Insurance - Charles King Co. Inc. 2017-03-31CHARKI-nn1
nI nPF7
ACORO' CERTIFICATE OF LIABILITY INSURANCE
`-�
DATE Y)
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
03131/2017
03/37/2017
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(las) 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 rights to the certificate holder in lieu of such endorsement(s).
PRODUCER License # OD79613 M ALT Denise Lopez
Bowermaster &Associates Insurance Agency, Inc. uc°, No, Eat): (714) 733-6219 uc, No):
10805 Holder Street, Suite 350
Cypress, CA 90630 E-MAIL . dlopez@bowermaster.com
INSURER(S) AFFORDING COVERAGE NAIC N
INSURER A: National Fire Insurance of Hartford 20478
INSURED INSURER B:COntinental Casual' Co./ 20443
Charles King Company, Inc. INSURER C: Continental Insurance Company/ 35289
2841 Gardena Avenue INSURER D:Starstone National Insurance Company 25496
Signal Hill, CA 90755 INSURER E: AIG Specialty Insurance Co.� 26883
INSURER F,
COVERAGES CERTIFICATE NUMBER- RFVIRInM NIIMRFR-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OF INSURANCE
ADDLSUBR INqD
MD
POLICYNUMBER
POLICY EFF
POLICY EXJJ&P LIMITS
EACH OCCURRENCE 1,000,006
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MAGE OCCUR[A]
X
4034952911
0313012017
0313012018 DAMAGE TOERENTED $ 100,000
X Deductible: $5,000
n
15,000
MED EXP (my one arson $
X PrpDamage/Subsidence
1,000,000
PERSONAL S ADV INJURY $
GEN -L AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE $ 2,000,000
POLICY JEOT F� LOC
2,000,000
PRODUCTS - COMP/OP AGO $
OTHER:
B
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT 1�gggg00
Ea accident)
AUTO
X
5091114974
0313012017
0313012018 BODILY INJURY Per arson
OWNED SCHEDULED
-
JXANY
AUTEOSONLY AUTO.pSyyry
BODILY INJURY Per accident $
AUTOS X AUTOS
PerOaa Gent AMAGE
ONLY ONLY
C
X UMBRELLA LIAR
X
OCCUR
EACH OCCURRENCE $ 19,000,000
EXCESS LIAB
CLAIMS -MADE
5091114988 -
0313012017
03130/2018 AGGREGATE $ 19,000,000
DED X RETENTION$ 10,000
D
AND EMPLOYERTLIABILIITY
X PIAT E ETH
YIN
X
T10160030
0610212016
06102/2017 1,000,000
ANY PROPRIETOR/PARTNERIEXECUTIVE
EXCLUDED?
NIA
E.L. EACH ACCIDENT $
QQF�FICERIMEMBER
(rnantlaro'y.NH)
110001000
Me es, dascdbe under
E.L. DISEASE-EAEMPLOYE $.
1,000,000
DE CRIPTIONOFOPERATIONSbelow
E.L. DISEASE -POLICY LIMB
E
Pollution Liability
CPL3850939
0313012017
0313012018 Ded: $10,006-71 000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
RE: Job #314, Grade 5 Non -phase Work #2
Costa Mesa Sanitary District, its directors, officials, officers, employees, agents, and volunteers shall be covered as Additional Insured as respects General
Liability per forms CNA74705XX & CNA75079XX; Primary and Non Contributory wording included. With respects to Auto Liability per form CNA63359XX;
Primary and Non Contributory wording Included. Waiver of Subrogation applies to Work Comp per form WC040306.
30 day notice of cancellation applies as per policy terms and conditions.
Costa Mesa Sanitary District
290 Paularino Avenue �
Costa Mesa, CA 92626 �C/ � k✓t
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORREO REPRESENTATIVE
ACORD 25 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
CNANi INSURED:- Charles Kind Company; -Inc. CNA63359XX
POLICY NUMBER: 5091114974
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ- IT CAREFULLY:
CONTRACTORS EXTENDED COVERAGE ENDORSEMENT
w BUSINESS AUTO PLUS
This -encoirsdindrit4nodifies insurance provided tinder the folcWho:
BUSINESS AUTO COVERAGE FORM
1. LIABILITY COVERAGE
A. Who Is An Insured
The following is added, to Section 11, Paragraph
A.1., Who Is An Insured;
1. a. Any Incorporated entity of which the
Named Insured owns a majority of the
voting stock an the date of inception of
this Coverage Form; provided that,
ll The irilsordince afforded by this provision
-A.1, does not apply to any such entity
that s. an Insured" under any other
I'lablilty "policy" providing auto!,
cOvefagp-
2. Any organizationyou newly acquire or form,
-other than a limited liability company,
partnership or joint'Verdure, and over Which
you maintain majority ownership interest.
The insurance afforded by this -provision
A.2.:,
a. Is effective on the acquisition or
formation date, and, is affordi until
the end of the policy -perlod of this
Coverage Form, or the next anniversary
of its inception date, winichover is
earlier.
b. Does notapply 'lic,
1(1) 'Scclfly 11p ry" Or "property damage"
caused by an "accide4' that
occurred. before you acquired or
formed the Organization; or
.(2) Any such organization that is ;an
;'insured" under any other liability
"l providing "autd'coverage.
8. Any penson or organization on that yqu are
required by a written contract to name as an
additional insured is an "Insured" but only
with respect to their legal liability for acts or
Missions of a person,
Who qualifies as an
'Insured" u nder Seotl n 11 — Who Is An
Insured and for whom Liability Coverage is
afforded under this policy. If required by
written contract, this. insurance Will be
primary and non-contributory to insutance
on'which the additional insured is 9 Named
Insured.
4. yours is an "insured" while
Operating an "auto" hired or rented under A
contract or -agreement in that "emplciyee's.".
name, with your perm-ission, while
perlpri-ning duties related to the conduct of
your business.
"Poliog" as Used in this provision A. -Who 1s
Insured, includes those politics that were in
"force on the inception date of this Coverage
Form but,'
1. W hich are no longer in for,c.w:or
2. 'Whose limits have been exhausted,
8, gall Bonds and Loss of Earnings
Section 11, Paragraphs -A.2. (2) and A.Z. (4)
are rdVited At1ollows:
1. In a.(2), the Itrilt for the cost otbalf bonds is
changed from $2,000 to $5j00,0; arid
2. In a.(4), the limit for the loss of parning,% 19
changedfrom $250 tQ$500 aday.
C. Fellow Employee
Sectlon'll, - Paragraph B5 does not apply.
Such coverage as is afforded try this provision
C. is excess over any other collectible
Insurance.
IL PHYSICAL DAMAGE COVERAGE
A. Glass Breakagd —,H11l Bird Of Animal—
Falling Objects Or Missiles
T40 follcWng is added 19 :Section III,
Paragraph A.3.,
With respect to any covered "auto," any
deductible shown In the DeclArations WTI not
apply to glass breakage it such glass Is
repaired, in a tanner acceptable to us, rather
than replac-ed,.
B. Transportation E xp6rises
Section Illi Paragraph -A.4.ai Is rev I 113od, with
respect to transpodation expense incurred by
you, to provide:
0. $60 per day, in lieu of $90.- sablootto,
b. $1,800 maximum, in lieu of $600,
CNA63359XX Copyright, CNA Cupar6tion; 2040.
(t& 04/12) lhcludm-coyrightOJd material of 1he insumhceli§drvices bfflce:uwd wlhift permission:
Page 1 of 3
CNA63359XX
CNA(Ed.
04(12]
C. Loss of Use Expenses
Section III, Paragraphs: 6,4.c:and 13.4,d. are
Section III, Paragraph A:4.b: is revised, with
deleted and replaced by the following:
respect to loss of use expenses incurred byyou,
c. .Physical :Damage Coverage on a ,covered
to provide:
"auto" also applies: .Yo "foss" to any
a. $1;000 maximum, in lieu of $600:.
permanently installed "electronic equipment
'
.including. Its antennas and other
D. Hired "Autos"
accessories.
The following is added to Section III.
d: :A $top per occurrence deductible applies to
Paragraph A;
the coverage provided by this provision.
5. Hired "Autos"
G: Diminution In Value
If Physical Damage coverage is providetl _under
The following is added to Section III,
this policy; and such coverage does not; extend
Paragraph B.&.'
to Hired Autos, then Physical. Damage coverage
Subject to ;the following, the "diminution- in
is`extended tod
value"exclusion does not applyto-
a. Any covered "auto" you lease, hire, rent
a. Any covered °jgutIo" of She private
or borrow without a driver; and
passenger type you lease; :hire, rent or
b. Any covered "auto" hired or rented by
borrow, without a driver for a. period of
your 'empioyee" without a driver; ;under
30 days or less, while performing duties
a contract in. that individual
related to the conduct of your business,
"employee's" name, with your
and
permission, while performing duties
related to the conduct of your business
b. Any `covered "auto" of ;the private
passenger type hired or rented by your
c. The most we will pay for :any one
"employee" without a driver for a period
"accident" -or "loss" is the actual cash
of 30. days or less, under a contractin
value, cost of repair, cost of
that individual "employee's" name, with
replacement or $75,000, whichever is
your permission, while performing
Mess, minus a $500deductible for each
duties related to the conduct of your
covered auto. No deductible applies to
business,
"loss" caused by fire or; lightning`.
c. Such coverage as is provided by fiifs
d. The physical damage coverage as 1s.
;provision is: limited to a "diminution in
provided by this, provision is equal to the
value" loss arising directly out of
physical damage coverage(s) provided
accidental damage and not as a result
on your owned "autos:"
of the failure to make repairs; faulty or
-
e. Such physical damage coverage W
incomplete maintenance or repairs; or
hired "autos" will:
the installation of substandard parts.
(1) Include loss of use, provided it is
d. The most we will pay for loss!' to a
covered "auto'` in any one accident is
the consequence of an "accident"
the lesser of:
m
for which the. Named Insured is
legally liable, and as a result of
(i) $5;000; or
which a monetary loss is sustained
(2) 20% of .the "auto's";actual cash
by the leasing or rental concern.
value (ACV).
C(2) Such coverage as Is provided by
III. Drive Other Car Coverage — Executive Officers
this, provision will be subject to a,
limit of $750 per "accident."
The following is added to:.Sections II and III:
E. Airbag coverage
1., Any, "auto' you don't own, hire or borrow Is a
The following is added to Section Ili,
covered "auto"for Liability Coverage while being
Paragraph 6:3:;
used by, and for Physical Damage Coverage
while in the care, custody or control of, any Of
The accidental discharge of an airbag shall not
your "executive officers;"except:
be considered mechanical breakdown.
a. An "auto" owned by that "executive officer"
F. Electr6nie Equipment
or a member of that person's household; or
CNA036VX Copyright cNA Corporalion 2006:: Page 2 of 3
(Ed. 04/12) Includes copynghledrnateriaiotihe Insurance:
Services office used WIN is permission;.
CNA63359XX
CNA(Ed 04112)
b. An "auto"'used by that '`executive officer"
while working in a business of selling,
servicing, repairing or parking "autos"
Such Liability andior ;Physical Damage
Coverage as is afforded by this provision::
(1) Equal to 'the greatest of :those
coverages afforded any covered `'auto";
and
(2j Excess over any other collectible
insurance..
2. Forpurposes of this provision, "executive
officer' means a person holding any of the
officer ;"positions created ;by your charter,
constitution, by-laws or any other similar
governing document, and, while a resident of
the same household, includes that person's
spouse:
Such "executive officers" are "insureds" "while
using a covered "auto" 'described fn this
provision.
IV. BUSINESS AUTO CONDITIONS
A. Duties In The Event Of Accident, Claim, Suit
Or Loss
The following is added to Section IV,
Paragraph A.2.6!
it Your "employees" may know of an
"accident" or "loss." This will not mean
that you have such knowledge, unless
such "accident" or "toss" Is known to
you or if you are not an individual, to
any of .your executive officers or
partners :oryour insurance manager.
The following, :It added ,to Section IV,
Paragraph A.2:b -
(6) Your "employees" may know of
documents received concerning a claim
or "suit{" This well not mean that you
have such knowledge, unless receipt of
such documents is known to you or if
you are not an individual, to any -of your
executive officers cr partners or your
insurance manager.
B Transfer Of Rights Of Recovery ,Against
Others To Us
The following Is added to 'Section JV;
Paragraph A.S. TransferOf Rights Of
Redovery Against Others To Us:
We walve any: right of recovery we may have,
because of payments we make for injUryor
damage, against any person or organization for
whom or which you are required by written
contract or agreement to obtain this waiver from
us,
This injury or damage must arise -out lot your
activities under a contract with. that person or
organization:.
You must agree to that requirement.prior to an
"accident"or "loss."
C. Concealment;' Misnapresentation,sr Fraud
The following is added to: Section IV,
Paragraph B2:;
Your failure to disclose all hazards existing on the
date of inception of this Coverage Form shall not
prejudice you with respect to the coverage afforded
provided such failure or omission Is not intentional.
D. Other insurance
The followng is added to Section IV,
Paragraph B.S.:
kogardfess of the provisions of Paragraphs 5.a.
and 5.d. above, the coverage provided by this
policy shall be on a primary non-contributory
basis. This provision .is applicable only when
required by a written 'Contract. That written
contract must have. been entered into prior to
"Accident" or "Loss""
E. Policy Period, Coverage Territory
Section IV, Paragraph:B. 7.(5).(a). is revised to
provide:
a. 45 days of coverage in lieu of 30 days.
V. DEFINITIONS
Section V. Paragraph C. is deleted and replaced
by the following:
"Bodily injury" means bodily Injury; sickness or
disease sustained by a person, including mental
anguish, mental injury or death resulting from any of
these.
QNA63359XX Copyright, CNA Oorphration, 20ll0: Page 3 of 3
(Ed. 04N 2) Includes copyrighted material or the Insurance SoMces Office used {Hili He permission,
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
1. ADDITIONAL INSUREDS
a. WHO IS AN INSURED is amended to include as an Insured any person or organization described in paragraphs
A. through H. below whom a Named Insured is required to add as an additional insured on this Coverage Part
under a written contract or written agreement, provided such contract or agreement:
(1) is currently in effect or becomes effective during the term of this Coverage Part; and
(2) was executed prior to:
(a) the bodily injury or property damage; or
(b) the offense that caused the personal and advertising injury,
for which such additional insured seeks coverage.
b. However, subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer
will not provide such additional insured with:
(1) a higher limit of insurance than required by such contract or agreement; or
(2) coverage broader than required by such contract or agreement, and in no event broader than that described
by the applicable paragraph A. through H. below.
Any coverage granted by this endorsement shall apply only to the extent permissible by law.
A. Controlling Interest
Any person or organization with a controlling interest in a Named Insured, but only with respect to such person or
organization's liability for bodily injury, property damage or personal and advertising injury arising out of:
1. such person or organization's financial control of a Named Insured; or
2. premises such person or organization owns, maintains or controls while a Named Insured leases or
occupies such premises;
provided that the coverage granted by this paragraph does not apply to structural alterations, new construction or
demolition operations performed by, on behalf of, or for such additional insured.
B. Co-owner of Insured Premises
A co-owner of a premises co -owned by a Named Insured and covered under this insurance but only with respect
to such co -owner's liability for bodily injury, property damage or personal and advertising injury as co-owner
of such premises.
C. Lessor of Equipment
Any person or organization from whom a Named Insured leases equipment, but only with respect to liability for
bodily injury, property damage or personal and advertising injury caused, in whole or in part, by the Named
Insured's maintenance, operation or use of such equipment, provided that the occurrence giving rise to such
bodily injury, property damage or the offense giving rise to such personal and advertising injury takes place
prior to the termination of such lease.
D. Lessor of Land
Any person or organization from whom a Named Insured leases land but only with respect to liability for bodily
injury, property damage or personal and advertising injury arising out of the ownership, maintenance or use
of such land, provided that the occurrence giving rise to such bodily injury, property damage or the offense
giving rise to such personal and advertising injury takes place prior to the termination of such lease. The
CNA74705XX (1-15) Policy No: 4034952911
Page 2 of 17 Endorsement No: 1.
Nat'l Fire Ins Co of Hartford Effective Date: 03/30/2017
Insured Name: CHARLES KING COMPANY, INC.
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Orfice, Inc., with its permission.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
coverage granted by this paragraph does not apply to structural alterations, new construction or demolition
operations performed by, on behalf of, or for such additional insured.
E. Lessor of Premises
An owner or lessor of premises leased to the Named Insured, or such owner or lessor's real estate manager, but
only with respect to liability for bodily injury, property damage or personal and advertising Injury arising out of
the ownership, maintenance or use of such part of the premises leased to the Named Insured, and provided that
the occurrence giving rise to such bodily injury or property damage, or the offense giving rise to such personal
and advertising injury, takes place prior to the termination of such lease. The coverage granted by this
paragraph does not apply to structural alterations, new construction or demolition operations performed by, on
behalf of, or for such additional insured.
F. Mortgagee, Assignee or Receiver
A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or receiver's
liability for bodily injury, property damage or personal and advertising injury arising out of the Named
Insured's ownership, maintenance, or use of a premises by a Named Insured.
The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition
operations performed by, on behalf of, or for such additional insured.
G. State or Governmental Agency or Subdivision or Political Subdivisions — Permits
A state or governmental agency or subdivision or political subdivision that has issued a permit or authorization but
only with respect to such state or governmental agency or subdivision or political subdivision's liability for bodily
injury, property damage or personal and advertising injury arising out of:
1. the following hazards in connection with premises a Named Insured owns, rents, or controls and to which
this insurance applies:
a. the existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings,
canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk
vaults, street banners, or decorations and similar exposures; or
b. the construction, erection, or removal of elevators; or
c. the ownership, maintenance or use of any elevators covered by this insurance; or
2. the permitted or authorized operations performed by a Named Insured or on a Named Insured's behalf.
s
The coverage granted by this paragraph does not apply to:
9
a. Bodily injury, property damage or personal and advertising injury arising out of operations performed
for the state or governmental agency or subdivision or political subdivision; or
b. Bodily injury or property damage included within the products -completed operations hazard.
With respect to this provision's requirement that additional insured status must be requested under a written
contract or agreement, the Insurer will treat as a written contract any governmental permit that requires the
Named Insured to add the governmental entity as an additional insured.
Nall
H. Trade Show Event Lessor
1. With respect to a Named Insured's participation in a trade show event as an exhibitor, presenter or displayer,
any person or organization whom the Named Insured is required to include as an additional insured, but only
with respect to such person or organization's liability for bodily injury, property damage or personal and
advertising injury caused by:
CNA74705XX (1-15) Policy No: 4039952911
Page 3 of 17 Endorsement No: 1
Nat'l. Fire Ins Co of Hartford Effective Date: 03/30/2017
Insured Name: CHARLES KING COMPANY, INC.
copyright CNA All Rights Reserved. Includes copyrighted material of Insurance services Office, Inc., with Its permission.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
a. the Named Insured's acts or omissions; or
b. the acts or omissions of those acting on the Named Insured's behalf,
in the performance of the Named Insured's ongoing operations at the trade show event premises during the
trade show event.
2. The coverage granted by this paragraph does not apply to bodily injury or property damage included within
the products -completed operations hazard.
2. ADDITIONAL INSURED -PRIMARY AND NON-CONTRIBUTORY TO ADDITIONAL INSURED'S INSURANCE
The Other Insurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended to
add the following paragraph:
If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and non-
contributory relative to an additional insured's own insurance, then this insurance is primary, and the Insurer will not
seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own
insurance means insurance on which the additional insured is a named insured. Otherwise, and notwithstanding
anything to the contrary elsewhere in this Condition, the insurance provided to such person or organization is excess
of any other insurance available to such person or organization.
3. BODILY INJURY— EXPANDED DEFINITION
Under 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, humiliation, shock,
mental anguish or mental injury sustained by that person at any time which results as a consequence of the physical
injury, sickness or disease.
4. BROAD KNOWLEDGE OF OCCURRENCE/ NOTICE OF OCCURRENCE
Under CONDITIONS, the condition entitled Duties in The Event of Occurrence, Offense, Claim or Suit is amended
to add the following provisions:
A. BROAD KNOWLEDGE OF OCCURRENCE
The Named Insured must give the Insurer or the Insurer's authorized representative notice of an occurrence,
offense or claim only when the occurrence, offense or claim is known to a natural person Named Insured, to a
partner, executive officer, manager or member of a Named Insured, or an employee designated by any of the
above to give such notice.
B. NOTICE OF OCCURRENCE
The Named Insured's rights under this Coverage Part will not be prejudiced if the Named Insured fails to give
the Insurer notice of an occurrence, offense or claim and that failure is solely due to the Named Insured's
reasonable belief that the bodily injury or property damage is not covered under this Coverage Part. However,
the Named Insured shall give written notice of such occurrence, offense or claim to the Insurer as soon as the
Named Insured is aware that this insurance may apply to such occurrence, offense or claim.
5. BROAD NAMED INSURED
WHO IS AN INSURED is amended to delete its Paragraph 3. in its entirety and replace it with the following:
3. Pursuant to the limitations described in Paragraph 4. below, any organization in which a Named Insured has
management control:
a. on the effective date of this Coverage Part; or
GNA74705XX (1-15) Policy No: 4034952911
Page 4 of 17 Endorsement No: 1
Nat'l Fire Ins Co of Hartford Effective Date: 03/30/2017
Insured Name: CHARLES KING COMPANY, INC,
copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc, With its permission.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
(2) If the cause of loss to the damaged work arises as a result of:
(a) fire;
(b) smoke;
(c) collapse; or
(d) explosion.
B. The following paragraph is added to LIMITS OF INSURANCE:
Subject to 5. above, $100,000 is the most the Insurer will pay under Coverage A for the sum of damages arising
out of any one occurrence because of property damage to your product and your work that is caused by fire,
smoke, collapse or explosion and is included within the product -completed operations hazard. This sublimit
does not apply to property damage to your work if the damaged work, or the work out of which the damage
arises, was performed on the Named Insured's behalf by a subcontractor.
C. This Broadened Liability Coverage For Damage To Your Product And Your Work Provision does not apply if
an endorsement of the same name is attached to this policy.
7. CONTRACTUAL LIABILITY—RAILROADS
With respect to operations performed within 50 feet of railroad property, the definition of insured contract is replaced
by the following:
Insured Contract means:
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 to premises while rented to a Named Insured or temporarily
occupied by a Named Insured with permission of the owner Is not an insured contract;
b. A sidetrack agreement;
c. Any easement or license agreement;
d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a
municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement pertaining to the Named Insured's business (including an
indemnification of a municipality in connection with work performed for a municipality) under which the Named
Insured assumes the tort liability of another party to pay for bodily injury or property damage to a third person
or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or
agreement.
Paragraph f. does not include that part of any contract or agreement:
(1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of:
(a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; or
(b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or
damage;
(2) Under which the Insured, if an architect, engineer or surveyor, assumes liability for an injury or damage
arising out of the insured's rendering or failure to render professional services, including those listed in (1)
above and supervisory, inspection, architectural or engineering activities.
8. ELECTRONIC DATA LIABILITY
CNA74705XX (1-15) Policy No: 4034552911
Page 6 of 17 Endorsement No: 1
Nat'l Fire Ins Co of Hartford Effective Date: 03/30/2017
Insured Name: CHARLES KING COMPANY, INC.
Copyright CNA All Rights Reserved. Includes copyrighted meterlal of Insurance Services Once, Inc., with its permission.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
claims arising solely out of their capacity or status as such and, in the case of a spouse, where such claim seeks
damages from marital community property, jointly held property or property transferred from such natural person
Insured to such spouse. No coverage is provided for any act, error or omission of an estate, heir, legal
representative, or spouse outside the scope of such person's capacity or status as such, provided however that the
spouse of a natural person Named Insured and the spouses of members or partners of joint venture or partnership
Named Insureds are Insureds with respect to such spouses' acts, errors or omissions in the conduct of the Named
Insured's business.
10. EXPECTED OR INTENDED INJURY—EXCEPTION FOR REASONABLE FORCE
Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Expected or Intended Injury and replace it with the following:
This insurance does not apply to:
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.
11. GENERAL AGGREGATE LIMITS OF INSURANCE - PER PROJECT
A. For each construction project away from premises the Named Insured owns or rents, a separate Construction
Project General Aggregate Limit, equal to the amount of the General Aggregate Limit shown in the Declarations,
is the most the Insurer will pay for the sum of:
1. All damages under Coverage A, except damages because of bodily Injury or property damage included in
the products -completed operations hazard; and
2. All medical expenses under Coverage C,
that arise from occurrences or accidents which can be attributed solely to ongoing operations at that construction
project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations, nor the
Construction Project General Aggregate Limit of any other construction project.
B. All:
1. Damages under Coverage B, regardless of the number of locations or construction projects involved;
2. Damages under Coverage A, caused by occurrences which cannot be attributed solely to ongoing
operations at a single construction project, except damages because of bodily injury or property damage
included in the products -completed operations hazard; and
3. Medical expenses under Coverage C caused by accidents which cannot be attributed solely to ongoing
operations at a single construction project,
will reduce the General Aggregate Limit shown in the Declarations.
C. The limits shown in the Declarations for Each Occurrence, for Damage To Premises Rented To You and for
Medical Expense continue to apply, but will be subject to either the Construction Project General Aggregate Limit
or the General Aggregate Limit shown in the Declarations, depending on whether the occurrence can be
attributed solely to ongoing operations at a particular construction project.
D. When coverage for liability arising out of the products -completed operations hazard is provided, any payments
for damages because of bodily injury or property damage included in the products -completed operations
hazard will reduce the Products -Completed Operations Aggregate Limit shown in the Declarations, regardless of
the number of projects involved.
CNA74705XX (1-15) Policy No: 4 034 952 911
Page 8 of 17 Endorsement No: 1
Nat'l Fire rns Co of Hartford Effective Date: 03/30/2017
Insured Name: CHARLES KING COMPANY, INC.
Copyright CNA AII Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with Its permission;
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE — ELEVATORS Provision, the
Other Insurance conditions is amended to add the following paragraph:
This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other
basis that is Property insurance covering property of others damaged from the use of elevators.
23. SUPPLEMENTARY PAYMENTS
The section entitled SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended as follows:
A. Paragraph 1.b. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a $5,000.
limit; and
B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a
$1,000. limit.
24. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named
Insured's Coverage Part, the Insurer will not deny coverage under this Coverage Part because of such failure.
25. WAIVER OF SUBROGATION - BLANKET
Under CONDITIONS, the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to
add the following:
The Insurer waives any right of recovery the Insurer may have against any person or organization because of
payments the Insurer makes for injury or damage arising out of:
1. the Named Insured's ongoing operations; or
2. your work included in the products -completed operations hazard.
However, this waiver applies only when the Named Insured has agreed in writing to waive such rights of recovery in
a written contract or written agreement, and only if such contract or agreement:
1. is in effect or becomes effective during the term of this Coverage Part; and
2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise to the
claim.
26. WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS
Note: The following provision does not apply to any public construction project in the state of Oklahoma, nor to any
construction project in the state of Alaska, that is not permitted to be insured under a consolidated (wrap-up)
Insurance program by applicable state statute or regulation.
If the endorsement EXCLUSION — CONSTRUCTION WRAP-UP is attached to this policy, or another exclusionary
endorsement pertaining to Owner Controlled Insurance Programs (O.C.I.P.) or Contractor Controlled Insurance
Programs (C.C.I.P.) is attached, then the following changes apply:
A. The following wording is added to the above -referenced endorsement:
With respect to a consolidated (wrap-up) insurance program project in which the Named Insured is or was
involved, this exclusion does not apply to those sums the Named Insured become legally obligated to pay as
damages because of:
1. Bodily injury, property damage, or personal or advertising injury that occurs during the Named Insured's
ongoing operations at the project, or during such operations of anyone acting on the Named Insured's
behalf; nor
CNA74705XX (1-15) Policy No: 40 34 952 911
Page 16 of 17 Endorsement No: 1
Nat'l fire Ins Co of Hartford Effective Date: 03/30/2017
Insured Name: CHARLES KING COMPANY, INC.
Copyright CNA All Rights Reserved, Includes copydghled malarial or Insurance Services Once. Inc., with its permission.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
2. Bodily injury or property damage included within the products -completed operations hazard that arises
out of those portions of the project that are not residential structures.
B. Condition 4. Other Insurance is amended to add the following subparagraph 4.b.(1)(c):
This insurance is excess over:
(c) Any of the other insurance whether primary, excess, contingent or any other basis that is insurance available
to the Named Insured as a result of the Named Insured being a participant in a consolidated (wrap-up)
Insurance program, but only as respects the Named Insured's involvement in that consolidated (wrap-up)
insurance program.
C. DEFINITIONS is amended to add the following definitions:
Consolidated (wrap-up) Insurance program means a construction, erection or demolition project for which the
prime contractor/project manager or owner of the construction project has secured general liability insurance
covering some or all of the contractors or subcontractors involved in the project, such as an Owner Controlled
Insurance Program (O.C.I.P.) or Contractor Controlled Insurance Program (C.C.I.P.).
Residential structure means any structure where 30% or more of the square foot area is used or is intended to
be used for human residency, including but not limited to:
1. single or multifamily housing, apartments, condominiums, townhouses, co-operatives or planned unit
developments; and
2. the common areas and structures appurtenant to the structures in paragraph 1. (including pools, hot tubs,
detached garages, guest houses or any similar structures).
However, when there is no individual ownership of units, residential structure does not include military housing,
college/university housing or dormitories, long term care facilities, hotels or motels. Residential structure also
does not include hospitals or prisons.
This WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS Provision
does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect
on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and
expires concurrently with said Policy.
CNA74705XX (1-15) Policy No: 4034952911
Page 17 of 17 Endorsement No: 1
Nat'l Fire Ins Co of Hartford Effective Date: 03/30/2017
Insured Name: CHARLES KING COMPANY, INC.
Copyright CNA NI Rights Reserved Includes copyrighted material of Insurance Sen lees Office, Inc., with its permission.
CNA CNA PARAMOUNT
Blanket Additional Insured - Owners, Lessees or
Contractors -with Products -Completed
Operations Coverage Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
It is understood and agreed as follows:
I. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the Named
Insured is required by written contract to add as an additional insured on this coverage part, including any such
person or organization, if any, specifically set forth on the Schedule attachment to this endorsement. However, such
person or organization is an Insured only with respect to such person or organization's liability for:
A. unless paragraph B. below applies,
1. bodily injury, property damage, or personal and advertising injury caused in whole or in part by the acts
or omissions by or on behalf of the Named Insured and in the performance of such Named Insured's
ongoing operations as specified in such written contract; or
2. bodily Injury or property damage caused in whole or in part by your work and included in the products -
completed operations hazard, and only if
a, the written contract requires the Named Insured to provide the additional insured such coverage; and
b, this coverage part provides such coverage.
B. bodily injury, property damage, or personal and advertising injury arising out of your work described In such
written contract, but only if:
1. this coverage part provides coverage for bodily injury or property damage included within the products
completed operations hazard; and
2. the written contract specifically requires the Named Insured to provide additional insured coverage under
the 11-85 or 10-01 edition of CG201 Q or the 10-01 edition of CG2037.
II. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide
such additional insured with:
A. coverage broader than required by the written contract; or
B. a higher limit of insurance than required by the written contract.
R
III. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property
s damage, or personal and advertising injury arising out of:
A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services,
including:
1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; and
2. supervisory, inspection, architectural or engineering activities; or
B. any premises or work for which the additional insured is specifically listed as an additional insured on another
.., endorsement attached to this coverage part.
IV. Notwithstanding anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS,
the Condition entitled Other Insurance, this insurance is excess of all other insurance available to the additional
s
insured whether on a primary, excess, contingent or any other basis. However, if this insurance is required by written
CNA75079XX (1-15) Policy No: 9 039 952 911
Page 1 of 2 Endorsement No: 3
Nat'l Fire Ins. Co of Hartford Effective Date: 03/30/2017
Insured Name: CHARLES KING COMPANY, .INC.
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance services Office, Inc., with its permission,
CNA CNA PARAMOUNT
/�+� Blanket Additional Insured - Owners, Lessees or
Contractors - with Products -Completed
Operations Coverage Endorsement
contract to be primary and non-contributory, this insurance will be primary and non-contributory relative solely to
insurance on which the additional insured is a named insured.
V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL
LIABILITY CONDITIONS is amended as follows:
The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition
of the following:
Any additional insured pursuant to this endorsement will as soon as practicable:
1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim;
2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance the
additional insured has for any loss covered under this coverage part;
3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the
investigation, defense, or settlement of the claim; and
4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program
applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires
this insurance to be primary and non-contributory, this paragraph (4) does not apply to insurance on which
the additional insured is a named insured.
The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer
receives written notice of a claim from the additional insured.
VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to
add the following definition:
Written contract means a written contract or written agreement that requires the Named Insured to make a person
or organization an additional insured on this coverage part, provided the contract or agreement:
A. is currently in effect or becomes effective during the term of this policy; and
B. was executed prior to:
1. the bodily injury or property damage; or
2. the offense that caused the personal and advertising injury
for which the additional insured seeks coverage.
Any coverage granted by this endorsement shall apply solely to the extent permissible by law.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect
on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and
expires concurrently with said Policy.
CNA75079XX (1-15) Policy No: 4034952911
Page 2 of 2 Endorsement No: 3
Nat'l Eire Ins Co of Hartford Effective Date: 03/30/2017
Insured Name: CHARLES KING COMPANY, INC.
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Once, Inc., with its permission.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our
right against the person or organization named in the Schedule. (This agreement applies only to the extent that you
perform work under a written contract that requires you to obtain this agreement from US.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work
described in the Schedule.
The additional premium for this endorsement shall be _*_% of the California workers' compensation premium otherwise
due on such remuneration.
Schedule
Person or Organization
Job Description
WHERE YOU ARE REQUIRED BY WRITTEN CONTRACT TO
OBTAIN THIS AGREEMENT FROM US, PROVIDED THE
CONTRACT IS SIGNED AND DATED PRIOR TO THE DATE OF
LOSS TO WHICH THIS WAIVER APPLIES. IN NO INSTANCE
SHALL THE PROVISIONS AFFORDED BY THIS
ENDORSEMENT BENEFIT ANY COMPANY OPERATING
AIRCRAFT FOR HIRE.
*The premium charge for this endorsement shall be 2% of the premium developed in the State of California, but not less
than $500 policy minimum premium.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required. only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective 06/02/16 Policy No. T10160030 Endorsement No. 12
Insured Charles King Company, Inc. Policy Effective Date 06/02/16
Insurance Company StarStone National Insurance Company
Countersigned By
WC 04 03 06
(Ed. 4-84)
®1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved.