Insurance - Charles King Company - 2022-06-1ACCORV� CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYY)
6/1/2022
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 rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
BOWermaster & Associates
10805 Holder St
Ste 350
CONTACT
NAME: Denise Lopez
PHONE FAX
A/C No. Ext): 714-733-6219 A/C No): 714-252-8253
A DRIESS: dlopez@bowermaster.com
INSURERS AFFORDING COVERAGE NAIC #
Cypress CA 90630
INSURERA: Continental Insurance Company 35289
4034952911
INSURED CHARKWO1
Charles King Company
2841 Gardena Avenue
INSURER B. StarStone National Insurance Company 25496
INsuRERc: AIG Specialty Insurance Co. 26883
INSURER D: Columbia Casualty Ins. CO. 1 31127
Signal Hill CA 90755
INSURER E: American Casualty Company CNA Ins Co 20427
INSURER F:
COVERAGES CERTIFICATE NUMBER: 656621793 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.
INSR
LTR
OF INSURANCE
ADDLSUBRTYPE
INSO
WVD
POLICY NUMBER
P OLICY EFF
M DD/YYYY
POLICY EXP
/Y
MM DDYYY
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
Y
4034952911
3/30/2022
3/30/2023
EACH OCCURRENCE $ 1,000,000
F�F7
CLAIMS -MADE OCCUR
DAMAGE TO
PREMISES (Ea occu ence $ 100,000
MED EXP (Any one person) $ 15,000
X 5,000
IX PrpDmg/Subsidnce
PERSONAL &ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $ 2,000,000
POLICY JE O F_� LOC
PRODUCTS - COMP/OP AGG $ 2,000,000
$
OTHER:
E
AUTOMOBILE LIABILITY
Y
5091114974
3/30/2022
3/30/2023
COMBINED SINGLE LIMIT $ 1,000,000
Ea accident
BODILY INJURY (Per person) $
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
Per accident
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
A
X
UMBRELLA LIAS
X
OCCUR
5091114988
3/30/2022
3/30/2023
EACH OCCURRENCE $10,000,000
AGGREGATE $ 10,000,000
EXCESS LIAB
CLAIMS -MADE
DED X RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE❑
Y
T10220030
6/2/2022
6/2/2023
X PER OTH-
STATUTE I I ER
E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBEREXCLUDED?
N / A
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT $ 1,000,000
C
Pollution Liability
CPL3850939
3/30/2022
3/30/2023
Ded: $10,000 $10,000,000
D
Professional Liability
6024298386
3/30/2022
3/30/2023
SIR: $10,000 $1,000,000
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.
CERTIFICATE HOLDER CANCELLATION
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Costa Mesa Sanitary District �l-l�a�—
ACCORDANCE WITH THE POLICY PROVISIONS.
290 Paularino Avenue
AUTHORIZED REPRESE�TA,'
Costa Mesa CA 92626
USA
+
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
NAMED INSURED, Charles King Company,
POLICY NUMBER: 5091114974
CNA63359XX
(Ed. 04/12)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ iT CAREFULLY.
CONTRACTORS EXTENDED COVERAGE ENDORSEMENT
- BUSINESS AUTO PLUS -
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
I. 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 towns a majority of the
voting stock on the date of inception of
this Coverage Form; provided that,
b. The insurance afforded by this provision
A.1. does not apply to any such entity
that is an "insured" under any other
liability "policy" providing "auto"
coverage
2. Any organization you newly acquire or form,
other than a limited liability company,
partnership or joint venture, 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 afforded only until
the end of the policy period of this
Coverage Form, or the next anniversary
of its inception date, whichever is
earlier.
b. Does not apply to:
(1) "Bodily injury" or "property damage"
caused by an "accident" that
occurred before you acquired or
formed the organization; or
(2) Any such organization that is an
"insured" under any other liability
"policy" providing "auto" coverage.
3. Any person or organization that you 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
omissions of a person, who qualifies as an
"insured" under Section 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 insurance
on which the additional insured is a Named
Insured.
4. An "employee" of yours is an "insured" while
operating an "auto" hired or rented under a
contract or agreement in that "employee's"
name, with your permission, while
performing duties related to the conduct of
your business.
"Policy," as used in this provision A. Who is An
Insured, includes those policies that were in
force on the inception date of this Coverage
Form but:
1. Which are no longer in force; or
2. Whose limits have been exhausted.
B. Bail Bonds and Loss of Earnings
Section 11, Paragraphs A.2. (2) and A.2. (4)
are revised as follows:
1. In a.(2), the limit for the cost of bail bonds is
changed from $2,000 to $5,000; and
2. In a.(4), the limit for the loss of earnings is
changed from $250 to $500 a day.
C. Fellow, Employee
Section 11, Paragraph B.5 does not apply.
Such coverage as is afforded by this provision
C. is excess over any other collectible
insurance.
PHYSICAL DAMAGE COVERAGE
A. Glass Breakage — Hitting A Bird Or Animal --
Failing Objects Or Missiles
The following is added to Section 111,
Paragraph A.3.:
With respect to any covered "auto," any
deductible shown in the Declarations Will not
apply to glass breakage if such glass is
repaired, in a manner acceptable to us, rather
than replaced.
B. Transportation Expenses
Section III, Paragraph A.4.a. is revised, with
respect to transportation expense incurred by
you, to provide:
a. $60 per day, in lieu of $20; subject to
b. $1,800 maximum, in lieu of $600..
CNA63359XX Copyright, CNA Corporation, 2000. Page 1 of 3
(Ed. 04112) Includes copyrighted material of the insurance Services Office used with its permission.
C. Loss of Use Expenses
Section ill: Paragraph A.4.b. is revised, with
respect to loss of use expenses incurred by you,
to provide:
a. $1,000 maximum, in lieu of $600.
D. Hired '"Autos"
The following is added to Section III,
Paragraph A.
5. Hired "Autos`'
If Physical Damage coverage is provided under
this policy, and such coverage does not extend
to Hired Autos, then Physical Damage coverage
is extended to
a. Any covered "auto" ou tease; hire, rent
or borrow without a driver;and
b. Any covered "auto" hired or rented by
your "employee" without a driver, under
a contract in that individual
"employee's name;, with your
permission, while performing, duties
related to the conduct of your business.
c. The most we will pay for any one
"accident" or "loss_" is the actual cash
value, cost of repair, cosh of
replacement or $75,000, whichever is
Tess, minus a $500 deductible for each
covered auto. No deductible applies to
"loss" caused by fire or lightning.
d. The physical damage coverage as is
provided by this provision is equal to the
physical damage coverage(s) provided
on your owned '"autos:
e. Such physical damage coverage for
hired "autos" will;
(1) Include loss of use, provided it is
the consequence of an "accident"
for which the Named Insured is
legally liable, and as a result of
which a monetary less is sustained
by the leasing or rental concern..
(2) Such coverage as is provided by
this, provislon will be subject to a.
limit of $750 per "accident."
E. Airbag Coverage
The following is added to Section Ill,
Paragraph B.3.
The accidental discharge of an airbag shall not
be considered mechanical breakdown.
F. Electronic Equipment
CNA63359XX
(Ed. 041 2)
Section ill, ;Paragraphs B.4.c and B.4.d. are
deleted and replaced by the following:
c. Physical Damage Coverage on a covered
"auto'" also applies to "loss to any
permanently installed electronic equipment
including its antennas and other
accessories..
d. A $1,00 per occurrence deductible applies to
the coverage provided by this provision.
G. Diminution in Value
The following is added to Section Ills
Paragraph B.G.:
Subject to the following, the "diminution in
value" exclusion does not apply to:
a. Any covered "auto" of the private
passenger type you lease, hire, rent or
borrow; without, a driven for a period of
30 days or less, while performing duties
related to the conduct of your business;
and
b. Any covered "auto" of the private
passenger type hired or rented by your
"employee" without a driver for a period
of 30 days or less, under a contract in
that individual '"employee's" name, with
your permission,, performing
duties related to the conduct of your
business.
c. 'Such coverage as is provided by this
provision is limited to a .diminution in
value"' loss arising directly out of
accidental damage and not as a result
of the failure to make repairs; faulty or
incomplete maintenance or repairs, or
the installation of substandard parts.
d. The most we will pay for "loss" to a
covered '"auto'" in any one accident is
the lesser of:
(1 j $5;000; or
(2) 20% of the " auto's„ actual cash
value (ACV).
Ill. Drive Other Car Coverage — Executive Officers
The following is added to Sections 0 and Ill:
1. Any "auto" you don't own, hire or. borrow is a
covered "auto" for Liability Coverage while being
used by, and for Physical Damage Coverage
white in the care, custody or control of, any of
your "executive officers," except
a. An. "auto owned by that "executive. officer"
or a member of that person's household; or
CNA63359XX Copyright, CNA Gorporatron; 2000. Page 2 of 3
(Ed. 04/12) Includes copyrighted.malerial of the Insurance Services Office used vAth its permission.
b. An "auto' used by that "executive officer"
while working in a business of selling,
servicing, repairing or parking "autos."
Such Liability and/or Physical Damage
Coverage as is afforded by this provision.
(1) Equal to the greatest of those
coverages afforded any covered "auto"
and
(2) Excess over any other collectible
insurance,
2. For purposes of this provision, "executive
officer" means a person holding any of the
officer positions created by your charter,
constitution, by -laves orany 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 in this
provision.
IV. BUSINESS AUTO CONDITIONS
A. Duties In The Event Of Accident, Claim, Suit
far Loss
The following is added to Section IV,
Paragraph A.2.a.:
(4) Your "employees" may know of an
"accident' or "loss. This will not mean
that you have such knowledge, unless
such "accident`` or "loss" is known to
you or if you are not an individual, to
any of your executive officers or
partners or your insurance manager.
The following is added to Section IV,
Paragraph A.2.b.:
(6) Your "employees" may know of
documents received concerning a claim
or "suit." This will 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 or partners or your
insurance manager.
B. Transfer Of Rights Of Recovery Against
Others To Us
CNA63359XX
(Ed. 04/12)
The :following is added to Section IV,
Paragraph A.S. Transfer 4f Rights Of
Recovery Against Others To Us:
We waive any right of recovery we may have,
because of payments we make for :injury or
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 of your
activities under a contract with that person or
organization.
You must agree to that requirement prior to an
"`accident or "loss."
C. Concealment, Misrepresentation or Fraud
The following is added to Section IV,
Paragraph B.2.:
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 following is added to Section IV,
Paragraph B.S.:
Regardless of the provisions of Paragraphs S.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.
CNA63359XX Copyright, CNA Corporation, 2000. Page 3 of 3
(Ed. 04/12) Includes copyrighted material of the Insurance Services Oitice used wish its 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)
Page 2 of 17
Insured Name: CHARLES KING COMPANY
Policy NO: 4034952911
Endorsement No:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, 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.
The coverage granted by this paragraph does not apply to:
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.
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)
Page 3of17
Insured Name: CHARLES KING COMPANY
Policy No: 4034952911
Endorsement No:
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 INSUREDS 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
CNA74705XX (1-15)
Paqe 4 of 17
Insured Name: CHARLES KING COMPANY
Policy No: 4034952911
Endorsement No:
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)
Page 6 of 17
Policy No: 4034952911
Endorsement No:
Insured Name: CHARLES KING COMPANY
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, 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)
Page 8 of 17
Nat'l Fire Ins Co of Hartford
Insured Name: CHARLES KING COMPANY
Policy No: 4034952911
Endorsement No: 1
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
E. If a single construction project away from premises owned by or rented to the Insured has been abandoned and
then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or
timetables, the project will still be deemed to be the same construction project.
F. The provisions of LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as
stipulated.
12. IN REM ACTIONS
A quasi in rem action against any vessel owned or operated by or for the Named Insured, or chartered by or for the
Named Insured, will be treated in the same manner as though the action were in personam against the Named
Insured.
13. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE
Solely with respect to bodily injury that arises out of a health care incident:
A. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Insuring Agreement is amended to replace Paragraphs 1.b.(1) and 1.b.(2) with the following:
b. This insurance applies to bodily injury provided that the professional health care services are incidental to
the Named Insured's primary business purpose, and only if:
(1) such bodily injury is caused by an occurrence that takes place in the coverage territory.
(2) the bodily injury first occurs during the policy period. All bodily injury arising from an occurrence will
be deemed to have occurred at the time of the first act, error, or omission that is part of the occurrence;
and
B. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to:
i. add the following to the Employers Liability exclusion:
This exclusion applies only if the bodily injury arising from a health care incident is covered by other
liability insurance available to the Insured (or which would have been available but for exhaustion of its
limits).
ii. delete the exclusion entitled Contractual Liability and replace it with the following:
This insurance does not apply to:
Contractual Liability
the Insured's actual or alleged liability under any oral or written contract or agreement, including but not
limited to express warranties or guarantees.
iii. add the following additional exclusions:
This insurance does not apply to:
Discrimination
any actual or alleged discrimination, humiliation or harassment, including but not limited to claims based on
an individual's race, creed, color, age, gender, national origin, religion, disability, marital status or sexual
orientation.
Dishonesty or Crime
Any actual or alleged dishonest, criminal or malicious act, error or omission.
Medicare/Medicaid Fraud
CNA74705XX (1-15)
Paqe 9 of 17
Policy No: 4034952911
Endorsement No:
Insured Name: CHARLES KING COMPANY
Copyright CNA All 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)
Page 16 of 17
Insured Name: CHARLES KING COMPANY
Policy No: 4034952911
Endorsement No:
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. 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)
Page 17 of 17
Insured Name: CHARLES KING COMPANY
Policy No: 4034952911
Endorsement No:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, 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 6/2/2022 Policy No. T10220030 Endorsement No. 12
Insured Charles King Company Policy Effective Date 6/2/2022
Insurance Company StarStone National Insurance Company
f
Countersigned By
WC 04 03 06
(Ed. 4-84)
01998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved.
CNAGNA 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:
1. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by
written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily
injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions, or
the acts or omissions of those acting on your behalf:
A. in the performance of your ongoing operations subject to such written contract; or
B. in the performance of your work subject to such written contract, but only with respect to bodily injury or
property damage included in the products -completed operations hazard, and only if:
1. the written contract requires you to provide the additional insured such coverage; and
2. this coverage part provides such coverage.
11. But if the written contract requires:
A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10-
01 edition of CG2037; or
B. additional insured coverage with "arising out of language; or
C. additional insured coverage to the greatest extent permissible by law;
then paragraph I. above is deleted in its entirety and replaced by the following:
WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by
written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily
injury, property damage or personal and advertising injury arising out of your work that is subject to such written
contract.
111111. 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.
IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property
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.
V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to
add the following, which supersedes any provision to the contrary in this Condition or elsewhere in this coverage
part:
CNA75079XX (10-16)
Page 1 of 2
Insured Name: CHARLES KING COMPANY
Policy No: 4034952911
Endorsement No:
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
Primary and Noncontributory Insurance
With respect to other insurance available to the additional insured under which the additional insured is a named
insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written
contract requires the insurance provided by this policy to be:
1. primary and non-contributing with other insurance available to the additional insured; or
2. primary and to not seek contribution from any other insurance available to the additional insured.
But except as specified above, this insurance will be excess of all other insurance available to the additional insured.
VI. 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. 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
3. make available any other insurance, and 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 3. 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.
VII. 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 you 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 (10-16)
Page 2 of 2
Insured Name: CHARLES KING COMPANY
Policy No: 4034952911
Endorsement No:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.