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HomeMy WebLinkAbout162251 REDFLEX TRAFFIC SYSTEMS INC - INSURANCE CERTIFICATE (4)ATE C� CERTIFICATE OF LIABILITY INSURANCE o03/31/2014 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: R the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. H SUBROGATION IS WAIVED, subject to the terns 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). PROWLER LIC #0726293 1-925-299-1112 ONTACT CartifLCate Depaitaunt Arthur J. Gallagher E Co. NAME: Insurance Brokers of Cnllfoznia, Inc. PWC HONE 925-299-1112 — FAX NP1: 925-299-0326 3697 Nt. Diablo Boulevard, Suite 300 EipE : shexrl_joxdaaBajg.cm Lafavette. CA 96549 NNNRER(a) AFFORDING COVERAGE NAIC0 INSURED R"flax Traffic System-, Inc. �A I s 23751 N. 23rd Avv=e, Suite 150 Pbomix, AZ 85085-1856 COVERAGES CERTIFICATE NUMBER: 39081145 REVISION NUMBER: LIBERTY MOT FIRE LIBERTY INS CORP 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 'rHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. eMR TYPE OF INSURANCEinn Axis saw POLICY kU FA POLICY EiF POLICY E%P LNOs A GENERAL LMBILRY % TB2-Z91-153980-034 04/01/1 04/01/15 EACH OCCURRENCE $1,000,000 % COMMERCIAL GENERAL LNBILITY PREMISES Meo c name 111,000,000 CLAIMS MADE (OCCUR MEGE%P amp $5.000 Z i25Z BI/PD DID PERSONALAADVIWURY { 1,000,000 GENERAL AGGREGATE { 2,000,000 OFNL AGGREGATE DMR APPLIES PER PRODUCTS-COW/Op AGG $2,000,000 $ POLICY LX PRO- % LOC A AVTOMONLE MBNdIY x A82-Z91-653980-026 COMBINED SING E LIMIT (Eix:insJL--- 1,000,000 BODILY INJlNOYjPrpNaN1) It x ANY Al1T0 AIL OWNED SCHEDULED BODILY INJURY (Pa arddant) e AUTOS AUTOS FROPERtt DAMAGE s NONAWNED HIRED AUTOS AUTOS r t- ARAPD I)ed $ X COIB/COLT % 01IM045,000 B % UMBRELLA LAB Z OCCUR Tt17-Z91-453980-044 0e/01/1 04/01/15 EACHOCCURRENCE $3,000,000 AGGREGATE s5,000,000 EXCESS LAO CIANSIIADE OED I % I RETENTION 1110, 000 $ A WORI(ERSCOMPENSATIN 9=-Z91-653980-076 OU01/1 04/01/15 % R—CRYUAiuUNNI' a ER AND EMPLOYERS' MER-HY YIN ANY PROPRIETOWPARTNEREXECUTIVE El. EACH ACCIDENT 81.000,000 OFFICERMEMBER EXCLUDED? NIA El. DISEASE -EA EMPLOYEE 81.000,000 (MMIdran, In NH) 9Mdewnw.0 RIPnO OF OPERATIONS Caew EL DISEASE -POLICY LIMIT S1,000,000 C PROFSSSTONAL/CYeEt LIAR. 027435075 Os/O7/1 OA /01/15 {50A.82n BaClm/Agg 2,000,000 SIR 50,000 (See attached Suppl. Page...) DESCRIMON OF OPERATIONS I LOCAMNSI VEHICLES (Aft ch ACORD 101, Mdltlone RemaM1e 9cM1edule, a mon eMw H nAul,edl Be: Activities perforated by or on behalf of the permitter or contractor as required by contract. ADDITIONAL INSORBD(S): The City of Port Collins, CO, its officers, directors, agents, representatives and employees as required by written contract. <see attached for policy endorsement Eorme> of Port Collins Purchasing Division Box 580 Collins. CO 80522 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD shekarl 39081145 i i n LL c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before P you acquired or formed the organization. Item 14. Blanket Additional Insured Where Required By Written Contract P N Paragraph 2. of Section If - Who Is An Insured is amended to add the following: ^' e. Additional Insured by Written Contract or Written Agreement z w The following are insureds under the policy when you have agreed in a written contract or written agreement to provide them coverage as additional insureds under your policy: (1) Lessors of Leased Equipment: The person(s) or organization(s) from whom you lease equipment, but only with respect to liability for "bodily Injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). (2) Managers or Lessors of Premises: Any manager or lessor of premises leased to you in which the written lease agreement obligates you to procure additional insured coverage. The coverage afforded to the additional insured is limited to liability in connection with the ownership, maintenance or use of the premises leased to you and caused, in whole or in part, by some negligent acts or omissions of you, your "employees", your agents or your subcontractors. There is no coverage for the additional insured for liability arising out of the sole negligence of the additional insured or those acting on behalf of the additional insured, except as provided below. If the written agreement obligates you to procure additional insured coverage for the additional insured's sole negligence, then the coverage for the additional insured shall conform to the agreement, but only if the applicable law would allow you to indemnify the additional insured for liability arising out of the additional insored's se!e negligence. This insurance does not apply to: (a) Any "occurrence" which takes place after you cease to be a tenant in that premises or to lease that land; or (b) Any premises for which coverage is excluded by endorsement. (3) Mortgagees, Assignees or Receivers: Any person(s) or organization(s) with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of your premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. (4) Owners, Lessees or Contractors: any person(s) or organization(s) to whom you are obligated by a written agreement to procure additional insured coverage, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of your "employees", your agents, or your subcontractors, in the performance of your ongoing operations. This insurance does not apply to "bodily injury", "property damage", or "personal and advertising injury" arising out of "your work" included in the "products -completed operations hazard" unless you are required to provide such coverage for the additional insured by the written agreement, and then only for the period of time required by the written agreement and only for liability caused, in whole or in part, by your acts or omissions or the acts or omissions of your "employees", your agents, or your subcontractors. There is no coverage for the additional insured for liability arising out of the sole negligence of the additional insured or those acting on behalf of the additional insured, except as provided below. LC 04 43 0612 m 2012 Liberty Mutual Insurance. All rights reserved. Page 6 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. %3UMIltlWE m If the written agreement obligates you to procure additional insured coverage for the additional insured's sole negligence, then the coverage for the additional insured shall conform to the agreement, but only if 0 the applicable law would allow you to indemnify the additional insured for liability arising out the additional insured's sole negligence. a N This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" ry arising out of the rendering of, or the failure to render, any professional architectural, engineering or > surveying services, including:+ (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. (5) Architects, Engineers or Surveyors: any architect, engineer, or surveyor engaged by you but only with respect to liability for "bodily injury", "property damage" or "personal and advertising Injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In connection with your premises; or (b) In the performance of your ongoing operations. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, held orders, change orders or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. (6) Any Person or Organization Other Than a Joint Venture: Any person or organization (other than a joint venture of which you are a member) for whom you are obligated by a written agreement to procure additional insured coverage, but only with respect to liability for "bodily injuy", "property damage" or "personal and advertising injury" caused, in whole or in part, by your ads or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations; or (b) In connection with premises owned by you. This insurance does not apply to: 1. Any construction, renovation, demolition or installation operations performed by or on behalf of you, or those operating on your behalf; 2. Any person or organization whose profession, business or occupation is that of an architect, surveyor or engineer with respect to liability arising out of the preparation or approval of maps, drawings, opinions, reports, surveys, change orders, designs, specification or the performance of any other professional services by such person or organization; or 3. Any person or organization more specifically covered in Paragraphs e.(1) through (5) above. The insurance afforded to any person or organization as an insured under this Paragraph 2.e.: (1) Applies only to coverage and minimum limits of insurance required by the written agreement or written contract, but in no event exceeds either the scope of coverage or the limits of insurance provided by this policy; LC 04 43 05 12 © 2012 Liberty Mutual Insurance. All rights reserved. Page 7 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. I F_---, J (2) Does not apply to any person or organization for any "bodily injury", "property damage" or "personal and — advertising injury" if any other additional insured endorsement attached to this policy applies to that person or organization with regard to the "bodily injury", "property damage" or "personal and advertising injury"; (3) Applies only if the "bodily injury" or "property damage" occurs, or offense giving rise to "personal and advertising Injury' is committed, subsequent to the execution of the written agreement; and i (4) Applies only if the written agreement is in effect at the time the "bodily injury" or "property damage" occurs, or at the time the offense giving rise to the "personal and advertising injury" is committed. Item 15. Blanket Additional Insured — Grantors Of Permits Paragraph 2. of Section II - Who Is An Insured is amended to add the following: Any state, municipality or political subdivision with respect to any operations performed by you or on your behalf, or in connection with premises you own, rent or control and to which this insurance applies, for which the state, municipality or political subdivision has issued a permit. However, this insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the state, municipality or political subdivision; 2. Any "bodily injury" or "property damage" included within the "products -completed operations hazard", except when required by written contract or agreement initiated prior to loss; or 3. "Bodily injury', "property damage" or "personal and advertising injury', unless negligently caused, in whole or in part, by you or those acting on your behalf. Item 16. Waiver Of Right Of Recovery By Written Contract Or Agreement The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions. We waive any right of recovery because of payments we make under this policy for injury or damage arising out of your ongoing operations or "your work" included in the "products -completed operations hazard" that we may have against any person or organization with whom you have agreed in a written contract or agreement to waive your rights of recovery but only if the "bodily injury' or "property damage" occurs, or offense giving rise to "personal and advertising injury" is committed subsequent to the execution of the written contract or agreement. Item 17. Other Insurance Amendment If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person or organization that qualifies as an additional insured on this policy, this policy will apply solely on the basis required by such written agreement and Paragraph 4. Other Insurance of Section IV — Conditions will not apply. Where the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Paragraph 4. Other Insurance of Section IV — Conditions will govem. However, this insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured by attachment of an endorsement to another policy providing coverage for the same "occurrence", claim or "suit". Item 18. Contractual Liability —Railroads Paragraph 9. of Section V - Definitions is replaced by the following: 9. "Insured Contract" means: LC 04 43 0512 © 2012 Liberty Mutual Insurance. All rights reserved. Page 8 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. P5l 2.XR m a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that a indemnifies any person or organization for damage by fire to premises while rented to you or temporarily 0 occupied by you with permission of the owner is not an 'Insured contract", b. A sidetrack agreement; N N c. Any easement or license agreement; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; I. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bod!ly injury" or "property damage' to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of., (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that Is the primary cause of the injury or damage; or (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failing to render professional services, including those listed in Paragraph (1) above and supervisory, inspection, architectural or engineering activities. LC 04 43 05 12 © 2012 Liberty Mutual Insurance. All rights reserved. Page 9 of 9 Includes copyrighted material of Insurance Services Office. Inc., with its permission. Frrwu)ma RN U POLICY NUMBER. AS2-Z91 453980-024 COMMERCIAL AUTO O CA 20 4B 10 13 O0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A N DESIGNATED INSURED FOR > COVERED AUTOS LIABILITY COVERAGE 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 this endorsement, This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Redflex Traffic Systems, Inc. Endorsement Effective Date: 04101 Q014 SCHEDULE Name Of Person(s) Or Organization(s): Blanket as required by written contract Information required to complete this Schedule if not shown above, will be shown In the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Paragraph A.I. of Section 11 — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form, CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 Y�L!/�iLW�2 Policy Number AS2-L91-453980-024 ,'1'B2-Z91-453980-034 , Tl17-Z91-453980-044 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY — UMBRELLA COVERAGE FORM Schedule Name of Other Person(s) I Organlzatiko Email Address or mailing address: Number Days Notice: PER SCHEDULE ON FILE WITH THE COMPANY _ PER SCHEDULE ON FILE WITH THE COMPAN 30 A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 01 0611 © 2011 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Q 0 0 No- T 4 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. O a NOTICE OF CANCELLATION TO THIRD PARTIES P A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or ^' organizations shown in the Schedule below. We will send notice to the email or mailing address listed below > at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event w does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. SCHEDULE Name of Other Person(s) f Email Address or mailing address: Number Days Notice: Organization(s): PER SCHEDULE ON FILE WITH THE COMPANY 30 DAYS PER SCHEDULE ON FILE WITH THE COMPANY All other terms and conditions of this policy remain unchanged. Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY For attachment to Policy No. WC2-Z91453980-074 Effective Date 04101/2013 Premium $ Issued to Redflex Traffic Systems, Inc. WM 9018 06 11 © 2011 Liberty Mutual Group of Companies Page 1 of 1 Ed, 06/01/2011 All Rights Reserved PRax4uxR z AGENCY CUSTOMER ID: LOC E: i--*i • A` ORO ADDITIONAL REMARKS SCHEDULE Page of AGENCY Arthur J. Gallagher E Co. Insurance Brokers of California, Inc. NAMEDINSURED Redflex Traffic systems, Inc. 23751 N. 23rd Avenue, Suite 150 Phoenix, BE 85085-1854 POIXYNUMeER CARRIER NACCOCE EFFECTNE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORO FORM, FORM NUMBER: FORM TITLE: INSURED i TRIED PARTY FIDELITY COVERAGR- Carrier: TRAVELERS CAB E SURETY CO OF AI®t[A.,"I MAIC831194- Policy e: 105581296 1 Effective: 04/01/2014 to 04/01/2015 1 Limit: $500,000 Aggregate limit for Employee Theft 4 Employee Theft of Client Property I Retention: $50,000- PROPERTY/CARGO COVERAGE - Carrier: LIBERTY MUTUAL FIRE INS CO/LIBERTY MUTUAL INSURANCE CO. [A]daeet: A, AV] NAIC823035 Policy B:YU2-L9L-153980-066/SFONC100431051 Effective: 04/01/2014 to 04/01/2015- Blanket Personal Property: $23,210,0001 Installation-PP/PPO: $1,000,000 1 Installation / Transit: $250,000 (Blanket Personal Property includes Personal Property of Others and Valuable Papers and records at insured locations). ACORD 101 (2008101) ® 2008 ACORD CORPORATION. All rights reserved a N 7 i R The ACORD name and logo are registered marks of ACORD Arthur J. Gallagher & Co. 3697 Mt. Diablo Boulevard, Suite 300 Lafayette, CA 94549 21�111.,lz„z, Electronic Service Requested ALL FOR AADC 800 2129 1.7754 All 0.403 IIIIII 111111rrlldr��l�'I��IIIIIrJr"11�' City of Fort Collins Purchasing 60 Division P.O. BOX 580 FORT COLLINS, CO 80522-0560 EBIX BPO This document was brought to you by Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. in Lafayette, CA. via CertificateeNow.- Any documents forwarded with the certificate request were reviewed for the sole purpose of cleting the certificate. - If you have questions regarding the content of this document, please contact Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. Phone: (925) 299-1112 or Certificate Fax: (925) 953-6270- The data included in this notice and in the attached document is confidential to Ebix/Certificateallow, and Arthur J. Gallagher & Co. Insurance Brokers of California, Inc. - cc: The data included in this notice and in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. Certificate Delivery by CertificatesNow - www.ConfirmNet.com - 877.669.8600 SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE 03/31/301/ NAME OF INSURED: Aedf1" Traffic Systess. Inc. Additional Description of Operations/Remarks from Page t: Additional Intonnaf ion: nntaarr. LIABILITY: • Separation of Insureds applies par policy foa. • Additional Insured if required by writtea contract per attached form LC0443 0512. • Coverage is Primary i Non -Contributory if required by written, contract per form W04e3 0511. AUTG BXLN LIABILITY: • Designated Insured if required by written contract per attached form CA3048 1013. SUPP mW64) P12.Z J Policy Number T02--L91-453980-034 Issued by Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY ENHANCEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART Index of modified items: Item 1. Reasonable Force Item 2. Non -Owned Watercraft Extension Item 3. Damage To Premises Rented To You - Expanded Coverage Item 4. Bodily Injury To Co -Employees Item 5. Health Care Professionals As Insureds Item 6. Knowledge Of Occurrence Item 7. Notice Of Occurrence Item 8. Unintentional Errors And Omissions Item 9. Bodily Injury Redefinition Item 10. Supplementary Payments — Increased Limits Item 11. Property In Your Care, Custody Or Control Item 12. Mobile Equipment Redefinition Item 13. Newly Formed Or Acquired Entitios Item 14. Blanket Additional Insured Where Required By Written Contract Lessors of Leased Equipment Managers or Lessors of Premises Mortgagees, Assignees or Receivers Owners, Lessees or Contractors Architects, Engineers or Surveyors Any Person or Organization Item 15. Blanket Additional Insured — Grantors Of Permits Item 16. Waiver Of Right Of Recovery By Written Contract Or Agreement Item 17. Other Insurance Amendment Item 18. Contractual Liability - Railroads Item 1. Reasonable Force Exclusion a. of Section I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following: a. Expected Or Intended Injury "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 reasonable force to protect persons or property. Item 2. Non -Owned Watercraft Extension Paragraph (2) of Exclusion g. of Section I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following: (2) A watercraft you do not own that is. LC 04 43 05 12 U 2012 Liberty Mutual Insurance. All rights reserved. Page 1 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. %Etlq]&p2 (a) Less than 55 feet long, and (b) Not being used to carry persons or property for a charge; Item 3. Damage To Premises Rented To You - Expanded Coverage — A. The final paragraph of 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability is W replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning or explosion or subsequent damages resulting from such fire, lightning or explosion including water damage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III - Limits Of Insurance. B. Paragraph 6. of Section III —Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion or subsequent damages resulting from such fire, lightning or explosion including water damage to premises while rented to you or temporarily occupied by you with permission of the owner. The Damage To Premises Rented To You Limit is the greater of: a. $300,000; or b. The Damage To Premises Rented To You Limit shown on the Declarations. C. Paragraph 9.a. of the definition of "insured contract" in Section V — Definitions is replaced by the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion or subsequent damages resulting from such fire, lightning or explosion including water damage to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract". D. The paragraph immediately following Paragraph (6) of exclusion I. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by the following: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning or explosion or subsequent damages resulting from such fire, lightning or explosion including water damage) to premises, including the contents of such premises, rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III — Limits of Insurance. Item 4. Bodily Injury To Co -Employees A. Paragraph 2. of Section II -Who Is An Insured is amended to include: Each of the following is also an insured: Your supervisory or management "employees" (other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company)) are insureds while in the course of their employment or while performing duties related to the conduct of your business with respect to "bodily injury": (1) To you; (2) To your partners or members (if you are a partnership or joint venture); LC 04 43 0512 © 2012 Liberty Mutual Insurance. All rights reserved. Page 2 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. pllm. l (3) To your members (if you are a limited liability company); or (4) To a co -"employee" or "volunteer worker" while that co -"employee" or "volunteer worker" is either in the course of his or her employment by you or while performing duties related to the conduct of your business (including participation in any recreational activities sponsored by you). = N Your "employees" (other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company)) or "volunteer workers" are insureds while in the course of their employment or while performing duties related to the conduct of your business for a Good Samaritan Act that results in "bodily injury": (1) To you; (2) To your partners or members (if you are a partnership or joint venture); (3) To your members (if you are a limited liability company); or (4) To a co"employee" or "volunteer worker" while that co -"employee" or "volunteer worker' is either in the course of his or her employment by you or while performing duties related to the conduct of your business (including participation in any recreational activities sponsored by you). A Good Samaritan Act means an attempt to rescue or aid a person in imminent or serious peril, provided the attempt is not recklessly made. However, none of these "employees" (including supervisory or management "employees*) or "volunteer workers" are insureds for the providing or failure to provide professional health care services. B. The insurance provided by this Item 4. will not apply if the injured person's sole remedy for such injury is provided under a workers' compensation law or any similar law. C. Otherinsurance The insurance provided by this Item 4. is excess over any other valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis. Item 5. Health Care Professionals As Insureds A. Paragraphs 2.a.(i)(a) and (d) of Section II - Who Is An Insured do not apply to "bodily injury" or "personal and advertising injury' arising out of the providing of or failure to provide professional health care services by any "employee" or "volunteer' of the Named Insured who is a "designated health care provider" if the "bodily injury" or "personal and advertising injury" occurs in the course and scope of the "designated health care provider's" employment by the Named Insured. B. With respect to "employees" and "volunteer workers" providing professional health care services, the following exclusions are added to Paragraph 2. Exclusions of Section i — Coverage A — Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section I — Coverage B — Personal And Advertising Injury Liability: This insurance does not apply to: (1) Liability assumed under an "insured contract" or any other contract or agreement; (2) Liability arising out of the providing of professional health care services in violation of law; (3) Liability arising out of the providing of any professional health care services while in any degree under the influence of intoxicants or narcotics; (4) Liability arising out of any dishonest, fraudulent, malicious or knowingly wrongful act or failure to act; or LC 04 43 0512 ® 2012 Liberty Mutual Insurance. All rights reserved. Page 3 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. [_I'110il"i"Q (5) Punitive or exemplary damages, fines or penalties. C. The following definition is added to Section V - Definitions: x "Designated health care provider" means any "employee" or "volunteer worker" of the Named Insured whose duties include providing professional health care services, including but not limited to doctors, nurses, j emergency medical technicians or designated first aid personnel. Ei D. Other Insurance The insurance provided by this Item 5. is excess over any other valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis. Item 6. Knowledge Of Occurrence Knowledge of an "occurrence" by your agent, servant or "employee" will not in itself constitute knowledge by you unless your "executive officer" or "employee" a other third party designated by you to notify us of "occurrences" has knowledge of the "occurrence". Item 7. Notice Of Occurrence For purposes of Paragraph 2.a. of Section IV - Conditions, you refers to an "executive officer" of the Named Insured or to the "employee" designated by the insured to give us notice. Item 8. Unintentional Errors And Omissions Unintentional failure of the Named Insured to disclose all hazards existing at the inception of this policy shall not be a basis for denial of any coverage afforded by this policy. However, you must report such an error or omission to us as soon as practicable after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non - renewal. Item 9. Bodily Injury Redefinition The definition of "bodily injury" in Section V - Definitions is replaced by the following: "Bodily injury" means: a. Bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time; and b. Mental anguish, shock or humiliation arising out of injury as defined in Paragraph a. above. Mental anguish means any type of mental or emotional illness or distress. Item 10. Supplementary Payments - Increased Limits Paragraphs 1.1b. and 1.d. of Section I - Supplementary Payments - Coverages A And B, are replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to fumish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit" including substantiated loss of earnings up to $500 a day because of time off from work. LC 04 43 05 12 0 2012 Liberty Mutual Insurance. All rights reserved. Page 4 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Pf2e 2.2 Item l 1. Property In Your Care, Custody Or Control in P 0 0 A. Paragraphs (3) and (4) of exclusion J. of Section I — Coverage A — Bodily Injury and Property Damage Liability only apply to: a N 1. 'Properly damage' to borrowed equipment, or 2. 'Property damage' to property in your care, custody and control while in transit. B. This insurance does not apply to any portion of a loss for which the insured has available any other valid and collectible insurance, whether primary, excess, contingent, or on any other basis, unless such other insurance was specifically purchased by the insured to apply in excess of this policy. C. Limits of Insurance Subject to Paragraphs 2., 3., and 5. of Section III — Limits Of Insurance, the most we will pay for insurance provided by Paragraph A., above is: $10,000 Each Occurrence Limit $25,000 Aggregate Limit The Each Occurrence Limit for this coverage applies to all damages as a result of any one 'occurrence' � regardless of the number of persons or organizations who sustain damage because of that occurrence". The Aggregate Limit is the most we will pay for the sum of all damages under this Item 11. Item 12. Mobile Equipment Redefinition The definition of "Mobile Equipment' in Section V — Definitions is amended to include self-propelled vehicles with permanently attached equipment less than 1000 pounds gross vehicle weight that are primarily designed for: (1) Snow removal; (2) Road Maintenance, but not construction or resurfacing; or (3) Street cleaning. Item 13. Newly Formed Or Acquired Entities Paragraph 3. of Section II — Who Is An Insured is replaced by the following: 3. Any organization, other than a partnership or joint venture, you newly acquire or form and over which you maintain majority ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. a. Coverage under this provision is afforded only until: (1) The 180th day after you acquire or form the organization; (2) Separate coverage is purchased for the organization; or (3) The end of the policy period, whichever is earlier. b. Coverage A does not apply to "bodily injury" or 'property damage" that occurred before you acquired or formed the organization; and LC 04 43 0512 © 2012 Liberty Mutual Insurance. All rights reserved. Page 5 of 9 Includes copyrighted material of Insurance Services Office, Inc., with its permission.