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484523 AVI PC DBA AVI ENGINEERING PC - INSURANCE CERTIFICATE
AVIPCAV-01 TIRWADKARV CERTIFICATE OF LIABILITY INSURANCE DA5/9/012rr) 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 endomement(s). PRODUCER Willis of Wyoming, Inc. U026 Century Blvd. P.O. Box 305191 Nashville, TN 37230-5191 CONTACT NAME: PHONE 877 945-7378 FAX 888 467-2378 (WC, No,.Est):( JINC. No):( J ADDRESS: INSURERS) AFFORDING COVERAGE NAICp INSURERA:Travelers Indemnity Company INSURER B : Travelers Property Casualty Company Of America 25658 25674 _ INSURED �� AV] PC dba AVI Engineering PC INSURER c:Travelers Indemnity Co. of America 25666 INSURER D: 1103 Old Town Lane, Suite 101 INSURER E : Cheyenne, WY 82009 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 ADDL SUER POLICY EFF POLICY UP LTR TYPE OF INSURANCE INSR VND POLICY NUMBER (MMIODlYYYY) fMMIDD/YYYYJ LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X 6808686X4661ND12 9/812012 518/2013 DAMAGES(Ed E6 occurrence PREMISES Ea E 300,000 CLAIMS -MADE FXI OCCUR MED UP (Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO- n LOC JECT $ LIJUHLITY COMBINED SINGLE LIMIT (Ea accident E 1,000,000' BODILY INJURY(Per person) $ B ANY AUTO X BA868SX63812GRP 5/8/2012 51812013 ALL CANNED ,SCHEDULED NO.OBILE BODILY INJURY (Per accident) E AUTOS AUTOS NONLNNED PROPERTY DAMAGE Per amdent E HIRED AUTOS AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE CUP3711T4061247 5/8/2012 5l8/2013 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION WC STATU- OTH- TORY_UMITS X ER ANDEMPLOYERS' LIABILITY YIN E.L. EACH ACCIDENT $ 1,000,000 C ANY PROPRIETORIPARTNERIEXECUTIVE XHUB3711T39912 5/812012 5/812013 OFFICERNEMBER EXCLUDED' R NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 1,000,000 Ity desvl0e under DESCRIPTION OF OPERATIONShelox EL DISEASE - POLICY LIMIT E 1,000,000' A Stop Gap - Empl Liab 6808686X466IND12 5/8/2012 5/8/2013 SEE ATTACHED DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schetlule, a more space is required) The City of Fort Collins, its officers, agents and employees are named as Additional Insureds on the General Liability and Auto Liability insurance policies in respect to: Larimer Co. Rd 15/Rawhide Flats Road project. City of Fort Collins Attn: Mark Sears P.O. Box 580 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 REPRESENTATNE 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABIL,.' However, this exclusion does not apply to your liability with respect to your conduct of the business of any current or past partner- ship or joint venture: a. That is not shown as a Named Insured in the Common Policy Declarations, and . b. In which you are a member or partner where each and every one of your co - ventures In that join( venture is an archi- tectural, engineering, or surveying firm. 2. This Provision P. does not apply to any per- son or organization for which coverage Is ex- cluded by another endorsement to this Cov- erage Part. 3. The Insurance provided by this Provision P. shall be excess over any valid end collectible other insurance, whether primary, excess, contingent or on any. other basis, which is available covering your liability with respect to your conduct of the business of any current or past partnership or joint venture that is not shown as a Named Insured in the Common Policy Declarations and which is Issued to such partnership or joint venture. Q. PER PROJi_CT GENERAL AGGREGATE LIMIT t. Paragraph 2. of LIMITS OF INSURANCE (Section III) is deleted and replaced by the following: The General Aggregate Limit Is the most we will pay for the sum of; a. Damages under Coverage B; and b. Damages from "occurrences" under Cov- erage A and for all medical expenses caused by accidents under Coverage C which cannot be attributed only to opera - dons at a single "project". 2. The following is added to LIMITS OF IN- SURANCE (Section 111): A separate Per Project General Aggregate Limit applies to each "project" for.all sums which the Insured becomes legally obligated to pay as damages caused by "occurrences" under Coverage A and for all medical ex- penses caused by accidents under Coverage C which can be attributed only to operations at a single "project", and that limit Is equal to the amount of the General Aggregate Limit shown In the Declarations for this Coverage Part. Any payments made under Coverage A for damages and under Coverage C for medical expenses shall reduce the Per Project Gen- eral Aggregate Limit for that "project", but shall not reduce: a. Any other Per Project General Aggregate Limit for any other "protect'; b. The General Aggregate Limit; or c.. The Products -Completed Operations Ag- gregate Limit.. The limits shown In the Declarations for this Coverage Part for Each Occurrence, Dam- age To Premises Rented To You and Medical Expense are also .subject to the Per Project General Aggregate Limit when the Per Pro- ject General Aggregate Limit applies. 3. As used In the Provision Q.: "Project" means an area away from promises owned by of rented to you at which you are ..performing operations pursuant to a contract or agreement. For the purposes of determin- ing the applicable aggregate Iimit.of Insur- ance, each "project" that Includes promises Involving the same' or connecting lots, or premises whose connection .is interrupted only by a street, roadway, waterway or right. of-wayof a railroad shall be considered a sin, We "project'. R. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE The following Is added to Paragraph 2. Duties in The Event of Occurrence, Offense, Claim Or Suit of COIVINIERCIAL GENERAL LIABILITY CONDITIONS (Section IV): Notice of an "occurrence" or of an offense which may result in a claim must be given as soon as practicable after knowledge -of the "occurrence" or offense has been reported to you, one of your "executive officers" (if you are a corporation), one of your partners who Is an Individual of you are a partnership), one of your managers Of you are a limited liability company),. one of your trustees who is an Individual of you are a trust), or an "employee" (such as an Insurance, loss control or risk.manager or administrator) designated by you to give such notice. Knowledge by any other "employee" of an "occur- rence" or offense does not Imply that you also have such knowledge. Page 6 of 8 0 2007 The Travelers Campenles, Inc, 004011 CG D3 79 09 07 Notice of an "occurrence" or of an offense which may result In a claim will be deemed to be given as soon as practicable to us if It Is given in good faith as soon as practicable to your workers' com- pensation, accident, or health Insurer. This ap- plies only If you subsequently give notice of the "occurrence" or offense to us as soon as practi- cable after you, one of your "executive officers" (If you are a corporation), one of your partners who is an Individual (f .you are a partnership), one of your managers (if you are a limited liability, company), one of your tmstess who, is, an indlvid- uat (If you are a trust), or an 'employee" (such, as an Insurance,,loss control or risk manager or ad- ministrator) designated by you to give such notice discovers that the "occurrence" or offense may Involve this policy. S. UNINTENTIONAL OMISSION 1. The following Is added to Paragraph 6. Rep- resentations of COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): The 'unintentional omission of, or uninten- tional error in, any Information provided by you which we relied upon in issuing this pol- Icy shall not prejudice your rights under this Insurance. 2. This Provision S. does not affect our right to . collect additional premium or to exercise our right of cancellation or nonrenewal in accor. dance with applicable insurance laws or regu- lations. T. WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST,OTHERS TO US WHEN REQUIRED BY CONTRACT OR AGREEMENT The following is added to Paragraph 8. Transfer .of Rights of Recovery Against Others to Lis of COMMERCIAL GENERAL LIABILITY CONDI- TIONS (Section IV):-_ We waive any rights of recovery we may have against .any person or organization because of payments we make for "bodily Injury", "property damage", "personal injury" or "advertising injury" arising out of: 1. Premises owned by you, temporarily occu- pied by you with permisslon of the owner, or leased or rented to you; 2. Ongoing operations performed by you, or on your behalf, under a'contract or agreement with that person or.organization; 3.. "Your work"; or C�. .IERCIAL GENERAL LIABILITY 4. "Your products". We waive these rights only where you have agreed to do so as part of a contract or agree- ment entered Into by you before, and in effect when, the "bodily injury" or "property damage" occurs, orihe."personal Injury" offense or"adver- tising Injury" offense Is committed. U. AMENDED BODILY INJURY DEFINITION The definition of "bodily injury" In DEFINITIONS (Section V) is deleted and replaced by the follow- ing: "Bodily Injury" means: a. Physical harm, including sickness or disease, sustained bye person; b. Mental anguish, Injury or Illness, or emotional distress, resulting at any time from such physical harm, sickness or disease; or . c. Cara; loss of services or death resulting at .anytime from such physical harm, sickness or disease. V. AMENDED INSURED CONTRACT DEFINITION — RAILROAD EASEMENT 1. Subparagraph c. of the definition of "Insured contract".in DEFINITIONS (Section V) Is de- leted and replaced by the following: c. Any easement or license agreement; 2. Subparagraph f.(1) of the definition of "In- sured contract' In DEFINITIONS (Section V) Is deleted. W. AMENDED PROPERTY DAMAGE DEFINITION -- TANGIBLE. PROPERTY The definition of "property damage" In DEFINI- TIONS (Section V) Is deleted and replaced by the following: "Property damage" means — -- a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused It; or b. Loss of use of tangible property that is not physically Injured. All such loss of use shall be deemed to occur at the time of.the "occur- renee" that caused It. For the purposes of this Insurance, tangible prop• erty does not Include data. ' CG D3 79 09 07 © 2007 The Travelers companies. [no. Page 7 of 8 COMMERCIAL GENERAL LIAK.,, X. The following defin tion is added to SECTION V — DEFINITIONS: "Contract or agreement requiring Insurance" means that part of .any contract or agreement under.which you are required to Include a person or organization as an additional insured on this Coverage Part, provided that the 'bodily Injury" and "property damage". occurs, and the "personal Injury" is caused by an offense committed: a. After you have entered into that contract or agreement; b. .While that part of the contract or agreement Is in effect; and c. Before the end of the policy period. COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following'listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BLANKET ADDITIONAL INSURED B. EMPLOYEE HIRED AUTO C. EMPLOYEES AS INSURED D. SUPPLEMENTARY PAYMENTS —INCREASED LIMITS E. TRAILERS — INCREASED LOAD CAPACITY F. HIRED AUTO PHYSICAL DAMAGE G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT A. BLANKET ADDITIONAL INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COV- ERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or- ganization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. B. EMPLOYEE HIRED AUTO H. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT— INCREASED LIMIT I. WAIVER OF DEDUCTIBLE — GLASS J. PERSONAL EFFECTS K. AIRBAGS L. AUTO LOAN LEASE GAP M. BLANKET WAIVER OF SUBROGATION performing duties related to the conduct of your business. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while perform- ing duties related to the conduct of your business. However, any "auto" that is leased, hired, 1. The following is added to Paragraph A.1., rented or borrowed with a driver is not a Who Is An Insured, of SECTION II — LI- covered "auto". ABILITY COVERAGE: An "employee" of yours is an "insured" while C. EMPLOYEES AS INSURED operating a :covered "auto" hired or rented The following is added to Paragraph A.1., Who Is under a contract or agreement in that "em- An Insured, of SECTION II — LIABILITY COV- ployee's" namey'with your permission, while ERAGE: CA T4 20 07 10 02010 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 003348 COMMERCIAL AUTO Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. D. SUPPLEMENTARY PAYMENTS —INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2) of SECTION II — LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4) of SECTION If — LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, Including actual loss of earnings up to $500 a day be- cause of time off from work. E. TRAILERS — INCREASED LOAD CAPACITY The following replaces Paragraph CA. of SEC- TION I — COVERED AUTOS: (3) If a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. (4) A deductible equal to the highest Physical Damage deductible applicable to any owned covered "auto". (5) This Coverage Extension does not apply to: (a) Any "auto" that is hired, rented or bor- rowed with a driver, or (b) Any "auto" that is hired, rented or bor- rowed from your "employee". G. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT 1. "Trailers" with a load capacity of 3,000 H. pounds or less designed primarily for travel on public roads. F. HIRED AUTO PHYSICAL DAMAGE The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Hired Auto Physical Damage Coverage If hired "autos" are covered "autos" for Liability Coverage but not covered "autos" for Physical Damage Coverage, and this policy also provides Physical Damage Coverage for an owned "auto", then the Physical Damage Coverage is extended to "autos" that you hire, rent or borrow subject to the following: (1) The most we will pay for "loss" in any one "accident" to a hired, rented or borrowed "auto" is the lesser of: (a) $50,000; (b) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (c) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. (2) An adjustment for depreciation and physical . condition will be made in determining actual cash value in the event of a total "loss". The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT —INCREASED LIMIT Paragraph C.2.. Limit Of Insurance, of SEC- TION III — PHYSICAL DAMAGE COVERAGE is deleted. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. J. PERSONAL EFFECTS The following is added to Paragraph AA., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Effects Coverage We wilt pay up to $400 for "loss" to wearing ap- parel and other personal effects which are: (1) Owned by an "insured"; and (2) In or on your covered "auto". This coverage only applies in the event of a total theft of your covered "auto". No deductibles apply to Personal Effects cover- age. Page 2 of 3 02010 The Travelers Indemnity Company. Ali rights reserved. CA T4 20 07 10 Includes copyrighted material of Insurance Services Office, Inc. with its permission. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to 'loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of 'loss" set forth in Paragraphs A.t.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. AUTO LOAN LEASE GAP The following is added to Paragraph A.4., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Auto Loan Lease Gap Coverage for Private Passenger Type Vehicles In the event of a total "loss" to a covered "auto" of the private passenger type shown in the Schedule or Declarations for which Physical Damage Cov- erage is provided, we will pay any unpaid amount due on the lease or loan for such covered "auto" less the following: (1) The amount paid under the Physical Damage Coverage Section of the policy for that "auto"; and COMMERCIAL AUTO (2) Any: (a) Overdue lease or loan 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 les- sor, (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 orleases. M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract exe- cuted prior to any "accident" or 'loss", pro- vided that the "accident" or "loss" arises out of the operations contemplated by such con- tract. The waiver applies only to the person or organization designated in such contract. CA T4 20 07 10 C 2010 The Travelers Indemnity Company. All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc. with its permisslon. )03349 ADDITIONAL COVERAGE SCHEDULE COVERAGE LIMITS POLICY TYPE: WY Stop Gap Stop gap/Employers Liability - WY CARRIER: Travelers Indemnity Company Bodily Injury by Accident Each Accident - $1,000,000 POLICY TERM: 05/08/2012 — 05/08/2013 Bodily Injury by Disease Aggregate - $1,000,000 POLICY NUMBER: 6808686X4661ND12 Bodily Injury by Disease Each Employee - $1,000,000 CO -a'RICAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY..PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following Is added to WHO IS AN INSURED INSURANCE (Section III) for this Coverage (Section II): Any person or organization that. you agree in 'a "contract or agreement requiring Insurance" to In- clude as an addhlonal Insured on this Coverage Part, but only with respect to liability for "bodily in- jury", "property damage" or "personal Injury" caused, in whole or In part, by your acts or omis- slons or the acts or omissions of those acting on Your behalf. a. In the performance of your ongoing opera- tions; b. in connection with premises owned by or rented to you; or ' C. In connection with "your work" and included within the "products -completed operations hazard". Such person or organization does not.qualify as an additional Insured for "bodily Injury", "property damage" or "personal injury" for which that per- son or organization has assumed liability In.a con- tract or agreement. The Insurance provided to such additional insured Is limited as follows: d. This Insurance does not apply on any basis to any person or organization for which cover- age asanadditional insured specificallyIs added by another endorsement to this Cover- age Part. e. This insurance does not apply to the render- Ing of or failure to render any "professional services". f. :The limits of insurance afforded to the addt- tlonal insured shall be the limits which you agreed In that "contract or agreement requir- ing Insurance" to provide for. that additional Insured, or the limits shown in the Declara- tions for this Coverage Part, whichever are less. This endorsement does not increase the, limits of Insurance stated In the LIMITS OF Part. B. The following Is added to Paragraph a. of d. Other Insurance in 'COMMERCIAL GENERAL LIABILITY CONDITIONS (Section iV)i However, If you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional Insured under this Cov- erage Part must apply on a primary basis, or a primary and non-contributory basis, this Insurance Is primary to other insurance that is available to such additional insdnr d which covers such addi. tional insured as a named Insured, and we will not share with the other insurance, provided that; (1) The "bodily injury' or "property damage" for which coverage Is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring Insurance". But .this. insur- ance still Is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that Is available to the Insured when the insured Is an additional Insured under any other insurance. C. The following is added to Paragraph 8, Transfer ---Of Rights of Recovery -Against Others To "Us In COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV): We waive any rights'of recovery we may have against any person or organization because of payments we make for "bodily Injury", "property damage" or "personal Injury" arising out of "your work" performed by you, or on your behalf, under e "contract or agreement requiring Insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insur- ance" with such person or organization entered into by you before, and In effect when, the "bodily CG D3 8109 07 ® 2007 The.Travelers Companies, Inc. Page 1 of 2 Includes the copyrighted material of Insurance Services Oface, Inc., Kith as permission. IA6221 COMMERICAL GENERAL LIABILi i Y Injury' or "property damage" occurs, or the "per. sonal injury" offense is committed. . D. The following definition is added to DEFINITIONS (Section V): "Contract . or. agreement requiring Insurance means that part of any contract or agreement un- der which you are required to Include a person or organization asan additlonal Insured on this Cov- .Page 2 of 2 erage Part, provided that the "bodily injury" and "property damage." occurs, and the 'personal In- jury" Is caused by an offense committed: a. After you have. entered Into that contract or agreement; b. While that part of the contract or agreement Is In effect; and c. Before the end of the policy period. 02007 The Travelers Companies, Inc. CG D3 8109 07 Includes the copyrighted materiel of InsumnCt Services Circe, Inc., With its permisslon 1 CL 1ERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ARCHITECTS, ENGINEERS AND SURVEYORS XTEND ENDORSEMENT This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE Provisions A. — T. and V. Of this endorsement broaden coverage. Provisions U. and W. of this endorsement may limit coverage. The rOlIDWing Ilsting is a general coverage description only. Ltmftations.and exclusions may apply to these coverages. Read all the PROVISIONS of this endorsement carefully to determine rights, duties, and what is and Is not covered. A. Broadened Named Insured B. Incidental Medical Malpractice C. Reasonable Force — Bodily Injury Or Property Damage' D. Non -Owned Watercraft — Increased To Up To 75 feel E. Aircraft Chartered With Crew` F. Extension Of Coverage — Damage To Premises Rented To You G. Malicious Prosecution — Exception To Knowing . Violation Of Rights Of Another Exclusion H. Medical Payments Limit I. Increased Supplementary Payments' J. Additional Insured — Owner, Manager Or Lessor Of Premises K. Additional Insured — Lessor Of Leased Equipment L. Additional Insured — State Or Political Subdivi- sions — Permits Relating To Premises M. Additional Insured — State Or Political Subdivi- sions —.Permits Relating To Operations PROVISIONS A. BROADENED NAMED INSURED 1. The Named Insured In Item 1. of the.Com. mon Policy Declarations Is amended as fol- lows: The person or organization named in Item 1. of the Common Policy Declarations and any organization, other than a partnership, joint venture, limited liability company or trust, of which you are the sole owner or In which you maintain. the majority ownership interest on the effective date of the policy. However, N. Additional Insured — Architect, Engineer Or Surveyor O, Who Is An Insured — Newly Acquired Or Formed Organizations P.. Who Is An Insured — Unnamed Partnership Or Joint Venture — Excess O. Per Project General Aggregate Limit R. Knowledge And Notice Of .Occurrence Or. offense - S. Unintentional Omission T. Waiver Of Transfer Of Rights Of Recovery Against Others To Us When .Required By Con- tract Or Agreement U. Amended Bodily Injury Definition V. Amended Insured Contract Definition — Railroad Easement W. Amended Property Damage Definition — Tangible Property X. Additional Definition — Contract or Agreement Requiring Insurance coverage,for any such additional organization will cease as of the date, if any, during the . policy period, that you no longer are the sole owner of, or maintain the majority ownership Interest in, such organization. 2. This Provision A. does not apply to any per- son or organization for which coverage Is ex- cluded by another endorsement to this Cov. erage Part.' B. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to Paragraph 1. Insur- ing Agreement of COVERAGE A BODILY CO D3 79 09 07 0 20077he Travelers Companies, Inc. Page 1 of 8 COMMERCIAL GENERAL LIABI. INJURY AND PROPERTY DAMAGE LI- ABILITY in COVERAGES (Section 1): "Bodily Injury" arising out of the rendering of, or failure to render, "first aid" or "Good Sa- maritan services" to a person, other than a co="employee" or "voluntear worker", will be deemed to be caused by an "occurrence", For the purposes of determining the applica- ble limits of Insurance, any act or omission together with all related acts or omissions in the furnishing of the services to any one per- son will be deemed one "occurrence". 2. As used in this Provision B.: a. "First aid" means medical or nursing ser- vice, treatment, advice or instruction; the related furnishing of food or beverages; the furnishing or dispensing of drugs or medical supplies or appliances; b. "Goad Samaritan services" means those medical services rendered or provided In an emergency and for which no remu- neration is demanded or received, 3. Paragraph 2.a,(1)(d) of WHO, IS AN IN- SURED (Section II) does not apply to any of your "employees", who are not employed as a doctor or nurse by you, but only while per- forming the services described in Paragraph 1, above and while acting within the scope of their employment by you. Any such "employ- ees" rendering "Good Samaritan services will be deemed to be acting within the scope of their employment by you. C. REASONABLE FORCE — BODILY INJURY OR PROPERTY DAMAGE The Expected Or Intended Injury Exclusion in Paragraph 2. Exclusions of COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY In COVERAGES (Section 1) is de- leted and replaced by the following: Expected Or Intended Injury Or Damage "Bodily Injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of rea- sonable force to protect any person or property. D. NON -OWNED WATERCRAFT — INCREASED TO UP TO 76 FEET 1. The exception contained In Subparagraph (2) of the Aircraft, Auto Or Watercraft Exclu- sion in 2. Exclusions of COVERAGE 'A BODILY INJURY AND PROPERTY DAM- AGE LIABILITY In COVERAGES (Section 1) Is deleted and replaced by the following: '(2) A watercraft you do not own that is: (a) Less than 75 feet long;'and (b) Not being used to cant persons or Property for a charge; 2. Only as respects the Insurance provided by this Provision D., WHO IS AN INSURED (Section 11) Is amended to include as an in- sured any person who, with your expressed or implied consent,' either uses or Is respon- sible for the use of the watercraft. 4. The following exclusion is ..added to Para-.... 3, The insurance provided by this Provision D. graph 2. Exclusions of COVERAGE A SOD- shall be excess over any valid and collectible ILY INJURY AND PROPERTY DAMAGE other Insurance available to the Insured, LIABILITY In COVERAGES (Section 1): whether primary, excess, contingent or on Sale.of.Pharmaceuticals_ _.-.------- _ any- ny other -basis, .except for Insurance pur- — -- "Bodily Injury" or "property damage" arts- chased specifically by you to apply In excess ing out of the willful violation of a penal of the Limits of Insurance shown in the Decla- statute or ordinance relating to the sale of rations for this Coverage Part. pharmaceuticals committed by or with the knowledge or consent of the Insured. 51 The insurance provided by this Provision B. shall be excess over any valid and collectible other Insurance available to the Insured, whether primary, excess, contingent or on any other basis, except for Insurance pur- chased specifically by you to apply in excess of the Limits of Insurance shown In the Decla- rations for this Coverage Part, E. AIRCRAFT CHARTERED WITH CREW 1. The following is added to the exceptions con- tained In the Aircraft, Auto Or Watercraft Exclusion in Paragraph 2. Exclusions of COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY in COV- ERAGES (Section 1): Aircraft chartered with crew, Including a pilot, to any Insured. Page 2 of 8 ® 2007 The Travelers companies, Inc. 09400 CG D3 79 09 07 2. This Provision E. does not apply if the char. tared aircraft Is owned by any Insured. 3. The insurance provided by this Provision E. shall be excess over any valid and collectible other Insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance pur- chased specifically by you to apply In excess of the Limits of Insurance shown in the Decla- rations for this Coverage Part. F. EXTENSION OF COVERAGE.— DAMAGE TO PREMISES RENTED TO YOU 1. The last paragraph of COVERAGE A BOD- ILY INJURY AND PROPERTY DAMAGE LIABILITY in COVERAGES (Section 1) Is deleted and replaced by the following: Exclusions c, through n. do not apply to dam-. age to premises while rented to you, or tem. porarily occupied by you with permission of the owner, caused by: a. Fire;. b. Explosion; c. Lightning; d. Smoke resulting from such fire, explo- sion, or lightning; or e. Water. A separate limit of insurance applies to this coverage as described In LIMITS OF IN. SURANCE (Section 111). 2, The Insurance under this Provision F. does not apply to damage to premises while rented to' you, or temporarily occupied by You with' permission of. the owner, caused by: a. Rupture, bursting, or operation of pres- sure relief devices; b. Rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from wa- ter; or c. Explosion of steam boilers, steam pipes, steam engines, or steam turbines. 3. Paragraph 6. of LIMITS OF INSURANCE (Section III) is deleted and replaced by the following: Subject to S, above, the Damage To Prem- Ises Rented To You Limit Is the most.we will pay under Coverage A for the sum of all damages. because of "property, damage" to Ct, .IERCIAL GENERAL LIABILITY any one premises while rented to you, or temporarily occupied by you with permission { of the owner, caused by: fire; explosion; light- ning; smoke resulting from such fire, explo- sion, or lightning; or water. The Damage To Premises Rented To You Limit will apply to all "property damage" proximately caused by the same 'occurrence", whether such dam- age results from: fire; explosion; .lightning; smoke reselling from such fire, explosion, or lightning; or water; or any combination of any of these causes. The Damage To Premises Rented To You Limit will be the Higher of: a. $1,000,000; or. b. The amount shown for the Damage To Premises Recited To You Limit In the Declarations forihis Coverage Pad. 4. Paragraph a. of the definition of "insured con- tract" In DEFINITIONS (Section V) Is deleted and replaced by the following: a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of 'Premises that Indemnifies any person or organization for damage to premises while rented to you, or tempo- redly occupied by you with permission of the owner, caused by: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water Is not an "insured contract"; S. This Provision F. does not apply If coverage for. Damage To Premises Rented. To .YOU of COVERAGE A BODILY INJURY AND, PROPERTY DAMAGE LIABILITY In COV. ERAGES (Section 1) is excluded by another endorsement to this Coverage Part. G. MALICIOUS PROSECUTION — EXCEPTION TO KNOWING VIOLATION OF RIGHTS OF AN. OTHER EXCLUSION The followirig is added to the Knowing Violation Of Rights Of Another Exclusion In 2. Exclu- sions of COVERAGE a PERSONAL INJURY, ADVERTISING INJURY AND WEB SITE IN- JURY LIABILITY of the WE XTEND LIABILITY Endorsement: This exclusion does not apply to "personal Injury" caused by malicious prosecution. CG D3 79 09 07 V 2007 The Travelers companies, Inc. Page 3 of 8 COMMERCIAL GENERAL LIABIL, Y H. MEDICAL PAYMENTS LIMIT The Medical Expense Limit shown in the Declare - lions for this Coverage Part is increased to $10,000. I. INCREASED SUPPLEMENTARY PAYMENTS Paragraphs 1,b. and 1.d. of SUPPLEMENTARY PAYMENTS — COVERAGES A AND B in COV ERAGES (Section 1) are amended as follows: 1. In Paragraph 1.b., the amount we will pay for the cost of bail bonds is Increased to $2500. 2. In Paragraph 1.d., the amount we will pay for loss of earnings Is Increased to $50I)a day. K. A ADDITIONAL INSURED — OWNER, MANAGER OR LESSOR OF PREMISES 1. WHO IS AN INSURED (Section II) Is . amended to Include as an Insured: Any person or organization that you .have agreed In a contract or agreement to include ak an additional insured on this Coverage Part, but: a. Only with respect to liability for "bodily In- jury" or "property damage" that occurs; or "pdrsohal injury" caused by an offense committed, after you have entered Into . that contract or agreement; and' - b. Only If the "bodily injury', "property dam- age" or "personal Injury" Is caused, In whole or In part, by eels or omissions of you or any person or organization per- forming operations on your behalf, and arises out of the ownership, maintenance or use of that part of any premises leased' to you under that contract or agreement. 2. The Insurance provided to such additional insured under this Provision J. Is subject to - - the following -provisions:- -"- - ___-- -- ----------` a. The limits of insurance afforded to such additional insured shall be the limits which you agreed to provide in the con- tract or agreement', or the limits shown in the Declarations for this Coverage Part, whichever are less; and b. The Insurance afforded to such additional Insured does not apply to: (1)'Any "bodily Injury" or "property dam- age" that occurs, or "personal Injury" caused by an offense committed, af- ter you cease to .be a tenant In that premises; (2) Any structural alterations, new con- struction or demolition operations performed by. or on behalf of such additional Insured; or (3) Any premises for which coverage Is excluded by another endorsement to this Coverage Part. 3. This Provision J. does not apply on any basis to any person or organization for which coverage as an additional Insured specifically is added by another en- dorsement to this Coverage ParL ADDITIONAL INSURED — LESSOR OF LEASED EQUIPMENT 1. WHO IS AN INSURED (Section II) Is amended to Include as an Insured: Any person or organization that you have agreed in a contract or agreement to Include es an additional Insured on. this Coverage Part, but: a. Only with respect to liability for "bodily in- jury" or "property damage" that occurs, or "personal injury' caused by an offense committed, after'you have entered Into that contract or agreement; and b, Only If the "bodily Injury", "property dam- age" or "personal injury" is caused, in whole or In part, by acts or omissions of you or any person or organization per- forming operations on.your behalf, in the maintenance, operation or use of equip ment leased to you by such additional in- sured. 2, The :Insurance provided to such additional insured under this Provision K. Is subject to the following provisions: a. The limits of Insurance afforded to such additional insured shall be the limits which you agreed to provide In the con- tract or agreement, or the limits shown in the Declarations for this Coverage Part, whichever are less; and b. The Insurance afforded to such additional Insured does not apply: (1) To any "bodily injury" or "property damage" that occurs, or "personal in- jury" caused by an offense commit. led, after the equipment lease ex- pires; or Page 4 of 8 ® 2007 The Travelers Companles, Ina. oaoio CG D3 79 09 07 (2) If the equipment Is leased with an operator. S. This Provision K. does not apply on any basis 10 any person or organization for which cov- erage as an additional Insured specifically is added by another endorsement to this Cov- erage Part. L. ADDITIONAL INSURED - STATE OR POLITI- CAL SUBDIVISIONS - PERMITS RELATING TO PREMISES The following is added to Paragraph 2. of WHO IS AN INSURED (Section II) to Include as an Insured: Any state or political subdivision that has Issued a permit In connection with premises owned or oc- cupied by, or rented or loaned to, you, but only with respect to "bodily injury", "property damage", "personal injury" or "advertising injury" arising out. of the existence, ownership, use, maintenance, repair,, construction, erection or removal of adver- tising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, elevators, street banners or decorations for.which that state or political subdivision -has issued such permit. CL IIERCIAL GENERAL -LIABILITY N. ADDITIONAL INSURED - ARCHITECT, ENGI. j NEER OR SURVEYOR 1 1. The following Is added to Paragraph 2. of WHO IS AN INSURED (Section II) to Include as an insured: Any archhecl, engineer'or surveyor engaged by or for you that you agree in a "conlraot or agreement requiring insurance" to include as an additional Insured on this Coverage Part, but only with respect to liability for"bodily in- jury", "property damage" or 'personal injury" that Is caused, in whole or in part, by acts or omissions of you or any person or organiza- tion acting on your behalf In connection with your premises or "your work". 2. This Provision N. does not apply on any basis to any person or organization for which cov- erage as an additional insured speciflgaily is added by another endorsement to this Cov- erage Part. O. WHO IS AN INSURED -NEWLY ACQUIRED OR FORMED ORGANIZATIONS 1. Paragraph 4.a. of WHO IS AN INSURED (Section II) is deleted and replaced by the following: M. ADDITIONAL INSURED - STATE OR `POLITI- a. Coverage under this provision Is afforded CAL SUBDIVISIONS - PERMITS RELATING only until the 180th day after you acquire TO OPERATIONS or form the organization or the end of the The following is added to Paragraph 2. of WHO policy period, whichever Is earlier. Any IS AN INSURED (Section 11) to include as an such newly acquired or formed organiza- insured; tion that you report in writing to us within Any slate or political subdivision that has issued a 180 days after you acquire or form the permit, but only with respect to "bodily Injury", organization will be covered under -this "properly damage", "personal Injury" or "advertis-. provisioh until .the end of the policy pe- Ing injury" arising out of operations performed by riod, even If there are more than 180 you or on your behalf for which that state or po- days remaining until the end of the policy Iltical-subdivision.has Issued -such- permit,. Haw .__.____ _ ___.Period _ ever, no such state or political subdivision Is an 2. This Provision 0. does not apply to any or - insured for. ganization for which coverage Is excluded by 2. "Bodily Injury", "property damage", "personal Injury" or "advertising Injury" arising out of operations performed for that state or political subdivision; or "Bodily Injury" or "property damage" Included within the "products - completed operations hazard'. CG 03 79 09 07 another endorsement to this Coverage Part. P. WHO IS AN INSURED -UNNAMED PART- NERSHIP OR JOINT VENTURE - EXCESS 1. The last paragraph of WHO IS AN INSURED {Section II) Is deleted and replaced by the following: No person or organization is an Insured with respect to the conduct of any current or past partnership, joint venture or limited liability company. that is not shown as a Named In- I sured_ In the Common Policy Declarations. ® 2007 The Travelers companies, Inc. Page 5 of 8