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Insurance - National Plant Services - 2019-11-15 (2)AIIC"R" CERTIFICATE OF LIABILITY INSURANCE DATE(M5/2019 Y) llha .i'' 11/15/2019 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 INSURERS), 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 rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: Christina Zumrick.. Client Service Manager Arthur J. Gallagher Risk Management Services, Inc. PHONE _----- __—�-----___ FAX — -- ------ – 2850 Golf Road R��j`T�+ . 630.694.5458 a1c No): EMAIL ADDRESS: Christina zumrick@ajg.com Rolling Meadows IL 64008 INSURER(S) AFFORDING COVERAGE NAIC # -- — --- - -- N Q u 21 2019 INSURER A: Zurich American Insurance Compan 16535 INSURED cAR°coy-04 NATIONAL INC. INSURER B: American Zurich Insurance Company 40142 —� —� -- --- ---- --- PLANT SERVICES, 1461 HARBOR AVENUE C Mesa Sankary I ii INSURER c: American Guarantee and Liabilitylns Co 26247 --- ---- --- LONG BEACH, CA 90813-2741 INSURER D: INSURER E: INSURER F: ��I�i+�a.rl�rta.+EIa:��l-ril�jllr.�4�I�iiTli:����.-r�z�:�►r:�vr. 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 A0bL;SUBR; -_ f POLICY EFF POLICY EXP LTR IND WVD' POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y I GLO9377201-16 10/31/2019 10/31/2020 ;EACH OCCURRENCE $2,000.000 IOCCURRENCE E DAMAGE TO RENTED ------ ------ ---- — CLAIMS MADE X ;OCCUR PREMISES Ea occurrence} $ 300,000 X XCU INCLUDED MED EXP (Anyone person) — $ 0 _—_--V—_� --- --- — ----- ` PERSONAL & ADV INJURY $ 2.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY X PEO LOG PRODUCTS COMP/OP AGG 1 $4,000,000 $ -- OTHER: A AUTOMOBILE LIABILITY Y '. BAP 9377199-1610131/2019 10/31/2020 COMBINED SINGLE LIMIT ! $ 5,000.000 Ea accident X ;ANY AUTO BODILY INJURY (Per person' j $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY {Per accident) r $ _ X HIRED i X NON -OWNED PROPERTY DAMAGE - - — -- - AUTOS ONLY AUTOS ONLY i (Per accident) $ C X UMBRELLA LIAB X OCCUR AUC 5916947-14 10/31/2019 10/31/2020 EACH OCCURRENCE $1,000,000 EXCESS LIAR CLAIMS ------ ;---------- --------- MADE AGGREGATE $1.000,000 DEQ X j RETENTION $ In nnn$ B WORKERS COMPENSATIONWC 9377202-16 10/31/2019 10/31/2020 jX PER OTH LL STATUTE ER_ AND EMPLOYERS' LIABILITY YIN _- -- - ---- ANYPROPRIETORIPARTNERIEXECUTIVE a E.L. EACH ACCIDENT $1,000,000 OFFICERMEMBEREXCLUDED? N I A ---.--- - - — (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE'i, $ 1,000.000 It yes, describe under ---.---— _.— —_--_------------ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 f DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Costa Mesa Sanitary District, their elected and appointed officials, agents, officers , volunteers. and employees are shown as Additional Insureds solely with respect to General Liability coverage as evidenced herein on a Primary/Non-Contributory basis and Auto Liability coverage as required by written contract with respect to work performed by the Named Insured. 30 Days' Notice of Cancellation applies in favor of Certificate Holder as required by written contract. • +�:LL44:I4WtI[*I► SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa Sanitary District ACCORDANCE WITH THE POLICY PROVISIONS. t 290 Paularino Avenue AUTHORIZED REPRESENTATIVE Costa Mesa CA 92626 x a 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE 2` of 18 683 Additional Insured - Owners, Lessees Or Contractors - Ongoing Operations — Scheduled endorsementThis ••ifies insurance provided under the: Commercial t Coverage Part tiTOTWUMITIM Name of Person or Organization : Eff. Date of Pol. Exp, Pol. Eff. Date of End. Producer No. AddT Prem Return Prem. t • 9377201-16 10/31/2020 i 1 • 24059000 -_,■ INSURANCE IS OTHERWISE SEPARATELY endorsementThis ••ifies insurance provided under the: Commercial t Coverage Part tiTOTWUMITIM Name of Person or Organization : Location and Description of Ongoing Operations: Additional Premium: ANY PERSON OR ORGANIZATION. BUT ONLY WHEN ANY LOCATION OR PROJECT, OTHER THAN A YOU ARE REQUIRED TO PROVIDE ADDITIONAL WRAP-UP OR OTHER CONSOLIDATED INSURANCE INSURED STATUS IN A WRITTEN CONTRACT OR PROGRAM LOCATION OR PROJECT FOR WHICH WRITTEN AGREEMENT EXECUTED PRIOR TO LOSS INSURANCE IS OTHERWISE SEPARATELY AND WHERE THAT CONTRACT SPECIFICALLY PROVIDED TO YOU BY A WRAP-UP OR OTHER REQUIRES THE ISO CG2010 10/2001 EDITION FORM CONSOLIDATED INSURANCE PROGRAM OR THE EQUIVALENT OF SAME A. Section 11 - Who Is An Insured is amended to include as an insured any person or organization shown in the Schedule of this endorsement but only with respect to liability arising out of your ongoing operations performed for that insured at or from the corresponding location designated and described in the Schedule. However, if you have entered into a construction contract with an additional insured person or organization shown in the Schedule of this endorsement, the insurance afforded to such additional insured only applies to the extent permitted by law. B. With respect to the insurance afforded to any additional insured shown in the Schedule of this endorsement, the following additional exclusion applies: This insurance does not apply to "bodily injury" or "property damage" occurring after 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. All other terms and conditions of this policy remain unchanged. Includes copyrighted material of Insurance Services Office. Inc., with its permission. U -GL -1465-D CW (12-13) Page 27 of 43 3* of 18 683 Additional If, r d Owners, Lessees rr Contractors Completed Operations - Scheduled r • mEil. Date i'riPol. ExpDate • • •l. Eff. - of * Producer No. i • • T Prem Return Prem. WRAP-UP OR OTHER CONSOLIDATED 10/31/2020 =1141AII CONTRACT OR WRITTEN AGREEMENT PROJECT FOR WHICH INSURANCE IS 1 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part MUM Name of Person or Organization: Location and Description of Completed Operations. Additional Premium: ANY PERSON OR ORGANIZATION, BUT ONLY ANY LOCATION OR PROJECT, OTHER THAN A WHEN YOU ARE REQUIRED TO PROVIDE WRAP-UP OR OTHER CONSOLIDATED ADDITIONAL INSURED STATUS IN A WRITTEN INSURANCE PROGRAM LOCATION OR CONTRACT OR WRITTEN AGREEMENT PROJECT FOR WHICH INSURANCE IS EXECUTED PRIOR TO LOSS AND WHERE THAT OTHERWISE SEPARATELY PROVIDED TO YOU CONTRACT SPECIFICALLY REQUIRED THE ISO BY A WRAP-UP OR OTHER CONSOLIDATED CG2037 1012001 EDITION FORM OR THE INSURANCE PROGRAM EQUIVALENT OF SAME Section II - Who Is An Insured is amended to include as an insured any person or organization shown in the Schedule of this endorsement, but only with respect to liability arising out of "your work" at or from the corresponding location designated and described in the Schedule performed for that insured and included in the "products -completed operations hazard". However, it you have entered into a construction contract with an additional insured person or organization shown in the Schedule of this endorsement. the insurance afforded to such additional insured only applies to the extent permitted by law. All other terms and conditions of this policy remain unchanged. Includes copyrighted material of Insurance Services Office. Inc.. with its permission. Ll -GL -1 466-D CW (12-13) Page 26 of 43 4" of 18 683 -t' -• a. •rs•.. • Agent Name GALLAGHER BLANKET NOTIFICATION TO OTHERS OF CANCELLATION Effective Date: 10- 31-19 12.01 AM.. Standard Timp Agent 24059-000 rlu.. 24059- 000 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. U -G L -1114-A CW (10/02) 5* of 18 683 Z6 f Named Insured CARYLON CORPORATION Effective Date. 10-31-19 12:01 AM., Standard Time Agent name GALLAGHER Agent 24059 000 NAMED INSURED CARYLON CORPORATION VIDEO INDUSTRIAL SERVICES, INC. ACE PIPE CLEANING, INC. NATIONAL PLANT SERVICES, INC. DEEP SOUTH INDUSTRIAL SERVICES,INC. NATIONAL POWER RODDING CORP. ODESCO INDUSTRIAL SERVICES, INC. SEWER SYSTEM EVALUATIONS, INC. NATIONAL INDUSTRIAL MAINTENANCE, INC. MOBILE DREDGING &VIDEO PIPE, INC. NATIONAL WATER MAIN CLEANING COMPANY METROPOLITAN ENVIRONMENTAL SERVICES, INC. BIO—NOMIC SERVICES, INC. ROBINSON PIPE CLEANING CO» ROBINSON PIPE SERVICES, INC. BEAKY PROPERTIES, INC. DEEP SOUTH SOLUTIONS, INC. SPECIALIZED MAINTENANCE SERVICES, INC. NATIONAL INDUSTRIAL MAINTENANCE SOLUTIONS,INC. SELECT TRANSPORTATION, INC. VIDEO PIPE SERVICES, INC. NATIOINAL INDUSTRIAL MAINTENANCE — MICHIGAN, INC. BERRY MANAGEMENT SERVICES, INC. U -GU -621-A CW (10/ 02) 6` of 18 683 POLICYNUMBER:GLO 9377201-16 COMMERCIAL GENERAL LIABILITY CG250305099 1 . • �, 1:1011 1w2reTel f 1 This endorsement modifies insurance provided under the following: Designated s s • - WRAP- UPA GENERAL AGGREGATE LIMIT APPLIES TO EACH CONSTRUCTION PROJECT WHERE THE NAMED INSURED IS PERFORMING OPERATIONS, HOWEVER, A GENERAL AGGREGATE LIMIT DOES NOT APPLY TO ANY CONSTRUCTION PROJECT WHERE THE OR ANY OTHER CONSOLIDATED OR SIMILAR INSURANCE ♦ ••• i+i"1 `a • • - _ -m - svuOF sf MOM, A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I - Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum ofall damages under Coverage A,except damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard", and for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each {occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. CG 250305 09 fl Insurance Services Office, Inc., 2008 Page 1 oft r] 7' of 18 683 BLFor all sums which the insured becomes legally obligated topay asdamages caused by ^000urnenoeo"under Section |-Coverage A,and for all medical expenses caused byaccidents under Section |- Coverage C,which cannot be attributed only toongoing operations at a single designated construction project shown |nthe Schedule above: 8. Any payments made under Coverage Afor damages orunder Coverage Cfor medical expenses shall reduce thaamoumavailable under the General Aggregate Limit orthe Products -completed Operations Aggregate Limit, whichever imapplicable; and � Such payments shall not reduce any Designated Construction Project General Aggregate Limit. ui�M C. When coverage for liability arising out of the "prod ucto-completedoperations hazard" in provided, any payments for damages because of "bodily injury" or"property damage" included |n the "prod ucts-comp/etedoperations hazard" will reduce the Prod uoty-comp|etodOperations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. nthe applicable designated construction project has been abandoned, delayed, o,abandoned and then restarted, orifthe authorized contracting parties deviate from p|ono, b|ueprinta, designs, specifications ortimetables. the project will still bodeemed tobethe same construction project. E. The provisions ofSection III ' Limits C>f Insurance not otherwise modified bythis endorsement shall continue toapply aa C Insurance Services Office, Inc., 2008 CG 25 0305 09 F� 8* of 18 683 POLICY NUMBER: GLO 9377201-16 COMMERCIAL GENERAL LIABILITY CG 02 2410 93 "WARLIER NOTICE OF CANCELLATIOK PROVIDED BY US This endorsement modifies insurance provided under the following: COMMERCIAL GENERALLIABILITY COVERAGEPART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. CG 02 241093 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 M 9* of 18 683 Policv No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. ProdUCel' Add'! Prem. Return Prem. GLO 9377201-16 10/31/2019 10/31/2020 24059000 $ INCL $ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part The followin-,Z-- is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: If you are required by a written contract or agreement, which is executed before a loss. to waive your rights of recovery from others, we agree to waive our rights of recovery. This waiver of ri&,hts shall not be construed to be a waiver with respect to any C7 other operations in which the insured has no contractual interest. L3 -GL -9215-B CW (12/0 1) 10* of 18 683 Other Insurance Amendment - Primary And Non- ZURICH') Contributory Policy No. / soDate o/Pol. Exp. Date n/Pol. EfzDate "rEnm. Producer No. Add". Prem nctumrom. GLO 9377201-16 1 10/3112019 10/31/2020 10/3 1 /20 19 24059000 INCL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured: Carylon Corporation Address (including ZIP Code): 2500 Arthington; Chicago, IL 60611 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part 1. The following paragraph is added to the Other Insurance Condition of Section IV~Commercial General Liability This insurance isprimary insurance to and will not seek contribution from any other insurance available to an additional insured under this policy provided that: u' The additional insured iasNamed Insured under such other insurance; and b. You are required byawritten contract orwritten agreement that this insurance would be primary and would not seek contribution from any any other insurance available to the additional insured. 2' The following paragraph |s added to Paragraph 4.b.ofthe Other Insurance Condition ofSection PV' Commercial General Liability Conditions: This insurance is excess over: Any of the other ineuranc o` whether prim ery, exoeos, contingent or on any ot her basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional ins ured on another policy provd| ng coverage for the same "occurrence", offonae, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by xvhtt en contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis. All other terms and conditions of this policy remain unchanged. uGL-1327aCw(04/13) Page |ufI Includes copyrighted materialof Insurance Services Office, Inc.,withits permission. 11of,m 683 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 (Ed. 4-84) 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION, WC 00 0313 (Ed. 4-84) o 1983 National Council on Compensation Insurance. 12* of 18 683 Named Insured CARYLON CORPORATION Effective Date: 1 0 - 31-19 12:01 A.M., Standard Time Agent Name GALLAGHER Agent No. 24059-000 NAMED INSURED CARYLON CORPORATION ACE PIPE CLEANING, INC. BEARY PROPERTIES, INC. BIO-NOMIC SERVICES, INC. DEEP SOUTH INDUSTRIAL SERVICES,INC. DEEP SOUTH SOLUTIONS, INC. METROPOLITAN ENVIRONMENTAL SERVICES,INC. MOBILE DREDGING & VIDEO PIPE, INC. NATIONAL INDUSTRIAL MAINTENANCE, INC. NATIONAL INDUSTRIAL MAINTENANCE SOLUTIONS, INC. NATIONAL PLANT SERVICES, INC. NATIONAL POWER RODDING CORP. NATIONAL WATER MAIN CLEANING COMPANY ODESCO INDUSTRIAL SERVICES, INC. ROBINSON PIPE CLEANING CO. ROBINSON PIPE SERVICES, INC. SEWER SYSTEM EVALUATIONS, INC. SPECIALIZED MAINTENANCE SERVICES, INC. VIDEO INDUSTRIAL SERVICES, INC. SELECT TRANSPORTATION, INC. BEARY MANAGEMENT SERVICES, INC. NATIONAL INDUSTRIAL MAINTENANCE - MICHIGAN, INC. VIDEO PIPE SERVICES, INC. U -CU -521-A CW (10/ 02) 13` of 18 683 '-OLICY NUMBER: BAP 9377199-16 COMMERCIAL AUTO CA 04441013 THIS ENDORSEMENT i i IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: ILYA Lei i- i i• With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: CARYLON CORPORATION Endorsement Effective Date: 10/31/2019 Name(s) Of Person(s) Or Organ ization(s): ALL PERSONS AND/OR ORGANIZATIONS TH♦ • • REQUIRED BY CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THE POLICY FOR WORK PERFORMED BY YOUFOR THAT PERSON •ND/OR ORGANIZATION. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. Page 2 of 12 ©Insurance Services Office, Inc., 2011 CA 04 441013 F) 14` of 18 683 Insurance forthiscoverage partprovided y: RoficyNumber ZURICH AMERICAN INSURANCE COMPANY BAP 9377199-16 Renewal of Number BAP 9377199-15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE: COMMERCIAL AUTO COVERAGE PART A. IF WE CANCEL THIS COVERAGE PART BY WRITTEN NOTICE TO THE FIRST NAMED INSURED FOR ANY REASON OTHER THAN NONPAYMENT OF PREMIUM, WE WILL DELIVER ELECTRONIC NOTIFICATION THAT SUCH COVERAGE PART HAS BEEN CANCELLED TO EACH PERSON OR ORGANIZATION SHOWN IN A SCHEDULE PROVIDED TO US BY THE FIRST NAMED INSURED. SUCH SCHEDULE: 1. MUST BE INITIALLY PROVIDED TO US WITHIN 15 DAYS: A. AFTER THE BEGINNING OF THE POLICY PERIOD SHOWN IN THE DECLARATIONS; OR B. AFTER THIS ENDORSEMENT HAS BEEN ADDED TO POLICY; 2. MUST CONTAIN THE NAMES AND E-MAIL ADDRESSES OF ONLY THE PERSONS OR ORGANIZATIONS REQUIRING NOTIFICATION THAT SUCH COVERAGE PART HAS BEEN CANCELLED; 3. MUST BE IN AN ELECTRONIC FORMAT THAT IS ACCEPTABLE TO US; AND 4. MUST BE ACCURATE. SUCH SCHEDULE MAY BE UPDATED AND PROVIDED TO US BY THE FIRST NAMED INSURED DURING THE POLICY PERIOD. SUCH UPDATED SCHEDULE MUST COMPLY WITH PARAGRAPHS 2. 3. AND 4. ABOVE. B. OUR DELIVERY OF THE ELECTRONIC NOTIFICATION AS DESCRIBED IN PARAGRAPH A. OF THIS ENDORSEMENT WILL BE BASED ON THE MOST RECENT SCHEDULE IN OUR RECORDS AS OF THE DATE THE NOTICE OF CANCELLATION IS MAILED OR DELIVERED TO THE FIRST NAMED INSURED. DELIVERY OF THE NOTIFICATION AS DESCRIBED IN PARAGRAPH A. OF THIS ENDORSEMENT WILL BE COMPLETED AS SOON AS PRACTICABLE AFTER THE EFFECTIVE DATE OF CANCELLATION TO THE FIRST NAMED INSURED.. C. PROOF OF EMAILING THE ELECTRONIC NOTIFICATION WILL BE SUFFICIENT PROOF THAT WE HAVE COMPLIED WITH PARAGRAPHS A. AND B. OF THIS ENDORSEMENT. D. OUR DELIVERY OF ELECTRONIC NOTIFICATION DESCRIBED IN PARAGRAPHS A. AND B. OF THIS ENDORSEMENT IS INTENDED AS A COURTESY ONLY. OUR FAILURE TO PROVIDE SUCH DELIVERY OF ELECTRONIC NOTIFICATION WILL NOT: 1. EXTEND THE COVERAGE PART CANCELLATION DATE; 2. NEGATE THE CANCELLATION; OR 3. PROVIDE ANY ADDITIONAL INSURANCE THAT WOULD NOT HAVE BEEN PROVIDED IN THE ABSENCE OF THIS ENDORSEMENT. E. WE ARE NOT RESPONSIBLE FOR THE ACCURACY, INTEGRITY, TIMELINESS AND VALIDITY OF INFORMATION CONTAINED IN THE SCHEDULE PROVIDED TO US AS DESCRIBED IN PARAGRAPHS A. AND B. OF THIS ENDORSEMENT. U -CA -388-A (07-94) 15' of 18 683 Coverage Extension Endorsement — Liability Only CA 99 48 10 13 Policy No. Eff. Date of Pol. Exp. Date of Pol. Ef f . Date of End, oducer No. AddT Prem Return Prem. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who Is An Insured Provision in Section 11 — Covered Autos Liability Coverage: The following are also "insureds": a Any "employee` of yours is on "insured" while using a covered "auto" you don't mwn, hire or borrow for acts performed within the scope of employment by you. Any "employee" of yours is also an "insured" while operating an "auto" hired or rented under a contract or agreement in on "employee's" nome, with your permission, while performing duties related to the conduct of your business. bL Anyone volunteering services toyou is an1nsured"while using acovered "auto"you don't own, hire or borrow to transport your clients or other persons in activities necessary to your business. a Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a' and A.I.kz in this endorsement. ci Where and to the extent permitted by |avv any person(s) or orgenization(s)vvhero required by written contract or written agreement with you executed prior to any "accideny', including those person(s) or organization(a) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. 2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance —Primary and Excess Insurance Provisions Condition inthe Motor Carrier Coverage Form: Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "ano|dent', will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured" will apply on an excess basis. However. in no event will this coverage extend beyond the terms and conditions of the Coverage Form. Paragraphs a.(2) and a.(4)ofthe Coverage Extensions PmWsion inSecti#nU—Cmvered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law wolations)required because of an "accident" we cover. We do not have to furnish these bonds. NW All reasonable expenses incurred by the "insured" at our nequast, including actual loss of earnings up to $500 a day because of time off from work. Includes copyrighted material ofInsurance Services Office, mc,with its permission. u-cA-428+Ac»w(02-14) Faos 1m3 ,6* of 18 683 The Fellow Employee Exclusion contained in Section 11 — Covered Autos Liability Coverage does not apply. The following is added to the Racing Exclusion in Section 11 — Covered Autos Liability Coverage: This exclusion does not apply tocovered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. E. Amended Duties In The Event Of Accident, Claim, Suit Or Loss Paragraph a. of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following: a. In the event of "accident", o|eim. "suit" or 1ose', you must give us or our authorized representative prompt notice of the "accident", c|edm. "suit" or "loss". However, these duties only apply when the "accident", o|sdm. "suit" or "|mse"iaknown toyou (if you are anindividue|)' epartner (if you are apertnenahip)' amember (if you are alimited liability company) or an executive officer or insurance manager (if you are aoorpoodion). The failure of any agent servant or employee of the "insured" to notify us of any "accident", o|eim. "suit' or "loss" shall not invalidate the insurance afforded bythis policy. Include, as soon as practicable: (1) Hmw, when and whore the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written notice of the claim or ^au|t' inc|uding, but not limited to, the date and details of such claim or"suit'; (2) The "insureds" name and address; and (3) To the extent poss|h|e, the names and addresses of any injured persons and witnesses. If you report an "accident", claim, "suit" or or''|oam''to another insurer when you should have reported to us, your fe||uns to report to us will not be seen as e violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you. F. Waiver of Transfer Of Rights Of Recovery Against Others loLs The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: This Condition does not apply tothe extent required ofyoubyewhttenoontract,:xecutedphorbzany"accidenf or ^|mss', proWded that the "accident' or "loss" arises out of operations contemplated by such oontnaot. This waiver only applies to the person or organization designated in the contract, The following is added to the Concealment Misrepresentation Or Fraud Condition: Hovvever, we will not deny coverage under this Coverage Form if you unintentionally: (1) Fail to disclose any hazards existing at the inception date of this Coverage Form; or (2) Make an error, om|asiun, improper description of "autos" or other misstatement of information. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us phor to the acceptance of this policy. Paragraph 7m.(5) of the Policy Pedod, Coverage Territory Condition is replaced by the following: (5) Anywhere in the word if covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less, Imomill3mmgmem, =-c The definition of"bodily injury" inthe Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental enguish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. u-CA-428+Ac»V(02-14) Page unr3 JL Expected OrIntended Injury The Expected Or Intended Injury Exclusion in Paragraph B. Exclusions under Section U—Cmvenad Auto Liability Coverage is replaced by the following: Expected 0rIntended 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 All other terms, conditions, pro\Asions and exclusions of this policy remain the same. u-ox-428-Acm/(02-14) Includes copyrighted material of Insurance Services Off ice, Inc., w ith its perrnission. Page 3orn