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Insurance - Charles King Co. Inc. - 2014-04-03CHAKIN -001 LODE �� CERTIFICATE OF LIABILITY INSURANCE 1 Dnr4 4/33 /20/20nrrrl 14 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 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 ( 888 ) 825 -4322 Bowermaster & Associates P.O. BOX 6026 10805 Holder Street - Suite 350 Cypress, CA 90630 RECTIV CONTACT NAME: Denise Lopez o E.1:714- 733 -6200 219 c C. 714- 252 -8253 E -MAIL ADDRESS: diopez@bowermaster.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Valley Fore Insurance Company X INSURED Charles King Company, Inc. 2841 Gardena Avenue APR 042014 Signal Hill, CA 90755 �OSIAC�IESA SANItARY DISiRICI INSURER B: Continental Casualty Co. 3/3012014 INSURER c: Travelers Propedy & Casualty CID -of Amer. EACH OCCURRENCE INSURER D:AIG S ecial Insurance Company DA REMiSES Ea o «urrence INSURER E: MED EXP (Any one person) INSURER F : PERSONAL &ADV INJURY Vv V IZ "ES CERTiFiGA l t P1DMEIGH- ovamm�.. u a.er-.,- — — ,amen. 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, INR TYPE OF INSURANCE ADM D POLICY NUMBER MWDD/YYYY MM/DD Y YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X Deductible: $5,000 X X 4034952911 3/3012014 3130/2015 EACH OCCURRENCE $ 1,000,00 DA REMiSES Ea o «urrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL &ADV INJURY $ 1,000,00 X PropertyDamage /Subsidence GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER POLICY X PRO- LOC PRODUCTS - COMP /OP AGO $ 2,000,00 $ B AUTOMOBILE LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS X 5091114974 3130/2014 3/30/2015 COMBINED SINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Per person) $ P BODILY INJURY (Per a «ident) $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per a «itlent $ A X UMBRELLA LIAB EXCESS LIAB I X OCCUR CLAIMS -MADE 5091114988 3/30/2014 3/3012015 EACH OCCURRENCE $ 10,000,00 AGGREGATE $ 10,000,000 DED I X I RETENTION$ 10,0.00 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N F-1 OFFICER /MEMBER EXCLUDED? NIA X DTJUS3452N74313 6/212013 61212014 WC STATU- OTH- X TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,00 If f H) (Mandatory and yes, yes, describe E.L. DISEASE - EA EMPLOYEE$ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS below D Pollution Liability CPL3850939 313012014 3/30/2015 Ded: $10,000 $5,000,000 Agg DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more sparse required) Project No. 192 System Wide Sewer Reconstruction Phase II Costa Mesa Sanitary District, its employees and agents are Additional Insured with respects to General Liability per attached endorsement form G140331 D, Primary and Non - Contributory included. Waiver of Subrogation applies to WorkComp per attached endorsement form WC990376. Waiver of Subrogation applies to Auto Liability per formCNA63359XX and General Liability per form G1 8652J. Cancellation policy forms attached IL00171198 and IL02700907. CERTIFICATE HOLDER CANCELLATION U 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Costa Mesa Sanitary District THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 628 W. 19th Street Costa Mesa, CA 92627- AUTHORIZED REPRESENTATIVE U 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CNANAED INSURED: Charles POLICY NUMBER: 44952 111g Company, Inc. G- 140331 -D (Ed. 01113) BLANKET ADDITIONAL INSURED = OWNERS; LESSEES OR CONTRACTORS WITH PRODUCTS - COMPLETED OPERATIONS COVERAGE It's understood and agreed that this endorsement amends the COMMERCIAL. GENERAL LIABILITY COVERAGE PART as follows: SCHEDULE (OPTIONAL) Name of Additional Insured Persons OrOrganization"s jAs required by "written contract" per Paragraph A. below.) Locations of Covered Operations (As per the' "written contract," provided the location is within the 'coverage,territory" of this Coverage Part.). A. Section II - Who Is An Insured is amended to'mclude "as an additional Insured: J: Any person or organization whom you are required by "written contract" to add, as an additional ;insured on this Coverage Part; and - 2. The particular person or organization, if any, scheduled above. B. The insurance provider) to the additional Insured is limited as follows'. 1 The person or organization is an additional insured only with respect to liability for "bodily injury," "property damage," or 'personal and advertising injury" caused in whole or in part by: a. Your acts or omissions; or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations specified in the "written contract "; or b. "Your work' that is specified In the "written contract" but only for '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. 2. If the "written contract" specifically requires you to provide additional Insurance coverage via the 10/01 edition of CG2010 (aka CG 20 10 10 01), or via the 10/01 edition of CG2037 (aka CG 20 3710 01), or via the 11/85 edition of CG2010 (aka CG 20 10 11 85). then In paragraph 13.11.:above, the words'eaused in whole or in part by' are replaced by the words arising out of', 3. We will not provide the additional Insured any broader coverage or any higher limit of insurance than' a. The - maximum permitted bylaw; b. That required by the "written contract"; c. That described in B.1. above; or d. That afforded to you under this policy, whichever is less. 4. Notwithstanding anything to the contrary in Condition 4. Other Insurance (Section IV), this insurance is excess of all other insurance available to the additional Insured whether on a primary, excess, contingent or G- 140331 -D (Ed, 01/13) Page 1 of 2 Copyright, CNA All Rights Reserved: CNA G- 140331 -D (Ed. 01/13) any other basis, But if required by the "written contract 'to be primary and non- contributory, this insurance will be primary and non- contributory relative to insurance on which the additional insured is a Named Insured, 5. The insurance provided to the additional insured does not apply to "bodily injury," "property. damage;" or "personal and advertising injury" arising out of: et. 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. C. SECTION IV— ;COMMERCIAL; GENERAL LIABILITY CONDITIONS is amended asfollows: 1 The Duties In The Event of Occurrence, Offense, Claim or Suit condition is amended to add the following additional conditions applicable to the additional insured: An additional insured under this endorsementwill as soon as practicable.' (1) Give us written notice of an 'occurrence" or an offense which may result in a claim or "suit" ,under this insurance and of any claim or "suit" that does result; (2) Except as provided in Paragraph BA. of this endorsement;' agree to make available any other insurance the additional insured has for a loss we cover under this'Coverage-Part (3) Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of the claim or "suit'; and (4) Tender the defense and indemnity of any claim or, "suit" to any other insurer or self insurer whose policy or program applies to a loss we cover under this Coverage Part. But if the "written contract" requires this insurance to be primary and non - contributory, this provision (4) does not apply to insurance on which the additional insured is a Named Insured. We have no duty to :defend or indemnify:an additional insured under this endorsement until we receive from the additional insured written notice of a claim or "suit. A. Only for the purpose of the insurance provided by this endorsement,.:SECTION V = 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: 1. Is currently in effect or becomes effective during the term of this policy; and 2. Was executed prior to: a. The "bodily injury" or "property damage "; or b. The offense that caused the "personal and advertising injury-j"° for which the additional insured seeks coverage underthis Coverage Part. All,otherterms and conditions of the Policy remain unchanged. Material used with permission of 130 Properties, Inc. G 140331 -D (Ed. 01/1.3) Page 2.: of -2. Copyright, CNA All Rights Fesewed. ................ CNANAMED INSURED: Charles King Company, Inc. CNA63359XX POLICY NUMBER: 5091114974 (Ed. 04/12). THIS ENDORSEMENT CHANGES. THE POLICY, PLEASE READ IT CAREFULLY.. CONTRACTORS' EXTENDED COVERAGE ENDORSEMENT BUSINESS AUTO PLUS'- This endorsement modifies insurance providers under the following'; BUSINESS AUTO COVERAGE FORM" 1.- LIABILITY COVERAGE A. Who Is An Insured The following is added to Section II, Paragraph A.1, Who Is An Insured: 1. a. Any incorporated entity of which the Named Insured owns 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. hoes not applyto; I (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 II 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 III 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. $1,600 maximum, in lieu of $600. CNA63359XX. Copyright, CNA Corporation. 2000 (Ed. 04/12) Includes copyrighted malePlab of he Insurance Services C9ice used w1h its permission Page 1 of 3 CNA C. Loss of Use Expenses Section III, 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 io Section fh Paragraph A.: 5. Hired "Autos" If Physical Damage coverage is providedunder this policy, and such coverage does not extend to Hired Autos then Physical Damage coverage is extended to: a. Any covered "auto' you lease, 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, cost of replacement or $75,000, whichever is less, 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 loss Is sustained by the leasing or rental concern. (2) Such coverage as is provided by this provision 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 04/12) Section III, ;Paragraphs B.4.c and B.44 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. It. A $100 per occurrence deductible applies to the coverage provided by this provision: G. Diminution In Value The following is added to Section III, Paragraph B.6.: 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 driver for ra 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, while /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) $5,000; or (2) 20 % of the "auto's" actual cast/ value (ACV). III. Drive Other Car Coverage— Executive Officers The following is added to Sections fl 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 while 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 Copyrighl, CNA Corporation 2000 Page 2 of 3 (Ed. 04/12) Includes copyrighled n iedai oiahe insurance services Ctlice used Wih us permission. OVA 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 (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 -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 in 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.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 Of 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 M, 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.5.: Regardless 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.l 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 Gopyri h1 CNA corporati on, 2000. Page 3 of 3 (Ed. 04/12) Includes copyricdhled material of the Insurance Services Oltice used i,Alh its permission. NAMED INSURED: Charles King Company, Inc. G 18652 J CNA POLICY NUMBER: 4034952911 (Ed. 07 -12) CONTRACTORS` GENERAL LIABILITY EXTENSION ENDORSEMENT It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows. The changes this endorsement makes do not apply with respect to any coverage that has been excluded or amended by another endorsement attached to this policy. SCHEDULE Coverage is summarized below. For particulars and limitations affecting each coverage, please refer to the corresponding policy provisions In the body of this endorsement. 1. Additional Insureds Seven additional insured extensions: 2. Bodilyinjury — Expanded Definition 3. Broad Knowledge of Occurrencel Notice of Occurrence 4. Broad Namedansured 5. Broadened Liability Coverage For Damage To "Your Product" And "YourWork" Limit: $100;000;. 6. Contractual Liability — Railroads Expanded definftionrof "Insured contract." 7: Contractual Liability For Personal And Advertising Injury 8. Electronic Data Liability- Loss of Electronic Data Limit: $100,000. 9. Expanded Personal And Advertising Injury - Discrimination Or Humiliation 10, Expected Or Intended Injury ._ Reasonable force ''bodily injury" or "property damage," 11. General Aggregate Limits Of Insurance:- Per Project 12, In Rem Actions, 13. Incidental Health Care Malpractice Coverage, 14. Joint Ventures/Partnership /Limited Liability Companies Coverage for your interest In such terminated or ended organizations. 15. Legal Liability/Alienated Premises /Borrowed Equipment Coverage Extended perils. Default limit Increased to $500,000 for Damage to Premises Rented To You. $25,000 limit for "property damage" to borrowed tools or equipment at a jobsite. 16. Liberal izationCla 17. Liquor Liability Coverage Extension 1.8. , Medical Payments Limits increased to $15,000.: Reporting increased to -three years from the date of accident: 19. Non - owned Aircraft Coverage 20. Non -owned Watercraft Increased to 75 feet. 21. Primary And Non - Contributory To Other insurance 22. Property Damage - Elevators 23. Supplementary Payments Cost of bail bonds increased to $5.000. Dally loss of earnings increased to $1.000. 24. Unintentional Failure To Disclose Hazards 25. Waiver of Subrogation - Blanket Waiver of subrogation where required by-written contract or written agreement. 26. Wrap -Up Extension G-18652 -J (Ed. 07-12) Page 1 of 12' Copyright, CNA All Rights Reserved. CNA you own, rent, or control 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. 2. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. 3. This insurance does not apply to: a. 'Bodily injury,' "property damage or "personal and advertising injury" arising out of operations performed for the federal government; state or municipality, or b. "Bodily injury" or 'property damage' included within the "products completed operations hazard." A governmental permit which requires you to add the governmental entity as an additional insured will trigger this Provision 1. as if the permit were a written contract. 2. BODILYINJURY - EXPANDED: DEFINITION SECTION V - DEFINITIONS, the definition of "bodily injury" is changed to read: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death; humiliation, shock, mental anguish or mental injury by that person at anytime which results as a consequence of the bodily injury, sickness or disease. 3. BROAD KNOWLEDGE OF OCCURRENCE/ NOTICE OF OCCURRENCE Condition 2. Duties in The Event of Occurrence,. Off ense,Claim or Suit of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to add the following provisions; A. BROAD KNOWLEDGE OF OCCURRENCE G-18652 J (Ed. 07-12) Page 3,of 12 G- 18652 -J (Ed. 07 -12)' You must give us or your authorized representative notice of an "occurrence," offense. claim, or "suit' only when the "occurrence," offense, claim or "suit' is known to: (1) You, if you are an individual; (2) A partner, if you are a'partnership, (3) An executive officer or the employee designated by you to give such notice, if you are a corporation; or (4) A manager, if you are a limited liability company. B. NOTICE OF OCCURRENCE Your rights under this Coverage Part will not be prejudiced if you fail to give us notice of an "occurrence; "offense, claim or suit' and that failure is solely due to your reasonable belief that the "bodily injury or "property damage" is not covered under this Coverage Part. However, you shall give written notice of this occurrence," offense, claim 'or'suit" to us as soon as you are aware that this insurance may apply to such "occurrence," offense claim or "suit;" 4. BROAD NAMED INSURED A. Any subsidiary or affiliate organization, other than a partnership, joint venture or limited liability company, in which a Named Insured specifically shown in the Declarations has management control, directly or through one or more subsidiary organizations, at the time of loss will qualify as a Named Insured but only if there Is no other similar insurance available to such organization, nor similar insurance which would be available but for exhaustion of its limits For the purpose of this provision, similar insurance means general liability or equivalent insurance, no matter whether its coverage 1s broader or narrower than that provided by this Insurance. But if the only other similar insurance is for a "consolidated (wrap-up) program,' then a subsidiary that qualifies as a Named Insured on such project specific insurance can still qualify as a Named Insured on this insurance, but not for projects covered by the' consolidated (wrap-up) program." [Please see Item 26.C.. of this endorsement for the definition of - 'consolidated (wrap -up) program. "I B. This endorsement does not apply to any organization for which coverage is excluded by another endorsement attached to this policy. C. Only for the purpose of this endorsement Copyright, CNA All Rights Reserved.. CNA 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 your business (including an Indemnification of a municipality in connection with work performed for a municipality) under which you assume 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 Indemnities 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. 7. CONTRACTUAL LIABILITY FOR PERSONAL AND ADVERTISING INJURY Under SECTION I COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY, Paragraph 2. Exclusions is amended to delete exclusion e. Contractual Liability. This provision 7. does not apply to any person or organization who otherwise qualities as an additional Insured on this Coverage Part. 8 ELECTRONIC DATA LIABILITY A. Under SECTION: I — COVERAGE A — .BODILY INJURY AND PROPERTY DAMAGE.. Paragraph 2. Exclusions is amended to delete exclusion p. Electronic Data and replace it with the following: [This insurance does not apply to` :] p. Electronic Data G-1 8652-J (Ed. 07- Page 5 of 12 G- 18652 -J (Ed. 07-12) Damages arising out of the loss of loss of use of. damage to, corruption of, Inability to access, or inability to manipulate "electronic data" that does not result from physical injury to tangible property. However, this exclusion does not apply to liability for damages because of 'bodily injury" B. The following paragraph is added to SECTION III - LIMITS OF INSURANCE: Subject to 5. above, $100,000 Is the most we will pay under Coverage A for all damages arising out of anyone "occurrence" because of 1. property damage' that results from physical injury to tangible property and arises out of "electronic data." C. The following definition Is added to the SECTION V - DEFINITIONS: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software (including systems and applications software), hard or floppy disks, CD- -ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. D. For the purposes of the coverage provided by this endorsement, the definition of 'property damage' in SECTION V DEFINITIONS is replaced by the following: 17. "Property damage" means:: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it;_ b. Loss of use of tangible property that is not physically injured. All such loss of use shall be doomed to occur at the time of the "occurrence' that caused it; or c. Loss of, loss of use of, damage to. corruption of. inability to access, or inability to properly manipulate electronic data," resulting from physical injury to tangible' property. All such loss of 'electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this insurance, "electronic data" is not tangible property. E. if Electronic Data Liability is provided at a higher limit by another endorsement rattached to this Copyright, CNA All Rights Reserved. CNA 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 Aggregate Limit or the General; Aggregate Limit, 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;" regardless of the number of locations involved will reduce the Products- Competed Operations Aggregate Limit: shown in the Declarations. 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 SECTION III LIMITS. - OF - INSURANCE not otherwise modified by this endorsement shall continue to apply as stipulated. 12. IN REM ACTIONS Any action in rem against any vessel owned or operated by or for you, or chartered by or for you will be treated in the same manner as though the action were In Personam against you. In rem is a term used to designate actions instituted against the thing. as distinct from actions against the person, which are said to be in personam. 13. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE A. With respect only to "bodily injury" that arises out of a "health care Incident." COVERAGE A — BODILYINJURY AND PROPERTY DAMAGE LIABILITY OF SECTION I — COVERAGES is amended to "replace Insuring Agreement Paragraphs 1.b.(1) and 1.b.(2) with the following: b. This insurance applies to "bodily injury" only if you are not in the business of providing professional health care services. and only if: G- 18652 -J Page 7 of 1 (1) The 'bodily Injury" is caused by an "occurrence" that takes place in the "coverage territory." For the purpose of this insurance: G- 18652 -J (Ed. 07-12) (a) "Bodily Injury" caused by a "health care incident' will be considered caused by "occurrence "; and (b) All acts, errors or omissions that are logically connected by any common fact, circumstance. situation, transaction, event, advice or decision will be considered to constitute a single "occurrence'; (2) The "bodily Injury" 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. With respect only to the insurance provided by this 'Provision 13., Exclusion 2.e. Employer's Liability of ISECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE. is amended to append the following: Only for "bodily Injury not covered by other liability insurance (including state- sanctioned self! insurance) available to the insured (or which would be available but for exhaustion of its limits), this exclusion does not apply to "bodily Injury' that arises out of a "health care incident" C. SECTION V — DEFINITIONS is amended to add the following new definition: "Health care incident" means a negligent act, error or omission by your "employees" or "volunteer workers" working on your behalf in the rendering of or failure to render professional health care services In any of the following capacities, or the related furnishing of food. beverages; medical supplies or appliances: a. Physician; b. Nurse: c. Emergency medical technician; d. Paramedic; e. Chiropractor; f. Dentist: g. Athletic trainer: h. Audiologist; i. Physical therapist; I. Psychologist; k. Speech therapist; L Other allied health professional; or Copyright CNA All Rights Reserved. CNA [Please see Item 26.C. of this endorsement for the definition of "consolidated (wrap -up) program.'] B. The last paragraph of SECTION II - WHO IS AN INSURED is deleted and replaced by the following: Except as provided under the Contractors' General Liability Extension Endorsement or by the attachment of another endorsement _(if any), no person or organization is an Insured with respect to the 'conduct of any current or past partnership, joint venture or limited liability company that Is not shown as a Named Insured _ In the Declarations.: 15. LEGAL LIABILITY /ALIENATED PREMISES/ BORROWED EQUIPMENT A. Under SECTION I -- COVERAGE A BODILY B' INJURY AND PROPERTY DAMAGE, Paragraph 2. Exclusions Is amended to delete exclusion j. Damage to Property in its entirety and replace it with the following: [This Insurance does not apply to:) j. Damage to Property "Property damage" to: (1) Property you own; rent; or occupy; (2) Premises you sell, give away or abandon, if the 'property damage" arises out of any part of those premises, (3) Property loaned to you; (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations; If the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraph (2) of this exclusion does not apply if the premises are "your work." Paragraphs (3) and (4) of this exclusion do not apply to "property damage" to tools or equipment loaned to you. A separate limit of insurance applies to such tools or equipment that are damaged while being used in your operations. G- 18652 -J (Ed. 07 -12) Page 9 of 12 G- 18652 -J (Ed. 07 -12) Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises rented to you or temporarily occupied by you with the permission of the owner, or to the contents of premises rented to you for period of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in SECTION III — LIMITS OF INSURANCE. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph (6) of this exclusion does not apply to "property damage" included in the " products - completed operations hazard Under SECTION 1 COVERAGE A — 'BODILY INJURY AND PROPERTY DAMAGE the last paragraph of Paragraph 2. Exclusions Is deleted and replaced by the following. Exclusions- c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner nor to the contents of premises rented to you for ra period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. C. The following paragraph is added to SECTION III — LIMITS OF INSURANCE: Subject to 5. above, $25;000 is the most we will pay under Coverage A for damages arising out of any one "occurrence" because of "property damage' to tools or equipment loaned to you by others that occurs while the equipment is being used to perform operations. D. Paragraph 6. Damage To Premises Rented To You Limit of SECTION III LIMITS OF INSURANCE is replaced by the following: 6. Subject to Paragraph 5. above, (the Each Occurrence Limit), the Damage To Premises Rented To You Limit is the most we will pay under SECTION — I — COVERAGE A for damages because of "property damage" to any one premises while rented to you or temporarily occupied by you with the permission of the owner. including contents of such premises rented to you for a period of 7 or fewer consecutive days. The Damage To Premises Rented To You Limit is the greater of: a. S500,000; or Copyright, GNA All Rights Rese,vedd. CNA A. Under SECTION I — COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE, Paragraph 2. Exclusions is amended such that exclusion k. Damage to Your Product, and subparagraph (3), (4) and (6) of exclusion, j. Damage to Property do not apply "property damage" that results from the use of elevators. B. With respect only to the coverage provided by this endorsement;. Condition 4, Other Insurance in SECTION IV — COMMERCIAL. GENERAL LIABILITY CONDITIONS is amended to add the following subparagraph b.(1)(a)(v) 4. Other Insurance b. Excess Insurance (1) This - insurance is excess.over: (a) Any of the other insurance, whether primary, excess, contingent or on any 'other basis: (v) That is Property h0ifr4nge: covering-property of others damaged from the use of elevators: 23. SUPPLEMENTARY PAYMENTS A. Under Section I — Supplementary Payments Coverages A and B, Paragraph 1.b., the limit of $250 shown for the cost of bail bonds `is replaced by S5,000: B. In Paragraph 1.d., the limit of $250shownfor dally loss;of earnings is replaced by $1,000. 24. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If unintentionally you should fail to disclose all existing hazards at the inception date of your policy, we, will not deny coverage under this Coverage Part because of such failure. 25. WAIVER OF SUBGROGATION BLANKET Under SECTION IV —COMMERCIAL GENERAL LIABILITY CONDITIONS, The Transfer Of Rights Of Recovery Against Others To Us Condition is amended by the addition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising::out of: 1. Your ongoing operations; or 2. "Your work" Included in the "products completed operations hazard." Page 11 G- 1'8652 -J (Ed.07 -12) However, this waiver applies only when have agreed in writing to waive such rights of recovery in a contractor agreement; and only if the contract or agreement: 1. Is - ineffect or becomes effective during the term of this policy; and 2. Was executed prior to loss. 26. WRAP -UP EXTENSION: OWNER CONTROLLED INSURANCE PROGRAM, CONTRACTOR CONTROLLED INSURANCE PROGRAM 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 or another exclusionary endorsement pertaining to Owner Controlled Insurance Programs (O.C.I.P.) or Contractor Controlled Insurance Programs (C.C.I.R) Is attached to this policy, then the following changes apply: A. The following wording is added to the endorsement: With respect to a 'consolidated (wrap rup) insurance program" project in which you are or were involved, this exclusion does not apply to those sums you become legally obligated to pay as damages because of: 1. 'Bodily injury," "property damage,." or ":personal or advertising injury" that occurs during your 'ongoing operations at the project, or during such operations of anyone acting on your behalf; nor 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. SECTION JV COMMERCIAL 'GENERAL LIABILITY CONDITIONS is amended to add the following subparagraph 4.b.(1)(c) to Condition 4. Other Insurance: [ This' insurance is excess over:] (q) Any of the other insurance whether primary, excess, contingent or any other basis that is insurance available to you as a result of your being a participant in a "consolidated (wrap -up) insurance program," out only as Copyright, CNA All {tights Reserved. TRAVELERS Jam' WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) — DOI POLICYNUMBM DTJUB3452N74313 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 1 .0 % of the California workers wrnpensetiun pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE NAM ID INSURED HAS AGREED BY WRITTEN CONTRACT EXE=ED PRIOR TO LOSS TO FURNISH THIS WAIVER. 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 6/02/2013 Policy No. DTJUB3452N74313 Endorsement No. Insured Charles King Company, Inc. limn Insurance Company Countersigned by DATE OF ISSUE: ST ASSIGN: Page 1 of 1 X2IL0017 1198 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. Page I of 2 A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or b. 30 days before the effective date of cancellation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to US. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refmid will be o rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancella ion will be effective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be sufficient proof of notice. B. Changes This policy contains 8.11 the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at any time; b. Give you reports on the conditions we find; and e. Recommend changes. 2. We are not obligated to make any inspections, surveyys, reports or recommendations and an such actions we do undertake relate only, to insti ability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards_ 3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes insurance inspections. surveys, reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recommendations we may make relative to certification, tinder state or municipal statutes, ordinances or regulations, of boilers, pressure vessels or elevators. E. Premiums The first Named Insured shown in the Declarations: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay. http: // formnet- ci.cna.com /ilhtm /14- b234.htin 4/3/2014 IL0270 0907 Page 1 of 4 IL 02 70 09 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT - RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART A. Paragraphs 2. and 3. of the Cancellation Common Policy Condition are replaced by the following: 2. All Policies In Effect For 60 Days Or Less If this policy has been in effect for 60 days or less, and is not a renewal of a policy we have previously issued, we may cancel this policy by mailing or delivering to the first Named Insured at the mailing address shown in the policy and to the producer of record, advance written notice of cancellation, stating the reason for cancellation, at least: a. 10 days before the effective date of cancellation if we cancel for: (1) Nonpayment of premium; or (2) Discovery of fraud by: (a) Any insured or his or her representative in obtaining this insurance; or (b) You or your representative in pursuing a claim under this policy_ b. 30 days before the effective date of cancellation if we cancel for any other reason. 3. All Policies In Effect For More Than 60 Days a. If this policy has been In effect for more than 60 days, or is a renewal of a policy we Issued, we may cancel this policy only upon the occurrence, after the effective date of the policy, of one or more of the following: (1) Nonpayment of premium, including payment due on a prior policy we issued and due during the current policy term covering the same risks. (2) Discovery of fraud or material misrepresentation by: (a) Any insured or his or her representative in obtaining this insurance; or (b) You or your representative in pursuing a claim under this policy. (3) A judgment by a court or an administrative tribunal that you have violated a California or Federal law, having as one of its necessary elements an act which materially Increases any of the risks insured against. (4) Discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or regulations establishing safety standards, by you or your representative, which materially increase any of the risks insured against. littpJ/ formnet- ci.cna.com /ilhtm /i102709r.htm 4/1/2014 IL0270 0907 Page 3 of 4 We will mail or deliver our notice to the first Named Insured, and to the producer of record, at the mailing address shown in the policy. 2. Residential Property This provision applies to coverage on real property used predominantly for residential purposes and consisting of not more than four dwelling units, and to coverage on tenants' household property contained in a residential unit, if such coverage is written under one of the following: Capital Assets Program (Output Policy) Coverage Part Commercial Property Coverage Part Farm Coverage Part — Farm Property — Farm Dwellings, Appurtenant Structures And Household Personal Property Coverage Form a. We may elect not to renew such coverage for any reason, except as provided in b., c. and d. below: b. We will not refuse to renew such coverage solely because the first Named Insured has accepted an offer of earthquake coverage. However, the following applies only to insurers who are associate participating insurers as established by Cal. Ins. Code Section 10089.16. We may elect not to renew such coverage after the first Named Insured has accepted an offer of earthquake coverage, if one or more of the following reasons applies, (1) The nonrenewal is based on sound underwriting principles that relate to the coverages provided by this policy and that are consistent with the approved rating plan and related documents filed with the Department of Insurance as required by existing law; (2) The Commissioner of Insurance finds that the exposure to potential losses will threaten our solvency or place us in a hazardous condition. A hazardous condition includes, but is not limited to, a condition in which we make claims payments for losses resulting from an earthquake that occurred within the preceding two years and that required a reduction in policyholder surplus of at least 25% for payment of those claims, or (3) We have: (a) Lost or experienced a substantial reduction in the availability or scope of reinsurance coverage; or (b) Experienced a substantial increase in the premium charged for reinsurance coverage of our residential property Insurance policies, and the Commissioner has approved a plan for the nonrenewals that is fair and equitable, and that is responsive to the changes in our reinsurance position. c. We will not refuse to renew such coverage solely because the first Named Insured has cancelled or did not renew a policy, issued by the California Earthquake Authority that included an earthquake policy premium surcharge. d. We will not refuse to renew such uuverage solely because corrosive soil conditions exist on the premises. This Restriction (d.) applies only if coverage is subject to one of the following, which exclude loss or damage caused by or resulting from corrosive soil conditions: (1) Capital Assets Program Coverage Form (Output Policy); (2) Commercial Property Coverage Part — Causes Of Loss — Special Form; or (3) Farm Coverage Part — Causes Of Loss Form — Farm Property, Paragraph D. Covered Causes Of Loss —Special. 3. We are not required to send notice of nonrenewal in the following situations: a. If the transfer or renewal of a policy, without any changes in terms, conditions, or rates, is between us and a member of our insurance group. b. If the policy has been extended for 90 days or less, provided that notice has been given in accordance with Paragraph CA. c. If you have obtained replacement coverage, or if the first Named Insured has agreed, In writing, within 60 days of the termination of the policy, to obtain that coverage. d. If the policy is for a period of no more than 60 days and you are notified at the time of issuance that it will not be renewed. http: // formnet- ci.cna.com /ilhtm /i102709T.htin 4h/2014