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HomeMy WebLinkAbout124948 TOP GUN PRESSURE WASHING LLC - INSURANCE CERTIFICATECERTIFICATE HOLDER © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) AUTHORIZED REPRESENTATIVE CANCELLATION CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) JECT LOC POLICY PRO- GEN'L AGGREGATE LIMIT APPLIES PER: CLAIMS-MADE OCCUR COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY PREMISES (Ea occurrence) $ DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ DED RETENTION $ CLAIMS-MADE OCCUR $ AGGREGATE $ UMBRELLA LIAB EACH OCCURRENCE $ EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: TOPGU-1 1 1 Olson & Olson Ltd Top Gun Pressure Washing, LLC 500 W. 67th St. Loveland CO 80538 25 CERTIFICATE OF LIABILITY INSURANCE CONTRACTUAL LIABILITY APPLIES PER POLICY TERMS AND CONDITIONS A WRAP EXCLUSION APPLIES PER POLICY TERMS AND CONDITIONS Other Coverages: LEASED/RENTED EQUIPMENT POLICY: Policy Number: 8B845589 Policy Effective Date: 7-1-19 to 7-1-20 Insurer: Travelers Prop Cas Co of Amer (NAIC # 25674) Limit: $100,000 Deductible: $1,000 CRIME POLICY: Policy Number: CPA3235676 Policy Effective Date: 3-4-20 to 3-4-21 Insurer: Union Insurance Company (NAIC #25844) Theft of Client’s Property Limit: $100,000 Deductible: $1,000 GENERAL LIABILITY: CLCG2062 Form Attached Includes: Blanket Additional Insured – Competed Operations status when required by written contract. CA2001 Form Attached Includes: Blanket Primary & Non-Contributory status to Additional insured applies when required by a written contract. CLCG0492 Form Attached Includes: Blanket Additional Insured – Ongoing Operations status when required by written contract. Blanket Additional Insured for Various Relationships when required by written contract or written agreement. Blanket Waiver of Subrogation applies when required by written contract. AUTO LIABILITY: CLCA2093 Form Attached Includes: Blanket Additional Insured status applies when required by written contract. Blanket Waiver of Subrogation applies when required by written contract. Blanket Primary & Non-Contributory status to Additional insured applies when required by a written contract. WORKERS COMPENSATION WC000313 Form Attached Includes: Blanket Waiver of Subrogation applies when required by written contract. UMBRELLA LIABILITY: Umbrella Liability policy is on a follow form basis for the following underlying insurance coverages: General Liability, Automobile Liability and Employers Liability. CW1054 Form Attached Includes: Additional Insured status including Primary and Non-Contributory status, will follow form when required by written contract. POLLUTION LIABILITY: Policy Number: 6049865555 Policy Effective Date: 7-1-19 to 7-1-20 Insurer: Columbia Casualty Company (NAIC # 31127) COMMERCIAL GENERAL LIABILITY CL CG 04 92 10 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CL CG 04 92 10 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 8 GENERAL LIABILITY ULTRA PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SUMMARY OF COVERAGE EXTENSIONS Provision Name Of Coverage Extension Included or Limit of Insurance A. Miscellaneous Additional Insureds Included B. Expected Or Intended Injury Or Damage Included C. Knowledge Of Occurrence Included D. Legal Liability – Damage To Premises Rented To You (Fire, Lightning, Explosion, Smoke, Or Leakage From Automatic Fire Protective Systems) $300,000 E. Medical Payments See Declarations F. Mobile Equipment Redefined Included G. Newly Formed Or Acquired Organization, Partnership Or Limited Liability Company And Extended Period Of Coverage Included H. Who Is An Insured – Amendment Included I. Non-Owned Watercraft (Increased to maximum length of less than 51 feet) Included J. Supplementary Payments – Increased Limits 1. Bail Bonds $ 3,000 2. Loss Of Earnings $ 1,000 K. Unintentional Omission Or Unintentional Error In Disclosure Included L. Waiver Of Transfer Of Rights Of Recovery Against Others Included M. Liberalization Clause Included N. Incidental Medical Malpractice Included The above is a summary only. Please consult the specific provisions that follow for complete information on the extensions provided. The provisions of the Commercial General Liability Coverage Part apply except as otherwise provided in this endorsement. This endorsement applies only if such Coverage Part is included in this policy. A. MISCELLANEOUS ADDITIONAL INSUREDS 1. Section II – Who Is An Insured is amended to include as an insured any person or organization (referred to as an additional insured below) described in Paragraphs A.1.c.(1) through A.1.c.(9) below when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy, provided that: a. The written contract or written agreement is: (1) Currently in effect or becoming effective during the term of this policy; and (2) Fully executed by you and the additional insured prior to the "bodily CL CG 04 92 10 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 2 of 8 injury", "property damage" or "personal and advertising injury". b. The insurance afforded by this provision does not apply to any person or organization included as an additional insured by a separate endorsement issued by us and made a part of this policy or coverage part. c. Only the following persons or organizations are additional insureds under this provision, with coverage for such additional insureds limited as provided herein: (1) Persons or Organizations For Whom Operations Are Performed (a) Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured to your policy; and (b) Any other person or organization you are required to add as an additional insured under the contract or agreement described in paragraph (a) above. (c) Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: (i) Your acts or omissions; or (ii) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. (d) With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: (i) "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1.1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, CL CG 04 92 10 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 3 of 8 you and subject to the following additional exclusions: This insurance does not apply to: (a) Any "occurrence" which takes place after you cease to be a tenant in that premises. (b) Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. (3) Mortgagee, Assignee Or Receiver A mortgagee, assignee, or receiver but only with respect to their liability as mortgagee, assignee, or receiver and arising out of the ownership, maintenance, or use of a covered premises by you. This insurance does not apply to structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. (4) Owners Or Other Interests From Whom Land Has Been Leased An owner or other interest from whom land has been leased to you but only with respect to liability arising out of the ownership, maintenance or use of that part of the land leased to you and subject to the following additional exclusions: This insurance does not apply to: (a) Any "occurrence" which takes place after you cease to lease that land. (b) Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. (5) Lessor Of Leased Equipment Any person(s) or organization(s) from whom you lease equipment but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). A person’s or organization’s status as an additional insured under this endorsement ends when their written contract or written agreement with you for such leased equipment ends. This insurance does not apply to any "occurrence" which takes place after the equipment lease expires. CL CG 04 92 10 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 4 of 8 (b) This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the state, municipality, governmental agency or subdivision or other political subdivision. (7) Controlling Interest Any person(s) or organization(s) with a controlling interest in the Named Insured but only with respect to their liability arising out of: (a) Their financial control of you; or (b) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction or demolition operations performed by or for such person(s) or organization(s). (8) Co-Owner Of Insured Premises A co-owner of a premises co-owned by you and covered under this insurance but only with respect to the co-owner’s liability as co-owner of such premises. (9) Vendors (a) Any person(s) or organization(s) (referred to as vendor), but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor’s business. The insurance afforded the vendor does not apply to: (i) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a written contract or written agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the written contract or written agreement; (ii) Any express warranty unauthorized by you; (iii) Any physical or chemical change in the product made intentionally by the vendor; (iv) Repackaging, except when CL CG 04 92 10 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 5 of 8 in the usual course of business, in connection with the distribution or sale of the products. (b) This insurance does not apply to any insured person or organization, from whom you have acquired products, or any ingredient, part or container, entering into, accompanying or containing such products. 2. With respect to coverage provided by this Provision A. Miscellaneous Additional Insureds, the following additional provisions apply: a. Any insurance provided to an additional insured designated under Paragraphs A.1.c.(1) through A.1.c.(8) above does not apply: (1) To "bodily injury" or "property damage" included within the "products-completed operations hazard"; or (2) To "bodily injury", "property damage" or "personal and advertising injury" arising out of the sole negligence of such additional insured. b. The insurance afforded to such additional insured only applies to the extent permitted by law. c. The insurance afforded to such additional insured will not be broader than that which you are required to provide by the written contract or written agreement. 3. With respect to the insurance afforded to the additional insureds within this Provision A. Miscellaneous Additional Insureds, the following is added to Section III – Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the written contract or written agreement; or b. Available under the applicable Limits Of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits Of Insurance shown in the Declarations. B. EXPECTED OR INTENDED INJURY OR DAMAGE Exclusion 2.a. Expected Or Intended Injury of Section I – Coverage A – Bodily Injury And Property Damage Liability is deleted and replaced by the following: CL CG 04 92 10 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 6 of 8 Exclusions c. through n. do not apply to damage by fire, lightning, explosion, "smoke", or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with the permission of the owner. A separate limit of insurance applies to this coverage as described in Section III – Limits Of Insurance. 2. The paragraph immediately after Sub- paragraph j.(6) of Paragraph 2. Exclusions of Section I – Coverage A – Bodily Injury And Property Damage Liability is deleted and replaced by the following: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, "smoke", or leakage from automatic fire protective systems) to premises, including the contents of such premises, rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III – Limits Of Insurance. 3. Paragraph 6. of Section III – Limits Of Insurance is deleted and replaced by the following: 6. Subject to Paragraph 5. above, the greater of: a. $300,000; or b. The Damage To Premises Rented To You Limit shown in the Declarations, is the most we will pay under Coverage A for damages because of "property damage" to premises while rented to you, or in the case of damage by fire, lightning, explosion, "smoke", or leakage from automatic fire protective systems, while rented to you or temporarily occupied by you with permission of the owner. This limit will apply to all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, "smoke", leakage from automatic fire protective systems, or other covered causes of loss or any combination thereof. 4. Subparagraph b.(1)(a)(ii) of Paragraph 4. Other Insurance of Section IV – Commercial General Liability Conditions is deleted and replaced by the following: (ii) That is fire, lightning, explosion, "smoke" or leakage from automatic fire protective systems insurance for premises rented to you or temporarily occupied by you with permission of the owner; 5. Subparagraph a. of Definition 9. "Insured CL CG 04 92 10 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 7 of 8 c. Majority interest of more than 50% as an owner of a newly acquired or formed limited liability company; will qualify as a Named Insured if there is no other similar insurance available to that organization. However, for these organizations: (i) Coverage under this provision is afforded only until the next anniversary date of this policy’s effective date after you acquire or form the organization, partnership or limited liability company, or the end of the policy period, whichever is earlier; (ii) Section I – Coverage A – Bodily Injury And Property Damage Liability does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization, partnership or limited liability company; (iii) Section I – Coverage B – Personal And Advertising Injury Liability does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization, partnership or limited liability company; (iv) Coverage applies only when operations of the newly acquired organization, partnership or limited liability company are the same or similar to the operations of insureds already covered under this insurance; (v) Coverage only applies for those limited liability companies who have established a date of formation as recorded within the filed state articles of organization, certificates of formation or certificates of organization; and (vi) Coverage only applies for those partnerships who have established a date of formation as recorded within a written partnership agreement or partnership certificate. H. WHO IS AN INSURED – AMENDMENT The last paragraph of Section II – Who Is An Insured is deleted and replaced by the following: No person or organization is an insured with respect to the conduct of any: a. Current partnership or limited liability company, unless otherwise provided for under Paragraph 3. of Section II – Who Is An Insured; b. Current joint venture; or c. Past partnership, joint venture or limited liability company; that is not shown as a Named Insured in the Declarations. I. NON-OWNED WATERCRAFT CL CG 04 92 10 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 8 of 8 person(s) or organization(s) agreed to in the written contract or written agreement and is subject to those provisions. This waiver does not apply unless the written contract or written agreement has been executed prior to the "bodily injury" or "property damage". However, if any person or organization is separately scheduled on a separate waiver of transfer of rights of recovery which is attached to this policy, then this waiver does not apply. M. LIBERALIZATION CLAUSE The following is added to Section IV – Commercial General Liability Conditions: If we adopt a mandatory attachment form change which broadens coverage under this edition of the Commercial General Liability CG0001 for no additional charge, and those changes are intended to apply to all insureds under this edition of CG0001, that change will automatically apply to your insurance as of the date we implement the change in your state. This liberalization clause does not apply to changes implemented through introduction of a subsequent edition of the Commercial General Liability form CG0001. N. INCIDENTAL MEDICAL MALPRACTICE 1. Paragraph 2.a.(1)(d) of Section II – Who Is An Insured does not apply to a physician, nurse practitioner, physician assistant, nurse, emergency medical technician or paramedic employed by you if you are not in the business or occupation of providing medical, paramedical, surgical, dental, x-ray or nursing services. 2. This provision is excess over any other valid and collectible insurance whether such insurance is primary, excess, contingent or on any other basis. Any payments by us will follow Paragraph 4.b. of Section IV – Commercial General Liability Conditions. COMMERCIAL GENERAL LIABILITY CL CG 20 62 09 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CL CG 20 62 09 16 Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 2 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – COMPLETED OPERATIONS: AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Additional Insured(s) 1. Section II – Who Is An Insured is amended to include as an additional insured any person or organization for whom you have agreed to add as an additional insured on your policy in a written contract or written agreement, but only with respect to liability for “bodily injury” or “property damage” caused, in whole or in part, by “your work” performed for that additional insured and included in the “products-completed operations hazard”. 2. The insurance afforded to such additional insured(s) described in Paragraph 1. above is subject to each of the following additional provisions: a. The coverage provided to the additional insured by this endorsement does not apply to “bodily injury” or “property damage” beyond: (1) The period of time required by the written contract or written agreement described in Paragraph 1. above, or 10 years from the date of the completion of “your work” described in Paragraph 1. above, whichever is less; or (2) Two years from the date of the completion of “your work” described in Paragraph 1. above, if the written contract or written agreement does not specify the period of time. b. The insurance afforded to the additional insured(s) only applies to the extent permitted by law. c. The written contract or written agreement must have been executed prior to when the “bodily injury” or “property damage” occurs. d. The following is added to Section III – Limits Of Insurance: The most we will pay on behalf of the additional insured(s) is the amount of insurance: (1) Required by the written contract or written agreement described in Paragraph 1. above; or (2) Available under the applicable Limits of Insurance shown in the Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc. with its permission CL CG 20 62 09 16 Professional Liability Having rendered or having failed to render any professional architectural, engineering or surveying services, including: 1. The preparation, approval, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in having supervised, hired, employed, trained or monitored others by that insured, if the “occurrence” which caused the “bodily injury” or “property damage” involved the rendering of or the failure to render any professional architectural, engineering or surveying services. C. Duties In Event Of Occurrence, Claim Or Suit With respect to the coverage provided by this endorsement, the following replaces Paragraphs 2.a. and 2.b. of Section IV – Commercial General Liability Conditions: a. You and any additional insured must see to it that we are notified as soon as practicable of an “occurrence” which may result in a claim. To the extent possible, notice should include: (1) How, when and where the “occurrence” took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the “occurrence”. b. If a claim is made or “suit” is brought against any insured, the insured must: (1) Immediately record the specifics of the claim or “suit” and the date received; and (2) Notify us as soon as practicable. The insured must see to it that we receive written notice of the claim or “suit” as soon as practicable. COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. COMMERCIAL AUTO CL CA 20 93 03 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CL CA 20 93 03 19 Includes copyrighted material of Insurance Services Page 1 of 8 Offices, Inc. with its permission BUSINESS AUTO ENHANCEMENT – PLATINUM PLUS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SUMMARY OF COVERAGE EXTENSIONS Paragraph No. Name Of Extension Limit or Included A. Additional Insured by Contract Or Agreement Including Primary and Noncontributory Other Insurance Condition Included B. Airbags - Extended Coverage Included C. Telematics & GPS Equipment Coverage $2,500 D. Electronic Equipment – Increased Coverage $2,500 E. Auto Loan/Lease Gap Coverage Unlimited F. Autos Rented by Employees Included G. Bail Bonds - Extended Coverage $5,000 H. Broad Form Named Insured Including Newly Acquired or Formed Organizations Included I. Custom Signs & Decorations Included J. Employees as Insureds Included K. Family Emergency Travel Reimbursement $2,500 L. Fellow Employee Coverage Included M Fire Extinguisher Recharge Included N. Glass Repair – No Deductible Included O. Hired Auto Physical Damage and Increased Loss of Use Expenses Loss of use (Per Day / Maximum) $100,000 $500 / $3,500 P Hybrid Auto Payment Coverage (per auto / per loss) $2,500/ $5,000 Q. Knowledge Of An Accident, Claim, Suit Or Loss Included R. Limited Worldwide Hired & Non Owned Auto Coverage Included S. Loss Of Earnings - Extended Coverage $1,000 T. New Vehicle Replacement Cost Included U. Rental Reimbursement Coverage Maximum Rental Expenses Per Day $75 Maximum Rental Expenses Because Of Loss To Any One Covered "Auto" $3,375 Maximum Rental Expenses Because Of Loss To All Covered "Autos" In Any One Policy Period $15,000 Page 2 of 8 Includes copyrighted material of Insurance Services CL CA 20 93 03 19 Offices, Inc. with its permission V. Personal Effects Coverage $500 W. Resultant Mental Anguish Included X. Towing And Labor Coverage Extension Private Passenger Type Other than Private Passenger Type $200 $250 Y. Transportation Expenses - Coverage Extension ( Per Day / Maximum) $75 / $2,500 Z. Unintentional Failure To Disclose Hazards Included AA. Waiver Of Collision Deductible – Attached Autos Included BB. Waiver Of Subrogation By Contract Or Agreement Included A. ADDITIONAL INSURED BY CONTRACT OR AGREEMENT INCLUDING PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION The following is added to Paragraph A.1. Who Is An Insured of Section II – Covered Autos Liability Coverage: When you have agreed in a written contract or agreement to include a person or organization as an additional insured, such person or organization is included as an "insured" subject to the following: 1. Such person or organization is an additional insured only to the extent such person or organization is liable for "bodily injury" or "property damage" because of the conduct of an "insured" under Paragraphs a. or b. under Paragraph A.1. Who Is An Insured of Section II – Covered Autos Liability Coverage, caused by an "accident" and resulting from the ownership, maintenance or use of a covered "auto". 2. The written contract or agreement described above must have been executed prior to the "accident" that caused the "bodily injury" or "property damage" and be in effect at the time of such "accident". 3. The insurance afforded to any such additional insured does not apply to any "accident" beyond the period of time required by the written contract or agreement described above. 4. The most we will pay on behalf of such additional insured(s) is the lesser of: a. The Limits of Insurance specified in the written contract or agreement described above; or b. The Limits of Insurance shown in the Declarations. This provision shall not increase the Limit of Insurance shown in the Declarations in this policy or coverage part. 5. The following changes are made to Paragraph 5. Other Insurance of B. General Conditions under Section IV – Business Auto Conditions: CL CA 20 93 03 19 Includes copyrighted material of Insurance Services Page 3 of 8 Offices, Inc. with its permission C. TELEMATICS & GPS EQUIPMENT COVERAGE Physical Damage Coverage is amended as follows: 1. In Section III – Physical Damage Coverage, Paragraphs B.4.c. and B.4.d. do not apply to: a. Global positioning systems; or b. “Telematics devices”; which are not: (1) Permanently installed in or upon the covered "auto"; (2) Removable from a housing unit which is permanently installed in or upon the covered "auto"; (3) An integral part of the same unit housing any electronic equipment described in Paragraphs a. and b. above; or; (4) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system. 2. In the event of a “loss” to a covered “auto”, the most we will pay for “loss” to global positioning systems and “telematics devices” in any one covered “auto” is the lesser of: a. The actual cash value of the damaged or stolen property at the time of loss; b. The cost of repairing or replacing damaged or stolen property with other property of like kind and quality; or c. $2,500 3. For each covered “loss”, a deductible of $100 shall apply. “Telematics Devices” include devices that are not installed by the vehicle manufacturer and that are designed for the collection and dissemination of data for the purpose of monitoring vehicle and/or driver performance. This includes global positioning systems and wireless safety communication devices. Cellular, mobile and smart phones are not considered global positioning systems or “telematics devices” for purposes of this coverage provision. D. ELECTRONIC EQUIPMENT – INCREASED COVERAGE The $1,000 limit indicated in Paragraph C.1.b. under Section III – Physical Damage Coverage is increased to $2,500. E. AUTO LOAN/LEASE GAP COVERAGE The following is added to Section III – Physical Damage Coverage, Paragraph C.: In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered "auto", less: The amount paid under the Physical Damage Coverage section of the policy; and any: Page 4 of 8 Includes copyrighted material of Insurance Services CL CA 20 93 03 19 Offices, Inc. with its permission H. BROAD FORM NAMED INSURED INCLUDING NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following is added to sub paragraph A1. Who Is An Insured of Section II – Covered Autos Liability Coverage: For any covered “auto”; Any organization, other than a partnership, joint venture or limited liability company, over which you maintain ownership or majority interest of more than 50 percent on the effective date of this endorsement and for which you are obligated prior to the loss to provide insurance, unless that organization is an “insured” under any other automobile policy or would be an “insured” under such a policy but for the exhaustion of its Limit of Insurance. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company or any organization excluded either by this Coverage Part or by endorsement, and over which you maintain ownership or majority interest of more than 50 percent will qualify as a Named Insured. However: 1. This insurance does not apply to any newly acquired or formed organization that is an "insured" under any other automobile policy or would be an "insured" under such policy but for its termination or the exhaustion of its Limit of Insurance. 2. Coverage under this provision does not apply to "bodily injury", "property damage", expense or "loss" that occurred before you acquired or formed the organization. 3. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. I. CUSTOM SIGNS & DECORATIONS Physical Damage coverage on a covered “auto” extends to “loss” to custom signs and decorations including custom murals, paintings or other decals or graphics. Our limit of liability for each “loss” to custom signs and decorations shall be the least of: (1) Actual cash value of the stolen or damaged property; or (2) Amount necessary to repair or replace the property; This coverage does not apply to Hired Auto Physical Damage Coverage. J. EMPLOYEES AS INSUREDS Section II- Covered Autos Liability Coverage, Paragraph A.1.b.(2) is deleted and replaced by the following: (2) Any “employee” of yours is an “insured” while using a covered “auto” you don’t own, hire or borrow in your business or your personal CL CA 20 93 03 19 Includes copyrighted material of Insurance Services Page 5 of 8 Offices, Inc. with its permission per mile for the actual miles driven. 5. AII ''travel reimbursement expenses" must be supported by written receipts submitted to us no later than 120 days from the date such “travel reimbursement expenses” were incurred. "Travel reimbursement expenses" include reasonable ground, rail, or air (coach class) transportation, room accommodations, meals, and parking expenses only. “Designated representative” is an individual identified by the “insured” as a close personal friend or as having decision making authority pertaining to the insured’s care in the event of incapacity or death. “Family member” means a person related to the injured “insured” by blood, marriage, state- recognized civil union, or adoption, including a ward or foster child. L. FELLOW EMPLOYEE COVERAGE Exclusion B. 5. of Section II - Covered Autos Liability Coverage is deleted and replaced with the following: 5. Fellow Employee a. "Bodily injury" to any fellow "employee" of an "insured" arising out of and in the course of the fellow "employee’s" employment or while performing duties related to the conduct of your business; or b. The spouse, child, parent, brother or sister of that fellow "employee" as a consequence of Paragraph a. above. However, this exclusion does not apply to liability incurred by your “employees” that are “executive officers”. No "employee" is an "insured" for "bodily injury" to a co-employee if such co- employee's exclusive remedy is provided under a workers compensation law or any similar law. For the purpose of Fellow Employee Coverage only, paragraph B.5. of Business Auto Conditions is changed as follows: This FELLOW EMPLOYEE COVERAGE is excess over any other collectible insurance. As used in this provision, "executive officer" means a person holding any of the officer positions created by your charter, constitution, by-laws or any other similar governing document. M. FIRE EXTINGUISHER RECHARGE The following is added to Paragraph A.4. Coverage Extensions of Section III – Physical Damage Coverage: When fire extinguishers are kept in your covered "auto" and are discharged in an attempt to extinguish a fire, we will pay the lesser of the actual cost of recharging or replacing such fire Page 6 of 8 Includes copyrighted material of Insurance Services CL CA 20 93 03 19 Offices, Inc. with its permission amount of the highest deductible shown for any owned “auto” of the same classification for that coverage. In the event there is no owned “auto” of the same classification, the highest deductible for any owned “auto” will apply for that coverage. b. No deductible will apply to “loss” caused by fire or lightning. 3. Coverage provided under this extension will be excess over any other collectible insurance you have. Paragraphs 1 through 3 above do not apply if separate Hired Auto Physical Damage is indicated in the declarations. 4. For “autos” you lease, hire, rent or borrow covered under this Hired Auto Physical Damage Coverage extension or under separate coverage provided in the declarations, the limits in subparagraph b. Loss Of Use Expenses under paragraph 4. Coverage Extensions as found in paragraph A. Coverage of SECTION III – PHYSICAL DAMAGE COVERAGE, are increased to $500 per day, to a maximum of $3,500. P. HYBRID AUTO PAYMENT COVERAGE Section III – Physical Damage Coverage, A. 4 Coverage Extensions is amended to include the following: 1. In the event of a total “loss” to a non-“hybrid auto” for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under the Business Auto Coverage form, then Physical Damage Coverages are amended as follows: a. If a non-“hybrid auto” is replaced with a “hybrid auto” or “electric auto” we will pay an additional 10% of the non-“hybrid auto’s” actual cash value or replacement cost, to a maximum of $2,500, whichever is less; b. The non-“hybrid autos” must be replaced and a copy of a bill of sale or lease agreement must be received by us within 60 calendar days of the date of “loss”; and c. If more than one non-“hybrid auto” is damaged in any one “loss”, the most we will pay under this Coverage for any one “loss” is $5,000. 2. For the purpose of this coverage provision the following Definitions are added: a. “Hybrid auto” is defined as an “auto”, including a hybrid “electric auto” that is powered by two sources, an internal combustion engine, and an electric motor. CL CA 20 93 03 19 Includes copyrighted material of Insurance Services Page 7 of 8 Offices, Inc. with its permission T. NEW VEHICLE REPLACEMENT COST The following is added to the Paragraph C. Limit of Insurance provision of Section III – Physical Damage Coverage: In the event of a total “loss” to your “new vehicle” to which this coverage applies, we will pay at your option: a. The cost to replace the covered “auto” with a new “auto” of like make, model and year; or b. An amount equal to the original purchase price you paid to acquire the vehicle, including taxes, but excluding any extended warranties and licensing fees. This coverage applies only to a covered “auto” of the private passenger, light truck or medium truck type (20,000 lbs. or less gross vehicle weight). As used in this endorsement, a “new vehicle” means an “auto” of which you are the original owner that has not been previously titled and which you purchased less than 180 days before the date of the “loss”. U. RENTAL REIMBURSEMENT COVERAGE 1. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductible applies to this coverage. This coverage is only available to those covered “autos” involved in a “loss” and Physical Damage is provided to the covered “auto”. 2. We will pay only for those expenses incurred during the policy period, beginning 24 hours after the "loss" and ending, regardless of the expiration date of the policy, with the lesser of the following; 1. The number of days reasonably required to repair or replace 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 2. 45 days. 3. Our payment is limited to the lesser of the following amounts: 1. Necessary and actual expenses incurred. 2. The maximum rental expenses indicated below: (1) Not more than $75 per day; (2) The maximum rental expenses shown below: (a) $3,375 because of "loss" to any one covered "auto"; (b) $15,000 because of all "loss" to all covered "autos" in any one policy period. 4. We will pay up to an additional $300 for Page 8 of 8 Includes copyrighted material of Insurance Services CL CA 20 93 03 19 Offices, Inc. with its permission W. RESULTANT MENTAL ANGUISH Section V - Definitions, Paragraph C. is deleted and replaced by the following: C. "Bodily injury" means bodily injury, disability, sickness, or disease sustained by a person, including death resulting from any of these at any time. "Bodily injury" includes mental anguish or other mental injury resulting from "bodily injury". X. TOWING AND LABOR COVERAGE EXTENSION The following is added to Section III – Physical Damage Coverage, paragraph A.2.: 1. We will pay up to: a. $200 for a covered "auto" of the private passenger type or b. $250 for a covered "auto" that is not of the private passenger type, for towing and labor costs incurred each time the covered "auto" is disabled. However, the labor must be performed at the place of disablement. 2. This coverage applies only for an "auto" covered on this policy for Comprehensive or Specified Causes of Loss Coverage and Collision Coverages. 3. Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". Y. TRANSPORTATION EXPENSES - COVERAGE EXTENSION Paragraph A.4.a. Transportation Expenses of Section III – Physical Damage Coverage is amended as follows: 7. The Limits of Insurance are increased to $75 per day to a maximum of $2,500. 8. We will also pay reasonable and necessary expenses to facilitate the return of the stolen "auto" to you. Z. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following is added to Section IV - Business Auto Conditions, Paragraph B.2.: If you unintentionally fail to disclose any hazards existing at the inception of this policy, such failure will not prejudice the coverage provided to you. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or nonrenewal. AA. WAIVER OF COLLISION DEDUCTIBLE – ATTACHED AUTOS The following is added to paragraph D. under SECTION III - PHYSICAL DAMAGE COVERAGE of the Business Auto Coverage Form: If a “trailer” is connected to an “auto” that is not a “trailer” and both “autos”: 1. Are covered “autos” for Collision Coverage COMMERCIAL LIABILITY UMBRELLA CW 10 54 U 01 90 MANUSCRIPT ENDORSEMENT_CW 10 54 U_01/90 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY NUMBER: CPA 3235676 - 22 CW 10 54 U 01 90 Page 1 of 1 MANUSCRIPT ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL PROPERTY COVERAGE PART BUSINESSOWNERS INLAND MARINE CRIME COVERAGE PART COMMERCIAL AUTO COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART 7 COMMERCIAL EXCESS POLICY WORKERS' COMPENSATION POLICY Name of Additional Insured Person or Organization: "Any person or organization as agreed in writing in a contract or agreement" The following Replaces: A. SECTION II - WHO IS AN INSURED Paragraph 3. Any additional insured under any policy of "underlying insurance" will automatically be an insured under this insurance.Subject to Section III - Limits Of Insurance, if coverage provided to the additional insured is required by a contract oragreement, the most we will pay on behalf of the additional insured is the amount of insurance:a. Required in a written contract on a non-contributory basis for such additional insured, less any amounts payableby any "underlying insurance", orb. The limits of insurance available after the payment of "ultimate net loss" on any insured's behalf from any claimor "suit"; whichever is less.This provision is included within and does not act to increase the Limit of Insurance stated in the Declarations.Additional insured coverage provided by this insurance will not be broader than coverage provided by the "underlyinginsurance".The following is added toB. SECTION IV - CONDITIONS, Paragraph 5. Other Insurance.5. Other InsurancePrimary And Noncontributory InsuranceThis insurance is primary to and will not seek contribution from any other insurance available to an additionalinsured under your policy provided that;a. The additional insured is a Named Insured under such other insurance; andb. You have agreed in writing in a contract or agreement that this insurance would be primary and would notseek contribution from any other insurance available to the additional insured. nnnn 7501 E. Lowry Blvd. Denver, CO 80230-7006 303.361.4000 / 800.873.7242 Pinnacol.com Top Gun Pressure Washing Inc 500 W 67th St Loveland, CO 80538 Olson and Olson Insurance Services, 5655 S. Yosemite St. Suite 200 Greenwood Village, CO 80111 (303) 867-2055 7501 E. Lowry Blvd Denver, CO 80230-7006 Page 1 of 1 P ROSSIGNB - Underwriter 06/28/2019 08:30:14 4031609 54161092 359-B NCCI #: WC000313B Policy #: 4031609 ENDORSEMENT: Blanket Waiver of Subrogation Effective Date:July 1, 2019 Expires on: July 1, 2020 Pinnacol Assurance has issued this endorsement June 28, 2019 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE To any person or organization when agreed to under a written contract or agreement, as defined above and with the insured, which is in effect and executed prior to any loss. CNA90038XX (Ed. 01-18) ADDITIONAL INSURED WITH PRIMARY/NON CONTRIBUTORY PROVISION ENDORSEMENT It is understood and agreed that the Policy is amended as follows: The Section of the Policy entitled COVERAGE, the sub-section entitled DEFENSE & SETTLEMENT is amended by the addition of the following: Additional Insured with Primary/Non-Contributory Provision I. We also have the right and duty to defend a claim against any person or organization whom you are required to add as an additional insured under this Policy under a written contract or written agreement, provided such contract or agreement: 1. is currently in effect or becomes effective during the term of this policy; 2. was executed prior to the bodily injury or property damage for which such additional insured seeks coverage; and 3. expressly requires making the person or organization an additional insured for pollution coverage such as is provided by this policy. II. The insurance provided to the additional insured is limited as follows: 1. The person or organization is an additional insured only with respect to liability for bodily injury or property damage: a. caused entirely by your negligent acts or omissions or those of others working on your behalf; and b. for which you would be covered under this policy, if the claim had been brought against you. 2. If defense of such a claim results in the additional insured's legal obligation to pay compensatory damages for bodily injury or property damage described in paragraph 2.a. above, then subject to all of the terms and conditions of this policy, we will pay such damages in excess of the self-insured retention up to the applicable Limit of Liability. 3. This insurance is excess of all other insurance available to the additional insured, whether on a primary, excess, contingent or any other basis. But if required by written contract or agreement to be primary and non-contributory, this insurance will be primary and non-contributory relative to insurance on which the additional insured is a Named Insured. 4. Any coverage granted by this provision shall apply only to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. CNA90038XX (Ed. 01-18) Policy No: Page 1 of 1 Endorsement No: Effective Date: Insured Name: Copyright, CNA All Rights Reserved. 30020005560498655551272 CNA83662XX (Ed. 10-15) SUBROGATION AMENDMENT ENDORSEMENT It is understood and agreed that the Section of the Policy entitled CONDITIONS, the Condition entitled Subrogation, is deleted in its entirety and replaced by the following: Subrogation If any of you have rights to recover amounts from another, those rights are transferred to us to the extent of our payment. You must do everything necessary to secure these rights and must do nothing after a claim is made to jeopardize them. We hereby waive subrogation rights against any person or organization with whom the Named Insured has made a written agreement, prior to a claim or circumstance, to waive such rights, to the extent provided in such agreement. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA83662XX (Ed. 10-15) Policy No: Page 1 of 1 Endorsement No: Effective Date: Insured Name: Copyright, CNA All Rights Reserved. 30020005560498655551271 that applies to that “accident”, and 2. Sustain damage in a single “accident”. we will waive the lowest of the applicable Collision deductibles. BB. WAIVER OF SUBROGATION BY CONTRACT OR AGREEMENT The following is added to Section IV - Business Auto Conditions, Paragraph A.5.: We waive any right of recovery we may have against any “insured” provided coverage under this endorsement under A. ADDITIONAL INSURED BY CONTRACT OR AGREEMENT INCLUDING PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION, but only as respects “loss” arising out of the operation, maintenance or use of a covered “auto” pursuant to the provisions or conditions of the written contract or agreement. the reasonable and necessary expenses you incur to remove your materials and equipment from the covered "auto" and replace such materials and equipment on the rental "auto". 5. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 6. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Physical Damage Coverage Extension. V. PERSONAL EFFECTS COVERAGE The following is added to Section III – Physical Damage Coverage, Paragraph A.4.: Physical Damage Coverage on a covered “auto” is extended to “loss” to your personal property and, if you are an individual, the personal property of a family member, that is in the covered “auto” at the time of “loss”; and caused by an "accident" and resulting from the ownership, maintenance or use of a covered "auto". The most we will pay for any one "loss" under this coverage extension is $500. However, our payment for "loss" to personal property will only be for the account of the owner of the property. Under this provision personal property does not include and we will not pay for "loss" of: 1. Currency, coins, securities or 2. Property that under federal or state law is a. An illegal controlled substance b. Property in the course of illegal transportation or trade. No deductible applies to this coverage extension. b. “Electric auto” is an “auto” that is powered by an electric motor instead of an internal combustion engine. The “electric auto” uses energy stored in its rechargeable batteries, which are recharged by common household electricity. Q. KNOWLEDGE OF AN ACCIDENT, CLAIM, SUIT OR LOSS The following is added to Section IV – Business Auto Conditions, Paragraph A.2.: Notice of an "accident" or "loss" will be considered knowledge of yours only if reported to you, if you are an individual, a partner, an executive officer or an employee designated by you to give us such notice. Notice of an "accident" or "loss" to your Workers’ Compensation insurer, for an event which later develops into a claim for which there is coverage under this policy, shall be considered notice to us, but only if we are notified as soon as you know that the claim should be addressed by this policy, rather than your Workers’ Compensation policy. R. LIMITED WORLDWIDE HIRED & NON OWNED AUTO COVERAGE In Section IV - Business Auto Conditions, Condition B.7., paragraph b.(5) is replaced by the following: (5) Anywhere in the world if a covered "auto" is leased, hired, rented or borrowed without a driver for a period of 30 days or less, S. LOSS OF EARNINGS - EXTENDED COVERAGE Section II – Covered Autos Liability Coverage, Paragraph A.2.a.(4) is deleted and replaced by the following: (4) All reasonable expenses incurred by the “insured” at our request, including actual loss of earnings up to $1,000 a day because of time off from work. extinguisher(s). No deductible applies to this coverage. N. GLASS REPAIR – NO DEDUCTIBLE Section III – Physical Damage Coverage, Paragraph D. is deleted and replaced by the following: D. DEDUCTIBLE For each covered “auto” our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Declarations. Any Comprehensive Coverage deductible shown in the Declarations does not apply to: 1. “Loss” caused by fire or lightning; or 2. “Loss” when you elect to patch or repair glass rather than replace. O. HIRED AUTO PHYSICAL DAMAGE COVERAGE AND INCREASED LOSS OF USE EXPENSES Section III – Physical Damage Coverage, A. 4 Coverage Extensions is amended to include the following: If hired "autos" are covered "autos" for Liability Coverage under this policy and if Physical Damage Comprehensive Coverage, Physical Damage Specified Causes Of Loss Coverage, or Physical Damage Collision Coverage is provided under this policy for any "auto" you own, then such Physical Damage Coverages are extended to apply to "autos" you lease, hire, rent or borrow without a driver, subject to the following provisions: 1. This extension is only available for “autos” you lease, hire, rent or borrow for less than 30 consecutive days. 2. The most we will pay in any one “loss” is the least of $100,000, the actual cash value of the “auto” or the cost to repair or replace the “auto”, except that such amount will be reduced by a deductible to be determined as follows: a. The deductible shall be equal to the affairs. However, the insurance provided by this provision, I. EMPOYEES AS INSUREDS, does not apply if separate Employee as Insured coverage (or any similar or equivalent coverage) has been provided by a separate endorsement issued by us and made a part of this policy or coverage part. K. FAMILY EMERGENCY TRAVEL REIMBURSEMENT SECTION II - LIABILITY COVERAGE, A. 2. Coverage Extensions is amended to include the following: In addition to the Limit of Insurance, we will pay reasonable "travel reimbursement expenses" incurred by a “family member” or “designated representatives”, of an "insured" or passenger for travel to visit that "insured" or passenger who was injured in an "accident" involving a covered "auto", subject to the following conditions: 1. Regardless of the number of traveling “family members” or “designated representatives”, injured "insureds" or passengers, claims made or vehicles involved in the "accident", the most we will pay for all “travel reimbursement expenses" resulting from any one "accident" is $ 2,500. 2. Travel must be to visit the injured party at the hospital to which such “insured” has been admitted and has received medical or surgical treatment for a period of 72 hours or more from the time of first admittance to such hospital, or in the event of death, to the location necessary to handle the immediate affairs of the deceased. 3. Subject to the $2,500 per accident limit, the most we will pay for the combined total of expenses for room accommodations, meals, and parking for each “family member” or “designated representatives” is $200 per day. 4. We will reimburse ground transportation using a personal vehicle at a rate of 40 cents 1. Overdue lease/loan payments at the time of the "loss"; 2. Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; 3. Security deposits not returned by the lessor; 4. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and 5. Carry-over balances from previous loans or leases. However, this provision does not apply to the extent loan/lease gap coverage has been provided by separate endorsement to this policy. F. AUTOS RENTED BY EMPLOYEES The following is added to Section II – Covered Autos Liability Coverage, Paragraph A.1.: The following is added to the Who Is An Insured Provision: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business G. BAIL BONDS - EXTENDED COVERAGE Section II – Covered Autos Liability Coverage, Paragraph A.2.a.(2) is deleted and replaced by the following: (2) Up to $5,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an “accident” we cover. We do not have to furnish these bonds. a. The following is added to Paragraph 5.a.: If required by the written contract or agreement described above, the insurance afforded to the additional insured under this provision will be primary to, and will not seek contribution from, the additional insured’s own insurance. b. Paragraph 5.c. is deleted in its entirety. 6. Paragraph A.1.c. under Section II - Covered Autos Liability Coverage is deleted in its entirety. 7. The definition of "insured contract" under Section V – Definitions is amended to add the following: An "insured contract" does not include that part of any contract or agreement: That pertains to the ownership, maintenance or use of an "auto" and which indemnifies a person or organization for other than the vicarious liability of such person or organization for "bodily injury" or "property damage" caused by your operation or use of a covered "auto". However, a person or organization is an additional "insured" under this provision only to the extent such person or organization is not named as an "insured" by separate endorsement to this policy. B. AIRBAGS- EXTENDED COVERAGE Section III – Physical Damage Coverage, Paragraph B.3.a. does not apply to the unintended discharge of an airbag. Coverage is excess over any other collectible insurance or warranty specifically designed to provide coverage. Declarations of this policy or coverage part; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations of this policy or coverage part. B. Professional Liability Exclusion With respect to coverage provided by this endorsement, the following exclusion is added to Paragraph 2. Exclusions of Section I – Coverage A – Bodily Injury And Property Damage Liability: This insurance does not apply to “bodily injury” or “property damage” arising out of: Subparagraph (2) of Exclusion 2.g. Aircraft, Auto Or Watercraft of Section I – Coverage A – Bodily Injury And Property Damage Liability is deleted and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge. J. SUPPLEMENTARY PAYMENTS – INCREASED LIMITS Section I – Supplementary Payments – Coverages A And B is changed as follows: 1. The limit shown in Paragraph 1.b. for the cost of bail bonds is changed from $250 to $3,000; and 2. The limit shown in Paragraph 1.d. for loss of earnings because of time off from work is changed from $250 a day to $1,000 a day. K. UNINTENTIONAL OMISSION OR UNINTENTIONAL ERROR IN DISCLOSURE The following provision is added to Paragraph 6. Representations of Section IV – Commercial General Liability Conditions: However, the unintentional omission of, or unintentional error in, any information given or provided by you shall not prejudice your rights under this insurance. This provision does not affect our right to collect additional premium or to exercise our right of cancellation or non-renewal. L. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Commercial General Liability Conditions: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" and included in the "products-completed operations hazard" when you have agreed in a written contract or written agreement that any right of recovery is waived for such person or organization. This waiver applies only to the contract" of Section V – Definitions is deleted and replaced by the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, "smoke" or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract". 6. As used in this Provision D. Legal Liability – Damage To Premises Rented To You: "Smoke" does not include smoke from agricultural smudging, industrial operations or "hostile fire". E. MEDICAL PAYMENTS The Medical Expense Limit is changed, subject to the terms of Section III – Limits Of Insurance, to the Medical Expense Limit shown in the Declarations. F. MOBILE EQUIPMENT REDEFINED Subparagraph f.(1) of Definition 12. "Mobile equipment" of Section V – Definitions is deleted and replaced by the following: (1) Equipment with a gross vehicle weight of 1,000 pounds or more and designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; G. NEWLY FORMED OR ACQUIRED ORGANIZATION, PARTNERSHIP OR LIMITED LIABILITY COMPANY AND EXTENDED PERIOD OF COVERAGE Paragraph 3. of Section II – Who Is An Insured is deleted and replaced by the following: 3. Any organization you newly acquire or form, other than a joint venture, and over which you maintain ownership or: a. Majority interest of more than 50% if you are a corporation; b. Majority interest of more than 50% as a general partner of a newly acquired or formed partnership; and/or a. Expected Or Intended Injury Or Damage "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. C. KNOWLEDGE OF OCCURRENCE Paragraph 2.a. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV – Commercial General Liability Conditions is deleted and replaced by the following: a. You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim only when the "occurrence" or offense is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A manager, if you are a limited liability company; or (4) An "executive officer" or the "employee" designated by you to give such notice, if you are an organization other than a partnership or a limited liability company. To the extent possible, notice should include: (i) How, when and where the "occurrence" or offense took place; (ii) The names and addresses of any injured persons and witnesses; and (iii) The nature and location of any injury or damage arising out of the "occurrence" or offense. D. LEGAL LIABILITY – DAMAGE TO PREMISES RENTED TO YOU (Fire, Lightning, Explosion, Smoke, Or Leakage From Automatic Fire Protective Systems) If damage to premises rented to you is not otherwise excluded from this policy or coverage part, then the following provisions apply: 1. Under Section I – Coverage A – Bodily Injury And Property Damage Liability, the last paragraph (after the exclusions) is deleted and replaced by the following: unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (v) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (vi) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor’s premises in connection with the sale of the product; (vii) 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; or (viii) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1.1) The exceptions contained in Sub- paragraphs (iv) or (vi); or (1.2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make (6) State, Municipality, Governmental Agency Or Subdivision Or Other Political Subdivision – Permits Or Authorizations Relating To Premises Any state, municipality, governmental agency or subdivision or other political subdivision subject to the following additional provisions: (a) This insurance applies only with respect to: (i) The following hazards for which the state, municipality, governmental agency or subdivision or other political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies: (1.1) The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or (1.2) The construction, erection or removal of elevators; or (1.3) The ownership, maintenance or use of any elevators covered by this insurance. (ii) Operations performed by you or on your behalf for which the state, municipality, governmental agency or subdivision or other political subdivision has issued a permit or authorization. surveys, field orders, change orders or drawings and specifications; or (1.2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. (ii) "Bodily injury" or "property damage" occurring after: (1.1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (1.2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. (2) Managers Or Lessors Of Premises A manager or lessor of premises but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to Per Claim Limit: $1,000,000 Aggregate Limit: $1,000,000 Self-Insured Retention: $10,000 CNA90038XX Form Attached Includes: Blanket Additional Insured status when required by written contract or written agreement. Blanket Primary & Non-Contributory status to Additional insured applies when required by a written contract or written agreement. CNA83662XX Form Attached Includes: Blanket Waiver of Subrogation applies when required by written contract. IMPORTANT: The policy forms referenced will be sent via email only. To obtain copies, please send your request with the email address to o2@olsonandolson.com Downtown Area. PROPERTY DAMAGE $ $ $ $ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Olson & Olson Ltd 5655 S. Yosemite St. #200 Greenwood Village CO 80111 303-867-2055 303-867-2074 o2@olsonandolson.com Pinnacol Assurance 41190 TOPGU-1 Union Insurance Company 25844 Top Gun Pressure Washing, LLC 500 W. 67th St. Loveland CO 80538 RSUI Indemnity Company 22314 1634097530 B X 1,000,000 500,000 X 1,000,000 2,000,000 2,000,000 CPA3235676 3/4/2020 3/4/2021 X 10,000 B 1,000,000 X X X CPA3235676 3/4/2020 3/4/2021 B X X 10,000,000 X 10,000,000 N/A CPA3235676 3/4/2020 3/4/2021 A Y 4031609 7/1/2019 7/1/2020 1,000,000 1,000,000 1,000,000 C Excess Liability 3/5/2020 X NHA089286 3/4/2020 3/4/2021 Each Occurrence Aggregate 5,000,000 5,000,000 See Attached... City of Fort Collins 215 N. Mason St. 2nd Floor PO Box 580 Fort Collins CO 80522