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HomeMy WebLinkAbout303367 CLEAN ENERGY - INSURANCE CERTIFICATE (4)OP ID: RG ACOQO' CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 11/29/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 310-356-8201 Dodge Insurance Services Inc. 310-316-1825 DBA: Arroyo Insurance Services Torrance Blvd., Suite 305 Torrance, CA 90503 Torrance, John M. Moody NAMEACT Rosemary Gomez PHONE 310-356-8218 ac No : 310-316-1825 AIC No Ea[: E MAIL - ADDRESS: rosema arro oins.com PRODUCER CLEAN-1 CUSTOMER ID#: INSLI AFFORDING COVERAGE NAIC # INSURED Clean Energy, A CA Corp. INSURERA: Federal Insurance Co 20281 3020 Old Ranch Parkway #400 Seal Beach, CA 90740 INSURER B: INSURER C INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MMIDDPOLICYIYYYY MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I —XI OCCUR X DED BI/PD $150000 35816898 11/30/11 11/30/12 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,00 MED EXP (Any one person) $ 10,00 PERSONAL BADV INJURY $ 1,000,00 X EMPLOYEE BENEFITS GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER-. POLICY X P"OTRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 Emp Ben $ 1,000,00 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 73521989 11I30111 11/30/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ Physical Dam $ 2,50 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 79860791 11130111 11130112 EACH OCCURRENCE $ 6,000,00 AGGREGATE $ 6,000,00 DEDUCTIBLE RETENTION $ None $ X $ A WORKERS COMPENSATION ANO EMPLOYERS' LIABILITYLIM ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe Under DESCRIPTION OF OPERATIONS below N I A 71736418 11/30/11 11/30/12 X WC STATU- OTH- E.L. EACH ACCIDENT It 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 EL DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) RE: Site #590 - 117 N. Mason, Fort Collins, CO 80524 City's Director of Purchasing Risk Management 215 N. Mason 2nd Floor Fort Collins, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �lZ. � ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD Liability Insurance Endorsement Policy Period Effective Date Policy Number Insured Name of Company Date Issued This Endorsement applies to the following forms: GENERAL LIABILITY NOVEMBER 30, 2011 TO NOVEMBER 30, 2012 NOVEMBER 30, 2011 613 IT-w:ro"T CLEAN ENERGY, A CA CORPORATION FEDERAL INSURANCE COMPANY NOVEMBER 30, 2011 In Under Conditions, the following condition is added. Conditions Other Insurance — If you agree, in a written contract, agreement or permit, to provide primary insurance for any Primary Additional person or organization included in Who Is An Insured, this Other Insurance — Primary Additional Insured Insured condition applies. If other valid and collectible insurance is available to the insured for loss we would otherwise cover under this insurance, our obligations are limited as follows. Primary Insurance This insurance is primary. We will not seek contributions from any other insurance available to the person or organization with whom you agree to include in Who Is An Insured, except when the Excess Insurance provision applies. Excess Insurance This insurance is excess over any other insurance, whether primary, excess, contingent or on any other basis: A. that is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar insurance for your work; Liability Insurance Other Insurance — Primary Additional Insured continued Form 80-02-2653 (Ed. 4-01) Endorsement Page 1 Conditions Other Insurance — B. that is insurance that applies to property damage to premises rented to you or temporarily Primary Additional occupied by you with permission of the owner; Insured (continued) C. if the loss arises out of aircraft, autos or watercraft (to the extent not subject to the Aircraft, Autos Or Watercraft exclusion); D. that is insurance: 1. provided to you by any person or organization working under contract or agreement for you; or 2. under which you are included as an insured; or E. that is insurance under any Property section of this policy. When this insurance is excess, we will have no duty to defend the insured against any suit if any other insurer has a duty to defend such insured against such suit. If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of loss, if any, that exceeds the sum of the total: • amount that all other insurance would pay for loss in the absence of this insurance; and • of all deductible and self -insured amounts under all other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not negotiated specifically to apply in excess of the Limits Of Insurance shown in the Declarations of this insurance. Method of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this method each insurer contributes equal amounts until it has paid its applicable limits of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limits of insurance to the total applicable limits of insurance of all insurers. All other terms and conditions remain unchanged. Authorized Representative Liability Insurance Other Insurance — Primary Additional Insured last page Form 80-02-2653 (Ed. 4-01) Endorsement Page 2 OP ID: RG CERTIFICATE OF LIABILITY INSURANCE DAT11/29DYYYY) 11/29/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 310-356-8201 Dodge Insurance Services Inc. 310-316-1825 DBA: Arroyo Insurance Services NAMEACT Rosemary Gomez PNGNE 310-356-8218 FAx IPA No ESI : AIc No: 310-316-1825 E-MAIL rOSema arr0 OInS.COm ADDRESS: 3510 Torrance Blvd., Suite 305 Torrance, CA 90503 John M. Moody PRODUCER CLEAN-1 CUSTOMER ID #: INSURERS AFFORDING COVERAGE NAIC # INSURED Clean Energy, A CA Corp. INSURERA:Federal Insurance Co 20281 3020 Old Ranch Parkway #400 Seal Beach, CA 90740 INSURER B: INSURER C INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN$R LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MM POLICY EFF IDD YYYY) POLICY EXP (MMIDDIYYYYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_1 OCCUR X DED BI/PD $150000 35816898 11/30/11 11/30/12 EACH OCCURRENCE $ 1,000,00 DAMA TETO RENTED PREMISES Ea occurrence $ 1,000,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 X EMPLOYEE BENEFITS GENERAL AGGREGATE $ 2,000,00 GENL AGGREGATE LIMIT APPLIES PER'. PRO LOG POLICY X JECT PRODUCTS - COMPIOP AGG $ 2,000,00 Emp Ben $ 1,000,00 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 73521989 11/30/11 11/30/12 COMBINED SINGLE LIMIT (Ea accldenp $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per aooidenl) $ PROPERTY DAMAGE (Per accident) $ X X $ Physical Dam $ 2,50 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 79860791 11I30111 11I30/12 EACH OCCURRENCE $ 6,000,00 AGGREGATE $ 6,000,00 oeoucrleLE RETENTION $ None $ X $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERXECUTIVE / OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 71736418 11/30/11 11/30/12 X WC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) RE: Site #3971 - Clean Scapes - 7308 7th Ave., South Seattle, WA 98108 Clean Scapes Chris Martin 5939 4th Ave South Seattle, WA 98108 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD OP ID: RG gCOR p' CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 11/29111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 310-356-8201 Dodge Insurance Services Inc. 310-316-1825 DBA: Arroyo Insurance Services 3510 Torrance Blvd., Suite 305 Torrance, CA 90503 John M. Moody CONTACT NAME; Rosemary Gomez PNONE 310-356-8218 FAX AIC No Eat: A/c No: 310-316-1825 E-MAIL ADDREss._rosemaryg@arroyoins.com PRODUCER CUSTOMER ID CLEAN-1 p: INSURERS AFFORDING COVERAGE NAIC a INSURED Clean Energy, A CA Corp. 3020 Old Ranch Parkway #400 Seal Beach, CA 90740 INSURER A: Federal Insurance Co 20281 INSURER B INSURER C INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR X 35816898 11/30/11 11/30/12 DAMAGETORENTED PREMISES Ea occurrence $ 1,600,00 MED EXP (Any one person) $ 10,00 X DED BI/PD $150000 PERSONAL BADV INJURY $ 1,000,00 X EMPLOYEE BENEFITS GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPIOP AGG $ 2,000,0010 POLICY X PRO LOC Emp Ben $ 1,000,00 A AUTOMOBILE LIABILITY ANY AUTO X 73521989 11/30/11 11/30/12 COMBINED SINGLE LIMIT lea accident) S 1,000,00 X BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accideri $ SCHEDULED AUTOS HIRED AUTOS X PROPERTY DAMAGE (Per accident) $ X $ NON -OWNED AUTOS Physical Dam $ 2,50 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 6,000,00 AGGREGATE $ 6,000,06 A EXCESS LIAB CLAIMS -MADE X 79860791 11130111 11/30/12 DEDUCTIBLE g X $ RETENTION $ None A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? N / A 71736418 11/30/11 11/30/12 WC STATU- OTH- X E.L. EACH ACCIDENT $ 1,000,06 E. L. DISEASE - FA EMPLOYEE $ 1,000,09 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT S 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) RE:Job Site #389-23923 S. Figueroa St., Carson, CA 90745. Certificate holder is included as additional insured with respects to general liability per endorsement 42-02.0038 (ed.80-89) and 16-02-0292 (ed. 9-10) attached to the policy. Primary wording applies per form #80-02.2653 (ed.4-01). County Sanitation Districts of Los Angeles County 1955 Workman Mill Rd. Whittier, CA 90601 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �,�D.a� ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD Energy Industries r_-Hucaum Insurance Group Endorsement Policy Period NOVEMBER 30, 2011 TO NOVEMBER 30, 2012 Effective Date NOVEMBER 30, 2011 Policy Number 3581-68-98 DAL Insured CLEAN ENERGY, A CA CORPORATION Name of Company FEDERAL INSURANCE COMPANY Date Issued NOVEMBER 30, 2011 Additional Premium Return Premium BLANKET ADDfnONAL INSURED This endorsement applies to the following form: 42-02-1004 General Liability Who is an Insured Designted Person or Organization Under Who is an Insured, the following provision is added: Any person or organization designated below is an Insured, but they are insureds only with respect to their liability arising out of your acts or failure to act. DESIGNATED PERSON OR ORGANIZATION Any person or organization, when required by written contract signed prior to the date of an occurrence covered by this policy arising out of operations of the insured. cominued Form 42-02-0038 (Ed. 8-69) Endorsement Page 1 All other terms and conditions remain unchanged. �•-�-��� cuuumemenr Page 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM This endorsement modifies the Business Auto Coverage Form. 1. EXTENDED CANCELLATION CONDITION Paragraph A.2.b. —CANCELLATION - of the COMMON POLICY CONDITIONS form IL 00 17 is deleted and replaced with the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. 2. BROAD FORM INSURED A. Subsidiaries and Newly Acquired or Formed Organizations As Insureds The Named Insured shown in the Declarations is amended to include: 1. Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance. 2. Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (a) That is an "insured" under any other automobile policy; (b) That has exhausted its Limit of Insurance under any other policy; or (c) 180 days or more after its acquisition or formation by you, unless you have given us written notice of the acquisition or formation. Coverage does not apply to "bodily injury" or "property damage" that results from an "accident" that occurred before you formed or acquired the organization. B. Employees as Insureds Paragraph A.I. —WHO IS AN INSURED —of SECTION II —LIABILITY COVERAGE is amended to add the following: d. Any "employee" of yours while using a covered "auto" you don't own, hire or Form: 16-02-0292 (Ed. 9-10) borrow in your business or your personal affairs. C. Lessors as Insureds Paragraph A.1. —WHO IS AN INSURED —of SECTION II —LIABILITY COVERAGE is amended to add the following: e. The lessor of a covered "auto" while the "auto" is leased to you under a written agreement if: (1) The agreement requires you to provide direct primary insurance for the lessor; and (2) The "auto" is leased without a driver. Such leased "auto" will be considered a covered "auto" you own and not a covered "auto" you hire. However, the lessor is an "insured" only for "bodily injury" or "property damage" resulting from the acts or omissions by: 1. You; 2. Any of your "employees" or agents; or 3. Any person, except the lessor or any "employee" or agent of the lessor, operating an "auto" with the permission of any of 1. and/or 2. above. D. Persons And Organizations As Insureds Under A Written Insured Contract Paragraph A.1 —WHO IS AN INSURED —of SECTION II —LIABILITY COVERAGE is amended to add the following: f. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed under an express provision in a written "insured contract", written agreement or a written permit issued to you by a governmental or public authority to add such person or organization to this policy as an "insured". However, such person or organization is an "insured" only: Page 1 of 4 "Includes copyrighted material of Insurance Services Office, Inc. with its permission" 3. 9 5. (1) with respect to the operation, maintenance or use of a covered "auto"; and (2) for "bodily injury" or "property damage" caused by an "accident" which takes place after: (a) You executed the 'insured contract" or written agreement; or (b) The permit has been issued to you. FELLOW EMPLOYEE COVERAGE EXCLUSION 5. - FELLOW EMPLOYEE - of SECTION II —LIABILITY COVERAGE does not apply. PHYSICAL DAMAGE —ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph AAa. —TRANSPORTATION EXPENSES — of SECTION III —PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $50 per day for temporary transportation expense, subject to a maximum limit of $1,000. AUTO LOAN/LEASE GAP COVERAGE Paragraph A. 4. —COVERAGE EXTENSIONS - of SECTION III —PHYSICAL DAMAGE COVERAGE is amended to add the following: c. Unpaid Loan or Lease Amounts In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the loan or lease for a covered "auto" minus: 1. The amount paid under the Physical Damage Coverage Section of the policy; and 2. Any: a. Overdue loan/lease payments at the time of the "loss"; b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; c. Security deposits not returned by the lessor: d. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and e. Carry-over balances from previous loans or leases. We will pay for any unpaid amount due on the loan or lease if caused by: 1. Other than Collision Coverage only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; 2. Specified Causes of Loss Coverage only if the Declarations indicate that Specified Causes of Loss Coverage is provided for any covered "auto", or 3. Collision Coverage only if the Declarations indicate that Collision Coverage is provided for any covered "auto". Form: 16-02-0292 (Ed. 9-10) 6. RENTAL AGENCY EXPENSE Paragraph A. 4. —COVERAGE EXTENSIONS —of SECTION III —PHYSICAL DAMAGE COVERAGE is amended to add the following: d. Rental Expense We will pay the following expenses that you or any of your "employees" are legally obligated to pay because of a written contract or agreement entered into for use of a rental vehicle in the conduct of your business: MAXIMUM WE WILL PAY FOR ANY ONE CONTRACT OR AGREEMENT: 1. $2,500 for loss of income incurred by the rental agency during the period of time that vehicle is out of use because of actual damage to, or "loss" of, that vehicle, including income lost due to absence of that vehicle for use as a replacement; 2. $2,500 for decrease in trade-in value of the rental vehicle because of actual damage to that vehicle arising out of a covered 'loss"; and 3. $2,500 for administrative expenses incurred by the rental agency, as stated in the contract or agreement. 4. $7,500 maximum total amount for paragraphs 1., 2. and 3. combined. 7. EXTRA EXPENSE —BROADENED COVERAGE Paragraph A.4. —COVERAGE EXTENSIONS —of SECTION III —PHYSICAL DAMAGE COVERAGE is amended to add the following: e. Recovery Expense We will pay for the expense of returning a stolen covered "auto" to you. 8. AIRBAG COVERAGE Paragraph B.3.a. -EXCLUSIONS —of SECTION III —PHYSICAL DAMAGE COVERAGE does not apply to the accidental or unintended discharge of an airbag. Coverage is excess over any other collectible insurance or warranty specifically designed to provide this coverage. 9. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT - BROADENED COVERAGE Paragraph BA. - EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE is deleted and replaced with the following: 4. We will not pay for "loss" to any of the following: a. Tapes, records, discs or other similar audio, visual or data electronic devices designed for use with audio, visual or data electronic equipment. b. Any device designed or used to detect speed -measuring equipment such as radar or laser detectors and any jamming apparatus intended to elude or disrupt speed -measuring equipment. Page 2 of 4 "Includes copyrighted material of Insurance Services Office, Inc, with its permission" 10. 11. c. Any electronic equipment, without regard to whether this equipment is permanently installed, that reproduces, receives or transmits audio, visual or data signals. d. Any accessories used with the electronic equipment described in paragraph c. above. Exclusions 4.c. and 4.d. do not apply to equipment designed to be operated solely by use of the power from the "auto's" electrical system that, at the time of "loss", is: a. Permanently installed in or upon the covered "auto",- b. Removable from a housing unit which is permanently installed in or upon the covered "auto"; c. An integral part of the same unit housing any electronic equipment described in Paragraphs a. and b. above, or d. Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system. $2,000 is the most we will pay for "loss" in any one "accident" to all electronic equipment that reproduces, receives or transmits audio, visual or data signals which, at the time of "loss", is: a. Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; b. Removable from a permanently installed housing unit as described in Paragraph 2.a. above or is an integral part of that equipment; or c. An integral part of such equipment. GLASS REPAIR —WAIVER OF DEDUCTIBLE Under Paragraph D. - DEDUCTIBLE —of SECTION III —PHYSICAL DAMAGE COVERAGE the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. TWO OR MORE DEDUCTIBLES Paragraph D.- DEDUCTIBLE —of SECTION III — PHYSICAL DAMAGE COVERAGE is amended to add the following: If this Coverage Form and any other Coverage Form or policy issued to you by us that is not an automobile policy or Coverage Form applies to the same "accident", the following applies: 1. If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible, it will be waived; or Form: 16-02-0292 (Ed. 9-10) 2. If the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. 12. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUITOR LOSS Paragraph A.2.a. - DUTIES IN THE EVENT OF AN ACCIDENT, CLAIM, SUIT OR LOSS of SECTION IV - BUSINESS AUTO CONDITIONS is deleted and replaced with the following: a. In the event of "accident", claim, "suit" or "loss you must promptly notify us when the "accident" is known to: (1) You or your authorized representative, if you are an individual; (2) A partner, or any authorized representative, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer, insurance manager, or authorized representative, if you are an organization other than a partnership or limited liability company. Knowledge of an "accident", claim, "suit" or "loss" by other persons does not imply that the persons listed above have such knowledge. Notice to us should include: (1) How, when and where the "accident" or "loss" occurred; (2) The insured's name and address; and (3) To the extent possible, the names and addresses of any injured persons or witnesses. 13. WAIVER OF SUBROGATION Paragraph A.5. -TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US of SECTION IV —BUSINESS AUTO CONDITIONS is deleted and replaced with the following: 5. We will waive the right of recovery we would otherwise have against another person or organization for "loss" to which this insurance applies, provided the "insured" has waived their rights of recovery against such person or organization under a contract or agreement that is entered into before such "loss". To the extent that the "Insured's" rights to recover damages for all or part of any payment made under this insurance has not been waived, those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after "accident" or "loss" to impair them. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. Page 3 of 4 "Includes copyrighted material of Insurance Services Office, Inc. with its permission" 14. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Paragraph B.2. —CONCEALMENT, MISREPRESENTATION or FRAUD of SECTION IV —BUSINESS AUTO CONDITIONS - is deleted and replaced with the following: If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not void coverage under this Coverage Form because of such failure. 15. AUTOS RENTED BY EMPLOYEES Paragraph B.5. -OTHER INSURANCE of SECTION IV —BUSINESS AUTO CONDITIONS - is amended to add the following: e. Any "auto" hired or rented by your "employee" on your behalf and at your direction will be considered an "auto" you hire. If an "employee's" personal insurance also applies on an excess basis to a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the "employee's" personal insurance. Form: 16-02-0292 (Ed. 9-10) 16. HIRED AUTO —COVERAGE TERRITORY Paragraph B.7.e. (1) - POLICY PERIOD, COVERAGE TERRITORY of SECTION IV — BUSINESS AUTO CONDITIONS is deleted and replaced with the following: (1) A covered "auto" of the private passenger type is leased, hired, rented or borrowed without a driver for a period of 45 days or less; and 17. RESULTANT MENTAL ANGUISH COVERAGE Paragraph C. of - SECTION V—DEFINITIONS is deleted and replaced by the following: 'Bodily injury" means bodily injury, sickness or disease sustained by any person, including mental anguish or death as a result of the "bodily injury" sustained by that person. Page 4 of 4 "Includes copyrighted material of Insurance Services Office, Inc. with its permission"