HomeMy WebLinkAbout284920 NEXANT INC - INSURANCE CERTIFICATEACORO® CERTIFICATE OF LIABILITY INSURANCE
DATE IMM DD YY V)
8/7/2014
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: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terns andconditionsof 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
CT
NAME: Susan Stockdale
Woodruff -Sawyer & CO.
50 California Street, Floor 12
San Francisco CA 94111
PHONE FAX,
No 1,415-989-9923
-MAIL
ADOREss
INSURERS AFFORDING COVERAGE
NAIC0
INSURER A:Federal Insurance Company
20981
INSURED NEXAINC-01
INSURER B:
INSURER C.TravelerS Property Casualty Company
25674
Nexant, Inc.
101 Second Street, Suite 1000
San Francisco CA 94105
INSURER D:
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: 1515106047 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
TYPE OF INSURANCE
ADDLSUBR
POLICY NUMBER
POLICY EFF
MMIDD/YYYY
POLICY EXP
MMIDDIYYYY
UNITS
A
GENERAL LIABILITY
35920727
1/1/2013
1/1/2014
EACH OCCURRENCE
$1.000,000
X COMMERCIAL GENERAL LIABILITY
AMA ET WED
PREMISES Es occurrence
$1,000,000
MED EXP(My one person)
$10,000
CLAIMS -MADE OCCUR
PERSONAL &ADV INJURY
$1,000.000
X Wondwide
_
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
_GENERALAG_GREGA_TE
PRODUCTS - COMF/O°AGG
1 $2.000,000
POLICY PRO LOC
_
E
A
AUTOMOBILE
LIABILITY
73564678
1/1/2013
111112014
Eetc,itlem
1000,000
BODILY INJURY (Par person)
E
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (PerauAtlanO
E
X
PROPERTY) DAMAGE
E
HIRED AUTOS x AVTOSWNED
E
X
$100 HirComp X $250 HirCol
A
X
UMBRELLA LIAB
X
OCCUR
79879772
11/1/2013
1/1/2014
EACH OCCURRENCE
E1,000,000
AGGREGATE
E1,000,000
EXCESS LIAB
ClAIMB-MADE
DIED RETENTION EO
E
C
WORKERS COMPENSATION
JUB258M1049
11/1/2013
1/1/2014
X WC STATU- OTH-
AND EMPLOYERS' LIABILITY YINCRY
ANY PROPRIETORIPARTNEWEXECUTIVE
OFFICERIMEMBER EXCLUOED7 F
NIA
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1.000,000
(Mandatory In NH)
If yea, describe under
E. L. DISEASE -POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS below
B
Errors & Omissions
11/1/2013
1/1/2014
Info Tech & Internet $2,000,000
SIR Each Claim E300k
r7�
Prof Liability $2,000.000
Privacy & Security $2,000.000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Anson ACORD 101. Additional Remarks Schedule, if more Space is required)
The City of Fort Collins included as GL Additional Insured, per form No. 80 02 2000 04 01 & AUTO Additional Insured, per form No. 16 02
0292 04 11.
The City of Fort Collins
Purchasing Division
P.O. Box 580
Fort Collins CO 80522
ACORD 25 (2010/05)
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
R�EPRE,SENTATIVVEE _�/
✓/wr
The ACORD name and logo are registered marks of ACORD
All riahts reserved.
Nexant,Inc. Policy #35920727
em"I—B
General Liability
Supplementary
b. release ataenments:
Payments
(continued)
but oniv for bund anxmnls widen the available Linut tN Insurance. We do nut h;tvc lu
funlish these bonds.
C. rea..sunable expenses inclined by the insured it our request to assist us in the illyeiligatlon or
defense of such ehtini or Nit, InCludinp aclunl foss of rvnings up to S 11)(10 a day because of
tinx off from work.
I. cn5l5 (axed ;Quint the insured in the soil, except any:
1. anurnep fees or litipltiuu expenses: ur
J. other Ins,, cost or expense;
in connection with any injunction or other cyuilnbir relief-
F. prejudgment interest awarded against thr inwred on that earl of" a judg ictit we pay. If we
make an uffcr to pav the applleahle Linuit 01 Insurance, we will not prey ;my prejudgment
interest based on that period of finle atler the offer.
F interest on the full auamnt of a judgnxut [flat accrues altet eulry of the judgment and Mon:
we have paid, oftered to pav or depo.sacd ill court the putt of the judgment that in within the
applicable Lingo 01 Insurance.
Supplenientiry payments does not include any Gne or other penalty.
'Ihese payments will vol reduce the Linuis [ If Inainmce.
Our obligation to make these puvnents ends when we h:i%c used up the applicable. l.iuut Of
Insurunnce,
.,.,.
Coverage Territory
:.._.. W ... . . ... ...
This insuratce applies aamhere, provided the insureds responsibility to pay tLuntgv , w which
this insurance applies. t.i &-termincd In a wit on the. merits hrouyht In the I Initcd Snics nl Amenca
(inefuding its possessions and territories), Canada or pueno Rico, or in a settic:nient to which we
agree.
Who Is An Insured
Sole Proprietorships If you ate an individual. you and your spou..s ae insureds; but gnu and yaar spouse uC insvrtrts
I'll]. with respect w the conduct of a bltanleis of which you are the .sole owner.
If sou die
pers.tls ur urganiaahuus havuig proper tcmporary alshidy of your P10I)Mv are insvreds: but
they are insureds only with respect to the nutinlcuance or use of such pnrywrty and only fur
acts until pour legal representative has hveu appoiulcd:and
your legal rcpresenl;tivcs atc insureds: hill they are insureds only with respect ut lieu
duties as your lcg;d rcin'esentarycs. Such leg:d represemmme. will ;L sums your nghii sod
duties under Ihis insurance.
1 raLinry IRruranca
Fcxm a0-0?-20W (Rev 4-011 Confrarl Page 5 or 7'
Who Is An Insured
(continued)
Partnerships Or Joint If you arc a partnership (including a limited liability partnership) or a joint venture, you
Ventures are aninsured. Your members, your partners and their spouses are insureds; but they are
insureds only with respect to the conduct of your business.
Limited Liability Companies If you are a limited liability company, you are an insured. Your members and their
spouses are insureds; but they are insureds only with respect to the conduct of your
business. Your managers are insureds; but they are insureds only with respect to their
duties as your managers.
Other Organizations If you are an organization (including a professional corporation) other than a partner ship,
joint venture or limited liability company, you are an insured. Your directors and officers
are insureds; but they are insureds only with respect to their duties as your directors or
officers. Your stockholders and their spouses are insureds; but they arc insureds only
with respect to their liability as your stockholders.
Employees Your employees are insureds; but they are insureds only for acts within the scope of
their employment by you or while performing duties related to the conduct of your
business.
However, no employee is an insured for:
A. bodily injury, advertising injury or personal injury:
1, to you, to any of your directors, managers, members, officers or partners
(whether or not an employee) or to any co -employee while such injured person
is either in the course of his or her employment or while performing duties
related to the conduct of your business; .
2. to the brother, child, parent, sister or spouse of such injured person as a
consequence of any injury described in subparagraph A.1. above; or
3. for which there is any obligation to share damages with or repay someone else
who must pay damages because of any injury described in subparagraphs A.1. or
A.2. above.
With respect to bodily injury only, this limitation does not apply to:
• you or to your directors, managers, members, officers, partners or
supervisors as insureds; or
• your employees, as insureds, with respect to such damages caused by
cardio-pulmonary resuscitation or first aid services administered by
such an employee; or
B. property damage to any property owned, occupied or used by you or by any of your
directors, managers, members, officers or partners (whether or not an employee) or by
any of your employees.
This limitation does not apply to property damage to premises while rented to you or
temporarily occupied by you with permission of the owner.
Liability Insurance
Form 80-02-2000(Rev. 4-01) Contract Page 6 0132
C
muss
Who Is An Insured
(continued)
Volunteers
Real Estate Managers
Permissive Users Of
Mobile Equipment
General Liability
persons who atc rulunteer workers for vuu are insureds; but [hey are insureds only for acts within
the scope of their activities for you and at your direction.
Persons (o[her than vour employees) or organizations acting as your real estate managers arc
insureds; bul they are insureds only with respect to their duties as your real estate ntunagers.
Wilh respect In mobile equipment registered in your namie under a irxnur vehicle registration law:
A persons driving such cquipmrnt on a public road with your permission are insureds; and
It. persons oror; anizauuns responsible for [he conduct or such. persrmsdescribed in
subparagraph A. above are imvreds; but they are hasvredv only with respect to the operalitim
of the eyuipmcut and only it nu other msi muse of nhv kind is available to [hens.
However, no person nr urgawyation i1 an inW red with respect to:
hcrddy injury at ant. co -employee of the person driving the equipment; or
property damage to any property owned ur occupied by or loaned or rented to You, or in
your chaive or the charge of the employer ulany person who is an insured under this
pnisision
Vendors Persons; or organizations who :tic vcndurs of your products arc imvreds; but they arc insureds
only with respect to their liability for damages for bodily injury or property damage resulting
front the distribution or sale of your prnductc in the regular cnursc of their business and only it this
insurmice applies to the products- ompleted operations hazard.
However, no such person ur organ uzahtin is an imvrrd with respect toany:
assumption of liahility by [hem in a contract or agreement. Thu litttiiatimt discs not apply to
the liability fnr dantages for Middy injury nr property damage that such vemdut would
have in the abscnec of such contract or agmcmcnr.
represculnliun or wananty unauthorized by vuu:
physical or chemical change in your products made intentionally by the vmudor;
• repackaging. mules,, unpskcal solcv for the purpnso olinspection, denionstrtnion or testing,
or the substiluliuu tit palls uudet iusouclum truni the ncmtdacturcr and then tcpaCkcd to the
original osntaincc
• Jailure to make such inspections, adluwmcnts, tcsis or servicing as the vendor has agreed to
make or nnnually nndenakcs to make in the usual aiursc of business in connection with the
distribmion or cdc tit ycarr prnductc;
• denumstraliuu. iti5nillitdtill, servicing or repair operations, exeepl such operations perlormcd
tit the vcndut'., p vou.%vr in connection with the sale tit your produrts; or
• tit your products which, after distribution or s,lr by You, have. hero I:thelcd or relaheled or
used as a coutamrr, inytedteni or part of any other Ching or suh.mancr by tar for the vendor.
f raWhty insurance
Form 80-0770rA1(Rev. 4-01) Contract Page 7 of 32
Who A An Insured
Vendors Further, no pcnnn ururganization from whom you have acquired your products, or any container.
(continued) ingredient of part entering into, accumpnnyine or contaminK, your products. is an insured under
[his provision.
Lessors Of Equipment persons or organizations from whom you (case equipment are insureds: but lhcv are insureds only
with respect to the maintenance or use by you of such equipment and only if you are contractually
obligated to provide them with such insurance as is afforded by this contract.
However, no such person or organization is an inured with respect in any:
• damages ;rising out of their sole negligence; or
• occurrence Ihut occurs, or offense that is committed, after the equipment lease ends.
Lessors Of Premises
lVsims or orgamtations from whom you lease premises are insureds; but they are inarreds only
with respect lit the ownership, maintenance or use of that particular part ul such premises leased to
You and unly it you are contractually nhlig;ded to provide them with such insurdnce as ix afforded
by this Contract.
However. no .such person or organization is an insured with respect to any:
• damages arising out of their sole negligence:
• occurrence that occurs, or offense that is eurrmvued, after you erase to be a teetmu in the
premises: or
• structural alteration, new construction or demolition operations perfbrna:d by er un hchalf set
Them.
Subsidiary Or Newry
If there is no other ntsurance availahle, the following orguuizations will qualify as named insureds:
Acquired Or Formed
Organizations
a suhsidiltry organization of the tint named insured shfncn in the Declaration of which. at
the hcginning of the policy pentad and at the time of loss, such first named insured contmL..
either directly or indirectly, more than fifty (Sfl) percent of the interests entitled it, vole
gencrdly in the election of the governing hndy of such ur;tunuatioln or
• a suhatdnary organization of the first narued insured shown in the Declarations them .such lint
uamcd irtsored acquires or lbrms during the policy period, it at the time of )ass such first
named trrsured controls, either directly or indirectly, more than fifty (50) percent of the
interests entitled to vote generally in the election set the governing hndy of such orgauizatwn.
Limitations On Who Is An A. Except to the extent provided under the Subsidiary ( tr Newly Acquired Or Formed
Insured Organizations provision above, no person or -organization is an inured with n•spvct to The
conduct of any perwn or ureauizatiun Ilia[ is not shown as it named insured in the
Declaration'.
If. No person or urganizauun is an insured wills respect to the:
I_ ownership, maintenance or use of any a.ssels: or
2. conduct of ant; person or nrganntation whose assets, husiuess ur siremnintiow
r abrhh, rnsurencp
Form 8"P-2000(Rev 4.011 Cmlraci
U
crausm General Liability
Who Is An Insured
Limitations On Who Is An you acquire, either directly or indirectly, for any:
Insured bodily injury or property damage that occurred; ur
(continued)
• advertising injuq or personal injury arising orn of an offense first conunuued;
in whole or in part, before you, directly of indirectly, squired such assets, business or
organization.
Limits 61 Insurance
I he Linars 01 Insurance slurwn in the Ileclaratiom and the rules helow fix the mos[ we will pay,
regardless of the number Lit:
• insureds;
• claims nmde or suits brcu,ghl; or
• liersons or urg:mizations making cluims or hnuging suits.
Ibe Limits (IIInsurance apply separately at each consecutive annual period and to any rent:onmg
period nl less than twelve (12) nx>ntha starting with the beginning ul the policy period,twwu in
the Ucularatiuns, unless the Ixdicy period is extended after issuance for an additional period of less
than twelve (12) months. In that rase, the additional period will he teemed part of the last
preceding per od for purpovs of deternaning the Urrufs Of Insurance.
Genera! Aggregate Limit
Subject tLi the Bach ()ccurrcucc Lim t, the t ienerul Aggrefate I Snit is doe rn oat we will pay lior the•
Null] of:
• damages for hudily injury and property damage, except damages included in [he
products -completed operations hazard; and
• medical expenses.
Products -Completed
Subject ILi the Hach f lccurience Linut, the IYuducls-Completed Operniuns Aggregate Limit is the
Operations Aggregate
nwst we will Pay Fir the sum of damages for hud'dy injury and property damage included in the
Limit
products -completed operations hazard.
Advertising Injury And
'ihe Advertising Injury And Personal Injury Aggregate Lurdt is the mu,,( we will pay for the suer t.l
Personal Injury Aggregate
damages lur advertising injury and personal injury.
Limit
Each Occurrence Limit 'tbv Such Occurrcuue Limit is [he must we will pay for the sum if
• darnu,:r, for bodily injure' oral properly damage; oI d
• medical expenses;
arising out of any Line occurrence.
An% amount paid for d:mugcs or medical expenses will reduce the anumni of the applicahlc
aggregalc knot available for any other payment.
I rabdify hrsurance
Fwm 49&02.2000 (Rev 4 aft Cnnnaof Page 9 of g?
COMMERCIAL AUTOMOBILE
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT
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.21. — 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. 1. — WHO IS AN INSURED — of
SECTION 11—LIABILITY COVERAGE is amended to
add the following:
d. Any "employee" of yours while using a
covered "auto" you don't own, hire or
borrow in your business or your personal
affairs.
C. Lessors as Insureds
Paragraph A. 1. — WHO IS AN INSURED —of
SECTION If —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 11—LIABILITY COVERAGE is
amended to add the following:
L 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:
Form: 16-02-0292 (Rev. 4-11) Page I of 3
"Includes copyrighted material of Insurance Services Office, Inc. with its permission"
3.
4.
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 B.S. - FELLOW EMPLOYEE - of
SECTION II -LIABILITY COVERAGE does not apply.
PHYSICAL DAMAGE - ADDITIONAL TEMPORARY
TRANSPORTATION EXPENSE COVERAGE
Paragraph A.4.a -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 W -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 9.
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.
6. RENTAL AGENCY EXPENSE
Paragraph A. 4. -COVERAGE EXTENSIONS -of
9.
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.
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.
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.
AUDIO, VISUAL AND DATA ELECTRONIC
EQUIPMENT - BROADENED COVERAGE
Paragraph C.2. -LIMIT OF INSURACE -of
SECTION III - PHYSICAL DAMAGE, is deleted and
replaced with the following:
2. $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
Form: 16-02-0292 (Rev. 4-11) Page 2 of 3
'Includes copyrighted material of Insurance Services Office, Inc. with its permission"
c. An integral part of such equipment.
10. U ASS 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.
11. 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
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, SUIT OR 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 fisted 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.S. - 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 insureds" 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.
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.S. - OTHER INSURANCE of
SECTION IV —BUSINESS AUTO CONDITIONS -
is amended to add the following:
e. Any "auto" hived or rented by your "employee'
on your behalf and at your direction will be
considered an "auto"you hive. 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 "employees"personal insurance.
16. HIRED AUTO —COVERAGE TERRITORY
Paragraph 13.7.b.(5).(a) - POLICY PERIOD,
COVERAGE TERRITORY of SECTION IV —
BUSINESS AUTO CONDITIONS is deleted and
replaced with the following:
(a) 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.
Form: 16-02-0292 (Rev. 4-11) Page 3 of 3
'Includes copyrighted material of Insurance Services Office, Inc. with its permission"