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Insurance - Lan Wan Enterprise, Inc. 2021-07-19AC"Mam' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) DOCUMENT WITH RESPECT TO 07/19/21 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 CONTACT NAME: YASSA INSURANCE AGENCY INC (aoNNo. Ext): (949)417-0205 FAX o. (949)751-0208 26361 Crown Valle Y Parkway #230 E-MAIL aooREss: yassaagency@yahoo.com g y@y ahoo.com Mission Viejo, CA 92691 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Insurance Company 19026 INSURED Lan Wan Enterprise, Inc. INSURER B: Travelers Insurance Company 19026 PERSONAL & ADV INJURY $ INSURER C: Travelers Insurance Company 19026 17500 Red Hill, Suite # 120 INSURER D: Travelers Insurance Company 19026 Irvine, CA 92614 INSURER E: PRODUCTS - COMP/OP AGG $ INSURER F: trUV r-MAUt:b GtK I IFIGATE NUMBER: 09=1111Q! KI K1 Rfi0=0. 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. AUTHORIZED REPRESENTATIVE 290 PAULARINO AVENUE INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,0001000 XCLAIMS-MADE X' OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 MED EXP (Any one person) $ 5,000 A Y 680-2H705893-21-42 08/19/21 08/19/22 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 ANY AUTO BODILY INJURY (Per person) $ B XDSCHEDULED AUTOS ONLY AUTOSY BA -8M547018-21-42 04/01/21 04101/22 BODILY INJURY (Per accident)' $ X ! HIRED X ; NON -OWNED AUTOS ONLY /� PROPERTY DAMAGE $ ; AUTOS ONLY (Per accident) X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 1,000,000 C EXCESS LIAR CLAIMS -MADE' CUP -6H274569-21-42 08/19/21 08/19/22 AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE _ER ANY PROPRIETOR/PARTNER/EXECUTIVE D OFFICER/MEMBER EXCLUDED? � N/A U13 -41-1533380-21-42-13E 08/09/21 08/09/22 L EACH ACCIDENT $ - - 1,000,000 (Mandatory in NH) If yes.. describe under E L. DISEASE - EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The Costa Mesa Sanitary District, Its elected and appointed officials, agents, officers, volunteers and employees are Additional Insured. taK I IFIL;A 1 t HULUtK rANr_FI I e-rinN ©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 Additional Insured: THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Vt ACCORDANCE WITH THE POLICY PROVISIONS. COSTA MESA SANITARY DISTRICT AUTHORIZED REPRESENTATIVE 290 PAULARINO AVENUE COSTA MESA CA 92626 GLddC� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Report Claims Immediately by Calling* 1-800-238-6225 Speak directly with a claim professional 24 hours a day, 365 days a year *Unless Your Policy Requires Written Notice or Reporting TECHNOLOGY OFFICE PAC COMP INSTL/SRVC/REPAIR, SYSTEM INTGRTRS, VA R A Custom Insurance Policy Prepared for: LAN WAN ENTERPRISE INC 17500 RED HILL AVE STE 120 IRVINE CA 92614 Presented by: EHAB MAKRAM YASSA One Tower Square, Hartford, Connecticut 06183 RENEWAL CERTIFICATE COMMON POLICY DECLARATIONS POLICY NO.: 680-2H705893-21-42 TECH OFFICE PAC ISSUE DATE: 06/28/2021 BUSINESS: COMP INSTL/SRVC INSURING COMPANY: TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA 1. NAMED INSURED AND MAILING ADDRESS: LAN WAN ENTERPRISE INC 17500 RED HILL AVE STE 120 IRVINE CA 92614 2. POLICY PERIOD: From 08/19/2021 to 08/19/2022 12:01 A.M. Standard Time at your mailing address. 3. LOCATIONS: PREM. BLDG. OCCUPANCY ADDRESS (same as Mailing Address NO. NO. unless specified otherwise) 001 001 COMP INSTL/SRVC 17500 RED HILL AVE STE 120 IRVINE CA 92614 4. COVERAGE PARTS AND SUPPLEMENTS FORMING PART OF THIS POLICY AND INSURING COMPANIES COVERAGE PARTS AND SUPPLEMENTS INSURING COMPANY Businessowners Coverage Part ACJ 5. The COMPLETE POLICY consists of this declarations and all other declarations, and the forms and endorse - ments for which symbol numbers are attached on a separate listing. 6. SUPPLEMENTAL POLICIES: Each of the following is a separate policy containing its complete provisions. POLICY POLICY NUMBER INSURING COMPANY DIRECT BILL 7. PREMIUM SUMMARY: Provisional Premium $ 20, 428.00 Due at Inception $ Due at Each $ NAME AND ADDRESS OF AGENT OR BROKER COUNTERSIGNED BY: EHAB MAKRAM YASSA DHQ47 26361 CROWN VALLEY PKWY STE 230 Authorized Representative MISSION VIEJO CA 92691 IL TO 25 08 01 (Page 1 of 01) DATE: 06/28/2021 Office: BREA/LA/ORANGE CA DOWN TRAVELERSJ� One Tower Square, Hartford, Connecticut 06183 BUSINESSOWNERS COVERAGE PART DECLARATIONS TECH OFFICE PAC POLICY NO.: 680-2H705893-21-42 ISSUE DATE: 06/28/2021 INSURING COMPANY: TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA POLICY PERIOD: From 08-19-21 to 08-19-22 12:01 A.M. Standard Time at your mailing address FORM OF BUSINESS: CORPORATION COVERAGES AND LIMITS OF INSURANCE: Insurance applies only to an item for which a "limit" or the word "included" is shown. COMMERCIAL GENERAL LIABILITY COVERAGE OCCURRENCE FORM LIMITS OF INSURANCE General Aggregate (except Products -Completed Operations Limit) $ 4,000,000 Products -completed Operations Aggregate Limit $ 4,000,000 Personal and Advertising Injury Limit $ 2,000,000 Each Occurrence Limit $ 2,000,000 Damage to Premises Rented to You $ 300,000 Medical Payments Limit (any one person) $ 5,000 BUSINESSOWNERS PROPERTY COVERAGE DEDUCTIBLE AMOUNT: Businessowners Property Coverage: $ 1,000 per occurrence. Building Glass: $ 100 per occurrence. BUSINESS INCOME/EXTRA EXPENSE LIMIT: Actual loss for 12 consecutive months Period of Restoration -Time Period: 24 Hours ADDITIONAL COVERAGE: Fine Arts: $ 25,000 Other additional coverages apply and may be changed by an endorsement. read the policy. SPECIAL PROVISIONS: COMMERCIAL GENERAL LIABILITY COVERAGE IS SUBJECT TO A GENERAL AGGREGATE LIMIT MP TO 01 02 05 (Pagel of ) Please BUSINESSOWNERS PROPERTY COVERAGE PREMISES LOCATION NO.: 001 BUILDING NO.: 001 LIMIT OF INFLATION COVERAGE INSURANCE VALUATION COINSURANCE GUARD BUSINESS PERSONAL PROPERTY $ 554,272 RC* N/A 0.0% *Replacement Cost COVERAGE EXTENSIONS: Accounts Receivable $ 275,000 Valuable Papers $ 125,000 Other coverage extensions apply and may be changed by an endorsement. Please read the policy. MP TO 01 02 05 (Page 2 of 2 ) POLICY NUMBER: 680-2H705893-21-42 EFFECTIVE DATE: 08/19/2021 ISSUE DATE: 06/28/2021 LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS BY LINE OF BUSINESS * IL TO 25 08 01 RENEWAL CERTIFICATE * MP TO 01 02 05 BUSINESSOWNERS COVERAGE PART DECLARATIONS * IL T8 01 01 01 FORMS ENDORSEMENTS AND SCHEDULE NUMBERS IL T3 15 09 07 COMMON POLICY CONDITIONS BUSINESSOWNERS MP T1 30 02 05 TABLE OF CONTENTS - BUSINESSOWNERS COVERAGE PART - DELUXE PLAN MP Tl 02 02 05 BUSINESSOWNERS PROPERTY COVERAGE SPECIAL FORM * MP T1 75 03 19 WINDSTORM OR HAIL PERCENTAGE DEDUCTIBLE * MP T3 48 10 12 PERIOD OF RESTORATION - TIME PERIOD MP T5 22 08 07 CALIFORNIA AMENDATORY PROVISIONS MP T9 97 10 12 AMENDATORY PROVISIONS - TECHNOLOGY OFFICE ENHANCEMENTS MP Tl 11 02 05 CONDOMINIUM COMMERCIAL UNIT - OWNERS COVERAGE * MP T3 06 02 07 SEWER OR DRAIN BACK UP EXTENSION * MP T3 25 01 21 FEDERAL TERRORISM RISK INSURANCE ACT DISCLOSURE * MP T3 35 02 05 INTERRUPTION OF COMPUTER OPERATIONS - INCREASED LIMIT MP T3 50 11 06 EQUIPMENT BREAKDOWN - SERVICE INTERRUPTION LIMITATION MP T3 56 02 08 AMENDATORY PROVISIONS - GREEN BUILDING AND BUSINESS PERSONAL PROP COV ENHANCEMENTS * MP T3 21 03 06 DENIAL OF SERVICE ATTACK - TIME ELEMENT ENDORSEMENT MP T4 90 05 10 LIMIT OF INS/OCCURRENCE ENDT - CALIFORNIA * MP T5 08 02 20 CALIFORNIA CHANGES COMMERCIAL GENERAL LIABILITY CG TO 34 02 19 TABLE OF CONTENTS - COMMERCIAL GENERAL LIABILITY COVERAGE FORM CG Tl 00 02 19 CG Tl 00 02 19 COMMERCIAL GENERAL LIABILITY COVERAGE FORM * CG 20 13 11 85 ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS - PERMITS RELATING TO PREMISES CG D3 09 02 19 AMENDATORY ENDORSEMENT - PRODUCTS -COMPLETED OPERATIONS HAZARD CG D4 36 02 19 AMDT COV B -DEL MEDIA & E-CHATROOMS EXCLS CG D2 03 12 97 AMEND - NON CUMULATION OF EACH OCC CG D4 17 02 19 XTEND ENDORSEMENT FOR TECHNOLOGY * CG D4 26 02 19 OTHER INS-DESIG ADDL INS -PRIMARY CG D4 21 07 08 AMEND CONTRAL LIAB EXCL - EXC TO NAMED INS CG D6 18 10 11 EXCLUSION - VIOLATION OF CONSUMER FINANCIAL PROTECTION LAWS CG D1 42 02 19 EXCLUSION - DISCRIMINATION * TEXT IN THIS FORM HAS CHANGED, OR THE FORM WAS NOT ON POLICY BEFORE. IL T8 01 01 01 PAGE: 1 OF 3 POLICY NUMBER: 680-2H705893-21-42 EFFECTIVE DATE: 08/19/2021 ISSUE DATE: 06/28/2021 CYBERFIRST ESSENTIALS LIABILITY ENDORSEMENTS * PR TO 19 02 12 CYBERFIRST ESSENTIALS COVERAGE PART DECLARATIONS PR T1 13 02 12 CYBERFIRST ESSENTIALS GENERAL PROVISIONS FORM PR Tl 14 02 12 CYBERFIRST ESSENTIALS INFORMATION SECURITY LIABILITY 01 21 CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM * IL COVERAGE FORM PR Tl 15 10 13 CYBERFIRST ESSENTIALS TECH PROD OR SERVICES ERRORS AND T9 96 02 19 WORLD BUSINESS ESSENTIALS OMISSIONS LIAB COVERAGE PR T5 00 02 12 CYBERFIRST ESSENTIALS GENERAL PROVISIONS PLUS * IL T8 02 08 ENDORSEMENT PR T5 21 03 15 COVG FOR FINANCIAL INTEREST IN FOREIGN INSURED 21 GENERAL PURPOSE ENDORSEMENT IL 00 ORGANIZATIONS-CYBERFIRST ESSENTIALS PR T4 98 02 12 CYBERFIRST ESSENTIALS INFORMATION SECURITY LIABILITY FORM) * PLUS ENDORSEMENT PR T4 99 10 13 CYBERFIRST ESSENTIALS ERRORS AND OMISSIONS LIABILTY IL 02 70 07 20 PLUS ENDORSEMENT * PR T5 01 03 15 BREACH ESSENTIALS ENDORSEMENT - TECHNOLOGY PR T5 14 01 15 AMEND OF AI AND PI DEFINITIONS - INFORMATION SECURITY LIABILITY PR F3 46 02 12 CALIFORNIA MANDATORY ENDORSEMENT EMPLOYMENT PRACTICES LIABILITY * PR TO 07 02 15 EMPLOYMENT PRACTICES LIAB COVG PART DEC PR Tl 10 04 09 EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM PR T5 23 03 15 COVG FOR FINANCIAL INTEREST IN FOREIGN ORGANIZATIONS -EMPLOYMENT PRACTICES LIABILITY MULTIPLE SUBLINE ENDORSEMENTS CG T3 33 11 03 LIMITATION WHEN TWO OR MORE POLICIES APPLY INTERLINE ENDORSEMENTS * IL T3 20 05 19 NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US IL T4 12 03 15 AMNDT COMMON POLICY COND-PROHIBITED COVG * IL T4 14 01 21 CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM * IL T4 40 10 20 PROTECTION OF PROPERTY MP T9 96 02 19 WORLD BUSINESS ESSENTIALS IL T3 82 05 13 EXCLUSION OF LOSS DUE TO VIRUS OR BACTERIA * IL T8 02 08 21 GENERAL PURPOSE ENDORSEMENT * IL T8 03 08 21 GENERAL PURPOSE ENDORSEMENT IL 00 21 09 08 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (BROAD FORM) * IL 01 04 07 20 CALIFORNIA CHANGES * IL 02 70 07 20 CALIFORNIA CHANGES - CANCELLATION AND NONRENEWAL IL T4 00 05 19 DESIG PERSON, ORG-NOTICE PROVIDED BY US * TEXT IN THIS FORM HAS CHANGED, OR THE FORM WAS NOT ON POLICY BEFORE. IL T8 01 01 01 PAGE: 2 OF 3 POLICY NUMBER: EFFECTIVE DATE: ISSUE DATE: 680-2H705893-21-42 08/19/2021 06/28/2021 POLICY HOLDER NOTICES * PN T4 54 01 08 IMPORTANT NOTICE REGARDING INDEPENDENT AGENT AND BROKER COMPENSATION * PN T5 86 04 09 EPL+ - RISK MANAGEMENT LETTER PN MP 38 01 11 IMPORTANT NOTICE - JURISDICTIONAL INSPECTIONS PN T5 72 09 20 GLOBAL EXECUTIVE SUPPORT SERVICE AGREEMENT * TEXT IN THIS FORM HAS CHANGED, OR THE FORM WAS NOT ON POLICY BEFORE. IL T8 01 01 01 PAGE: 3 OF 3 TRAVELERS PROPERTY POLICY NUMBER: 680-2H705893-21-42 BUSINESSOWNERS ISSUE DATE: 06/28/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESSOWNERS PROPERTY COVERAGE SPECIAL FORM Prem/Loc No. Building No. 001 001 The Windstorm or Hail Deductible, as shown in the Schedule, applies to covered loss or damage caused directly or indirectly by Windstorm or Hail. This Deductible applies to each occurrence of Windstorm or Hail. Nothing in this endorsement implies or affords coverage for any loss or damage that is excluded under the terms of the Water Exclusion or any other exclusion in this policy. If this policy is endorsed to cover Flood under the Causes Of Loss — Broad Form Flood Endorsement (or if you have a Flood insurance policy), a separate Flood Deductible applies to loss or damage attributable to Flood, in accordance with the terms of that endorsement or policy. As used in this endorsement, the terms "specific insurance" and "blanket insurance" have the following meanings: 1. Specific insurance covers each item of insurance (for example, each building or personal property in a building) under a separate Limit of Insurance; 2. Blanket insurance covers two or more items of insurance (for example, a building and personal B property in that building, or two buildings) under a single Limit of Insurance. Items of insurance and corresponding Limit(s) of Insurance are shown in the Declarations. WINDSTORM OR HAIL DEDUCTIBLE CLAUSE A. Calculation Of The Deductible — All Policies Windstorm or Hail Deductible Percentage - enter 1%, 2%, 3%, 4%, 5% or 10% 3.0% 1. A Windstorm or Hail Percentage (%) Deductible is calculated separately for, and applies separately to: a. Each building, if two or more buildings sustain loss or damage; b. The building and to personal property in that building, if both sustain loss or damage; c. Personal property at each building, if personal property at two or more buildings sustains loss or damage; d. Personal property in the open; e. Any other property insured under this Coverage Form. 2. We will not pay for loss or damage until the amount of loss or damage exceeds the applicable Deductible. We will then pay the amount of loss or damage in excess of that Deductible, up to the applicable Limits of Insurance, after any reduction required by any applicable coinsurance condition. Calculation Of The Deductible — Specific Insurance When specific insurance applies, we will calculate the deductible as follows. In determining the amount, if any, that we will pay for loss or damage, we will deduct an amount equal to 1%, 2%, 3%, 4%, 5% or 10% (as shown in the Schedule) of the Limit(s) of Insurance applicable MP T1 75 03 19 C 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc. with its permission. BUSINESSOWNERS to the property that has sustained loss or damage. C. Calculation Of The Deductible - Blanket Insurance When blanket insurance applies, we will calculate the deductible as follows. In determining the amount, if any, that we will pay for loss or damage, we will deduct an amount equal to 1%, 2%, 3%, 4%, 5% or 10% (as shown in the Schedule) of the value(s) of the property that has sustained loss or damage. The value(s) to be used are those shown in the most recent Statement of Values on file with us. If there is no Statement of Values on file with us or if the Statement of Values on file with us is dated more than two years before the date of loss, then the value(s) to be used will be the value of the property at the time of loss. D. Calculation Of The Deductible - Property Covered Under The Newly Acquired or Constructed Property Additional Coverage The following applies when property is covered under the Newly Acquired or Constructed Property Additional Coverage: In determining the amount, if any, that we will pay for loss or damage to such property, we will deduct an amount equal to a percentage of the value(s) of the property at time of loss. The applicable percentage for Newly Acquired or Constructed Property is the highest percentage shown in the Schedule. EXAMPLES - APPLICATION OF DEDUCTIBLE Example #1 - Specific Insurance The amounts of loss to the damaged property are $60,000 (building) and $40,000 (business personal property in building). The value of the damaged building at time of loss is $100,000. The value of the business personal property in that building is $80,000. The actual Limits of Insurance on the damaged property are $80,000 on the building and $64,000 on the business personal property. The Deductible is 2%. Building Step (1): $80,000 X 2% = $1,600 Step (2): $60,000 - $1,600 = $58,400 Business Personal Property Step (1): $64,000 X 2% = $1,280 Step (2): $40,000 - $1,280 = $38,720 The most we will pay is $97,120 ($58,400 + $38,720). The portion of the total loss that is not covered due to the application of the Deductible is $2,880 ($1,600 + $1,280). Example #2 - Specific Insurance The amounts of loss to the damaged property are $60,000 (building) and $40,000 (business personal property in building). The actual Limits of Insurance on the damaged property are $100,000 on the building and $64,000 on the business personal property. The Deductible is 2%. Building Step (1): $100,000 X 2% = $2,000 Step (2): $60,000 - $2,000 = $58,000 Business Personal Property Step (1): $64,000 X 2% = $1,280 Step (2): $40,000 - $1,280 = $38,720 The most we will pay is $96,720 ($58,000 + $38,720). The portion of the total loss that is not covered due to the application of the Deductible is $3,280 ($2,000 + $1,280). Example #3 - Specific Insurance The amount of loss to the damaged building is $60,000. The value of the damaged building at time of loss is $100,000. The Coinsurance percentage shown in the Declarations is 80%; the minimum Limit of Insurance needed to meet the Coinsurance requirement is $80,000 (80% of $100,000). The actual Limit of Insurance on the damaged building is $70,000. The Deductible is 1 %. Step (1): $70,000 - $80,000 = .875 Step (2): $60,000 X .875 = $52,500 Step (3): $70,000 X 1 % = $700 Step (4): $52,500 - $700 = $51,800 The most we will pay is $51,800. The remainder of the loss, $8,200, is not covered due to the Coinsurance penalty for inadequate insurance (Steps (1) and (2)) and the application of the Deductible (Steps (3) and (4)). Example #4 - Blanket Insurance The sum of the values of Building #1 ($500,000), Building #2 ($500,000) and Building #3 ($1,000,000) as shown in the Declarations is $2,000,000. Page 2 of 3 © 2019 The Travelers Indemnity Company. All rights reserved. MP T1 75 03 19 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Buildings #1 and #2 have sustained damage; the amounts of loss to these buildings are $40,000 (Building #1) and $20,000 (Building #2). The Deductible is 2%. Building #1 Step (1): $500,000 X 2% = $10,000 Step (2): $40,000 — $10,000 = $30,000 Building #2 Step (1): $500,000 X 2% = $10,000 Step (2): $20,000 — $10,000 = $10,000 The most we will pay is $40,000 ($30,000 + $10,000). The portion of the total loss that is not covered due to the application of the Deductible is $20,000. Example #5 — Blanket Insurance The sum of the values of Building #1 ($500,000), Building #2 ($500,000) and Building #3 ($1,000,000), as shown in the most recent Statement of Values on file with us, is $2,000,000. The Coinsurance percentage shown in the Declarations is 90%; the minimum Blanket Limit of BUSINESSOWNERS Insurance needed to meet the Coinsurance requirement is $1,800,000 (90% of $2,000,000). The actual Blanket Limit of Insurance covering Buildings #1, #2 and #3, shown in the Declarations, is $1,800,000. Therefore there is no Coinsurance penalty. Buildings #1 and #2 have sustained damage; the amounts of loss to these buildings are $40,000 (Building #1) and $20,000 (Building #2). The Deductible is 2%. Building #1 Step (1): $500,000 X 2% = $10,000 Step (2): $40,000 — $10,000 = $30,000 Building #2 Step (1): $500,000 X 2% = $10,000 Step (2): $20,000 — $10,000 = $10,000 The most we will pay is $40,000. The portion of the total loss not covered due to the application of the Deductible is $20,000. MP T1 75 03 19 © 2019 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: 680-2H705893-21-42 BUSINESSOWNERS ISSUE DATE: 06/28/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESSOWNERS PROPERTY COVERAGE SPECIAL FORM SCHEDULE Limit of Insurance $ 50000 The following is added to Paragraph A. 7. Coverage Extensions : Water or Sewage Back Up and Sump Overflow (1) When the Declarations show that you have cov- erage for Building or Business Personal Property, you may extend that insurance to apply to direct physical loss of or damage to Covered Property at the described premises caused by or resulting from water or sewage that backs up or overflows from a sewer, drain or sump. (2) When the Declarations show that you have cov- erage for Business Income and Extra Expense, you may also extend that insurance to apply to the actual loss of Business Income you sustain and reasonable and necessary Extra Expense you incur caused by or resulting from water or sewage that backs up or overflows from a sewer, drain or sump. (3) Paragraph B.1.g.(3) does not apply to this Cover- age Extension. (4) The most we will pay under this Coverage Exten- sion in any one occurrence at each described premises is the Limit of Insurance shown in the Schedule above. MP T3 06 02 07 © 2007 The Travelers Companies, Inc. Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FEDERAL TERRORISM RISK INSURANCE ACT DISCLOSURE This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE PART The federal Terrorism Risk Insurance Act of 2002 as amended ("TRIA") establishes a program under which the Federal Government may partially reimburse "Insured Losses" (as defined in TRIA) caused by "Acts Of Terrorism" (as defined in TRIA). "Act Of Terrorism" is defined in Section 102(1) of TRIA to mean any act that is certified by the Secretary of the Treasury — in consultation with the Secretary of Homeland Security and the Attorney General of the United States — to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property, or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of certain air carriers or vessels or the premises of a United States Mission; and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. The Federal Government's share of compensation for such Insured Losses is 80% of the amount of such Insured Losses in excess of each Insurer's "Insurer Deductible" (as defined in TRIA), subject to the "Program Trigger" (as defined in TRIA). In no event, however, will the Federal Government be required to pay any portion of the amount of such Insured Losses occurring in a calendar year that in the aggregate exceeds $100 billion, nor will any Insurer be required to pay any portion of such amount provided that such Insurer has met its Insurer Deductible. Therefore, if such Insured Losses occurring in a calendar year exceed $100 billion in the aggregate, the amount of any payments by the Federal Government and any coverage provided by this policy for losses caused by Acts Of Terrorism may be reduced. The charge for such Insured Losses under this Coverage Part is included in the Coverage Part premium. The charge for such Insured Losses that has been included for this Coverage Part is indicated below, and does not include any charge for the portion of such Insured Losses covered by the Federal Government under TRIA: 4% of your total Businessowners Coverage Part premium if your primary location is in a Designated City (as listed below). 2% of your total Businessowners Coverage Part premium if your primary location is not in a Designated City (as listed below). Designated Cities are Albuquerque, NM EI Paso, TX Miami, FL San Antonio, TX Atlanta, GA Fort Worth, TX Milwaukee, WI San Diego, CA Austin, TX Fresno, CA Minneapolis, MN San Francisco, CA Baltimore, MD Honolulu, HI Nashville -Davidson, TN San Jose, CA Boston, MA Houston, TX New Orleans, LA Seattle, WA Charlotte, NC Indianapolis, IN New York, NY St. Louis, MO Chicago, IL Jacksonville, FL Oakland, CA Tucson, AZ Cleveland, OH Kansas City, MO Oklahoma City, OK Tulsa, OK Colorado Springs, CO Las Vegas, NV Omaha, NE Virginia Beach, VA Columbus, OH Long Beach, CA Philadelphia, PA Washington, DC Dallas, TX Los Angeles, CA Phoenix, AZ Wichita, KS Denver, CO Memphis, TN Portland, OR Detroit, MI Mesa, AZ Sacramento, CA MP T3 25 01 21 © 2020 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: 588-2H705893-21-42 BUS|NESSOWNER3 ISSUE DATE: n6/28/o021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INTERRUPTION OF COMPUTER OPERATIONS INCREASED LIMIT This endorsement modifies insurance provided under the following: BUS|NESSDVVNERSPROPERTY COVERAGE SPECIAL FORM A. The BUSINESSOWNERS PROPERTY COVERAGE SPECIAL FORM is changed as follows: 1. The limit applicable to the Coverage Extension — Interruption of Computer Operations is increased f rom$25.00Oto$so,nUO. MP T3 35 02 05 Copyright, The Travelers Indemnity Company, 2004 Page 1of1 POLICY NUMBER: 680-2H705893-21-42 BUSINESSOWNERS ISSUE DATE: 06-28-21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE PART The following is added to Paragraph G.119.a.(1)(i) under "Period of Restoration" definition: (C) 24 hours after the time of direct physical loss or damage, if the Declarations show 24 hours for Period of Restoration — Time Period; or MP T3 48 10 12 @ 2012 The Travelers Companies, Inc. All rights reserved- Page 1 of 1 POLICY NUMBER: 680-2H705893-21-42 BUSINESSOWNERS ISSUE DATE: 06/28/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DENIAL OF SERVICE ATTACK - TIME ELEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS PROPERTY COVERAGE SPECIAL FORM SCHEDULE Limit of Insurance: $ 25,000 The following is added to Paragraph A.7. Coverage Extensions: Denial of Service Attack — Time Element (1) When the Declarations show that you have coverage for Business Income and Extra Ex- pense, you may extend that insurance to ap- ply to the actual loss of Business Income you sustain and reasonable and necessary Extra Expense you incur due to the necessary "suspension" of your "Electronic Commerce Computer Operations" during the "Denial of Service Period of Restoration". The "suspen- sion" must be caused by a "Denial of Service Attack". (2) If the necessary "suspension" of your "Elec- tronic Commerce Computer Operations" caused by a "Denial of Service Attack" pro- duces a Business Income loss payable under the Business Income coverage provided in Paragraph (1) above, we will also pay for the actual loss of Business Income you sustain during the period of time that: (a) Begins on the date when service is re- stored and your "Electronic Commerce Computer Operations" are resumed; and (b) Ends on the earliest of the following dates: (i) The date you could restore your "Electronic Commerce Computer Op- erations" with reasonable speed to the level which would generate the Business Income amount that would have existed if no "Denial of Service Attack" had occurred; or (3) The following additional exclusions apply to this Coverage Extension: We will not pay for: (a) Any additional loss caused by or resulting from: (i) Direct physical loss or damage to any property, including any computer programs, computer instructions and any other electronic data; or (ii) The time required to repair, replace or restore such lost or damaged prop- erty; even if such loss or damage is the result of a "Denial of Service Attack"; (b) Any loss caused by or resulting from "Electronic Vandalism"; (c) Any increase of loss caused by or result- ing from: (i) Delay in restoring "Electronic Com- merce Computer Operations" ser- vices due to interference by strikers or other persons; or (ii) Suspension, lapse or cancellation of any license, lease or contract. But if the suspension, lapse or cancellation is directly caused by the "suspension" of your "Electronic Commerce Com- puter Operations", we will cover such loss that affects your Business In- come during the "Denial of Service Period of Restoration" and during the period described in Paragraph (2) above; or (ii) 30 consecutive days after the date (d) Any other consequential loss. determined in Paragraph (a) above. MP T3 21 03 06 Includes the copyrighted material of Insurance Services Office, Inc. Page 1 of 3 Includes the copyrighted material of The St. Paul Travelers Companies, Inc. BUSINESSOWNERS (4) The amount of Business Income loss under this Coverage Extension will be determined based on: (a) The Net Income of the business before the "Denial of Service Attack" occurred; (b) The likely Net Income of the business if the "Denial of Service Attack" had not oc- curred; (c) The operating expenses, including payroll expenses, necessary to resume your "Electronic Commerce Computer Opera- tions" with the same quality of service that existed just before the "Denial of Service Attack"; (d) The amount that the reduction in busi- ness volume from your "Electronic Com- merce Computer Operations" is offset by an increase in business volume through other means of commerce; and (e) Other relevant sources of information in- cluding: (i) Your financial records and accounting procedures; (ii) Bills, invoices and other vouchers; and (iii) Deeds, liens or contracts. (5) The amount of Extra Expense under this Cov- erage Extension will be determined based on: (a) The reasonable and necessary expenses that exceed the normal operating ex- penses that would have been incurred by your "Electronic Commerce Computer Operations" during the "Denial of Service Period of Restoration" if no "Denial of Service Attack" had occurred. We will de- duct from the total of such expenses the salvage value that remains of any prop- erty bought for temporary use during the "Denial of Service Period of Restoration", once your "Electronic Commerce Com- puter Operations" are resumed; and (b) The necessary expenses incurred by you to reduce the amount of Business Income loss we otherwise would have paid under this Coverage Extension. (6) Under this Coverage Extension: (a) We will reduce the amount of your Busi- ness Income loss to the extent that you can resume your "Electronic Commerce Computer Operations", in whole or in part, by using other computer systems, other sources of computer services, other computer service providers, any other property or services, or any other means of commerce available to you. (b) We will reduce the amount of your Extra Expense loss to the extent you can return your "Electronic Commerce Computer Operations" to normal and discontinue such Extra Expense. (c) If you do not resume your "Electronic Commerce Computer Operations", or do not resume your "Electronic Commerce Computer Operations" as quickly as pos- sible, we will pay based on the length of time it would have taken to resume your "Electronic Commerce Computer Opera- tions" as quickly as possible. (7) in the event of a "Denial of Service Attack", you must take all reasonable steps to: (a) Save your computer system logs or the computer system logs of others that are in your care, custody or control; and (b) Secure the computer system logs of oth- ers that are not in your care, custody or control; that document the "Denial of Service Attack" and its inception. (8) With respect only to this Coverage Extension, the Coverage Territory condition as described In Paragraph F.8.b. is amended as follows: Under this Coverage Extension, a "Denial of Service Attack" can originate from anywhere in the world, but this Coverage Extension ap- plies only to loss you incur within the Cover- age Territory as a result of the "suspension" of your "Electronic Commerce Computer Op- erations" within the Coverage Territory. (9) The following additional definitions apply to this Coverage Extension: (a) "Denial of Service Attack" means an identifiable act or series of related acts committed by one or more persons with the intent of restricting or preventing ac- cess to: (i) Your computer systems or the com- puter systems of others in your care, custody or control, that are: a) Located anywhere within the Coverage Territory; and b) Used in your "Electronic Com- merce Computer Operations"; Page 2 of 3 Includes the copyrighted material of Insurance Services Office, Inc. MP T3 21 03 06 Includes the copyrighted material of The St. Paul Travelers Companies, Inc. (ii) Computer systems that are: a) Owned by others whom you have contracted with, in writing, to per- form or provide computer ser- vices, on your behalf, in your "Electronic Commerce Computer Operations"; and b) Located anywhere within the Coverage Territory; or (iii) The computer systems of the Internet or other computer communication network, located anywhere in the world, but only to the extent that the "Denial of Service Attack" on such systems affects your "Electronic Commerce Computer Operations" within the Coverage Territory; by inundating the computer system(s) with protocols or instructions, transmitted over the Internet or other computer com- munication network, which trigger the use of the computer system's resources to the extent that the capacity of those re- sources to accommodate authorized us- ers is depleted. All loss caused by or involving: (i) One person acting alone; or (ii) Multiple persons acting in collusion with each other; whether the result of a single act or a se- ries of related acts, will constitute a single "Denial of Service Attack" occurrence. (b) "Denial of Service Period of Restora- tion" means the period of time that: (i) Begins 24 hours after the time that the "suspension" of your "Electronic Commerce Computer Operations" caused by a "Denial of Service At- tack" first begins; and (ii) Ends on the date when service should be restored and your "Elec- tronic Commerce Computer Opera- tions" should be resumed with rea- sonable speed and similar quality. BUSINESSOWNERS (c) "Electronic Commerce Computer Op- erations" means your normal computer activities that: (i) Involve the collection, recording, creation, generation, receipt, trans- mission, communication, processing, retrieval, display or storage of data, in an electronic or digital format; (ii) Are conducted via the Internet or other computer communication net- work between: a) Any of the following: i) Your computer systems; iii) The computer systems of others in your care, custody or control; or iii) The computer systems of others whom you have con- tracted with, in writing, to per- form such computer services on your behalf; all wherever located within the Coverage Territory; and b) The computers or computer sys- tems of others (other than the computers or computer systems of others described in Para- graphs a)ii) and a)iii) above), wherever located, anywhere in the world; and (iii) Are conducted by you for the purpose of transacting business and directly generating income. (10) The most we will pay for Business Income and Extra Expense under this Coverage Extension is the Limit of Insurance shown in Schedule above for the sum of all covered loss arising out of all "Denial of Service At- tacks" occurring during each separate 12 month period of this policy beginning with the effective date of this endorsement. (11) Payments made under this Coverage Ex- tension are in addition to the applicable Limits of Insurance. MP T3 21 03 06 Includes the copyrighted material of Insurance Services Office, Inc. Page 3 of 3 Includes the copyrighted material of The St. Paul Travelers Companies, Inc. BUSINESSOWNERS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES This endorsement modifies insurance provided under the following: BUSINESSOWNERS PROPERTY COVERAGE SPECIAL FORM A. The BUSINESSOWNERS PROPERTY COVERAGE SPECIAL FORM is changed as follows: 1. With respects to an "open policy", the following is added to any provision which uses the term actual cash value: a. In the event of a partial or total loss to a building or structure, actual cash value is calculated as a.(1) or a.(2), whichever is less: (1) The amount it would cost to repair, rebuild or replace the property less a fair and reasonable deduction for physical depreciation of the components of the building or structure that are normally subject to repair or replacement during its useful life. Physical depreciation is based upon the condition of the property at the time of the loss; or (2) The Limit of Insurance applicable to the property. b. In the event of a partial or total loss to Covered Property other than a building or structure, actual cash value is calculated as b.(1) or b.(2), whichever is less: (1) The amount it would cost to repair or replace the property less a fair and reasonable deduction for physical depreciation, based on the condition of the property at the time of loss; or (2) The Limit of Insurance applicable to the property. c. An "open policy" is a policy under which the value of Covered Property is not fixed at policy inception, but is determined at the time of loss in accordance with policy provisions on valuation. The term "open policy" does not apply to Covered Property that is subject to an Agreed Value clause or similar clause that establishes an agreed value prior to loss, unless such clause has expired. 2. Paragraph E.4.e.(1)(b) under Loss Payment — Building and Personal Property is replaced by the following: (b) We will not pay on a replacement cost basis for any loss or damage until the lost or damaged property is actually repaired or replaced. Prior to such repair or replacement, we will pay the actual cash value of the lost or damaged property as described in Paragraph A.1. of this endorsement. If actual cash value does not exhaust the applicable limit of insurance, we will then pay the difference between the actual cash value and the replacement cost, provided that the repair or replacement is completed: (i) Within 12 months after we pay the actual cash value; or Within 36 months after we pay the actual cash value if the loss or damage relates to a state of emergency under California Law. The following provision applies to real property which is used predominantly for residential purposes and consisting of not more than four dwelling units, and to coverage on tenants' household personal property in a residential unit: If you, acting in good faith and with reasonable diligence, encounter a delay or delays in approval for, or reconstruction of, the residence that are beyond your control, we shall provide one or more additional extensions of six months for good cause. Circumstances beyond your control include, but are not limited to: a. Unavoidable construction permit delays; b. The lack of necessary construction materials; or c. The unavailability of contractors to perform the necessary work. MP T5 08 02 20 © 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc. with its permission. BUSINESSOWNERS Nothing in this Paragraph (b) constitutes a waiver of our right to deny the claim for any valid reason or to restrict payment in cases of suspected fraud. 3. Paragraph E.4.e.(7) under Loss Payment — Building and Personal Property is replaced by the following: (7) Tenants' Improvements and Betterments at: (a) Replacement cost in accordance with the terms set forth in Paragraph (1)(b) above. (b) A proportion of your original cost if the property is not repaired or replaced. We will determine the proportionate value as follows: (i) Multiply the original cost by the number of days from the loss or damage to the expiration of the lease; and (ii) Divide the amount determined in (i) above by the number of days from the installation of improvements to the expiration of the lease. If your lease contains a renewal option, the expiration of the renewal option period will replace the expiration of the lease in this procedure. (c) Nothing if others pay for repairs or replacement. Page 2 of 2 © 2019 The Travelers Indemnity Company. All rights reserved. MP T5 08 02 20 Includes copyrighted material of Insurance Services Office, Inc. with its permission. il� '114 oll illilil''ll 11,1111,11AL GENERAL LIABILITY POLICY NUMBER: 680-2H705893-21-42 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 06/28/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State or Political Subdivision: COSTA MESA SANITARY DISTRICT 290 PAULARINO AVE COSTA MESA CA 92626 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured any state or political sub- division shown in the Schedule, subject to the follow- ing additional provision: This insurance applies only with respect to the follow- ing hazards for which the state or political sub- division has issued a permit in connection with premises you own, rent, or control and to which this insurance applies: 1. The existence, maintenance, repair, construction, erection, or removal of advertising signs, awn- ings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar exposures; or 2. The construction, erection, or removal of elevators; or 3. The ownership, maintenance, or use of any elevators covered by this insurance. CG 20 13 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 POLICY NUMBER: 680-2H705893-21-42 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 06/28/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ♦ i ♦0_4411m; A*• i s i W Z1:1 ivi I y This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART State or Political Subdivision: PER IL T8 02 6550 MILES AVENUE HUNTINGTON PARK CA 90256 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured any state or political sub- division shown in the Schedule, subject to the follow- ing additional provision: This insurance applies only with respect to the follow- ing hazards for which the state or political sub- division has issued a permit in connection with premises you own, rent, or control and to which this insurance applies: 1. The existence, maintenance, repair, construction, erection, or removal of advertising signs, awn- ings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar exposures; or 2. The construction, erection, or removal of elevators; or 3. The ownership, maintenance, or use of any elevators covered by this insurance. CG 20 13 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 POLICY NUMBER: 680-2H705893-21-42 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 06/28/2021 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. OTHER INSURANCE - DESIGNATED ADDITIONAL INSUREDS - PRIMARY WITH RESPECT TO CERTAI OTHERINSURANCE i This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE OF DESIGNATED ADDITIONAL INSUREDS COSTA MESA SANITARY DISTRICT 290 PAULARINO AVE., COSTA MESA CA 92626 PROVISIONS The following is added to Paragraph 4.a., Primary Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance afforded under this Coverage Part to any additional insured shown in the Schedule Of Designated Additional Insureds is primary to any of the other insurance, whether primary, excess, contingent or on any other basis, that is available to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance. CG D4 26 02 1 9 ©2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. CYBERFIRST ESSENTIALS TRAVELERSJ� CYBERFIRST ESSENTIALS COVERAGE PART DECLARATIONS One Tower Square, Hartford, Connecticut 06183 POLICY NUMBER: 680-2H705893-21-42 ISSUE DATE: 06-28-21 THIS COVERAGE IS PROVIDED ON A CLAIMS -MADE BASIS. DEFENSE EXPENSES ARE PAYABLE WITHIN, AND ARE NOT IN ADDITION TO, THE LIMITS OF INSURANCE. INSURING COMPANY: TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA Policy Period: From 08-19-21 to 08-19-22 12:01 A.M. Standard Time at your mailing address shown in the Common Policy Declarations. Information Security Retroactive Date: 0 8 -19 -16 Errors And Omissions Retroactive Date: 05-15-15 The CyberFirst Essentials Coverage Part consists of these Declarations, the CyberFirst Essentials General Provi- sions Form and the Coverage Forms shown below. ITEM 1. COVERAGE CYBERFIRST ESSENTIALS INFORMATION SECURITY LIABILITY COVERAGE FORM CYBERFIRST ESSENTIALS TECHNOLOGY PRODUCTS AND SERVICES ERRORS AND OMISSIONS LIABILITY COVERAGE FORM ITEM 2. LIMITS OF INSURANCE: Aggregate Limit $ 1,000,000 Each Wrongful Act Limit $ 1,000,000 ITEM 3. DEDUCTIBLE: Each Wrongful Act Deductible $ 11000 ITEM 4. NUMBERS OF FORMS, SCHEDULES AND ENDORSEMENTS FORMING THIS COVERAGE PART ARE ATTACHED AS A SEPAR ATE LISTING. PR TO 19 02 12 Page 1 of 1 POLICY NUMBER: 680-2H705893-21-42 CYBER LIABILITY ISSUE DATE: 06-28-21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, BREACH ESSENTIALS ENDORSEMENT - TECHNOLOGY This endorsement modifies insurance provided under the following: CYBERFIRST ESSENTIALS GENERAL PROVISIONS FORM CYBERFIRST ESSENTIALS INFORMATION SECURITY LIABILITY COVERAGE FORM CYBERFIRST ESSENTIALS TECHNOLOGY PRODUCTS AND SERVICES ERRORS AND OMISSIONS LIABILITY COVERAGE FORM SCHEDULE OF CYBER FIRST -PARTY LIMIT AND DEDUCTIBLE Cyber First -Party Limit and Deductible PROVISIONS A. INTRODUCTION The following is added to the Introductory Note in the CYBERFIRST ESSENTIALS GENERAL PROVISIONS FORM: THE LIMITS OF INSURANCE WILL BE REDUCED BY THE PAYMENT OF: 1. YOUR SECURITY BREACH NOTIFICATION AND REMEDIATION EXPENSES, YOUR PAYMENT CARD EXPENSES AND YOUR CRISIS MANAGEMENT SERVICE EXPENSES COVERED BY YOUR CYBERFIRST ESSENTIALS INFORMATION SECURITY LIABILITY COVERAGE FORM; AND 2. YOUR CRISIS MANAGEMENT SERVICE EXPENSES COVERED BY YOUR CYBERFIRST ESSENTIALS TECHNOLOGY PRODUCTS OR SERVICES ERRORS AND OMISSIONS LIABILITY COVERAGE FORM, IF THAT COVERAGE FORM IS PART OF YOUR POLICY. B. CYBER FIRST -PARTY COVERAGES 1. The following is added to Paragraph 1., Insuring Agreement, of SECTION I — INFORMATION SECURITY LIABILITY COVERAGE in the CYBERFIRST ESSENTIALS INFORMATION SECURITY LIABILITY COVERAGE FORM: Security Breach Notification And Remediation Expenses And Payment Card Expenses Coverage We will reimburse you for loss to which this insurance applies that is "your security Limit $ 250,000 nprl„rti hip $ 5,000 breach notification and remediation expenses" or "your payment card expenses" directly attributed to a "security breach" that: (1) Is caused by an "information security wrongful act" committed on or after the Information Security Retroactive Date shown in the Declarations of this Coverage Part and before the end of the policy period; (2) Occurs during the policy period; and (3) Is first reported to us during the policy period or within 90 days after the end of the policy period. But we will not reimburse you for "your payment card expenses" that are "payment card contract penalties" or "chargebacks" unless you have agreed to pay such "payment card contract penalties" or "chargebacks" in a "merchant service agreement" you entered into before such "security breach" occurred. Each "security breach" in a series of "related security breaches" will be deemed to occur on the date the first "security breach" in that series occurs. A "security breach" will be deemed to have been first reported to us on the date that we first receive a written notice of such "security breach" from any insured or any authorized government entity. In the event of a "foreign cyber first -party loss" that is "your security breach notification and remediation expenses" or "your payment PR T5 01 03 15 © 2014 The Travelers Indemnity Company. All rights reserved. Page 1 of 6 CYBER LIABILITY card expenses" incurred and paid by a In the event of a "foreign cyber first -party "foreign insured organization", we will loss" that is "your crisis management service reimburse the first Named Insured, or any expenses" incurred and paid by a "foreign other Named Insured that is not a "foreign insured organization", we will reimburse the insured organization", for such "foreign cyber first Named Insured, or any other Named first -party loss" because of its "financial Insured that is not a "foreign insured interest" in that "foreign insured organization". organization", for such "foreign cyber first - For purposes of this insurance: party loss" because of its "financial interest" (1) "Your security breach notification and in that "foreign insured organization". For remediation expenses" that we reimburse purposes of this insurance, "your crisis as "foreign cyber first -party loss" will be management service expenses" that we deemed to be "your security breach reimburse as "foreign cyber first -party loss" notification and remediation expenses"; will be deemed to be "your crisis (2) "Your payment card expenses" that we management service expenses" under this reimburse as "foreign cyber first -party Crisis Management Service Expenses loss" will be deemed to be "your payment Coverage. card expenses"; 2. The following is added to Paragraph 1., under this Security Breach Notification and Insuring Agreement, of SECTION 1 — Remediation Expenses And Payment Card ERRORS AND OMISSIONS LIABILITY Expenses Coverage. COVERAGE in the CYBERFIRST Crisis Management Service Expenses ESSENTIALS TECHNOLOGY PRODUCTS Coverage OR SERVICES ERRORS AND OMISSIONS LIABILITY COVERAGE FORM, if that We will reimburse you for "your crisis coverage form is part of your policy: management service expenses" that: Crisis Management Service Expenses (1) Arise out of loss to which this insurance Coverage applies that is caused by an "information security wrongful act" committed on or We will reimburse you for "your crisis after the Information Security Retroactive management service expenses" that: Date shown in the Declarations of this (1) Arise out of loss to which this insurance Coverage Part and before the end of the applies that is caused by an "errors and policy period; omissions wrongful act" committed on or (2) Are first incurred by you during the policy after the Errors And Omissions period; and Retroactive Date shown in the (3) Are reported to us during the policy Declarations of this Coverage Part and period or within 90 days after the end of before the end of the policy period; the policy period. (2) Are first incurred by you during the policy Each "information security wrongful act" in a period: and series of "related information security (3) Are reported to us during the policy wrongful acts" will be deemed to have been period or within 90 days after the end of committed on the date the first "information the policy period. security wrongful act" in that series is committed. Each "errors and omissions wrongful act" in a Any of ;your crisis management service series of "related errors and omissions wrongful acts" will be deemed to have been expenses that: committed on the date the first "error and (1) Are first incurred by you after the end of omissions wrongful act" in that series is the policy period; and committed. (2) Relate to any of "your crisis management Any of "your crisis management service service expenses" that are first incurred expenses" that: by you during the policy period; will be deemed to have been incurred by you (1) Are first incurred by you after the end of the policy period; and during the policy period. Page 2 of 6 O 2014 The Travelers Indemnity Company. All rights reserved. PR T5 01 03 15 (2) Relate to any of "your crisis management service expenses" that are first incurred by you during the policy period; will be deemed to have been incurred by you during the policy period. In the event of a "foreign cyber first -party loss" that is "your crisis management service expenses" incurred and paid by a "foreign insured organization", we will reimburse the first Named Insured, or any other Named Insured that is not a "foreign insured organization", for such "foreign cyber first - party loss" because of its "financial interest" in that "foreign insured organization". For purposes of this insurance, "your crisis management service expenses" that we reimburse as "foreign cyber first -party loss" will be deemed to be "your crisis management service expenses" under this Crisis Management Service Expenses Coverage. 3. The following replaces the third paragraph of Paragraph 1.a., Defense Of Claims Or Suits, of SECTION I — COVERAGE in the CYBERFIRST ESSENTIALS GENERAL PROVISIONS FORM: We may, at our discretion, investigate any "wrongful act" or "claim" and settle any "claim" or "suit". But our right and duty to defend ends when we have used up the: a. Aggregate Limit in the payment of: (1) Judgments, settlements or "defense expenses": and (2) Loss that is "your cyber first -party loss"; or b. Each Wrongful Act Limit in the payment of judgments, settlements or "defense expenses". 4. The following replaces the last paragraph of Paragraph 2., Supplementary Payments, of SECTION I — COVERAGE in the CYBERFIRST ESSENTIALS GENERAL PROVISIONS FORM: Our duty to make such payments ends when we have used up the: a. Aggregate Limit in the payment of: (1) Judgments, settlements or "defense expenses"; and (2) Loss that is "your cyber first -party loss"; or CYBER LIABILITY b. Each Wrongful Act Limit in the payment of judgments, settlements or "defense expenses". 5. The following exclusion is added to Paragraph 2., Exclusions, of SECTION I — INFORMATION SECURITY LIABILITY COVERAGE in the CYBERFIRST ESSENTIALS INFORMATION SECURITY LIABILITY COVERAGE FORM: PCI Attestation Of Compliance "Your payment card expenses" if: (1) You have not attested compliance with the "payment card security standards" by completing and signing a "PCI attestation of compliance" within the twelve months immediately preceding the "security breach"; or (2) You fraudulently or intentionally misrepresent that you are in compliance with the "payment card security standards" in completing the "PCI attestation of compliance". C. LIMITS OF INSURANCE 1. The following is added to SECTION III — LIMITS OF INSURANCE in the CYBERFIRST ESSENTIALS GENERAL PROVISIONS FORM: Subject to the Aggregate Limit, the Cyber First -Party Limit shown in the Schedule Of Cyber First -Party Limit And Deductible is the most we will pay for the sum of all loss that is "your cyber first -party loss". 2. The following replaces the first paragraph of Paragraph 2. of SECTION III — LIMITS OF INSURANCE in the CYBERFIRST ESSENTIALS GENERAL PROVISIONS FORM: The Aggregate Limit is the most we will pay for the sum of all: a. "Damages" and "defense expenses" for the combined total of all "claims" or "suits" for loss; and b. Loss that is "your cyber first -party loss"; to which the insurance provided under one or more of "your cyber liability coverage forms" applies. D. DEDUCTIBLE 1. The following is added to the last sentence of Paragraph 1. of SECTION IV — DEDUCTIBLE in the CYBERFIRST PR T5 01 03 15 © 2014 The Travelers Indemnity Company. All rights reserved. Page 3 of 6 CYBER LIABILITY ESSENTIALS GENERAL PROVISIONS FORM: The Each Wrongful Act Deductible does not apply to payments we make for loss that is "your cyber first -party loss." 2. The following is added to SECTION IV — DEDUCTIBLE in the CYBERFIRST ESSENTIALS GENERAL PROVISIONS FORM: We will not reimburse you for any of "your cyber first -party loss" to which this insurance applies until the amount of such loss exceeds the deductible shown in the Schedule Of Cyber First -Party Limit And Deductible. We will then reimburse you for the amount of such loss in excess of the deductible, up to the limit of insurance shown in the Schedule. E. CYBER LIABILITY CONDITIONS 1. The following is added to Paragraph 14., Currency, of SECTION V — CYBER LIABILITY CONDITIONS in the CYBERFIRST ESSENTIALS GENERAL PROVISIONS FORM: Payments for loss that is "your cyber first - party loss" will be in currency of the United States of America. At our sole option, we may make these payments in a different currency. Any necessary currency conversion for such payments will be calculated based on the rate of exchange published in the Wall Street Journal immediately preceding the date the payment is processed. 2. The following is added to SECTION V — CYBER LIABILITY CONDITIONS in the CYBERFIRST ESSENTIALS GENERAL PROVISIONS FORM: Duties In The Event Of A Security Breach a. You must see to it that we are notified in writing as soon as practicable of a "security breach" which may result in "your security breach notification and remediation expenses" or "your payment card expenses". Such notice should include: (1) Authorize us to obtain records and other information; (2) Cooperate with us in the investigation of the "security breach"; and (3) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to you because of loss to which this insurance may also apply. Duties In The Event Of An Information Security Wrongful Act That Causes A Foreign Cyber First -Party Loss In the event an "information security wrongful act" causes a "foreign cyber first -party loss", the first Named Insured must comply with all conditions of this policy as if the insured that incurred and paid such "foreign cyber first - party loss" is not a "foreign insured organization". F. DEFINITIONS The following is added to the DEFINITIONS Section in the CYBERFIRST ESSENTIALS GENERAL PROVISIONS FORM: "Chargebacks": a. Means "payment card" charge reversals because of the fraudulent use of "payment cards" or "identity information". b. Includes transaction fees assessed to process such "payment card" charge reversals. "Merchant service agreement" means a contract between you and an acquiring bank or other acquiring institution that establishes the terms and conditions for accepting and processing "payment card" transactions. "Payment card" means a credit card, debit card or charge card issued by a financial institution. "Payment card contract penalties": a. Means fines or penalties incurred by you after a "security breach" because of non- compliance with the "payment card security standards". (1) How, when and where the "security b. Does not include: breach" occurred; and (1) Fines or penalties assessed because of (2) The nature and extent of fees, costs not promptly reporting a "security or expenses incurred and paid by you breach"; which can be directly attributed to a "security breach". (2) Fines or penalties assessed because of b. You must: failure to properly validate system Page 4 of 6 C 2014 The Travelers Indemnity Company. All rights reserved. PR T5 01 03 15 security according to the "payment card security standards"; or (3) Any interchange fees or changes in interchange fee schedules. "Payment card security standards" means: a. The most current edition of security standards contained in: (1) The Payment Card Industry Data Security Standards program (PCI DSS); (2) Visa's Cardholder Information Security Program (CISP); (3) MasterCard's Site Data Protection program (SDP); (4) American Express's Data Security Operating Policy; or (5) Discover's Information Security and Compliance program (DISC); or b. Other security standards similar to those in Paragraphs a.(1) through a.(5) above that you have agreed to in a "merchant service agreement" with a financial institution: that apply to you. "PCI attestation of compliance" means the declaration of compliance status with the Payment Card Industry Data Security Standards program found in the "PCI self-assessment questionnaire" that applies to you. "PCI forensic investigation" means a professional review of your computer systems by a "qualified forensic investigator" to determine your compliance with the "payment card security standards". "PCI self-assessment questionnaire" means the questionnaire, developed by the Payment Card Industry Security Standards Council, that assists you in self-evaluation of your compliance with the "payment card security standards". "Qualified forensic investigator" means an organization approved by the applicable "payment card" issuing bank to conduct forensic investigations after a "security breach". "Qualified security assessor" means a person or organization certified by the Payment Card Industry Security Standards Council to assess compliance with "payment card security standards". CYBER LIABILITY "Related security breaches" means two or more "security breaches" that have as a common connection, tie, or link any fact, circumstance, situation, event, transaction, cause, or series of related facts, circumstances, situation, events, transactions, or causes. "Security breach" means unauthorized access to, or acquisition of, "identity information" owned, licensed, maintained or stored by you. "Security breach notification law" means any law or regulation that requires an organization to notify persons that their nonpublic personal information was or may have been accessed or acquired without their authorization. "Software and hardware upgrade and scanning services expenses" means: a. Fees, costs or expenses for a "PCI forensic investigation" arising out of a written notification by a "payment card" issuing bank, merchant bank, acquiring bank or other acquiring institution that you are a likely common point of purchase source of a "security breach" or otherwise involved in a "security breach" to determine if you are in compliance with the "payment card security standards"; b. Costs or expenses to purchase and install anti-virus software, point-of-sale systems software, firewall protection software, or firewall protection hardware that satisfies the requirements of the "payment card security standards", if, after a "security breach", it is determined through a "PCI forensic investigation" that you are out of compliance with the "payment card security standards"; or c. Costs for the scanning services of a "qualified security assessor" to certify that your upgraded software and hardware systems meet the requirements of the "payment card security standards", but only for the first such scanning services after your software or hardware systems, or both, are upgraded. "Your crisis management service expenses": a. Means the reasonable fees, costs or expenses incurred and paid by you in: (1) Retaining a public relations consultant or firm, or a crisis management consultant or firm; or (2) Planning or executing your public relations campaign; PR T5 01 03 15 © 2014 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 CYBER LIABILITY to mitigate any actual or potential negative publicity generated from loss to which this insurance applies. b. Does not include fees, costs or expenses you incur to comply with any law or regulation. "Your cyber first -party loss" means loss that is: a. "Your security breach notification and remediation expenses"; b. "Your payment card expenses"; or c. "Your crisis management service expenses". "Your payment card expenses": a. Means any of the following reasonable fees, costs or expenses incurred and paid by you which are directly attributed to a "security breach": (1) "Software and hardware upgrade and scanning services expenses"; (2) "Payment card contract penalties"; or (3) "Charge backs". b. Does not include: (1) Remuneration paid to your regular "employees" for work beyond their normal scheduled hours; (2) Fees, costs, or expenses of outside consultants retained by you, unless we agree to reimburse you for such fees, costs, or expenses; (3) Amounts that you voluntarily agree to pay to any person whose "identity information" was accessed or acquired without his or her authorization; (4) Fees, costs, or expenses in: (a) Retaining a public relations consultant or firm, or a crisis management consultant or firm; or (b) Planning or executing your public relations campaign; to mitigate any actual or potential negative publicity generated from the "security breach"; or (5) "Your security breach notification and remediation expenses". "Your security breach notification and remediation expenses": which can be directly attributed to a "security breach": (1) Forensic fees, costs or expenses to determine the cause of the "security breach" and the persons whose "identity information" was accessed or acquired without their authorization. (2) Fees, costs or expenses to develop documents or materials to notify the persons whose "identity information" was accessed or acquired without their authorization. (3) Costs of mailings or other communications required to notify the persons whose "identity information" was accessed or acquired without their authorization. (4) Costs of providing 365 days of credit monitoring services to persons whose "Identity information" was accessed or acquired without their authorization, starting with the date that you first notify such persons of the "security breach". (5) Costs of establishing and maintaining a call center to be used by persons whose "Identity information was accessed or acquired without their authorization. (6) Any other fees, costs, or expenses necessary to comply with any "security breach notification law" that applies to you. b. Does not include: (1) Remuneration paid to your regular "employees" for work beyond their normal scheduled hours. (2) Fees, costs, or expenses of outside consultants retained by you, unless we agree to reimburse you for such fees, costs, or expenses. (3) Fines or penalties imposed by law or that any insured has agreed to pay for any reason. (4) Amounts that you voluntarily agree to pay to any person whose "identity information" was accessed or acquired without his or her authorization. a. Means any of the following reasonable fees, (5) "Your crisis management service costs or expenses incurred and paid by you expenses. Page 6 of 6 © 2014 The Travelers Indemnity Company. All rights reserved. PR T5 01 03 15 EMPLOYMENT PRACTICES LIABILITY} AIIII-1111k TRAVELERS EMPLOYMENT PRACTICES LIABILITY + WITH IDENTITY FRAUD EXPENSE REIM BU RSEM ENTCOVERAGE PART DECLARATIONS One Tower Square, Hartford, Connecticut 06183 POLICY NO.: 680-2H705893-21-42 ISSUE DATE:06/28/2021 THIS FORM PROVIDES CLAIMS -MADE COVERAGE WITH DEFENSE EXPENSES INCLUDED IN THE LIMIT OF LIABILITY FOR EMPLOYMENT PRACTICES LIABILITY COVERAGE INSURING COMPANY: TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA POLICY PERIOD: From 08/19/2021 to 08/19/2022 12:01 A.M. Standard Time at your mailing address shown in the Common Policy Declarations. The Employment Practices Liability+ With Identity Fraud Expense Reimbursement Coverage Part consists of these Declarations and the Coverage Form shown below. ITEM 1. LIMIT OF INSURANCE AND RETENTION FOR EMPLOYMENT PRACTICES LIABILITY COVERAGE Limit of Insurance: $ 100,000 (Defense Expenses are included within the Limit of Insurance) Retention Amount applicable to each Employment Practices Liability Claim: $ 2, 500 ITEM 2. LIMIT OF INSURANCE AND DEDUCTIBLE FOR IDENTITY FRAUD EXPENSE REIMBURSEMENT COVERAGE Limit of Insurance: $ 2,500 Deductible Amount applicable to Identity Fraud Expense Reimbursement: $ 0 ITEM 3. EMPLOYMENT PRACTICES LIABILITY COVERAGE EXTENDED REPORTING PERIOD Subject to the terms and conditions of the Employment Practices Liability Coverage, an optional Extended Re- porting Period may be purchased for: 12 months for 75% % of the Premium for the Policy Period. ITEM 4. EMPLOYMENT PRACTICES LIABILITY CONTINUITY DATE Continuity Date: 08/19/2016 ITEM 5. PREMIUM: INCLUDED ITEM 6. NUMBERS OF FORMS, SCHEDULES AND ENDORSEMENTS FORMING THIS COVERAGE PART ARE ATTACHED AS A SEPARATE LISTING. PR TO 07 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 «.��i�r,r� INTERLINE ENDORSEMENTS POLICY NUMBER: 680-2x705893-21-42 ISSUE DATE: 06/28/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: WHEN WE DO NOT RENEW (Nonrenewal): PROVISIONS A. If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. Number of Days Notice: 30 Number of Days Notice: 3 0 B. If we do not renew this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for When We Do Not Renew (Nonrenewal) in the Schedule above, we will mail notice of nonrenewal at least the number of days shown for When We Do Not Renew (Nonrenewal) in such Schedule before the effective date of nonrenewal. IL T3 20 05 19 © 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 POLICY NUMBER: 680-2H705893-21-42 ISSUE DATE: 06/28/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY CANCELLATION: SCHEDULE Number of Days Notice: WHEN WE DO NOT RENEW (Nonrenewal): Number of Days Notice: PERSON OR ORGANIZATION: COSTA MESA SANITARY DISTRICE ADDRESS: 290 PAULARINO AVE COSTA MESA CA 92626 PROVISIONS A. If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. 30 30 B. If we do not renew this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for When We Do Not Renew (Nonrenewal) in the Schedule above, we will mail notice of nonrenewal to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for When We Do Not Renew (Nonrenewal) in such Schedule before the effective date of nonrenewal. IL T4 00 05 19 © 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, This endorsement modifies insurance provided under the following: BOILER AND MACHINERY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CYBERFIRST ESSENTIALS GENERAL PROVISIONS FORM CYBERFIRST GENERAL PROVISIONS FORM DELUXE PROPERTY COVERAGE PART EMPLOYEE BENEFITS LIABILITY COVERAGE PART EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART EMPLOYMENT PRACTICES LIABILITY+ WITH IDENTITY FRAUD EXPENSE REIMBURSEMENT COVERAGE PART ENVIRONMENTAL HAZARD POLICY EQUIPMENT BREAKDOWN COVERAGE PART EXCESS FOLLOW -FORM AND UMBRELLA LIABILITY INSURANCE EXCESS (FOLLOWING FORM) LIABILITY INSURANCE LAW ENFORCEMENT LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART MANUFACTURERS ERRORS AND OMISSIONS LIABILITY COVERAGE PART MEDFIRST PRODUCTS/COMPLETED OPERATIONS, ERRORS AND OMISSIONS, AND INFORMATION SECURITY LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART PUBLIC ENTITY MANAGEMENT LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY - NEW YORK DEPARTMENT OF TRANSPORTATION TRAVELERS PROPERTY COVERAGE PART TRIBAL BUSINESS MANAGEMENT LIABILITY COVERAGE PART Any other Coverage Part or Coverage Form included in this policy that is subject to the federal Terrorism Risk Insurance Act of 2002 as amended The following is added to this policy. This provision can limit coverage for any loss arising out of a "certified act of terrorism" if such loss is otherwise covered by this policy. This provision does not apply if and to the extent that coverage for the loss is excluded or limited by an exclusion or other coverage limitation for losses arising out of "certified acts of terrorism" in another endorsement to this policy. If aggregate insured losses attributable to "certified acts of terrorism" exceed $100 billion in a calendar year and we have met our insurer deductible under "TRIA", we will not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case, insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. "Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in accordance with the provisions of "TRIA", to be an act of terrorism pursuant to "TRIA". The criteria contained in "TRIA" for a "certified act of terrorism" include the following: 1. The act resulted in insured losses in excess of $5 million in the aggregate, attributable to all types of insurance subject to "TRIA"; and 2. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. "TRIA" means the federal Terrorism Risk Insurance Act of 2002 as amended. IL T4 14 01 21 © 2020 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL PROPERTY COVERAGE PART DELUXE PROPERTY COVERAGE PART The insurance provided under this Coverage Part for direct physical loss of or damage to Covered Property at the described premises is extended to include the following Additional Coverage: Protection of Property We will pay the necessary and reasonable expenses actually incurred by you to temporarily safeguard Covered Property at the described premises against the threat of imminent covered direct physical loss or damage by a "specified cause of loss", subject to the following: 1. This Additional Coverage only applies to expenses incurred within 72 hours before the time the imminent "specified cause of loss" is reasonably likely to begin to cause direct physical loss or damage to the Covered Property. 2. This Additional Coverage does not apply to any expenses: (a) To which any Preservation of Property coverage in this Coverage Part may apply; or (b) For maintenance that reasonably should have been performed in the absence of any threat of imminent covered direct physical loss or damage by a "specified cause of loss". 3. The most we will pay under this Additional Coverage for all expenses arising out of all threats of imminent direct physical loss or damage by a "specified cause of loss" occurring during each separate 12 -month period of this policy beginning with the effective date of this policy is: (a) $5,000 at each of the described premises; and (b) $10,000 for all described premises. This is additional insurance. If the "specified cause of loss" from which the property is being safeguarded is subject to an aggregate limit of insurance (meaning the limit of insurance is the most we will pay for all loss or damage arising out of all occurrences of such "specified cause of loss" in any one annual period of this policy), the Limit of Insurance that applies to this Additional Coverage is not included in, and does not reduce, the aggregate Limit of Insurance that applies to such "specified cause of loss". 4. This Additional Coverage is subject to the deductible that applies to loss or damage to the Covered Property by the "specified cause of loss" from which the property is being safeguarded. In the event the "specified cause of loss" from which the property is being safeguarded actually causes covered direct physical loss or damage to the Covered Property, the total of the deductible amounts applied under this Additional Coverage and under the coverage provided for such loss or damage to the Covered Property will not exceed the deductible that applies to the covered loss or damage to the Covered Property by the "specified cause of loss". IL T4 40 10 20 © 2020 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 TECH OFFICE PAC POLICY NUMBER: 680-2H705893-21-42 ISSUE DATE: 06/28/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: THE CITY OF HUNTINGTON PARK, ITS OFFICERS, OFFICIALS, EMPLOYEES, AND VOLUNTEERS ARE TO BE COVERED AS ADDITIONAL INSUREDS IL T8 02 08 21 Page 1 of 1 TECH OFFICE PAC POLICY NUMBER: 680-2H705893-21-42 ISSUE DATE: 06/28/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE WAIVER OF TRANSFER RIGHTS OF RECOVERY AGAINST OTHERS AMENDMENT - SEPARATION OF INSUREDS This endorsement modifies insurance provided under the following: THE COSTA MESA SANITARY DISTRICT, ITS ELECTED AND APPOINTED OFFICIALS, AGENTS, OFFICERS, VOLUNTEERS AND EMPLOYEES ARE ADDITIONAL INSUREDS IL T8 03 08 21 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES This endorsement modifies insurance provided under the following: COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART — FARM PROPERTY — OTHER FARM PROVISIONS FORM — ADDITIONAL COVERAGES, CONDITIONS, DEFINITIONS FARM COVERAGE PART — LIVESTOCK COVERAGE FORM FARM COVERAGE PART — MOBILE AGRICULTURAL MACHINERY AND EQUIPMENT COVERAGE FORM STANDARD PROPERTY POLICY A. When this endorsement is attached to the Standard Property Policy CP 00 99 the term Coverage Part in this endorsement is replaced by the term Policy. B. The Concealment, Misrepresentation Or Fraud Condition is replaced by the following with respect to loss ("loss") or damage caused by fire: We do not provide coverage to the insured ("insured") who, whether before or after a loss ("loss"), has committed fraud or intentionally concealed or misrepresented any material fact or circumstance concerning: 1. This Coverage Part; 2. The Covered Property, 3. That insured's ("insured's") interest in the Covered Property; or 4. A claim under this Coverage Part or Coverage Form. C. The Concealment, Misrepresentation Or Fraud Condition is replaced by the following with respect to loss ("loss") or damage caused by a Covered Cause of Loss other than fire: This Coverage Part is void if any insured ("insured"), whether before or after a loss ("loss"), has committed fraud or intentionally concealed or misrepresented any material fact or circumstance concerning: 1. This Coverage Part; D. Except as provided in E., the Appraisal Condition is replaced by the following: If we and you disagree on the value of the property or the actual cash value or the amount of loss ("loss"), either may make written request for an appraisal of the loss ("loss"). In this event, each party will select a competent and impartial appraiser. However, in the event of a government -declared disaster, as defined in the Government Code, appraisal may be requested by either you or us but shall not be compelled. Each party shall notify the other of the appraiser selected within 20 days of the request. The two appraisers will select an umpire. If they cannot agree within 15 days, either may request that selection be made by a judge of a court having jurisdiction. The appraisers will state separately the value of the property and actual cash value and amount of loss ("loss"). If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will set the amount of actual cash value and loss ("loss") and will be binding. Each party will: 1. Pay its chosen appraiser; and 2. Bear the other expenses of the appraisal and umpire equally. If there is an appraisal, we will still retain our right to deny the claim. E. The Appraisal Condition in: 2. The Covered Property; 1. Business Income (And Extra Expense) 3. An insured'sCoverage Form CP 00 30; and insured's("insured's") interest in the Covered Property; or 2. Business Income (Without Extra Expense) 4. A claim under this Coverage Part or Coverage Form CP 00 32; Coverage Form. is replaced by the following: IL 01 04 07 20 © Insurance Services Office, Inc., 2020 Page 1 of 2 if we and you disagree on the amount of Net Income and operating expense or the amount of loss, either may make written request for an appraisal of the loss. If the request is accepted, each party will select a competent and impartial appraiser. Each party shall notify the other of the appraiser selected within 20 days of the request. The two appraisers will select an umpire. If they cannot agree within 15 days, either may request that selection be made by a judge of a court having jurisdiction. The appraisers will state separately the amount of Net Income and operating expense or amount of loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will be binding. Each party will: a. Pay its chosen appraiser; and b. Bear the other expenses of the appraisal and umpire equally. If there is an appraisal, we will still retain our right to deny the claim. Page 2 of 2 © Insurance Services Office, Inc., 2020 IL 01 04 07 20 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 MEDICAL PROFESSIONAL LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS 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. IL 02 70 07 20 © Insurance Services Office, Inc., 2020 Page 1 of 4 (5) Failure by you or your representative to implement reasonable loss control requirements, agreed to by you as a condition of policy issuance, or which were conditions precedent to our use of a particular rate or rating plan, if that failure materially increases any of the risks insured against. (6) A determination by the Commissioner of Insurance that the: (a) Loss of, or changes in, our reinsurance covering all or part of the risk would threaten our financial integrity or solvency; or (b) Continuation of the policy coverage would: (i) Place us in violation of California law or the laws of the state where we are domiciled; or Threaten our solvency. (7) A change by you or your representative in the activities or property of the commercial or industrial enterprise, which results in a materially added, increased or changed risk, unless the added, increased or changed risk is included in the policy. b. We will mail or deliver advance written notice of cancellation, stating the reason for cancellation, to the first Named Insured, at the mailing address shown in the policy, and to the producer of record, at least: (1) 10 days before the effective date of cancellation if we cancel for nonpayment of premium or discovery of fraud; or (2) 30 days before the effective date of cancellation if we cancel for any other reason listed in Paragraph 3.a. B. The following provision is added to the Cancellation Common Policy Condition: 7. Residential Property This provision applies to coverage on real property which is used predominantly for residential purposes and consisting of not more than four dwelling units, and to coverage on tenants' household personal property in a residential unit, if such coverage is written under one of the following: Commercial Property Coverage Part Farm Coverage Part — Farm Property — Farm Dwellings, Appurtenant Structures And Household Personal Property Coverage Form a. If such coverage has been in effect for 60 days or less, and is not a renewal of coverage we previously issued, we may cancel this coverage for any reason, except as provided in b. and c. below. b. We may not cancel this policy solely because the first Named Insured has: (1) Accepted an offer of earthquake coverage; or (2) Cancelled or did not renew a policy issued by the California Earthquake Authority (CEA) that included an earthquake policy premium surcharge. However, we shall cancel this policy if the first Named Insured has accepted a new or renewal policy issued by the CEA that includes an earthquake policy premium surcharge but fails to pay the earthquake policy premium surcharge authorized by the CEA. c. We may not cancel such coverage solely because corrosive soil conditions exist on the premises. This restriction (c.) 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) Commercial Property Coverage Part — Causes Of Loss — Special Form; or (2) Farm Coverage Part — Causes Of Loss Form — Farm Property, Paragraph D. Covered Causes Of Loss — Special. d. If a state of emergency under California Law is declared and the residential property is located in any ZIP Code within or adjacent to the fire perimeter, as determined by California Law, we may not cancel this policy for one year, beginning from the date the state of emergency is declared, solely because the dwelling or other structure is located in an area in which a wildfire has occurred. However, we may cancel: Page 2 of 4 © Insurance Services Office, Inc., 2020 IL 02 70 07 20 (1) When you have not paid the premium, at any time by letting you know at least 10 days before the date cancellation takes effect; (2) If willful or grossly negligent acts or omissions by the Named Insured, or his or her representatives, are discovered that materially increase any of the risks insured against; or (3) If there are physical changes in the property insured against, beyond the catastrophe -damaged condition of the structures and surface landscape, which result in the property becoming uninsurable. C. The following is added and supersedes any provisions to the contrary: Nonrenewal 1. Subject to the provisions of Paragraphs C.2. and C.3. below, if we elect not to renew this policy, we will mail or deliver written notice, stating the reason for nonrenewal, to the first Named Insured shown in the Declarations, and to the producer of record, at least 60 days, but not more than 120 days, before the expiration or anniversary date. 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: Commercial Property Coverage Part Farm Coverage Part — Farm Property — Farm Dwellings, Appurtenant Structures And Household Personal Property Coverage Form a. If this policy provides coverage as described in the preceding paragraph, and we elect not to renew this policy, we will mail or deliver written notice, stating the reason for nonrenewal, to the first Named Insured shown in the Declarations, and to the producer record at the mailing address shown in the policy, at least 75 days, but not more than 120 days, before the expiration or anniversary date. If we fail to give the first Named Insured shown in the Declarations notice of nonrenewal at least 75 days prior to the policy expiration, as required in the paragraph above, this policy, with no change in its terms and conditions, shall remain in effect for 75 days from the date that the notice of nonrenewal is delivered or mailed to the Named Insured. A notice to this effect shall be provided by us to the first Named Insured with the notice of nonrenewal. b. We may elect not to renew such coverage for any reason, except as provided in Paragraphs c., d. and e. below. c. 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 IL 02 70 07 20 O Insurance Services Office, Inc., 2020 Page 3 of 4 (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. d. 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. e. We will not refuse to renew such coverage solely because corrosive soil conditions exist on the premises. This restriction (e.) 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) Commercial Property Coverage Part — Causes Of Loss — Special Form; or (2) Farm Coverage Part — Causes Of Loss Form — Farm Property, Paragraph D. Covered Causes Of Loss — Special. f. If a state of emergency under California Law is declared and the residential property is located in any ZIP Code within or adjacent to the fire perimeter, as determined by California Law, we may not nonrenew this policy for one year, beginning from the date the state of emergency is declared, solely because the dwelling or other structure is located in an area in which a wildfire has occurred. However, we may nonrenew: (1) If willful or grossly negligent acts or omissions by the Named Insured, or his or her representatives, are discovered that materially increase any of the risks insured against; (2) If losses unrelated to the postdisaster loss condition of the property have occurred that would collectively render the risk ineligible for renewal; or (3) If there are physical changes in the property insured against, beyond the catastrophe -damaged condition of the structures and surface landscape, which result in the property becoming uninsurable. 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 C.1. 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. e. If the first Named Insured requests a change in the terms or conditions or risks covered by the policy within 60 days of the end of the policy period. f. If we have made a written offer to the first Named Insured, in accordance with the timeframes shown in Paragraph CA., to renew the policy under changed terms or conditions or at an increased premium rate, when the increase exceeds 25%. Page 4 of 4 © Insurance Services Office, Inc., 2020 IL 02 70 07 20 '• • � t POLICYHOLDER NOTICES IMPORTANT NOTICE - INDEPENDENT AGENT COMPENSATION NO COVERAGE IS PROVIDED BY THIS NOTICE. THIS NOTICE DOES NOT AMEND ANY PROVISION OF YOUR POLICY. YOU SHOULD REVIEW YOUR ENTIRE POLICY CAREFULLY FOR COMPLETE INFORMATION ON THE COVERAGES PROVIDED AND TO DETERMINE YOUR RIGHTS AND DUTIES UNDER YOUR POLICY. PLEASE CONTACT YOUR AGENT OR BROKER IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE OR ITS CONTENTS. IF THERE IS ANY CONFLICT BETWEEN YOUR POLICY AND THIS NOTICE, THE PROVISIONS OF YOUR POLICY PREVAIL. For information about how Travelers compensates independent agents and brokers, please visit www.travelers.com, call our toll-free telephone number 1-866-904-8348, or request a written copy from Marketing at One Tower Square, 2GSA, Hartford, CT 06183. PN T4 54 01 08 Page 1 of 1 _MPORTANT NOTICE - RISK MANAGEMENT PLUS ONLIN FROM TRAVELERS BOND & FINANCIAL PRODUCTS NO COVERAGE IS PROVIDED BY THIS NOTICE. THIS NOTICE DOES NOT AMEND ANY PROVISION OF YOUR POLICY. YOU SHOULD REVIEW YOUR ENTIRE POLICY CAREFULLY FOR COMPLETE INFORMATION ON THE COVERAGES PROVIDED AND TO DETERMINE YOUR RIGHTS AND DUTIES UNDER YOUR POLICY. PLEASE CONTACT YOUR AGENT, BROKER OR LOCAL COMPANY REPRESENTATIVE IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE OR ITS CONTENTS. IF THERE IS ANY CONFLICT BETWEEN YOUR POLICY AND THIS NOTICE. THE PROVISIONS OF YOUR POLICY PREVAIL Thank you for choosing Travelers for your insurance needs.Travelers Select Accounts and Bond & Financial Products have partnered to offer you Employment Practices Liability+ with Identity Fraud Expense Reimbursement. Travelers Bond & Financial Products is a market leader in providing management liability coverage that is in -synch with your private company. As your risks evolve, so do we through our ability to provide you with responsive risk management services. With your purchase of Employment Practices Liabilitywith Identity Fraud Expense Reimbursement, Travelers is pleased to provide you with Risk Management PLUS Online, the industry's most comprehensive program for mitigating your management liability exposures. The site includes risk management tools for Employment Practices Liability, Identity Fraud Expense Reimbursement, and many other liability coverage related exposures Risk Management PLUSFOnline is a flexible, comprehensive loss prevention program specifically designed for Travelers customers and is available to you at no additional cost. Included in the site is a library of articles, checklists and training on relevant risk mitigation topics for the management liability areas mentioned above. Highlights of Risk Management PLUS+Online services include: • Web -based risk management training • Weekly articles on current issue • Model policies and forms for downloading or printing that cover major risks associated with the workplace The attached Risk Management PLUS+Online Registration Instructions contain easy, step-by-step instructions to register for this valuable tool. For more information, call 1-888-712-7667 and ask for your Risk Management PLUS Online representative. It's that simple. We strongly encourage you to take full advantage of this program. Once again, thank you for choosing Travelers PN T5 86 04 09 Page 1 of 2 Instructions for Registration & Orientation to Risk Management PLUS+Online Registration for Site Administrators.- The dministrators:The Site Administrator is the person in your organization who will oversee Risk Management PLUS+Online for the organization. The Site Administrator is typically a person who leads human resources and/or financial functions or is responsible for legal matters pertaining to personnel. The Site Administrator may add other Site Administrators later to assist with their responsibilities. To register: 1) Go to www.rmplusonline.com. 2) In the Sign -In box, click Register . 3) Enter the password/passcode: TRVP160000 (Please note there are 4 letters followed by 6 numbers in the code) 4) Fill in the Registration Information and click Submit. 5) Your organization is registered, and you are registered as Site Administrator. Learning to Navigate the Site: 1) Go to www.rmplusonline.com. On each page, you will see a box outlined in blue that contains the instructions for use of that page. 2) If you have any questions, just click on Contact Us on the front page. Enter your question in the form provided, and the System Administrator will get back to you quickly with the answer. 3) You can also schedule a live walk-through of the site by sending a request for a walk-through via the contact link on the front page. Page 2 of 2 PN TS 86 04 09 • : • ' • i •1111 a W , d6, - • - NO COVERAGE IS PROVIDED BY THIS NOTICE. THIS NOTICE DOES NOT AMEND ANY PROVISION OF YOUR POLICY. YOU SHOULD REVIEW YOUR ENTIRE POLICY CAREFULLY FOR COMPLETE INFORMATION ON THE COVERAGES PROVIDED AND TO DETERMINE YOUR RIGHTS AND DUTIES UNDER YOUR POLICY. PLEASE CONTACT YOUR AGENT, BROKER OR LOCAL COMPANY REPRESENTATIVE IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE OR ITS CONTENTS. IF THERE IS ANY CONFLICT BETWEEN YOUR POLICY AND THIS NOTICE, THE PROVISIONS OF YOUR POLICY PREVAIL. Employment Practices Liability Hotline As part of the services provided through Risk Management PLUS+ Online`R', Travelers is pleased to provide its Employment Practices Liability policyholders with up to one hour of access to a toll-free hotline designed to provide quick and practical risk management guidance on day-to-day workplace issues. This hotline is staffed by a nationally recognized employment law firm exclusively dedicated to representing management on workplace issues and is available at no additional cost to Employment Practices Liability policyholders. To utilize the hotline, call 1-866-EPL-TRAV (1-866-375-8728). We encourage policyholders to take advantage of this risk management tool. For more information about the hotline, go to www.rmplusonline.com/EPLhotline. From reviewing the proper steps for a sexual harassment investigation to discussing general factors to consider before making employment decisions, the firm's attorneys are available to assist policyholders in managing their workplace risk and minimizing employment-related claims. This material does not amend, or otherwise affect, the provisions or coverages of any insurance policy or bond issued by Travelers. It is not a representation that coverage does or does not exist for any particular claim or loss under any such policy or bond. Coverage depends on the facts and circumstances involved in the claim or loss, all applicable policy or bond provisions, and any applicable law. Availability of coverage referenced in this document can depend on underwriting qualifications and state regulations. PN T7 72 10 20 Page 1 of 1 Emergency Travel Assistance Services TRAVELERS J G FNIERNT, Insured Name:LAN WAN ENTERPRISE INC Policy Number: 680-2H705893-21-42 Employees are eligible for medical and personal assistance services. In the event of an emergency, first call local emergencv services and then contact us. Emergency Travel Assistance Services TRAVELERS .1 Insured Name:LAN WAN ENTERPRISE INC Policy Number: 680-2H705893-21-42 Employees are eligible for medical and personal assistance services. In the event of an emergency, first call local emergencv services and then contact us. Emergency Travel Assistance Services �. TRAVELERS J� Insured Name:LAN WAN ENTERPRISE INC Policy Number: 680-2H705893-21-42 Employees are eligible for medical and personal assistance services. In the event of an emergency, first call local emergency services and then contact us. The information on this card and / or a copy of this card should be provided to your employees who travel outside the country of their permanent workplace for the purpose of conducting your business. THIS IS NOT AN INSURANCE CARD. The purpose of this card is to provide contact information for the third - party provider that your employees can call when in need of medical or personal assistance services provided under your Global Executive Support Services Agreement. When you call, please be ready to Available 24/7 provide: Toll free in the US or • Your location, age, gender, and i Canada: +1 (866) 251-2870 home address • The telephone number from Collect outside of the which you are calling and/ or a US: +1 (240) 330-1304 number where we can reach you These services are not insurance Email: benefits. To the extent these services ops@us.generaliglobala are not included in your program, you ssistance.com may be responsible for payment. All services must be arranged and approved by GGA. When you call, please be ready to provide: • Your location, age. gender, and home address • The telephone number from which you are calling and/ or a number where we can reach you These services are not insurance benefits. To the extent these services are not included in your program, you may be responsible for payment. All services must be arranged and approved by GGA. Available 24/7 Toll free in the US or Canada: +1 (866) 251-2870 Collect outside of the US: +1 (240) 330-1304 Email: ops@ us. general iglobala ssistance.com When you call, please be ready to I Available 24/7 provide: Toll free in the US or • Your location.age, gender, and Canada:.. home address +1 (866) 251-2870 • The telephone number from which Collect outside of the you are calling and/ or a number US: +1 (240) 330-1304 where we can reach you These services are not insurance'! Email: benefits. To the extent these services 1ops@us.generaliglobaia are not included in your program, you ssistance.com may be responsible for payment. All services must be arranged and approved by GGA BACK TRAVELERSJ� IMPORTANT INFORMATION FOR MASTER PAC POLICYHOLDERS Dear Policyholder: Enclosed is your Travelers Master Pac Renewal Certificate. An asterisk on the Listing of Forms, Endorsements and Schedule Numbers, IL T8 01, indicates forms that are included with this year's renewal. Any forms previously attached to your policy that are not shown on that listing no longer apply. Please put the Certificate and the attached forms with your policy as soon as possible. If you have misplaced your policy, please contact your agent for a copy. This agreement provides executive support services to you and your employees who travel outside the country of their permanent workplace for your business. The services provided under this agreement are not insurance. There are limitations and restrictions which apply to this agreement. As a result, this agreement should be read carefully to determine the extent of the services provided to you and your employees. About This Service Agreement The Medical Assistance Services and Personal Assistance Services described in this agreement are available to your employees while engaged in temporary travel. For purposes of this agreement: Employee means any person, including any voluntary worker or independent contractor with whom you have a written contract, working for you at your workplaces anywhere in the world. Temporary travel means any trip outside of the country of an employee's permanent workplace for the purpose of conducting your business. Temporary travel includes any personal trip taken immediately before, during or immediately after the trip for the purpose of conducting your business, but only if such personal trip lasts five or fewer consecutive days and the total number of days for all such personal trips does not exceed ten. Foreign insured organization means any organization that is an insured under the insurance policy in which this Global Executive Support Services Agreement is included, and that is located in a country or jurisdiction in which we are not licensed to provide insurance and where providing insurance would violate the laws or regulations of such country or jurisdiction. We will provide you with service cards that explain how employees can reach the third -party provider of such services at any hour of the day. It is your responsibility to distribute the service cards to your employees who may require such services. You may ask us for additional cards as they are required by you. Medical Assistance Services Emergency Medical Payment We will advance on-site emergency inpatient medical payments to your employee, up to $10,000, upon receipt of satisfactory guarantee of reimbursement from you. The cost of medical services is the responsibility of you or your employee. Medical Search and Referral We will assist your employee in finding physicians, dentists and medical facilities. Replacement of Medication and Eyeglasses We will arrange to fill a prescription for your employee that has been lost, forgotten, or requires a refill, subject to local law, whenever possible. We will also arrange for shipment of replacement eyeglasses for your employee. Costs for shipping of medication or eyeglasses are the responsibility of you or your employee. Medical Monitoring During the course of a medical emergency resulting from an accident or sickness, we will arrange for professional case managers, including physicians and nurses, to monitor your employee's case to determine whether the care is appropriate. Visit by Family Member/Friend If your employee is traveling alone and must be or is likely to be hospitalized for seven or more days, or is in a life-threatening condition resulting from an accident or sickness, we will arrange and coordinate payment for the round-trip transportation for one family member or friend, designated by your employee, from his or her home to the place where your employee is located. Transportation costs are the responsibility of you, your employee, or your employee's family member or friend. Dependent Children Assistance If any of your employee's dependent children under the age of 19 traveling with your employee are left unattended because your employee is hospitalized, we will coordinate and arrange payment for their economy class transportation home. If transportation with an attendant is necessary, we will arrange for a qualified escort to accompany the children. Transportation costs are the responsibility of you or your employee. Traveling Companion Assistance If your employee's travel companion loses previously made travel arrangements due to your employee's PN T5 72 09 20 © 2020 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 medical emergency, we will arrange for such traveling companion's return home. Transportation costs are the responsibility of you, your employee, or your employee's traveling companion. Emergency Evacuation/Medically-Necessary Repatriation In the event of a medical emergency, if a physician designated by us determines that it is medically necessary for your employee to be transported under medical supervision to the nearest hospital or treatment facility or be returned to his or her place of residence for treatment, we will coordinate and arrange payment for the transport under proper medical supervision. Transport costs are the responsibility of you or your employee. Repatriation of Mortal Remains If your employee or your employee's immediate family member dies while traveling, we will coordinate and arrange payment for all necessary government authorization, including a container appropriate for transportation, and for the transportation of the remains to the employee's or family member's preferred place of burial. The costs of such container and transportation are the responsibility of you or your employee. Trip Interruption If your employee or your employee's immediate family member is critically injured or becomes sick while traveling, we will arrange for the transportation of such employee or such employee's immediate family member to the preferred place of medical treatment via the most direct route on economy class airfare. Transportation costs are the responsibility of you or your employee. Personal Assistance Services Pre -Trip Information We will provide, at your request, a wide range of informational services before your employee leaves home, including visa, passport, health hazards advisories, currency exchange, inoculation and immunization requirements, temperature and weather conditions, and embassy and consulate referrals. Interpretation/Translation We will assist your employee with telephone interpretation in all major languages. If your employee requires ongoing or more complex translation services, we will refer your employee to local translators. Locating Lost or Stolen Items We will assist your employee in locating and replacing lost luggage, transportation ticket application, documents and personal possessions. Emergency Cash Advance In the event of an emergency, we will advance up to $500 to your employee after satisfactory guarantee of reimbursement from you or your employee. Any fees associated with the transfer or delivery of funds are the responsibility of you or your employee. Emergency Travel Arrangements In the event of an emergency, we will help your employee make new travel arrangements, including airline, hotel and car rental reservations. Legal Assistance/Bail If your employee is incarcerated, we will notify the proper embassy or consulate of the incarceration, arrange for the receipt of funds from third -party sources, and locate an attorney and bail bonds, where permitted by law, with satisfactory guarantee of reimbursement from you or your employee. All attorney fees and any other costs are the responsibility of you or your employee. Emergency Message Relay We will transmit an urgent message for your employee to your employee's family, friends or business associates. We will also accept and retain messages for up to 15 days. Vehicle Return If your employee becomes physically unable to operate any non-commercial vehicle as a result of a medical emergency, we will coordinate and arrange payment for the return of the unattended vehicle to your employee's residence or place of rental. The vehicle must be in good driving condition and capable of being driven on the highway in compliance with local laws. Costs of services are the responsibility of you or your employee. Pet Return If a pet traveling with your employee is left unattended because such employee is hospitalized, we will coordinate and arrange payment for the return of the pet to your employee's residence. Costs of services are the responsibility of you or your employee. Pre -Approved Panel Counsel If you or any foreign insured organization requires legal advice under the laws of any country or jurisdiction in which you or any such organization is not located, or if any of your employees require legal Page 2 of 4 © 2020 The Travelers Indemnity Company. All rights reserved. PN T5 72 09 20 advice under the laws of any country or jurisdiction in which such employee is on temporary travel, we will refer the first Named Insured to one of our pre - approved panel counsel for that country or jurisdiction. All attorney fees and any other costs are the responsibility of you, your employee or a foreign insured organization. For more information regarding our pre -approved panel counsel, please contact us at GlobalCI@Travelers.com. Tax ArivirA If you or any foreign insured organization requires tax advice under the laws of any country or jurisdiction in which you or any such organization is not located, or if any of your employees require tax advice under the laws of any country or jurisdiction in which such employee is on temporary travel, we will assist the first Named Insured or any such organization or employee in finding a tax advisor for that country or jurisdiction. Costs of services and any other fees are the responsibility of you, your employee or a foreign insured organization. For more information regarding a tax advisor, please contact us at GlobalCI@Travelers.com. Exclusions and Conditions Exclusions We will not provide any service under this agreement that results from: Your employee's active participation in war (including undeclared or civil war), warlike action by a military force, insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these; or • Your employee's commission or attempted commission of an illegal act. Service Agreement Period We are not responsible for services first provided outside the effective date of the policy in which this Global Executive Support Services Agreement is included, including any extensions or renewals of such policy. If the policy is canceled for any reason before its expiration date, this Global Executive Support Services Agreement will end as of the effective date of the policy cancellation. Errors And Omissions We are not liable for any act or omission by a local physician or attorney who is not our employee or the employee of a third -party provider of the services described in this agreement. Conditions Beyond Our Control We are not liable for the failure to provide, or for the delay in providing, any service when such failure or delay is caused by conditions beyond our control, including restricted flight conditions, weather, Acts of God, strike, riot, civil commotion, war or uprising, or where providing such service is prohibited by local laws or regulations. Transfer Of Rights Of Recovery Against Others To Us If you or the employee to whom we provide services under this agreement have any rights to recover all or any part of the cost of any such services from any other person or organization, including rights to recover under any workers compensation law, health plan or insurance policies, we are entitled to an assignment of those rights to the extent of our payments. You and your employee will transfer those rights to us, and cooperate with us as may be necessary to enforce such rights. You and your employee agree to sign any papers, deliver them to us, and do anything else that we may reasonably require to help us pursue such rights. Suits Against Us You agree not to bring suit against us unless you have complied with all of the terms of this agreement. Any such suit must be brought within two years after the services are provided. No person or organization has any right to bring us into any action to determine your liability. Return to Work You have the responsibility for the decision of whether your employee returns to work. You are responsible for obtaining any medical releases and to determine your employee's suitability to travel or resume work. We will not be involved in such decision, and we have no liability arising out of your employee's return to work. Services Not Described In This Agreement At our discretion, we may provide your employee with a medical or personal assistance service that is not described in this agreement. You agree to promptly reimburse us or our designee for such service if we request reimbursement for it. Prohibited Services — Trade Or Economic Sanctions We will provide the services described in this agreement, or otherwise will provide any benefit, only to the extent that providing such services or benefit PN T5 72 09 20 C 2020 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 does not expose us or any of our affiliated or parent companies to: • Any trade or economic sanction under any law or regulation of the United States of America; or • Any other applicable trade or economic sanction, prohibition or restriction. Currency Cash advances under this agreement will be in the currency of the United States of America unless we agree to provide them to your employee in a different currency. Impact on Insurance Coverage Our providing or failure to provide any service under this agreement is not a representation that coverage does or does not exist for any particular claim or loss under any insurance policy or bond issued by Travelers. Page 4 of 4 © 2020 The Travelers Indemnity Company. All rights reserved. PN T5 72 09 20