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Insurance - Gentry General Engineering - 2021-5-4GENTR-3 ACaRL7` CERTIFICATE OF LIABILITY INSURANCE D05104ATE I2021 j 05/04/2021 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(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, 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 endorsements . PRODUCER 909-9804211 Sllverstone Insurance Services Jetton & Associates, Inc PO BOX 1200 RANCHO CUCAMONGA, CA 91729 House Account acT Brent Jetton, AAI, CIC PHONE 409-980-4211 FAX 909-980.4785 WC, No, Ext): WC, No): ADDRESS: INSURERS AFFORDING COVERAGE NA1C # INSURERA: James River Insurance C m an 12203 INSURED Gentry General Engineering Inc 9277 Archibald Avenue Rancho Cucamonga, CA 91730 INSURERB: Regent Insurance Co. 24449 Insurance Company of the We INSURER C : p Y 27847 INSURER D: Westchester Surplus Lines Ins 10172 INSURER E : INSURER F : C_OVFRaGFS f_FRTIFI[_ATF NIIMRF:R- Pr.VICInfJ NI IMR9t=1P. 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. ILNTR TYPE OF INSURANCE AN D SUB POLICY NUMBER MMIDD EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ®OCCUR X X 000865582 10/1912020 10/19/2021 EACH OCCURRENCE $ 1,000,000 AMAGE TO a ENEDo cur en R M S $ SO,OOO X MED EXP (Any one person) $ S,000 Ltd Contractual X X, C, U PERSONAL & ADV INJURY $ 1,000,000 NOT EXCLUDED GEN'L AGGREGATE LIMIT APPLIES PER: POLICY®® jECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 $ X BODILY INJURY (Per person) $ ANY AUTO X X BCA0005149-01 05/O6/2021 05/06/2022 BODILY INJURY Per accident OWNED SCHEDULED AUTOS ONLY AUTOS X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE 000965371 10/19/2020 1011912021 DED X I RETENTION $ O $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER,FMEMBE-R EXCLUDED? ® (Mandatory In INIA X SA 5048153 02 05106/2021 05/06/2022 X STATUTE X ERA E.L. EACH ACCIDENT 1,000,000 $ E.L DISEASE -EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 D POLLUTION LIAB G71564630002 10/19/2020 10/19/2021 GEN AGG 2,000,000 B PROPERTY BPK0008360-00 05/06/2021 05/0612022 BLDG 303,246 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE #321 Indus Sewer Main Replacement. Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers, and emplo ees are named as additional insureds with respects to general liability & au o liability. Waiver of subrogation applies to general liability, auto liability & workers comp. Coverage is primarylnon-contributory. *30 Days NOC COSTAMS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa Sanitary District � ACCORDANCE WITH THE POLICY PROVISIONS. (``/j 290 Paularino Avenue Costa Mesa CA 92626 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy No. 000865582 COMMERCIAL GENERAL LIABILITY CG 20 '10 07 04 THIS ENDORSEMENT CHANGES THE POLICY.. PLEASE READ IT CAREFULLY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION Th...'s end-ofsemenk modifies in-six-anCe provided under the. following: CO"IeVINIFE R;r, tAL QENE RAL L 1ABiLiTY '%�__'10V.-E_--RAGE P 1^1 RT SCHEDULE Name Of Addffi*nal InsUrOd Per,-50n(S) Or Or2anizolion(,,�,), Loc�afionf(s) of Govarod -Opp ns W,.,ere required, by written comralm rjv, wriften. agreement Nt nos-ravoin-s cuf the Namecl Insureds ----------- - -- - ---- - - -------------------- - - - - ---- - - - - - - ---- - - - ----------------- - ------- - - - --------------L------------ - --------------- - - - - - - - - - - - - - - - - - - ----- - ------------------- - -------- - -- Information re-qu.,ired tO com-piete ;11 nat shown above, wail ")a S'No"mr. in the, A. Section 11 - Who Is Art irsuirod is amended a. With reSDect tc-, tt�,P, ineiuranca_ aff--xded to as an additional irks 11;:Iled the per sours. "'Ir wdditiona.l. du - a ex shown in the J -,heduicn, but onIy sions appiy­ viftl respac't to ;j;r fcr %dijjy ;-I,; ry% )'-property T.-his does not apply to "bodiiy injury or 'a or "personal a,.n-d ia-.1, nlisinq r. n�qe r ve -ropertydia.ma(ge" -0 ter: Caused, in 'e"hole, or in Part, by: I All P<rls 03 tXjUlf).. 1. you.acs or arli�S`Pons: o in ;th suc",cwvk. as, (t.(KIIIS-slons ooe, 2. ctf thse '-e (x<3aviaThi_, 311thp-t lin 3-tce, fti 'y behalf; o, epair:s) tilt be perfori-ied or ont'beb-alf tr•thr, , ereos fr se aceoyouongoingoatio tby the adr,Ilionainsureds Wt he Jocaionothe Me a.0"alitional at M!e location(s) covered Operations b.-en corripleled�; or n, ated above. .Z.t poron of llyoLtt- wor; oW.. which the. 2� 7hti W1,11ury or damage ainses has beerl. Put t.", fts ir;- tended use by ally person or organization Gth- ef giari another contlmc-tor or subc.antf`,actcr 1: %.A - engaged in pe-ifformi-rig operar-!,Cj:!-rS for a P"11"': pal cas a parzo rr.e same proiect. Policy No. 000865582 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY.. PLEASE READ IT CAREFULLY. TF: s end-ofsiamen modifies -suF- m e prvvidw miler the following: GENE ZAL i._IA,,.11_I i Y i.iVfi7- --i.A E PART SCHEDULE Na p, Of Additi ral Insured Pewsonfs) i Location And Doscription Of Compi :ted Opera - Or £arc&t C i r d 3d33'#€ss i tionems s i = s i i ------ where required by written contract or wrftlmn j Ail opdtat€,-);ns -of the Named €nst>redS i s i i s i ; s i ; __ _ _ Information t re : ::red to 'com Yiete, t€ is ��'hedule, =f irmt ghcv.n above, ;dill tva sinm -n in the, €3ac€afaW—ns -------------------- Section 11 r— fir`€ o is .#fin Insured S 8i�'fPrided #off €f}dQ as as additiona- iins:r%^ th:e persons; or {organ iz t� i r.ho,, rion(s):.�Tn. in the 'f 4r K ti T t' .'t iiaiii:y !Qr Igo: !y injury"' or "�o':+ �.3�r�a 1` �a#�t;�. in {.;r in past, by "your wrar c" at the iocatio : e-sig_ natal and described e, Lie this ,.. ,,,v. V�,/- that addltionai tsar�;s� andn:;ii�d�, in ] operations i!aLG`f about:blank 5/8/2i Policy No. 000865582 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Th-;1`5 provided unde, the f Oil 'DIN—in-9: CQ'-"v1ME--F?,CtAL GENERAL LIABILITY CCOVERAIGE PART PRO,Dt'%-,'T�!CCiMP;—'---TEC- OPERATIONS LIABIL't-I've, C,,..,-IVERAG:--- PART SCHEDULE Name Of Person Or Organization.' Miere requ"irex" by writlen wri-Men 81g.M.Men't, ve. M, be shcs"'A'm in t�ie D. -daratik"IMS. .r ;Iele lh-is Schedule; ii� n 1(" "n at, ' mfc)rmaticm re�iuirecj- cot a 'r of The, fol wim is addc-xl to 8. 'rr. v 9 3, 1 and Rights Of Ramovery Agaias;t. Others. To Us -Of Se eftnIV � Conditions S We iwaive any dglhit of ri:- very w, rMaY 9 pe'r'Snn of in hi. S.."I -tedule ify VX rp -,, , �;'A .0 aix,rve i)ecaiuse 6-1 i)aymenfs v A -a fo 0 e " iabofii'�" c'-f I)L;t Ot VOW' .4190-ila of"'EH, C C vvof-k" Or ne, a cuixitract vv;:4h tha'* pZ!2-':0wr' (Y (IM'.1nizailu-0 afld, Included ;!n 'tie "INt only to 4%he "..'erson -X in 'the -:. s -. A L; 1: , e Policy No. 000865582 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Name Of Additional Insured Person(s) Or Or anization s If no entry appears above, this endorsement applies to all Additional Insureds covered under this policy. Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031 US O4.10 Page 1 of 1 POLICY NO. BCA0005149-01 COMMERCIAL AUTO AHCA85900917 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. BROADENED WHO IS AN INSURED Paragraph A.I. Who Is an Insured of SECTION II — LIABILITY COVERAGE is amended to include the following: d. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. e. Any "employee" of yours is an "insured" while using an "auto" hired or rented under a contract or agreement in that "employ- ee's" name, with your permission, while performing duties related to the conduct of your business. f. Each person or Organization to whom you are required by a written contract or agreement to provide additional insured status is an "insured" under Liability Cov- erage, but only to the extent that person or organization qualifies as an "insured" un- der the Who is an Insured Provision con- tained in Section II of the coverage form. The written contract or agreement must be in effect during the policy period shown in the Declarations and must have been exe- cuted prior to the "bodily injury" or "proper- ty damage." B. LIABILITY COVERAGE EXTENSIONS SUPPLE- MENTARY PAYMENTS Paragraphs A.2.a. (2) and A.2.a. (4) Coverage Extensions — Supplementary Payments of SECTION 11 — LIABILITY COVERAGE are deleted and replaced with the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "ac- cident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. C. FELLOW EMPLOYEE COVERAGE Paragraph B.5. Fellow Employee Exclusion con- tained in SECTION II — LIABILITY COVERAGE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire that is not a bus, motorcycle or van used to transport em- ployees. This Fellow Employee Coverage is excess over any other collectible insurance. D. POLLUTION LIABILITY — BROADENED COV- ERAGE FOR COVERED AUTOS 1. Liability Coverage is changed as follows: a. Paragraph B.11.a. of the Pollution Exclu- sion in SECTION 11 — LIABILITY COV- ERAGE applies only to liability assumed under a contract or agreement. b. With respect to the coverage afforded by Paragraph 1.a. Above, Exclusion B.6. Care, Custody or Control of SECTION 11 LIABILITY does not apply. 2. Changes in Definitions For the purposes of this endorsement, Para- graph D. of SECTION V — DEFINITIONS is replaced by the following: D. "Covered pollution cost or expense" means any cost or expense arising out of: 1. Any request, demand, order or statuto- ry or regulatory requirement that any "insured" or others test for, monitor, clean up, remove, contain, treat, de- toxify or neutralize, or in any way re- spond to, or assess the effects of "pol- lutants"; or Includes copyrighted material of Insurance Services Office, Inc., AH CA 85 90 09 17 with its permission. Page 1 of 6 2. Any claim or "suit" by or on behalf of a governmental authority for damages be- cause of testing for, monitoring, cleaning up, removing, containing, treating, detoxify- ing or neutralizing, or in any way respond- ing to or assessing the effects of "pollu- tants". "Covered pollution cost or expense" does not include any cost or expense arising out of the actual, alleged or threatened discharge, dis- persal, seepage, migration, release or escape of "pollutants": a. Before the "pollutants" or any property in which the "pollutants" are contained are moved from the place where they are accepted by the "insured" for movement into or onto the covered "auto"; or b. After the "pollutants" or any property in which the "pollutants" are contained are moved from the covered "auto" to the place where they are finally deliv- ered, disposed of or abandoned by the "insured". Paragraphs a. and b. above do not apply to "accidents" that occur away from prem- ises owned by or rented to an "insured" with respect to "pollutants" not in or upon a covered "auto" if: (1) The "pollutants" or any property in which the "pollutants" are con- tained are upset, overturned or damaged as a result of the maintenance or use of a covered "auto"; and (2) The discharge, dispersal, seep- age, migration, release or escape of the "pollutants" is caused di- rectly by such upset, overturn or damage. This Pollution Liability Coverage is subject to an Annual Aggregate Limit of Liability of $100,000. E. NEWLY ACQUIRED OR FORMED ORGANIZATIONS Throughout this policy, the words you and your al- so refer to any organization you newly acquire or form, other than a partnership, joint venture or lim- ited liability company, and over which you maintain ownership or majority interest, but only if there is no similar insurance available to that organization. However: 1. The coverage does not apply to an "accident" which occurred before you acquired or formed the organization. 2. Unless you notify us to add coverage to your policy, the coverage under this provision is af- forded only until: a. The 120th day after you acquire or form the organization, or b. The end of the policy period, whichever is earl ier. 01 k • l ►► Paragraph A.2. Towing of SECTION III — PHYS- ICAL DAMAGE COVERAGE is deleted and re- placed with the following: We will pay for towing and labor costs each time a covered "auto" is disabled. All labor must be per- formed at the place of disablement. If the "auto" is of the private passenger type, there will be no de- ductible. If the "auto" is other than a private pas- senger type, a $100 deductible will apply. The most we will pay under this EXTENDED TOW- ING coverage is $750 per occurrence. G. PHYSICAL DAMAGE COVERAGE EXTENSIONS Paragraph A.4. — Come ra ge Extensions of SEC- TION III — PHYSICAL DAMAGE COVERAGE is amended as follows: a. Transportation Expenses The amount we will pay for temporary transportation expense is increased to $50 per day to a maximum of $3, 000. b. Loss of Use Expenses The amount we will pay for loss of use is increased to $75 per day and to a maxi- mum limit of $1,000. 1. This coverage applies only to a covered "auto" described or designated in the Schedule or in the Declarations as carrying physical damage coverage. 2. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" be- cause of "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of coverage you have on each covered "auto". 3. We will pay only for those expenses incurred during the policy period beginning 24 hours af- ter the "loss" and ending, regardless of the pol- icy's expiration, with the lesser of the following number of days: Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 6 with its permission. AH CA 85 90 0917 a. The number of days reasonably required to repair or replace the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and re- turn it to you; or b. 30 days. 4. Our payment is limited to the lesser of the fol- lowing amounts: a. Necessary and actual expenses incurred; or b. $50 per day 5. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 6. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the paragraph A.4. Coverage Extensions in SECTION III — PHYSICAL DAMAGE COVERAGE. No Deductible applies to this coverage. 1. AIRBAG COVERAGE Exclusion B.3. in SECTION III — PHYSICAL DAMAGE COVERAGE is amended to add: This exclusion does not apply to the accidental discharge of an airbag. J. AUDIO, VISUAL AND DATA ELECTRONIC EQUI PM ENT 1. Cove rage a. We will pay with respect to a covered "au- to" described in the Schedule for "loss" to any electronic equipment that receives or transmits audio, visual or data signals and that is not designed solely for the repro- duction of sound. This coverage applies only if the equipment is permanently in- stalled in the covered "auto" at the time of the "loss" or the equipment is removable from a housing unit which is permanently installed in the covered "auto" at the time of the "loss", and such equipment is de- signed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto". b. We will pay with respect to a covered "au- to" described in the Schedule for "loss" to any accessories used with the electronic equipment described in Paragraph 1.a. above. However, this does not include tapes, records or discs. 2. Exclusions The exclusions that apply to SECTION III — PHYSICAL DAMAGE, except for the exclusion relating to Audio, Visual and Data Electronic Equipment, also apply to coverage provided by this endorsement. In addition, the following ex- clusions apply: We will not pay, under this endorsement, for either any electronic equipment or accessories used with such electronic equipment that is: a. Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system; or (1). An integral part of the same unit hous- ing any sound reproducing equipment designed solely for the reproduction of sound if the sound reproducing equip- ment is permanently installed in the covered "auto"; and (2). Permanently installed in the opening of the dash or console normally used by the manufacturer for the installation of a radio. 3. Limit Of Insurance With respect to coverage under this endorse- ment, the Limit Of Insurance provision of SECTION III — PHYSICAL DAMAGE COV- ERAGE is replaced by the following: a. The most we will pay for all "loss" to audio, visual or data electronic equipment and any accessories used with this equipment as a result of any one "accident" is the lesser of: (1). The actual cash value of the damaged or stolen property as of the time of the "loss"; (2). The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality; or (3). $1, 500. b. An adjustment for depreciation and physi- cal condition will be made in determining actual cash value at the time of the "loss". c. If a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. 4. Deductible No deductible applies to this coverage. The insurance provided by this extension is excess over any other collectible insurance. Includes copyrighted material of Insurance Services Office, Inc., AH CA 85 90 09 17 with its permission. Page 3 of 6 K. TAPES, RECORDS AND DISCS COVERAGE Exclusion BA~a, of SECTION KKU -- PHYSICAL DAMAGE COVERAGE kodeleted and replaced by the following: m. Tmpem, nyconjo, discs orother similar ou- d|c\ visual or data electronic deWomm de- signed for use with mudio, visual or data electronic equipment except when the tmpea, recordo, discs or other o|m||or ou- d|o. Wsum| ordata electronic devices- (1) Are your property or that mfofamily member, and (2) Are in o covered ''auto" etthe time of (a). The most we will pay fbx"looa" is $200No Physical Damage Cov- erage deductible applies to this coverage. This extension provides coverage only toacovered "auto" L. PHYSICAL DAMAGE DEDUCTIBLE -- SINGLE DEDUCTIBLE AND GLASS REPAIR Paragraph D. Deductible in SECTION III -- PHYSICAL DAMAGE COVERAGE is deleted and replaced by the following: D. Deductible For each cowered ''auto." our obligation to pay for, repe|r, return or replace damaged orstolen property will be reduced by the applicable de- ductible shown in the Declarations. AnyCom- pn*hona|ve Cowynage deductible shown in the Declarations does not apply to "loss" caused by fire or lightning. When two or more covered "autos" sustain "loss" |nthe same oocumsnoo, the total ofall the "loss" for all the involved covered "autos" will be reduced by a single deduct|b|a, which will be the largest of all the deductibles apply- ing toall such covered "mutos." No deductible applies to glass damage if the glass |srepaired rather than replaced. M. PERSONAL EFFECTS COVERAGE 1. If you purchase Comprehensive Coverage on this policy for m stolen owned "auto", we will pay up to $600 for "personal effects" stolen with the "auto". 2. "Personal effects" as used in this extension means tangible property that |oworn orcarried by the "insured". "Personal effects" does not include tools, jewvery, money, aecuMUeo, radar or laser detectors, or tapes, neconJs, discs or similar oud|c\ \AnuaU or data electronic equip- ment. No Deductible applies to this extension. The insurance provided by this extension is excess cnerany other collectible insurance. N. LOAN/LEASE PAYOFF COVERAGE The SECTION III -- PHYSICAL DAMAGE COV- ERAGE|o amended by the addition ofthe follow- ing: In the event of o total "loss" to o cowered "auto" shown in the Dec|arat|oma, we will pay any unpaid amount due on the lease or loan for covered "au- to", less -. 1. The amount paid under the Physical Ommoga Co\erageSection ofthe policy; and 2. Any: a. Overdue lease/loan payments edthe time ofthe "|oao"; b. Financial penalties imposed under elease for excessive use, abnormal wear and tear orhigh mileage. c' Security deposits not returned bythe |em- aoc . d. Costs for extended warranties, Credit Life Insurance, Health, Accident or [Uoab|||ty Insurance purchased with the loan or |amse'. and e. Carry-over balances from previous loans or leases. 0. CUSTOM SIGNS AND DECORATIONS In the «xent of atcta| |oee to o vehicle insured for auto physical damage coverage on this po|iuy, in addition to the ACV of the veh|c|e, we will pay the actual cost torepair orreplace o|gnaQeorcustom paint details upto$5.00O. P. HIRED AUTO PHYSICAL DAMAGE If hired "autos" are covered "autos" for Liability Coverage and if Physical Damage Coverage of Comprehensive, Specified Causes oYLoss, VrCo|- ||n|on are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverage's pnr\�idadl are extended to "autos" you hire of like kind and use subject to the following The most wmwill pay for any one loss is the lesser oYthe following: 1. $5OOOOper accident, Includes copyrighted material o[Insurance Services Office, Inc.. 2. Actual Cash Value, or 3. The cost of repair. The deductible will be equal to the largest deducti- ble applicable to any owned "auto" for that cover- age. No deductible applies to "loss" caused by fire or lightning. This Hired Auto Physical Damage cmL erage is excess over any other collectible insur- ance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. Q. DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Subparagraphs A.2.a. of SECTION IV — BUSI- NESS AUTO CONDITIONS is deleted and re- placed by: a. In the event of "accident", claim, "suit" or "loss", you, your insurance manager or any other person you designate must give us or our authorized representative prompt notice of such "accident" or "loss". Include: (1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and (3) To the extent possible, the names and ad- dresses of any injured persons and wit- nesses. Knowledge of an "accident" or "loss" by your agent, servant or "employee" shall not be consid- ered knowledge by you unless you, your insurance manager or any other person you designate has received notice of the "accident" or "loss" from your agent, servant, or "employee." R. WAIVER OF SUBROGATION SECTION IV — BUSINESS AUTO CONDI- TIONS— A. 5. Transfer of Rights of Recovery Against Others to Us is amended as follows: This condition does not apply to any person or or- ganization to which you waived this condition by written contract or agreement, but only to the ex- tent that subrogation is waived prior to the "acci- dent" or "loss" under a contract with that person or organization. S. UNINTENTIONAL FAILURE TO DISCLOSE HAZ- ARDS Any unintentional failure to disclose all exposures or hazards existing as of the effective date of the Business Auto Coverage Form or at any time dur- ing the policy period will not invalidate or adversely affect the coverage for such exposure or hazard. However, you must report the undisclosed expo- sure or hazard to us as soon as reasonably possi- ble after its discovery. T. EXTENDED EMPLOYEE HIRED AUTO PHYS I CAL DAMAGE Paragraph B.5.b. Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS is deleted and replaced by the following: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: 1. Any covered "auto" you lease, hire, rent or borrow; and 2. Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing du- ties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". U. POLICY PERIOD, COVERAGE TERRITORY Paragraph B.7. Policy Period, Coverage Territo- ry of SECTION IV — BUSINESS AUTO CONDI- TIONS is deleted and replaced by: 7. Policy Period, Coverage Territory Under this Coverage Form, we cover "acci- dents" and "losses" occurring: a. During the policy period shown in the Dec- larations; and b. Within the coverage territory. The coverage territory is: a. The United States of America; b. The territories and possessions of the United States of America; c. Puerto Rico; d. Canada; and e. Anywhere in the world if: Paragraph B.2. Concealment, Misrepresentation (1) A covered "auto" is leased, hired, Or Fraud in SECTION IV — BUSINESS AUTO rented or borrowed for a period of 30 CONDITIONS is amended by adding the following: days or less; and Includes copyrighted material of Insurance Services Office, Inc., AH CA 85 90 09 17 with its permission. Page 5 of 6 (2) The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, the territories and posses- sions of the United States of America, Puerto Rico, or Canada or in a settle- ment we agree to. We also cover "loss" to, or "accidents" involving, a covered "auto" while being transported between any of these places. V. DEFINITION OF BODILY INJURY AMENDED Paragraph C. of SECTION V — DEFINITIONS is amended to include: "Bodily Injury" includes mental anguish or other mental injury resulting from "bodily injury." Howev- er, no coverage is provided for mental anguish or mental injury absent physical injury. None of the extensions provided under this cover- age endorsement apply if coverage is more specifi- cally identified elsewhere in the policy or endorse- ments, for which a premium charge is made or a higher limit is identified. Under no circumstances is any limit provided under this extension to be com- bined with a limit provided elsewhere in the policy or endorsements. Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 6 with its permission. AH CA 85 90 0917 WORKERS COMPENSATION AND .LOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET 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). The additional premium for this endorsement shall be otherwise due. Person or Organization ANY PERSON/ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT 3 % of the total California Workers' Compensation premium Schedule Job Description ALL CALIFORNIA OPERATIONS 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 05/06/20 2 :1 Policy No. WSA 5048153 02 Endorsement No. Insured GENTRY GENERAL ENGINEERING INC Premium $ INCL . Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 99 06 34 (Ed. 8-00) INSURED