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HomeMy WebLinkAbout538741 NORCON OF NEW MEXICO - INSURANCE CERTIFICATE (3)08/27/2019 Hegarty-Haynes Insurance Inc 4500 S. Lakeshore Dr. #265 Tempe AZ 85282 Elizabeth Millwee (480) 820-2297 (480) 820-2570 liz@hegartyhaynes.com Norcon of New Mexico, LLC Norcon of Colorado LLC 8437 Washington Pl. NE Ste. B Albuquerque NM 87113 Cincinnati Insurance Co. 10677 CL1982602699 A CONTRACTUAL LIABILITY Y Y EPP 0207522 09/01/2019 09/01/2020 1,000,000 500,000 10,000 1,000,000 2,000,000 2,000,000 PD DED PER CLM 500 A Y Y EBA 0207522 09/01/2019 09/01/2020 1,000,000 A 0 EPP 0207522 09/01/2019 09/01/2020 5,000,000 5,000,000 NO COVERAGE WITH AGENT JOB NO 18-077: LINCOLN CENTER THEATRE, 417 W MAGNOLIA ST, FT COLLINS, CO 80521 JOB: PROVIDE AND INSTALL HUSSEY ADDITIONAL INSURED STATUS APPLIES TO THE EXTENT PROVIDED IN THE ATTACHED FORMS. CITY OF FORT COLLINS 215 N MASON ST 2ND FLR FORT COLLINS CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 1 of 16 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY CONTRACTORS’ COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A Endorsement Table of Contents: Coverage: Begins on Page: 1 Employee Benefit Liability Coverage 2 2 Unintentional Failure to Disclose Hazards 8 3 Damage to Premises Rented to You 8 4 Supplementary Payments 9 5 Medical Payments 10 6 Voluntary Property Damage (Coverage a ) and Care, Custody or Control Liability Coverage (Coverage b ) 10 7 180 Day Coverage for Newly Formed or Acquired Organizations 10 8 Waiver of Subrogation 10 9 Automatic Additional Insured Specified Relationships: 11 Managers or Lessors of Premises; Lessor of Leased Equipment; Vendors; State or Political Subdivisions Permits Relating to Premises; State or Political Subdivisions Permits; and Contractors’ Operations 10 Broadened Contractual Liability Work Within 50’ of Railroad Property 14 11 Property Damage to Borrowed Equipment 14 12 Employees as Insureds Specified Health Care Services: 15 Nurses; Emergency Medical Technicians; and Paramedics 13 Broadened Notice of Occurrence 15 B Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse ment, except as provided below: 1 Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3 Damage to Premises Rented to You The lesser of: a The Each Occurrence Limit shown in the Declarations; or b $500,000 unless otherwise stated $ 4 Supplementary Payments a Bail bonds: $ 1,000 b Loss of earnings: $ 350 5 Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 2 of 16 6 Voluntary Property Damage (Coverage a ) and Care, Custody or Control Liability Coverage (Coverage b ) Limits of Insurance (Each Occurrence) Coverage a $1,000 Coverage b $5,000 unless otherwise stated $ Deductibles (Each Occurrence) Coverage a $250 Coverage b $250 unless otherwise stated $ COVERAGE PREMIUM BASIS (a) Area (b) Payroll (c) Gross Sales (d) Units (e) Other RATE (For Limits in Excess of $5,000) ADVANCE PREMIUM (For Limits in Excess of $5,000) b Care, Custody or Control $ TOTAL ANNUAL PREMIUM $ 11 Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C Coverages: 1 Employee Benefit Liability Coverage a The following is added to SECTION I COVERAGES: Employee Benefit Liability Coverage (1) Insuring Agreement (a) We will pay those sums that the insured becomes legally obligated to pay as dam ages caused by any act, er ror or omission of the in sured, or of any other per son for whose acts the in sured is legally liable, to which this insurance ap plies We will have the right and duty to defend the in sured against any "suit" seeking those damages However, we will have no duty to defend against any "suit" seeking damages to which this insurance does not apply We may, at our discretion, investigate any report of an act, error or omission and settle any claim or "suit" that may re sult But: 1) The amount we will pay for damages is limited as described in SEC Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 3 of 16 fective date of this endorsement You will be deemed to have knowledge of a claim or "suit" when any "authorized repre sentative"; i) Reports all, or any part, of the act, error or omission to us or any other insurer; ii) Receives a written or ver bal demand or claim for dam ages because of the act, er ror or omis sion; and b) There is no other applicable insur ance (2) Exclusions This insurance does not apply to: (a) Bodily Injury, Property Damage or Personal and Advertising Injury "Bodily injury", "property damage" or "personal and advertising injury" (b) Dishonest, Fraudulent, Criminal or Malicious Act Damages arising out of any intentional, dishonest, fraudulent, criminal or mali cious act, error or omission, committed by any insured, including the willful or reck less violation of any statute (c) Failure to Perform a Con tract Damages arising out of fail ure of performance of con tract by any insurer (d) Insufficiency of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the "employee benefit pro gram" (e) Inadequacy of Perform ance of Investment / Ad Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 4 of 16 (j) Employment Related Practices Any liability arising out of any: (1) Refusal to employ; (2) Termination of em ployment; (3) Coercion, demotion, evaluation, reassign ment, discipline, defa mation, harassment, humiliation, discrimina tion or other employ ment related practices, acts or omissions; or (4) Consequential liability as a result of (1), (2) or (3) above This exclusion applies whether the insured may be held liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury (3) Supplementary Payments SECTION I COVERAGES, SUPPLEMENTARY PAY MENTS COVERAGES A AND B also apply to this Coverage b Who is an Insured As respects Employee Benefit Liabil ity Coverage, SECTION II WHO IS AN INSURED is deleted in its en tirety and replaced by the following: (1) If you are designated in the Declarations as: (a) An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner (b) A partnership or joint ven ture, you are an insured Your members, your part ners, and their spouses are also insureds but only with respect to the conduct of your business (c) A limited liability company, you are an insured Your members are also insureds, but only with respect to the conduct of your business Your managers are in Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 5 of 16 (b) Does not apply to any act, error or omission that was committed before you ac quired or formed the or ganization c Limits of Insurance As respects Employee Benefit Liabil ity Coverage, SECTION III LIMITS OF INSURANCE is deleted in its en tirety and replaced by the following: (1) The Limits of Insurance shown in Section B Limits of Insur ance, 1 Employee Benefit Li ability Coverage and the rules below fix the most we will pay regardless of the number of: (a) Insureds; (b) Claims made or "suits" brought; (c) Persons or organizations making claims or bringing "suits"; (d) Acts, errors or omissions; or (e) Benefits included in your "employee benefit pro gram" (2) The Aggregate Limit shown in Section B Limits of Insurance, 1 Employee Benefit Liability Coverage of this endorsement is the most we will pay for all damages because of acts, er rors or omissions negligently committed in the "administra tion" of your "employee benefit program" (3) Subject to the limit described in (2) above, the Each Employee Limit shown in Section B Limits of Insurance, 1 Employee Benefit Liability Coverage of this endorsement is the most we will pay for all damages sus tained by any one "employee", including damages sustained by such "employee’s" dependents and beneficiaries, as a result of: (a) An act, error or omission; or (b) A series of related acts, er rors or omissions, regard less of the amount of time that lapses between such acts, errors or omissions, negligently committed in the "administration" of your "em ployee benefit program" However, the amount paid un der this endorsement shall not Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 6 of 16 d Additional Conditions As respects Employee Benefit Li ability Coverage, SECTION IV COMMERCIAL GENERAL LIABIL ITY CONDITIONS is amended as follows: (1) Item 2 Duties in the Event of Occurrence, Offense, Claim or Suit is deleted in its entirety and replaced by the following: 2 Duties in the Event of an Act, Error or Omission, or Claim or Suit a You must see to it that we are notified as soon as practicable of an act, error or omission which may result in a claim To the extent possible, notice should include: (1) What the act, error or omission was and when it oc curred; and (2) The names and addresses of any one who may suffer damages as a result of the act, error or omission b If a claim is made or "suit" is brought against any insured, you must: (1) Immediately rec ord the specifics of the claim or "suit" and the date re ceived; and (2) Notify us as soon as practicable You must see to it that we receive written no tice of the claim or "suit" as soon as prac ticable c You and any other in volved insured must: (1) Immediately send us copies of any demands, notices, summonses or le gal papers re ceived in connec tion with the claim or "suit"; (2) Authorize us to obtain records and Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 7 of 16 method also Under this approach each in surer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first If any of the other in surance does not per mit contribution by equal shares, we will contribute by limits Under this method, each insurer’s share is based on the ratio of its applicable limit of in surance to the total ap plicable limits of insur ance of all insurers c No Coverage This insurance shall not cover any loss for which the insured is entitled to recovery un der any other insur ance in force previous to the effective date of this Coverage Part e Additional Definitions As respects Employee Benefit Li ability Coverage, SECTION V DEFINITIONS is amended as fol lows: (1) The following definitions are added: 1 "Administration" means: a Providing information to "employees", including their dependents and beneficiaries, with re spect to eligibility for or scope of "employee benefit programs"; b Interpreting the "em ployee benefit pro grams"; c Handling records in connection with the "employee benefit pro grams"; or d Effecting, continuing or terminating any "em ployee’s" participation in any benefit included in the "employee bene fit program" However, "administration" Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 8 of 16 benefits, workers’ com pensation and disability benefits; and d Vacation plans, includ ing buy and sell pro grams; leave of ab sence programs, in cluding military, mater nity, family, and civil leave; tuition assis tance plans; transpor tation and health club subsidies (2) The following definitions are deleted in their entirety and re placed by the following: 21 "Suit" means a civil pro ceeding in which money damages because of an act, error or omission to which this insurance applies are alleged "Suit" includes: a An arbitration pro ceeding in which such damages are claimed and to which the in sured must submit or does submit with our consent; b Any other alternative dispute resolution pro ceeding in which such damages are claimed and to which the in sured submits with our consent; or c An appeal of a civil proceeding 8 "Employee" means a per son actively employed, for merly employed, on leave of absence or disabled, or retired "Employee" includes a "leased worker" "Em ployee" does not include a "temporary worker" 2 Unintentional Failure to Disclose Haz ards SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, 7 Represen tations is hereby amended by the addi tion of the following: Based on our dependence upon your representations as to existing hazards, if unintentionally you should fail to disclose all such hazards at the inception date of your policy, we will not reject coverage under this Coverage Part based solely on Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 9 of 16 bursting caused by centrifugal force; e) Settling, cracking, shrinking or ex pansion; or f) Nesting or infesta tion, or discharge or release of waste products or secretions, by in sects, birds, ro dents or other animals (b) Loss caused directly or indi rectly by any of the follow ing: 1) Earthquake, volcanic eruption, landslide or any other earth move ment; 2) Water that backs up or overflows from a sewer, drain or sump; 3) Water under the ground surface press ing on, or flowing or seeping through: a) Foundations, walls, floors or paved surfaces; b) Basements, whether paved or not; or c) Doors, windows or other openings (c) Loss caused by or resulting from water that leaks or flows from plumbing, heat ing, air conditioning, or fire protection systems caused by or resulting from freez ing, unless: 1) You did your best to maintain heat in the building or structure; or 2) You drained the equipment and shut off the water supply if the heat was not main tained (d) Loss to or damage to: 1) Plumbing, heating, air conditioning, fire pro tection systems, or other equipment or ap pliances; or 2) The interior of any Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 10 of 16 All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to the limit shown in Section B Limits of Insurance, 4 b Loss of Earnings of this en dorsement per day because of time off from work 5 Medical Payments The Medical Expense Limit of Any One Person as stated in the Declarations is amended to the limit shown in Section B Limits of Insurance, 5 Medical Pay ments of this endorsement 6 Voluntary Property Damage and Care, Custody or Control Liability Coverage a Voluntary Property Damage Cov erage We will pay for "property damage" to property of others arising out of op erations incidental to the insured’s business when: (1) Damage is caused by the in sured; or (2) Damage occurs while in the in sured’s possession With your consent, we will make these payments regardless of fault b Care, Custody or Control Liability Coverage SECTION I COVERAGES, COV ERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2 Exclusions, j Damage to Property, Subparagraphs (3), (4) and (5) do not apply to "property damage" to the property of others described therein With respect to the insurance provided by this section of the endorsement, the fol lowing additional provisions apply: a The Limits of Insurance shown in the Declarations are replaced by the lim its designated in Section B Limits of Insurance, 6 Voluntary Property Damage and Care, Custody or Control Liability Coverage of this endorsement with respect to cover age provided by this endorsement These limits are inclusive of and not in addition to the limits being re placed The Limits of Insurance shown in Section B Limits of Insur ance, 6 Voluntary Property Dam age and Care, Custody or Control Liability Coverage of this endorse ment fix the most we will pay in any Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 11 of 16 injury or damage arising out of your on going operations or "your work" done un der a written contract requiring such waiver with that person or organization and included in the "products completed operations hazard" However, our rights may only be waived prior to the "occur rence" giving rise to the injury or damage for which we make payment under this Coverage Part The insured must do nothing after a loss to impair our rights At our request, the insured will bring "suit" or transfer those rights to us and help us enforce those rights 9 Automatic Additional Insured Speci fied Relationships a The following is hereby added to SECTION II WHO IS AN INSURED: (1) Any person or organization de scribed in Paragraph 9 a (2) below (hereinafter referred to as additional insured) whom you are required to add as an addi tional insured under this Cover age Part by reason of: (a) A written contract or agreement; or (b) An oral agreement or con tract where a certificate of insurance showing that per son or organization as an additional insured has been issued, is an insured, provided: (a) The written or oral contract or agreement is: 1) Currently in effect or becomes effective during the policy pe riod; and 2) Executed prior to an "occurrence" or offense to which this insurance would apply; and (b) They are not specifically named as an additional in sured under any other pro vision of, or endorsement added to, this Coverage Part (2) Only the following persons or organizations are additional in sureds under this endorsement, and insurance coverage pro vided to such additional in sureds is limited as provided herein: (a) The manager or lessor of a Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 12 of 16 a) "Bodily injury" or "property damage" for which the ven dor is obligated to pay damages by reason of the as sumption of liabil ity in a contract or agreement This exclusion does not apply to liability for damages that the vendor would have in the ab sence of the con tract or agree ment; b) Any express war ranty unauthorized by you; c) Any physical or chemical change in the product made intentionally by the vendor; d) Repackaging, un less unpacked solely for the pur pose of inspection, demonstration, testing, or the substitution of parts under in structions from the manufacturer, and then repackaged in the original container; e) Any failure to make such in spections, adjust ments, tests or servicing as the vendor has agreed to make or normally under takes to make in the usual course of business, in connection with the distribution or sale of the prod ucts; f) Demonstration, in stallation, servic ing or repair op erations, except such operations Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 13 of 16 banners, or decora tions and similar expo sures; or 2) The construction, erec tion, or removal of ele vators; or 3) The ownership, main tenance, or use of any elevators covered by this insurance (e) Any state or political subdi vision with which you have agreed per Paragraph 9 a (1) above to provide in surance, subject to the fol lowing provisions: 1) This insurance applies only with respect to op erations performed by you or on your behalf for which the state or political subdivision has issued a permit 2) This insurance does not apply to "bodily in jury", "property dam age" or "personal and advertising injury" aris ing out of operations performed for the state or political subdivision (f) With respect to injury or damage that occurs in New Mexico, any person or or ganization with which you have agreed per Paragraph 9 a (1) above to provide in surance, but only to the extent that the liability is caused by "your work" per formed for that additional insured and only to the ex tent that such liability is caused by your negligence, acts or omissions or the negligence, acts or omis sions of those acting on your behalf A person or or ganization’s status as an in sured under this provision of this endorsement contin ues for only the period of time required by the written contract or agreement, but in no event beyond the ex piration date of this Cover age Part If there is no writ ten contract or agreement, Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 14 of 16 1) The rendering of, or failure to render, any professional services by you or on your be half, but only with re spect to either or both of the following opera tions: a) Providing engi neering, architec tural or surveying services to others; and b) Providing, or hiring independent pro fessionals to pro vide, engineering, architectural or surveying services in connection with construction work you perform 2) Subject to Paragraph 3) below, professional services include: a) Preparing, ap proving, or failing to prepare or ap prove, maps, shop drawings, opin ions, reports, sur veys, field orders, change orders, or drawings and specifications; and b) Supervisory or in spection activities performed as part of any related ar chitectural or en gineering activi ties 3) Professional services do not include services within construction means, methods, tech niques, sequences and procedures employed by you in connection with construction work you perform (d) Subparagraphs (f) and (g) do not apply to "bodily in jury" or "property damage" arising out of "your work" for which a consolidated (wrap up) insurance program has been provided by the prime Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 15 of 16 written on an excess basis In such case, the coverage provided un der this endorsement shall also be excess (2) Condition 11 Conformance to Specific Written Contract or Agreement is hereby added: 11 Conformance to Specific Written Contract or Agreement a With respect to addi tional insureds de scribed in Paragraph 9 a (2)(f) above only: If a written contract or agreement between you and the additional insured specifies that coverage for the addi tional insured: (1) Be provided by the Insurance Serv ices Office addi tional insured form number CG 32 04 or CG 32 12; or (2) Include coverage for completed op erations; or (3) Include coverage for "your work"; and where the limits or coverage provided to the additional insured is more restrictive than was specifically re quired in that written contract or agreement, the terms of Para graphs 9 a (3)(a) or 9 b above, or any combination thereof, shall be interpreted as providing the limits or coverage required by the terms of the written contract or agreement, but only to the extent that such limits or cov erage is included within the terms of the Cover age Part to which this endorsement is at tached b With respect to addi tional insureds de scribed in Paragraph Includes copyrighted material of Insurance GA 233 NM 07 08 Services Office, Inc , with its permission Page 16 of 16 11 Property Damage to Borrowed Equip ment a The following is hereby added to Ex clusion j Damage to Property of Paragraph 2 , Exclusions of SEC TION I COVERAGES, COVERAGE A BODILY INJURY AND PROP ERTY DAMAGE LIABILITY: Paragraphs (3) and (4) of this exclu sion do not apply to tools or equip ment loaned to you, provided they are not being used to perform opera tions at the time of loss b With respect to the insurance pro vided by this section of the en dorsement, the following additional provisions apply: (1) The Limits of insurance shown in the Declarations are replaced by the limits designated in Sec tion B Limits of Insurance, 11 of this endorsement with respect to coverage provided by this endorsement These limits are inclusive of and not in addition to the limits being replaced The Limits of Insurance shown in Section B Limits of Insurance, 11 of this endorsement fix the most we will pay in any one "oc currence" regardless of the number of: (a) Insureds; (b) Claims made or "suits" brought; or (c) Persons or organizations making claims or bring "suits" (2) Deductible Clause (a) Our obligation to pay dam ages on your behalf applies only to the amount of dam ages for each "occurrence" which are in excess of the Deductible amount stated in Section B Limits of Insur ance, 11 of this endorse ment The limits of insur ance will not be reduced by the application of such De ductible amount (b) Condition 2 Duties in the Event of Occurrence, Of fense, Claim or Suit, ap plies to each claim or "suit" irrespective of the amount (c) We may pay any part or all of the deductible amount to GA 4094 10 01 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY PRIMARY / NONCONTRIBUTORY AMENDMENT OF CONDITIONS FOR DESIGNATED ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization (Additional Insured): With respect to insurance provided the additional insured shown in the Schedule, SECTION IV COMMERCIAL GENERAL LIABILITY CONDI TIONS, 5 Other Insurance is deleted in its en tirety and replaced by the following: 5 Other Insurance If other valid and collectible insurance is available to the additional insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a Primary Insurance Where required by a written contract, this insurance is primary and noncontributory as respects any other insurance policy issued to the additional insured Other wise, b below applies b Excess Insurance This insurance is excess over any of the other insurance available to the additional insured whether primary, excess, contin gent or on any other basis When this insurance is excess, we will have no duty under Coverages A or B to defend any claim or "suit" that any other insurer has a duty to defend If no other insurer defends, we will undertake to do so, but we will be entitled to the insured’s rights against all those other insurers When this insurance is excess over any other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self insured amounts under all that other insurance We will share the remaining loss, if any, with any other insurance that was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part c Method of Sharing If all of the other insurance permits con tribution by equal shares, we will follow this method also Under this approach each insurer contributes equal amounts until it has paid its applicable limit of in surance or none of the loss remains, Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission. Page 1 of 4 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CinciPlus ® BUSINESS AUTO XC+ ® (EXPANDED COVERAGE PLUS) ENDORSEMENT This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. A. Blanket Waiver of Subrogation SECTION IV - BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, 5. Transfer of Rights of Recovery Against Others to Us is amended by the addition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury" or "property damage" arising out of the operation of a covered "auto" when you have assumed liability for such "bodily injury" or "property damage" under an "insured contract", provid- ed the "bodily injury" or "property damage" oc- curs subsequent to the execution or the "in- sured contract". B. Noncontributory Insurance SECTION IV - BUSINESS AUTO CONDI- TIONS, B. General Conditions, 5. Other In- surance c. is replaced by the following: c. Regardless of the provisions of Par- agraph a. above, this Coverage Form's Liability Coverage is primary and we will not seek contribution from any other insurance for any lia- bility assumed under an "insured contract" that requires liability to be assumed on a primary noncontributo- ry basis. C. Additional Insured by Contract SECTION II - LIABILITY COVERAGE, A. Coverage, I. Who is an Insured is amended to include as an insured any person or organi- zation with which you have agreed in a valid written contract to provide insurance as is af- forded by this policy. This provision is limited to the scope of the valid written contract. This provision does not apply unless the valid written contract has been: 1. Executed prior to the accident causing "bodily injury" or "property damage"; and 2. Is still in force at the time of the "accident" causing "bodily injury" or "property dam- age". D. Employee Hired Auto 1. Changes in Liability Coverage The following is added to the Section II - Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission. Page 2 of 4 However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". E. Audio, Visual and Data Electronic Equip- ment SECTION III - PHYSICAL DAMAGE COV- ERAGE, C. Limit of Insurance is amended by adding the following: 4. The most we will pay for all "loss" to au- dio, visual or data electronic equipment and any accessories used with this equipment as a result of any one "acci- dent" is the lesser of: a. The actual cash value of the dam- aged or stolen property as of the time of the "accident"; b. The cost of repairing or replacing the damaged or stolen property with oth- er property of like kind and quality; or c. $2,500. Provided the equipment, at the time of the "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 in- stalled housing unit as described in Paragraph 2.a. above; or c. An integral part of such equipment. F. Who is an Insured - Amended SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who is an Insured is amended by adding the following: The following are "insureds": 1. Any subsidiary which is a legally incorpo- rated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this cover- age form. However, the insurance afforded by this provision does not apply to any subsidiary that is an "insured" under any other au- tomobile liability policy, or would be an "insured" under such policy but for termi- nation of such policy or the exhaustion of such policy's limits of insurance. 2. Any organization that is newly acquired or formed by you and over which you main- tain majority ownership. The insurance provided by this provision: a. Is effective on the date of acquisition or formation, and is afforded for 180 days after such date; b. Does not apply to "bodily injury" or "property damage" resulting from an "accident" that occurred before you Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission. Page 3 of 4 4. Subject to the above limit, deductible, and excess provisions we will provide cover- age equal to the broadest coverage appli- cable to any covered "auto" you own in- sured under this policy. Coverage includes loss of use of that hired au- to, provided it results from an "accident" for which you are legally liable and as a result of which a monetary loss is sustained by the leasing or rental concern. The most we will pay for any one "accident" is $3,000. If a limit for Hired Auto - Physical Damage is shown in the Schedule, then that limit replac- es, and is not added to, the $50,000 limit indi- cated above. J. Rental Reimbursement SECTION III - PHYSICAL DAMAGE is amended by adding the following: 1. We will pay for rental reimbursement ex- penses incurred by you for the rental of an "auto" because of a "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each cov- erage you have on a covered "auto". No deductible applies to this coverage. 2. We will pay only for those expenses in- curred during the policy period beginning 24 hours after the "loss" and ending, re- gardless of the policy's expiration, with the lesser of the following number of days: a. The number of days reasonably re- quired to repair the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you; or b. 30 days. 3. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses in- curred; or b. $50 per day. 4. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 5. We will pay under this coverage only that amount of your rental reimbursement ex- penses which is not already provided for under SECTION III - PHYSICAL DAM- AGE COVERAGE, A. Coverage, 4. Coverage Extensions. K. Transportation Expense - Higher Limits SECTION III - PHYSICAL DAMAGE COV- ERAGE, A. Coverage, 4. Coverage Exten- sions is amended by replacing $20 per day with $50 per day, and $600 maximum with $1,500 maximum in Extension a. Transpor- Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission. Page 4 of 4 2. SECTION V - DEFINITIONS is amended by adding the following, but only for the purposes of this Loan or Lease Gap Coverage: "Total loss" means a "loss" in which the cost of repairs plus the salvage value ex- ceeds the actual cash value. N. Glass Repair - Waiver of Deductible SECTION III - PHYSICAL DAMAGE COV- ERAGE, D. Deductible is amended by adding the following: No deductible applies to glass damage if the glass is repaired in a manner acceptable to us rather than replaced. O. Duties in the Event of an Accident, Claim, Suit or Loss - Amended SECTION IV - BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, 2. Duties in the Event of Accident, Claim, Suit or Loss, a. is amended by adding the following: This condition applies only when the "acci- dent" or "loss" is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. An executive officer or insurance manag- er, if you are a corporation; or 4. A member or manager, if you are a lim- ited liability company. P. Unintentional Failure to Disclose Hazards SECTION IV - BUSINESS AUTO CONDI- TIONS, B. General Conditions, 2. Conceal- ment, Misrepresentation or Fraud is amended by adding the following: However, if you unintentionally fail to disclose any hazards existing on the effective date of this Coverage Form, we will not deny cover- age under this Coverage Form because of such failure. Q. Mental Anguish Resulting from Bodily Inju- ry SECTION V - DEFINITIONS, C. "Bodily inju- ry" is deleted in its entirety and replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including men- tal anguish and death sustained by the same person that results from such bodily injury, sickness or disease. "Bodily injury" does not include mental anguish or death that does not result from bodily injury, sickness or disease. R. Coverage for Certain Operations in Con- nection with Railroads With respect to the use of a covered "auto" in operations for or affecting a railroad: 1. Section V - Definitions, H. "Insured con- tract", 1.c. is amended to read: c. An easement or license agreement; 2. Section V - Definitions, H. "Insured con- tract", 2.a. is deleted. tation Expenses. L. Airbag Coverage SECTION III - PHYSICAL DAMAGE COV- ERAGE, B. Exclusions, 3.a. is amended by adding the following: However, the mechanical and electrical breakdown portion of this exclusion does not apply to the accidental discharge of an airbag. This coverage for airbags is excess over any other collectible insurance or warranty. M. Loan or Lease Gap Coverage 1. SECTION III - PHYSICAL DAMAGE COVERAGE, C. Limit of Insurance is deleted in its entirety and replaced by the following, but only for private passenger type "autos" with an original loan or lease, and only in the event of a "total loss" to such a private passenger type "auto": a. The most we will pay for "loss" in any one "accident" is the greater of: (1) The amount due under the terms of the lease or loan to which your covered private passenger type "auto" is subject, but will not include: (a) Overdue lease or loan pay- ments; (b) Financial penalties imposed under the lease due to high mileage, excessive use or abnormal wear and tear; (c) Security deposits not re- funded by the lessor; (d) Costs for extended warran- ties, Credit Life Insurance, Health, Accident or Disabil- ity Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases, or (2) Actual cash value of the stolen or damaged property. b. An adjustment for depreciation and physical condition will be made in de- termining actual cash value at the time of "loss". acquired or formed the organization; c. Does not apply to any newly acquired or formed organization that is a joint venture or partnership; and d. Does not apply to an insured under any other automobile liability policy, or would be an insured under such a policy but for the termination of such policy or the exhaustion of such poli- cy's limits of insurance. 3. Any of your "employees" while using a covered "auto" in your business or your personal affairs, provided you do not own, hire or borrow that "auto". G. Liability Coverage Extensions - Supple- mentary Payments - Higher Limits SECTION II - LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a. Sup- plementary Payments is amended by: 1. Replacing the $2,000 Limit of Insurance for bail bonds with $4,000 in (2); and 2. Replacing the $250 Limit of Insurance for reasonable expenses with $500 in (4). H. Amended Fellow Employee Exclusion SECTION II - LIABILITY COVERAGE, B. Ex- clusions, 5. Fellow Employee is modified as follows: Exclusion 5. Fellow Employee is deleted. I. Hired Auto - Physical Damage If hired "autos" are covered "autos" for Liability Coverage, then Comprehensive and Collision Physical Damage Coverages as provided un- der SECTION III - PHYSICAL DAMAGE COVERAGE of this Coverage Part are ex- tended to "autos" you hire, subject to the fol- lowing: 1. The most we will pay for "loss" to any hired "auto" is $50,000 or the actual cash value or cost to repair or replace, which- ever is the least, minus a deductible. 2. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage, or $1,000, whichever is less. 3. Hired Auto - Physical Damage coverage is excess over any other collectible insur- ance. Liability Coverage, A. Coverage, 1. Who is an Insured: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. Changes in General Conditions SECTION IV - BUSINESS AUTO CON- DITIONS, B. General Conditions, 5. Other Insurance is amended by replac- ing Paragraph 5.b. with the following: b. For Hired Auto Physical Damage Coverage the following are deemed to be covered "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 "em- ployee's" name, with your per- mission, while performing duties related to the conduct of your business. whichever comes first If any of the other insurance does not permit contribution by equal shares, we will contribute by limits Under this method, each insurer’s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us 12 Employees as Insureds Specified Health Care Services It is hereby agreed that Paragraph 2 a (1)(d) of SECTION II WHO IS AN INSURED, does not apply to your "em ployees" who provide professional health care services on your behalf as duly li censed: a Nurses; b Emergency Medical Technicians; or c Paramedics, in the jurisdiction where an "occurrence" or offense to which this insurance applies takes place 13 Broadened Notice of Occurrence Paragraph a of Condition 2 Duties in the Event of Occurrence, Offense, Claim or Suit (SECTION IV COMMER CIAL GENERAL LIABILITY CONDI TIONS) is hereby deleted and replaced by the following: a You must see to it that we are noti fied as soon as practicable of an "occurrence" or an offense which may result in a claim To the extent possible, notice should include: (1) How, when and where the "oc currence" or offense took place; (2) The names and addresses of any injured persons and wit nesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense This requirement applies only when the "occurrence" or offense is known to an "authorized representative" 9 a (2)(g) above only: If a written contract or agreement between you and the additional insured specifies that coverage for the addi tional insured: a Be provided by the Insurance Serv ices Office addi tional insured form number CG 20 10 or CG 20 37 (where edition specified); or b Include coverage for completed op erations; or c Include coverage for "your work"; and where the limits or coverage provided to the additional insured is more restrictive than was specifically re quired in that written contract or agreement, the terms of Para graphs 9 a (3)(a), 9 a (3)(b) or 9 b above, or any combi nation thereof, shall be interpreted as providing the limits or coverage required by the terms of the written contract or agreement, but only to the extent that such limits or coverage is in cluded within the terms of the Coverage Part to which this endorse ment is attached If, however, the written contract or agreement specifies the Insurance Services Office addi tional insured form number CG 20 10 but does not specify which edition, or specifies an edition that does not exist, Paragraphs 9 a 3 b and 9 b of this endorsement shall not apply and Paragraph 9 a (3)(a) of this en dorsement shall apply 10 Broadened Contractual Liability Work Within 50’ of Railroad Property It is hereby agreed that Paragraph f (1) of Definition 12 "Insured contract" (SEC TION V DEFINITIONS) is deleted contractor / project man ager or owner of the con struction project in which you are involved b Only with regard to insurance pro vided to an additional insured desig nated under Paragraph 9 a (2) Sub paragraphs (f) and (g) above, SEC TION III LIMITS OF INSURANCE is amended to include: The limits applicable to the additional insured are those specified in the written contract or agreement or in the Declarations of this Coverage Part, whichever are less If no limits are specified in the written contract or agreement, or if there is no written contract or agreement, the limits ap plicable to the additional insured are those specified in the Declarations of this Coverage Part The limits of in surance are inclusive of and not in addition to the limits of insurance shown in the Declarations c SECTION IV COMMERCIAL GEN ERAL LIABILITY CONDITIONS is hereby amended as follows: (1) Condition 5 Other Insurance is amended to include: (a) Where required by a written contract or agreement, this insurance is primary and / or noncontributory as re spects any other insurance policy issued to the addi tional insured, and such other insurance policy shall be excess and / or noncon tributing, whichever applies, with this insurance (b) Any insurance provided by this endorsement shall be primary to other insurance available to the additional insured except: 1) As otherwise provided in SECTION IV COMMERCIAL GEN ERAL LIABILITY CONDITIONS, 5 Other Insurance, b Excess Insurance; or 2) For any other valid and collectible insurance available to the addi tional insured as an additional insured by attachment of an en dorsement to another insurance policy that is or if no period of time is re quired by the written con tract or agreement, a per son or organization’s status as an insured under this endorsement ends when your operations for that in sured are completed (g) With respect to injury or damage that occurs in the "coverage territory" but not in the state of New Mexico, any person or organization with which you have agreed per Paragraph 9 a (1) above to provide insurance, but only with respect to li ability arising out of "your work" performed for that additional insured by you or on your behalf A person or organization’s status as an insured under this provision of this endorsement contin ues for only the period of time required by the written contract or agreement, but in no event beyond the ex piration date of this Cover age Part If there is no writ ten contract or agreement, or if no period of time is re quired by the written con tract or agreement, a per son or organization’s status as an insured under this endorsement ends when your operations for that in sured are completed (3) Any insurance provided to an additional insured designated under Paragraph 9 a (2): (a) Subparagraphs (e), (f) and (g) do not apply to "bodily injury" or "property damage" included within the "prod ucts completed operations hazard"; (b) Subparagraphs (a), (b), (d), (e) and (g) do not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the sole negligence or willful misconduct of the additional insured or its "employees"; or (c) Subparagraph (f) and (g) do not apply to "bodily in jury", "property damage" or "personal and advertising injury" arising out of: performed at the vendor’s premises in connection with the sale of the product; g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor 2) This insurance does not apply to any in sured person or or ganization: a) From whom you have acquired such products, or any ingredient, part or container, entering into, ac companying or containing such products; or b) When liability in cluded within the "products completed opera tions hazard" has been excluded under this Cover age Part with re spect to such products (d) Any state or political subdi vision with which you have agreed per Paragraph 9 a (1) above to provide in surance, subject to the fol lowing additional provision: This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connec tion with premises you own, rent or control and to which this insurance applies: 1) The existence, mainte nance, repair, con struction, erection, or removal of advertising signs, awnings, cano pies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street premises leased to you with whom you have agreed per Paragraph 9 a (1) above to provide insurance, but only with respect to liability aris ing out of the ownership, maintenance or use of that part of a premises leased to you, subject to the following additional exclusions: This insurance does not apply to: 1) Any "occurrence" which takes place after you cease to be a ten ant in that premises 2) Structural alterations, new construction or demolition operations performed by or on be half of such additional insured (b) Any person or organization from which you lease equipment with whom you have agreed per Paragraph 9 a (1) above to provide in surance Such person(s) or organization(s) are insureds solely with respect to their liability arising out of the maintenance, operation or use by you of equipment leased to you by such per son(s) or organizations(s) However, this insurance does not apply to any "oc currence" which takes place after the equipment lease expires (c) Any person or organization (referred to below as ven dor) with whom you have agreed per Paragraph 9 a (1) above to provide in surance, but only with re spect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the ven dor’s business, subject to the following additional ex clusions: 1) The insurance afforded the vendor does not apply to: one "occurrence" regardless of the number of: (1) Insureds; (2) Claims made or "suits" brought; or (3) Persons or organizations mak ing claims or bringing "suits" b Deductible Clause (1) Our obligation to pay damages on your behalf applies only to the amount of damages for each "occurrence" which are in ex cess of the deductible amount stated in Section B Limits of Insurance, 6 Voluntary Prop erty Damage and Care, Cus tody or Control Liability Cov erage of this endorsement The limits of insurance will not be re duced by the application of such deductible amount (2) Condition 2 Duties in the Event of Occurrence, Offense, Claim or Suit, applies to each claim or "suit" irrespective of the amount (3) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the ac tion taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us 7 180 Day Coverage for Newly Formed or Acquired Organizations SECTION II WHO IS AN INSURED is amended as follows: Subparagraph a of Paragraph 4 is hereby deleted and replaced by the fol lowing: a Insurance under this provision is af forded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; 8 Waiver of Subrogation SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, 9 Transfer of Rights of Recovery Against Others to Us is hereby amended by the addition of the following: We waive any right of recovery we may have because of payments we make for building or structure, or to personal property in the building or structure caused by or resulting from rain, snow, sleet or ice, whether driven by wind or not c Limit of Insurance The Damage to Premises Rented to You Limit as shown in the Declara tions is amended as follows: (2) Paragraph 6 of SECTION III LIMITS OF INSURANCE is hereby deleted and replaced by the following: 6 Subject to 5 above, the Damage to Premises Rented to You Limit is the most we will pay under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, for damages because of "property damage" to premises while rented to you or temporarily occupied by you with permission of the owner, arising out of any one "occurrence" to which this insurance ap plies (3) The amount we will pay is lim ited as described in Section B Limits of Insurance, 3 Dam age to Premises Rented to You of this endorsement 4 Supplementary Payments Under SECTION I COVERAGE, SUP PLEMENTARY PAYMENTS COVER AGES A AND B: a Paragraph 2 is replaced by the fol lowing: Up to the limit shown in Section B Limits of Insurance, 4 a Bail Bonds of this endorsement 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 ap plies We do not have to furnish these bonds b Paragraph 4 is replaced by the fol lowing: such failure 3 Damage to Premises Rented to You a The last Subparagraph of Paragraph 2 SECTION I COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE, 2 LI ABILITY Exclusions is hereby de leted and replaced by the following: Exclusions c through q do not apply to damage by fire, explosion, light ning, smoke or soot to premises while rented to you or temporarily occupied by you with permission of the owner b The insurance provided under SEC TION I COVERAGES, COVERAGE A BODILY INJURY AND PROP ERTY DAMAGE LIABILITY applies to "property damage" arising out of water damage to premises that are both rented to and occupied by you (1) As respects Water Damage Le gal Liability, as provided in Paragraph 3 b above: The exclusions under SECTION I COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABIL ITY, 2 Exclusions, other than i War and the Nuclear Energy Liability Exclusion, are deleted and the following are added: This insurance does not apply to: (a) "Property damage": 1) Assumed in any con tract; or 2) Loss caused by or re sulting from any of the following: a) Wear and tear; b) Rust, corrosion, fungus, decay, deterioration, hid den or latent de fect or any quality in property that causes it to dam age or destroy it self; c) Smog; d) Mechanical breakdown in cluding rupture or does not include: a Handling payroll de ductions; or b The failure to effect or maintain any insurance or adequate limits of coverage of insurance, including but not limited to unemployment in surance, social security benefits, workers’ com pensation and disability benefits 2 "Cafeteria plans" means plan authorized by applica ble law to allow "employ ees" to elect to pay for cer tain benefits with pre tax dollars 3 "Employee benefit pro grams" means a program providing some or all of the following benefits to "em ployees", whether provided through a "cafeteria plan" or otherwise: a Group life insurance; group accident or health insurance; den tal, vision and hearing plans; and flexible spending accounts; provided that no one other than an "em ployee" may subscribe to such benefits and such benefits are made generally available to those "employees" who satisfy the plan’s eligi bility requirements; b Profit sharing plans, employee savings plans, employee stock ownership plans, pen sion plans and stock subscription plans, provided that no one other than an "em ployee" may subscribe to such benefits and such benefits are made generally available to all "employees" who are eligible under the plan for such benefits; c Unemployment insur ance, social security other information; (3) Cooperate with us in the investigation or settlement of the claim or de fense against the "suit"; and (4) Assist us, upon our request, in the enforcement of any right against any person or or ganization which may be liable to the insured be cause of an act, error or omission to which this in surance may also apply d No insured will, except at that insured’s own cost, voluntarily make a payment, assume any obligation, or incur any expense without our consent (2) Item 5 Other Insurance is de leted in its entirety and replaced by the following: 5 Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this Coverage Part, our obligations are limited as follows: a Primary Insurance This insurance is pri mary except when c below applies If this in surance is primary, our obligations are not af fected unless any of the other insurance is also primary Then, we will share with all that other insurance by the method described in b below b Method of Sharing If all of the other insur ance permits contribu tion by equal shares, we will follow this exceed, and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the "em ployee benefit program" (4) Deductible Amount (a) Our obligation to pay dam ages on behalf of the in sured applies only to the amount of damages in ex cess of the deductible amount stated in the Decla rations as applicable to Each Employee The limits of insurance shall not be reduced by the amount of this deductible (b) The deductible amount stated in the Declarations applies to all damages sustained by any one "em ployee", including such "employee’s" dependents and beneficiaries, because of all acts, errors or omis sions to which this insur ance applies (c) The terms of this insurance, including those with respect to: 1) Our right and duty to defend the insured against any "suits" seeking those dam ages; and 2) Your duties, and the duties of any other in volved insured, in the event of an act, error or omission, or claim, apply irrespective of the application of the deductible amount (d) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as we have paid sureds, but only with re spect to their duties as your managers (d) An organization other than a partnership, joint venture or limited liability company, you are an insured Your "executive officers" and di rectors are insureds, but only with respect to their duties as your officers or di rectors Your stockholders are also insureds, but only with respect to their liability as stockholders (e) A trust, you are an insured Your trustees are also in sureds, but only with re spect to their duties as trustees (2) Each of the following is also an insured: (a) Each of your "employees" who is or was authorized to administer your "employee benefit program" (b) Any persons, organizations or "employees" having proper temporary authori zation to administer your "employee benefit program" if you die, but only until your legal representative is ap pointed (c) Your legal representative if you die, but only with re spect to duties as such That representative will have all your rights and du ties under this Coverage Part (3) Any organization you newly ac quire or form, other than a part nership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if no other similar insurance applies to that organization However, cover age under this provision: (a) Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and vice Given With Respect to Participation Any claim based upon: 1) Failure of any invest ment to perform; 2) Errors in providing in formation on past per formance of investment vehicles; or 3) Advice given to any person with respect to that person’s decision to participate or not to participate in any plan included in the "em ployee benefit pro gram" (f) Workers’ Compensation and Similar Laws Any claim arising out of your failure to comply with the mandatory provisions of any workers’ compensation, unemployment compensa tion insurance, social secu rity or disability benefits law or any similar law (g) ERISA Damages for which any in sured is liable because of liability imposed on a fiduci ary by the Employee Re tirement Income Security Act of 1974, as now or hereafter amended, or by any similar federal, state or local laws (h) Available Benefits Any claim for benefits to the extent that such benefits are available, with reason able effort and cooperation of the insured, from the ap plicable funds accrued or other collectible insurance (i) Taxes, Fines or Penalties Taxes, fines or penalties, including those imposed under the Internal Revenue Code or any similar state or local law TION III LIMITS OF INSURANCE; and 2) Our right and duty to defend ends when we have used up the ap plicable limit of insur ance in the payment of judgments or settle ments No other obligation or liabil ity to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Pay ments (b) This insurance applies to damages only if the act, er ror or omission, is negli gently committed in the "administration" of your "employee benefit pro gram"; and 1) Occurs during the pol icy period; or 2) Occurred prior to the effective date of this endorsement provided: a) You did not have knowledge of a claim or "suit" on or before the ef If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ PROPERTY DAMAGE $ BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER (MM/DD/YYYY) LIMITS POLICY EXP (MM/DD/YYYY) POLICY EFF LTR TYPE OF INSURANCE POLICY NUMBER INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $ $ OCCUR CLAIMS-MADE DED RETENTION $ PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $ EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY