Loading...
Insurance - Gentry General Engineering - 2021-10-20GENTR-3 OP ID@ NM DATE 10(MM/0/20/22021021 Y) '4� Rau CERTIFICATE OF LIABILITY INSURANCE 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 909-980-4211 Silverstone Insurance Services Jetton & Associates, Inc C NTACT Kyle Visciglia PHONE 909-980-4211 FAX 909-980-4785 A/C, No, Ext): (A/C, No): IL ADDRESS; PO BOX 1200 RANCHO CUCAMONGA, CA 91729 RECETvi X Ltd Contractual Brent Jetton, AAI, CIC INSURERS AFFORDING COVERAGE NAIC # INSURER A: James River Insurance 99man 12203 NOT EXCLUDED INSURED Q C T 2 5 2021 Gentry General Engineering Inc 9277 Archibald Avenue INSURER B: Regent Insurance Co. 24449 INSURER C: Pan Insurance Com of the West 27847 Y Rancho Cucamonga, CA 91730 Costa Mesa Sanitary District INSURER D: Westchester Surplus Lines Ins 10172 INSURER E INSURER F: OTHER: CnVFRAGFR CFRTlFlr.ATF N11MRFR- RG\/ICInkl KII U92CQ• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE IADDL SUBR 1 POLICY NUMBER POLICY EFF POLICY EXPLTR ! LIMITS EACH OCCURRENCE 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X X 00086558-3 $ 10/19/2021 10/19/2022 1 DAMAGES RENTED 50,000 PREMISES $ ( Ea occurrence) X Ltd Contractual 5 000 MED EXP An one person)$ ' F— i X' C' U i NOT EXCLUDED i PERSONAL & ADV INJURY $ 1'000'000 GGEEN'L AGGREGATE LIMIT APPLIES PER: X PR� ! GENERAL AGGREGATE $ 2'000'000 2,000,000 POLICY LOC ( I i PRODUCTS - COMP/OP AGG $ OTHER: B AUTOMOBILE LIABILITY CEOMBI accaEeDtSINGLE LIMIT $ 1,000,000 X ANY AUTO X X BCA0005149-01 05/06/2021 05/06/2022 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X j HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY !PROPERTY DAMAGE ! Per accident $ A UMBRELLA LIAB X OCCUR! EACH OCCURRENCE $ 5'000'000 X EXCESS LIAB CLAIMS -MADE 00096537-2 10/19/2021 10/19/2022AGGREGATE $ 5'000'000 DED X I RETENTION $ 0 C WORKERS COMPENSATION ! TH- X PEAT TE X OR AND EMPLOYERS' LIABILITY a � N/ A I Y / N X ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? iWSA 5048153 02 05/06/2021105/06/2022 1,000,000 E.L. EACH ACCIDENT $ (Mandatory in NH) 1'000'000 If yes, describe under E.L. DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 D !POLLUTION LIAB IG71564630 003 10/19/2021;10/19/2022 GEN AGG 2,000,000 B j PROPERTY BPK0008360-00 05/06/2021 j 05/06/2022 BLDG j 303,246 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Costa Mesa Sanitary District is named as additional insureds with respects to general liability and auto liability. Waiver of subrogation applies to general liability, auto liability and workers comp. Coverage is primary/non-contributory. *30 Days NOC. COSMESA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa Sanitary District ACCORDANCE WITH THE POLICY PROVISIONS. j,� (/a 290 Paularino Avenue ` Costa Mesa, CA 92626 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy No. 00086558-3 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION endofsermem modifies prwded under ',he folkwving: C('3*::4M0E-RCtAL GEN11-DRAL; LIABIUTY L'•OVEERAGEE P)A-kRT SCHEDULE Name Of AddffionM Insured Person(s) Or Locationk-0 Of Covered Dpa:ra<tions V-'pnere recuire� by virit;en cj� vviriften agleemen" A';I rat;lol -�f t:le Name,,' lr-�3ufeds -- - -------------- - --- - --- - --- - --------- - --- - --- - --------- - -------- - ---------- .............r___------«_._«.. j - --------- - --- - -- - ----------- - - - -------- - --------- - --- - --- - ------ - ------------ --- - -------- Imormation ;'r� compiete ifin:ot. sinovin. abc>',"e' k.'OiI nte Sh':ov'j:r- in the Declarations. A, Section it - Who Is Art Msuimd s amended a. WiMl res3�'�'C-lk i'c- in'eiorance to irid>udle as anc addilrjional ins:';:reed, the, perg--.'>nts,s add;!43onal ft-)-7ovvinq 4A, exdu- 'jon's" shown irl t},.e S-heduie. bul u sions appiv: ' h re'spect to,•fc. r ,,>d,jjy 7-y% "prop doe�i not app�v to "bodiliv injury" or da' -'mage" or "personal ropt -;n il:damage" occum. .9, alter. caused, in 'v"We or;"� part, b"": .31 Or til (I U I f All vvovk. par - 1. yo%uracts or- ion -'ev-th �'t- vvo-�. 2. The acts o' un�--, of thclse ad' —01 On the projt."("I or --e-omirm. tc; be ppeilorr- ed by or on be�-aff of of ongoing, fj P.erp' t,;r, •ns -11-or the adr-''Iional Msured�s% at, the Iocatiof�, of tike 'Vour cove -reed cs-",pemtions }iss b. -en compietel;r; or both e. 2� Thfit PoOki-o- Of your'ear out cwhich tihe inii,ury -or damage ar;sas has beer,, puit i4 ji-S in- lend ed ucr-- by a!,.y y 4:• on a-- ofcqanizal:Cln rith- er trwl bof V"a" another 'con!" I.or or su -mffactr;� engaged in pelorming operatkJns for a p." pal as part o" Same pro;ect. Policy No. 00086558-3 COMMERCIAL, GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT GRANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONALINSURED - OWNERS, LESSEES OR CONTRACTORS — COMPLETED OPERATIONS r- Q`:'v r;�. F` ? ` r" rte` j { ' ` :31#g I„i Y f-'{:'+,''r�r' AGE RT L.s �iC SV:_.. iF+ !._ � i_ i-�r-?c. f. '-ti.�J L) <J l �."R1. S PART SCHEDULE meat Of Addiflon-al Insured Ptewsnn(s) Location And Description Of Co, mp :-ted Opera - Or i i i i i i r;7r t ^. v c1t'E'•� �i<:33f .....�,:;'t.;umpie��^hPd'r. f 7.�s.`! �vtn. above. .iiS ra in the, 3'da3a#iC-,T, Sec"- on 11 m Who IsAn InsuredJ's a : e d is :' ?� tw; )in}'t th(7tj�S h--d7ule but y { f Syr er,�S ^tlCS;r::"'� S .`.�27j ♦') ZIS the ��..l.W'..(i55\i> '^�tAG �t'7i �r C>i il,.'i lt�:rM �'4': �lJ 2yy Tyy F-�]�)ti(i�l .��.y(�.'�: :.y5f•..ilj: [f�}{(yt pGLT)L. -�y ';your 7VC��>':)[,!:Y S.tY the CSC�`rrG-}(G{t{i�!. :..ru '..E11.. C S.,tt`V+.) and :.f'�t+ ci,ibed in he, y7rihieclu!.'..i3 o �<SS•r`I X4'rs'���J`i ✓`Z,f+ lt_t fog 4-n ;•? ,at ,y. additional insured f• e;d in che "�?{�U{�t:��--fir,;,,.{p��1��� �.s��•r��;{.'s� �,, . ��.ZGkf' about:blank 5/8/2419 Policy No. 00086558-3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Name Of Additional Insured Person(s) Or Oroanization(s): [If no entry appears above, this endorsement applies to all Additional Insureds covered under -this policy. ---------- Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031 US O4-10 Page 1 of 1 Policy No. 00086558-3 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US en:lw,-ufsement rnodflifies insurafice pfcvided er the foflrov�;ng: C(_J`Mw!E'RCk,AL GENEERAL "}ABILITY—L1CjV'E7_RA,,'-:>E10ART 0P1r_7_.R,kT:10NS LiABIL—FI/ COVERAGLE PART SCHEDULE Name Of Person 0 r Organ izafion,. Where requir%ed r, �)kiritten con' ac. P,., wr;t1--n agreemient re�,�;iredi to corn;-;Iete W -.is 'Schedule- il.; r, "� shovvn be sivio,,A,,ri in vie T:.", f0i-ovvi'ng IS 'Ex"IdOd 1.0 Transfer Of Rights Of Racovooy Agairtsi. Others To Us Of Section :V � conditions" we "3r1v )X��J, of rec;ol ery'vV.: fflay hav- at a:: d I V , I . I 1.1,si fl -.e persi)fi (if if) the, &_,I-teduie above C"'t porwtnfls rpl&,._, fo•r inj"'ry ox dian--a-gee zir.,sffly o"ft Ofyou� optra.ions (If INleo -h .yuuf v."Ofk" c"ar'-e, a ecor,; ...ract vv,:* or -:,Iie ha/ard'. w-a;:Kef appiiili�w. oniv Ito 1he ..e.f,3on or 13-1 -the POLICY NO.BCA0005149-01 COMMERCIAL AUTO AH CA 85 90 09 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance prmAdedunder the following, BUSINESS AUTO COVERAGE FORM A. BROADENED WHO |S AN INSURED Paragraph A.1.Who |sanInsured ofSECTION U —LIABILITY COVERAGE |samended to include thefbUmw|ng- d. Any "employee' of yours is an "insured" while using a covered "auto" you don't own, h|ns or borrow in your business or your personal affairs. e. Any "employee" of yours is an "insured" while using an "auto" hired or rented under a contract or agreement in that "employ- ee's" name, with your pemnission, while performing duties related to the conduct of your business. f. Each person or Organization to whom you are required by a written contract or agreement to provide additional insured status is an ''|naunad" under Liability Cov- erage, but only tothe extent that person or organization qualifies as an "insured" un- der the Who n'dertheVVho is an Insured Pno\Ao|on con- tained in Section || of the novtenyge form. The written contract or agreement must be in effect during the policy period shown in the Declarations and must have been exe- cuted prior to the "bodily in]ury" or"proper- ty damage." 'proper-tydamage" B. LIABILITY COVERAGE EXTENSIONS SUPPLE- MENTARY PAYMENTS Paragraphs A.2.m. (2) and A.2.m' (4) Coverage Extensions -- Supplementary Pmyrnmmtm of SECTION |1 -- LIABILITY COVERAGE are deleted and replaced with the following: (2) Up to $5.00Ofor the cost cfbail bonds (including bonds for related tnyffio law \Ao|mt|onn) required because ofan ''ac- cidert" we cover. We do not haveto furnish these bonds. Ell WU All reasonable expenses incurred by the "insured" etour request, including actual |oaa of earnings up to $500 a day because cftime off from work. C. FELLOW EMPLOYEE COVERAGE Paragraph B.5. Fe||mvv Employee Exclusion con- tained in SECTION || — LIABILITY COVERAGE does not apply if the "bodily injury" results from the use of covered ''auho" you own or hire that is not o bua, motorcycle or van used to transport em- ployees. This Fellow Employee Coverage is excess over any other collectible insurance. D. POLLUTION LIABILITY -- BROADENED COV- ERAGE FOR COVERED AUTOS 1' Liability Coverage iochanged asfollows: m. Paragraph B.11'm. of the Pollution Exclu- sion in SECTION 11 -- LIABILITY COV- ERAGE applies only to liability assumed under acontract oragreement. b. With respect to the coverage afforded by Paragraph I.m. Above, Exclusion B.6' Came, Custody or Control of SECTION |H - - L\ABIL|Tfdoes not apply. 2. Changes inDefinitions For the purposes of this endorsement, Para- graph D. of SECTION V -- DEFINITIONS is replaced bythe following: D. "Covered pollution cost orexpense" means any cost orexpense arising out of: 1. Any nsqueot, demand' order orstatuto- ry or regulatory requirement that any "|naunad" or others test for, monitor, clean up, nemcxe, conta|n, treat, de- toxify or neutralize, or in any way re- spond to, or assess the effects of''po|' lutants": or Includes copyrighted material oYInsurance Services Office, Inc., 2. Any claim or "suit" by or on behalf of a 2. Unless you notify us to add coverage to your governmental authority for damages be- policy, the coverage under this provision is af- cause of testing for, monitoring, cleaning forded only until: up, removing, containing, treating, detoxify- a. The 120th day after you acquire or form the ing or neutralizing, or in any way respond- organization, or ing to or assessing the effects of "pollu- tants". b. The end of the policy period, whichever is earl ier. "Covered pollution cost or expense" does not include any cost or expense arising out of the actual, alleged or threatened discharge, dis- persal, seepage, migration, release or escape of "pollutants": a. Before the "pollutants" or any property in which the "pollutants" are contained are moved from the place where they are accepted by the "insured" for movement into or onto the covered "auto", or b. After the "pollutants" or any property in which the "pollutants" are contained are moved from the covered "auto" to the place where they are finally deliv- ered, disposed of or abandoned by the "i nsured ". Paragraphs a. and b. above do not apply to "accidents" that occur away from prem- ises owned by or rented to an "insured" with respect to "pollutants" not in or upon a covered "auto" if: (1) The "pollutants" or any property in which the "pollutants" are con- tained are upset, overturned or damaged as a result of the maintenance or use of a covered "auto"; and (2) The discharge, dispersal, seep- age, migration, release or escape of the "pollutants" is caused di- rectly by such upset, overturn or damage. This Pollution Liability Coverage is subject to an Annual Aggregate Limit of Liability of $100,000. E. NEWLY ACQUIRED OR FORMED ORGANIZATIONS Throughout this policy, the words you and your al- so refer to any organization you newly acquire or form, other than a partnership, joint venture or lim- ited liability company, and over which you maintain ownership or majority interest, but only if there is no similar insurance available to that organization. However. 1. The coverage does not apply to an "accident" which occurred before you acquired or formed the organization. F. EXTENDED TOW I NG Paragraph A.2. Towing of SECTION III — PHYS- ICAL DAMAGE COVERAGE is deleted and re- placed with the following: We will pay for towing and labor costs each time a covered "auto" is disabled. All labor must be per- formed at the place of disablement. If the "auto" is of the private passenger type, there will be no de- ductible. If the "auto" is other than a private pas- senger type, a $100 deductible will apply. The most we will pay under this EXTENDED TOW- ING coverage is $750 per occurrence. G. PHYSICAL DAMAGE COVERAGE EXTENSIONS Paragraph A.4. — Coverage Extensions of SEC- TION III — PHYSICAL DAMAGE COVERAGE is amended as follows: a. Transportation Expenses The amount we will pay for temporary transportation expense is increased to $50 per day to a maximum of $3,000. b. Loss of Use Expenses The amount we will pay for loss of use is increased to $75 per day and to a maxi- mum limit of $1,000. 1. This coverage applies only to a covered "auto" described or designated in the Schedule or in the Declarations as carrying physical damage coverage. 2. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" be- cause of "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of coverage you have on each covered "auto". 3. We will pay only for those expenses incurred during the policy period beginning 24 hours af- ter the "loss" and ending, regardless of the pol- icy's expiration, with the lesser of the following number of days: Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 6 with its permission. AH CA 85 90 09 17 m- The number ofdays reasonably required to repair or replace the covered "auto" If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and ns - tum |ttoyou: or b' 30 days. 4. Our payment is limited to the lesser of the fol- lowing amounts: u. Necessary and actual expenses incurred; or b. $5Oper day 5. This cowarage does not apply while there are spare or naeeme "autos" available to you for your operations. 0. K"|oem" results from the total theft ofacovered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the paragraph A.4. Coverage Extensions in SECTION 1I| — PHYSICAL DAMAGE COVERAGE. No Deductible applies tothis coverage. |. AIRBAG COVERAGE Exclusion B.3. in SECTION |I| -- PHYSICAL DAMAGE COVERAGE |oamended toadd: This exclusion does not apply to the accidental discharge ofanairbag. J. AUD|O, VISUAL AND DATA ELECTRONIC EQUIPMENT 1. Coverage m' We will pay with respect toacovered "au- to" described in the Schedule for "|osa" to any electronic equipment that receheo or transmits audio. Nsua| or data signals and that is not designed solely for the repro- duction of sound. This coverage applies only if the equipment is permanently in- stalled in the covered "suto" atthe time of the ''|oas" or the equipment is removable from a housing unit which is permanently installed in the cowered ''auto"mtthe time of the "|oas", and such equipment is de- signed to be solely operated by use ofthe power from the ^auto'o" electrical systom, in orupon the covered "auto" b. We will pay with respect to eccwered "au- to" described in the Schedule for ''|oss" to any accessories used with the electronic equipment described in Paragraph 1'a. above Hovnewsr, this does not include tapes, records ordiscs. 2. Exclusions The exclusions that apply to SECTION U| -- PHYSICAL DAMAGE, except for the exclusion relating to Aud|o. Visual and Data Electronic Equipment, also apply to ccwerageproWded by this endorsement. In addition, the following ex- clusions apply: We will not pay, under this endonsement. for either any electronic equipment oraccessories used with such electronic equipment that is-. m. Necessary for the normal operation of the covered "auto" or the monitoring of the covered ''auto'o''operating system; or � ON E 007 1 (1). An integral part ofthe same unit hous- ing any sound reproducing equipment designed solely for the reproduction of sound ifthe sound nsproducingequip- ment is permanently installed in the covered "auto"; and (2). Permanently installed |nthe opening of the dash or console normally used by the manufacturer for the installation of a radio. 3. Limit Of Insurance With respect to coverage under this endorse- ment, the Limit Of Insurance provision of SECTION IU -- PHYSICAL DAMAGE COV- ERAGE is replaced by the following, m. The most we will pay for all "loss" to audio, visual or data electronic equipment and any accessories used with this equipment as a result of any one "accident" is the lesser of (1). The actual cash value ofthe damaged orstolen property asofthe time ofthe "loss": (2). The cost of repairing or replacing the damaged or stolen property with other property oflike kind and qum|ity� or b. An adjustment for depreciation and physi- cal condition will be made in determining actual cash value atthe time oythe "|oss" o. If e repair or replacement results in better than like kind or quality, we will not pay for the amount ofbetterment. 4. Deductible No deductible applies tothis covensge. The insurance provided by this extension is excess over any other collectible insurance. Includes copyrighted material ofInsurance Services Office, Inc., K. TAPES, RECORDS AND DISCS COVERAGE Exclusion B.4~m. of SECTION UI -- PHYSICAL DAMAGE COVERAGE isdeleted and replaced by the following: m. Tapes' neoonJa, discs or other aim||arau- dio. visual or data electronic devicea de- signed for use with audio, visual or data electronic equipment except when the tapea, records, discs or other similar au- dio, visual or data electronic deWceo: (1) Are your property or that of a family member. and (2) Are in a covered "autm" atthe time of "|oae" (a). The most we will pay for "|oes" is $200. No Physical Damage Cov- erage o*erage deductible applies to this coverage. This extension provides coverage only toacovered "auto" L. PHYSICAL DAMAGE DEDUCTIBLE -- SINGLE DEDUCTIBLE AND GLASS REPAIR Paragraph D. Deductible in SECTION ||| -- PHYSICAL DAMAGE COVERAGE is deleted and replaced by the following - D. Deductible For each cowered "auto," our obligation to pay for, repair, return orreplace damaged orstolen property will be reduced bythe applicable de- ductible shown in the Declarations. Any Com- prehensive Cox,erage deductible shown in the Declarations dmso not apply to ''|oao" caused by fire or lightning. When two or more covered "auLos" sustain "loss" in the same 000urrence, the total of all the "loss" for all the involved covered "autos" will be reduced by a single deductib|e, which will be the largest of all the deductibles apply- ing toall such oovensd''autos" No deductible applies to glass damage if the glass iarepaired rather than replaced. M. PERSONAL EFFECTS COVERAGE 1. If you purchase Comprehensive Coverage on this policy for e stolen owned "auto'', we will pay up to $800 for "personal effecto" stolen with the "auto". 2. "Personal effects" as used in this extension means tangible property that is worn or carried by the "insured". "Personal effects" does not include tools, jewelry, money, securities, radar or laser detmctons, or tapee, reoonjs, discs or similar audio. \�sua| or data electronic equip- ment. No Deductible applies to this extension The insurance provided by this extension is excess overany other collectible insurance. N. LOAN/LEASE PAYOFF COVERAGE The SECTION I7| -- PHYSICAL DAMAGE COV- ERAGE|s amended bythe addition oythe follow- ing: In the event of a total "loss" to o covered "auto" shown in the [ec|arat|ono, we will pay any unpaid amount due on the lease or loan for acovened "au - ho' less: 1. The amount paid under the Physical Damage CcweraQe Section ofthe policy; and 2. Any: m. Overdue lease/loan payments atthe time ofthe "|oea"* b. Financial penalties imposed under alease for excessive use, abnormal wear and tear orhigh mileage. n. Security deposits not returned by the les- sor', d. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or |eeme. and m. Carry -overbalances from pns\Aouo loans or /eeaoo. 0. CUSTOM SIGNS AND DECORATIONS In the event of m total |oom to a vehicle insured for auto physical damage coverage on this po|ioy, in addition to the ACV of the veh|o|m, we will pay the actual cost to repair or replace signage or custom paint details upto$5.00O. P. HIRED AUTO PHYSICAL DAMAGE if hired "autos" are covered "autos" for Liability Coverage and if Physical Damage Coverage of Comprehensive, Specified Causes of Loss, orCol- lision are provided under this Coverage Form for any ''auto" you mwn, than the Physical Damage Coverage's provided are extended to "autos" you hire of like kind and use subject to the following limit.. The most we will pay for any one loss is the lesser ofthe fbUmw|ng- 1' $50, 000 per aooident. Includes copyrighted material ofInsurance Services Office, Inc., Page 4ofG with its permission. AH CA 85900917 2. Actual Cash Value, or 3. The cost of repair The deductible will be equal to the largoatdeiucM- ble applicable to any owned "auto" for that cover- age. No deductible applies to "loss" caused by fire or lightning. This Hired Auto Physical Damage cov- erage is excess over any other oo||eot|b|o insur- ance. Subject to the above ||m|t, deductible and excess proWa|one, we will pnzWde oowrageequa| . to the broadest coverage applicable to any covered "auto"you own. Q. DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Subparagraphs A.2.m. of SECTION 0/ -- BUSI- NESS AUTO CONDITIONS is deleted and re- placed by: e+p|aoedby: a. In the event of "accident", claim, "suit" or "loas", you. your insurance manager or any other person you designate must give msorour authorized represemtatiwe prompt notice of such "aocident'or"|osa" Include: (1) How, when and where the "accident" or "loss" occurred; (2) The "insureds" name and address- and (3) Tothe extent posoib|e, the names and ad- dresses of any injured persons and wit- nesses. Knowledge of an "accident" or "loss" by your agent, servant or "employee' shall not beconm|d- ered knowledge by you unless you, your insurance manager or any other person you designate has received notice of the "accident" or "loss" from your agent, servant, or"amp/oyee." R. WAIVER OF SUBROGATION SECTION |V -- BUSINESS AUTO CONCXI- T|ONS——A. 5. Transfer of Rights ofRecovery Aga |mst Others to Us is amended as follows: This condition does not apply to any person or or- ganization to which you waived this condition by written contract or agreement, but only to the ex- tent that subrogation is waived prior to the ''aoci- dent" or"|oso" under acontract with that person or organization. S. UNINTENTIONAL FAILURE TO DISCLOSE HAZ- ARDS Any unintentional failure to disclose all exposures or hazards existing as of the effective dote of the Business Auto Coverage Form or at any time dur- ing the policy period will not invalidate or adversely affect the coverage for such exposure or hazard. Hovwevac you must report the undisclosed expo- sure orhazard to un as soon asreasonably possi- ble after its discovery. T. EXTENDED EMPLOYEE HIRED AUTO PHYSICAL DAMAGE Paragraph B.5.b' Other |msanmmcm of SECTION |V -- BUSINESS AUTO CONDITIONS isdeleted and replaced bythe following: b- For Hired Auto Physical Damage Cover- age, the following one deemed to be cov- ered 1. Any cm& -red "auto' you (ease hire, rent orborrow; and 2. Any covered "ouh±' hired or rented by your "employee" under e contract in that (ndiNdua| "employee's" nmme, with your ponnies|on, while performing du- ties related to the conduct of your business. Hovwewsr, any "auto/' that is |eased, hired. rented or borrowed with a driver is not covered "auto". U. POLICY PERIOD, COVERAGE TERRITORY Paragraph B.7.Policy Period, Coverage Territo- ry of SECTION IV --BUSINESS AUTO CONDI- TIONS |sdeleted and replaced by'. 7. Policy Period, Coverage Territory Under this Coverage Fonn, we cowar "acci- dents" and "losses" occurring - a. During the policy period shown |nthe Dem- |mrations and b. Within the coverage territory. The coverage territory is: a. The United States of America: b. The territories and possessions of the United States of America, o. Puerto R|co- . d. Canada;and a. Anywhere |nthe world if Paragraph B.2. Concealment, Misrepresentation (1) A cmvand "auto is leased, hired, OrFraud |nSECTION IV—BUSYNESS AUTO rented or borrowed fora period of 30 CONDITIONS is amended byadding the following: days or less* and Includes copyrighted material ofInsurance Semioea Office, Inc., (2) The "inoured's" responsibility to pay damages is determined in o "suit" on the merits, in the United States of Amehos, the territories and posses- sions of the United States ofAmerica, Puerto Rico, orCanada or|nasettle- ment weagree to. We also cover "loss" to. or "accidents" |nvo|Wng, a covered "auto" vvh||n being transported between any ofthese places. V. DEFINITION OF BODILY INJURY AMENDED Paragraph C.ofSECTION \/--DEFINITIONS is amended toinclude: "Bodily Injury" includes mental anguish or other mental injury resulting from "bodily injury." Howev- er, no coverage is proNdedfor mental anguish or mento/ injury absent physical injury. None of the extensions pro\Aded under this cover- age endorsement apply if coverage is more specifi- cally identified elsewhere in the policy orendonee- ments. for which a premium charge is made or a higher limit |aident|fied.Under nocircumstances |a any limit proWdod under this extension to be com- bined with e limit provided elsewhere in the policy or endorsements. Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 6 with its permission. AH CA 85 900@17 COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance — Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". CA 04 49 11 16 0 Insurance Services Office, Inc., 2016 Page 1 of 1 WORKERS COMPENSATION AND LOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be otherwise due. Person or Organization ANY PERSON/ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT 3 % of the total California Workers' Compensation premium Schedule Job Description ALL CALIFORNIA OPERATIONS This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the porky.) Endorsement Effective 05/06/202;1 Policy No. WSA 5048153 0 2 Endorsement No. Insured GENTRY GENERAL ENGINEERING INC Premium $ INCL. Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 99 06 34 (Ed. 8-00) INSURED