial der SECTION IiI - PHYSICAL DAMAGE
interest of more than 50% of the voting COVERAGE of this Coverage Part are ex-
stock on the effective date of this cover- tended to "autos" you hire, subject to the fol-
age form. lowing:
However, the insurance afforded by this 1. The most we will pay for "loss" to any
provision does not apply to any subsidiary hired "auto" is$50.000 or the actual cash
that 1s an °insured" under any other au- value.or cost to repair or replace, which-
tomobiie liability policy. or would be an ever is the least, minus a deductible.
"insured" under such policy but for termi-
nation of such policy or the exhaustion of 2. The deductible will be equal to the largest
such policy's limits of insurance. deductible applicable to any owned "auto"
for that coverage, or$1,000, whichever is
2. Any organization that is newly acquired or less.
formed by you and over which you main-
tain majority ownership. The insurance 3. Hired Auto - Physical Damage coverage
provided by this provision: is excess over any other collectible insur-
ance.
Includes copyrighted material of ISO
AA 288 01 16 Properties, Inc.. with its permission. Page 2 of 4
4. Subject to the above limit,deductible, and K. Transportation Expense-Higher Limits
excess provisions we will provide cover- SECTION III - PHYSICAL DAMAGE COV-
age equal to the broadest coverage appli-
ERAGE, A. Coverage, 4. Coverage Exten-
cable to any covered "auto" you ownn In in- sions is amended by replacing S20 per day
sured under this policy. with $50 per day, and $600 maximum with
Coverage includes loss of use of that hired au- $1.500 maximum in Extension a. Transpor-
to, provided it results from an "accident" for tation Expenses.
which you are legally liable and as a result of
which a monetary loss is sustained by the L. Airbag Coverage
leasing or rental concern. The most we will SECTION III - PHYSICAL DAMAGE COV-
pay for any one "accident" is$3,000. ERAGE, B. Exclusions, 3.a. is amended by
If a limit for Hired Auto - Physical Damage is adding the following:
shown in the Schedule, then that limit reptac- However, the mechanical and electrical
es, and is not added to, the $50,000 limit indi- breakdown portion of this exclusion does not
cated above. apply to the accidental discharge of an airbag.
J. Rental Reimbursement This coverage for airbags is excess over any
other collectible insurance or warranty.
SECTION III - PHYSICAL DAMAGE is
amended by adding the following: M. Loan or Lease Gap Coverage
1. We will pay for rental reimbursement ex- 1. SECTION III - PHYSICAL DAMAGE
penses incurred by you for the rental of COVERAGE, C. Limit of Insurance is
an"auto" because of a "loss"to a covered • deleted in its entirety and replaced by the
following, but onlyforprivate passenger
"auto". Payment applies in addition to the p g
otherwise applicable amount of each coy- type "autos"with an original loan or lease,
erage you have on a covered "auto". No and only in the event of a "total loss" to
deductible applies to this coverage. such a private passenger type"auto":
2. We will pay only for those expenses in- a. The most we will pay for"loss"in any
curred during the policy period beginning one "accident"Is the greater of:
24 hours after the "loss" and ending. re- (1) The amount due under the terms
gardless of the policy's expiration, with of the lease or loan to which
the lesser of the following number of your covered private passenger
days: type "auto"is subject, but will not
a. The number of days reasonably re- include:
quired to repair the covered "auto". If (a) Overdue lease or loan pay-
"loss" is caused by theft,this number ments;
of days is added to the number of
days it takes to locate the covered (b) Financial penalties imposed
"auto"and return it to you; or under the lease due to high
mileause
b. 30 days. abnormal wearsansive d tear or
3. Our payment is limited to the lesser of the (c) Security deposits not re-
following amounts: funded by the lessor;
a. Necessary and actual expenses in- (d) Costs for extended warran-
curred; or ties, Credit Life Insurance,
b. $50 per day. Health, Accident or Disabil-
ity Insurance purchased
4. This coverage does not apply while there with the loan or lease; and
are spare or reserve "autos" available to
you for your operations. (e) Carry-over balances from
.previous loans or leases, or
5. We will pay under this coverage only that
amount of your rental reimbursement ex- (2) Actual cash value of the stolen
penses which is not already provided for or damaged property.
under SECTION III - PHYSICAL DAM- b, An adjustment for depreciation and
AGE COVERAGE, A. Coverage, 4. physical condition will be made in de-
Coverage Extensions. termining actual cash value at the
time of"loss".
includes copyrighted material of ISO
AA 288 01 16 Properties. Inc., with its permission. Page 3 of 4
2. SECTION V - DEFINITIONS Is amended P. Unintentional Failure to Disclose Hazards
by adding the following, but only for the SECTION IV - BUSINESS AUTO CONDI-
purposes of this Loan or Lease Gap
Coverage: TIONS, B. General Conditions, 2. Conceal-
ment, Misrepresentation or Fraud is
"Total loss" means a "loss" in which the amended by adding the following:
cost of repairs plus the salvage value ex-
ceeds the actual cash value. However, if you unintentionally fail to disclose
any hazards existing on the effective date of
N. Glass Repair-Waiver of Deductible this Coverage Form, we will not deny cover-
SECTION III - PHYSICAL DAMAGE COV- age under this Coverage Form because of
ERAGE, D. Deductible is amended by adding
such failure.
the following: Q. Mental Anguish Resulting from Bodily Inju-
No deductible applies to glass damage If the ry
glass is repaired in a manner acceptable to us SECTION V - DEFINITIONS, C."Bodily inju-
rather than replaced. ry" is deleted in its entirety and replaced by
the following:
O. Duties in the Event of an Accident, Claim,
Suit or Loss- Amended "Bodily injury"means bodily injury, sickness or
•IV. - BUSINESS AUTO CONDI- disease sustained by a person, including men-
SECTIONtal anguish and death sustained by the same
TIONS,A. Loss Conditions, 2. Duties in the person that results from such bodily injury.
Event of Accident,Claim,Suit or Loss,a. Is sickness or disease. "Bodily injury" does not
amended by adding the following: I include mental anguish or death that does not
This condition applies only when the "acci- result from bodily injury, sickness or disease.
dent"or"loss" is known to: R. Coverage for Certain Operations in Con-
t. You, if you are an individual; nection with Railroads
2. A partner. if you are a partnership; With respect to the use of a covered "auto" in
operations for or affecting a railroad: ;
3. An executive officer or insurance manag-
er, if you are a corporation; or 1. Section V- Definitions, H. "Insured con-
tract", 1.c. is amended to read:
4. A member or manager, if you are a lim-
itedAn easement or license a reement;
liability company. 9
• 2. Section V- Definitions, H. "Insured con-
tract", 2.a. is deleted.
•
Includes copyrighted material of ISO
AA 288 01 16 Properties. Inc.. with its permission. Page 4 of 4
Debarred Contractors List ' Page 1 of 1
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