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Insurance Certificates 2018/19 Willdan Financial ServicesCERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 04/18/2019 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 have ADDITIONAL INSURED provisions or 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). PRODUCER Aon Risk Insurance services West, Inc. Los An el es CA office 707 Wi 1 shire Boulevard Suite 2600 CONTACT NAME: PHONE (866) 283-7122 FAX (800) 363-0105 INC. No. Ext): AIC. No.): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Los Angeles CA 90017-0460 USA INSURED INSURERA: Travelers Property Cas CO Of America 25674 willdan Financial Services 27368 Via Industria INSURER B: Lexington Insurance Company 19437 INSURER C: Suite 200 -Temecula, CA 92590 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570075988393 REVISION NIJMRFR: 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 Limits shown are as requested LTR TYPE OF INSURANCE IUD VW0 POLICY NUMBER MMIDDIYYYY) (MMiUDnrYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY P U7J 66586TIL EACH OCCURRENCE $1,000,000 CLAIMS -MADE ❑X OCCUR TO PAMAG ES nccunence $1,000,000 X MED EXP (Any one person) $15 , 000 Employee Benefits Liability X Contractual Liability Included PERSONAL 8 ADV INJURY S1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2,000, 000 X POLICY ❑ PRO- JECT LOC PRODUCTS - COMPIOP AGG $2,000, 000 A AUTOMOBILE LIABILITY P-810-73365332-TIL-18 11/09/2018 11/09/2019 COMBINED SINGLE LIMIT Ea ac6depl) $1,000,000 BODILY INJURY ( Per person) X ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accidenl) AUTOS ONLY AUTOS HI REDAUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DED RETENTION A WORKERS ION AND N EMPLOYERS'LIABILITYYI ANY PROPRIETOR / PARTNER / EXECUTIVE N uBOL6 3678184 G 11/09J201 1 J09J2019 OTH X STATUTE IFR E L EACH ACCIDENT S1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA EL. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E L. DISEASE -POLICY LIMIT $1,000,000 B Archit&Eng Prof lapplies JSIR per policy terse & c/ nd8 ion09/2019 Perrrclaim $1,000.000 II SIR $250,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Landscaping District Administration and Assessment District Administration. City of La Quinta, its Officials, employees and agents are included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. A waiver of Subrogation is granted in favor of the city of La Quinta, its officials, employees and agents in accordance with the policy provisions of the General Liability, Automobile Liability and workers' Compensation policies. General Liability policy excludes claims arising out of the performance of professional services. Independent Contractors are included as respects to General Liability. Should General Liability, Automobile Liability and Workers' Compensation policies be cancelled before the expiration date thereof, the policy provisions CERTIFICATE HOLDER I� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS City Of La Quinta AUTHORIZED REPRESENTATIVE 78495 Calle Tampico La Quinta CA 92253 USA &e. ,11c,�LZMM �6Gt �d Ell ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD CANCELLATION AGENCY CUSTOMER ID: 570000066770 LOC #: A x ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Insurance Services West, Inc. NAMEDINSURED Willdan Financial Services POLICY NUMBER See Certificate Number: 570075988393 CARRIER See Certificate Number: 570075988393 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Description of Operations / Locations / Vehicles: will govern how notice of cancellation may be delivered to certificate holders in accordance with the policy provisions. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: P6307J366586TIL18 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED -WRITTEN CONTRACTS (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION 11 — WHO IS AN INSURED: Any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Coverage Part, but: a. Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b. If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is limited as follows: In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement shall not increase the limits of insurance described in Section III — Limits Of Insurance. d. This insurance does not apply to the render- ing of or failure to render any "professional services" or construction management errors or omissions. This insurance does not apply to "bodily in- jury" or "property damage" caused by "your work" and included in the "products - completed operations hazard" unless the "written contract requiring insurance" specifi- cally requires you to provide such coverage for that additional insured, and then the insur- ance provided to the additional insured ap- plies only to such "bodily injury" or "property damage" that occurs before the end of the pe- riod of time for which the "written contract re- quiring insurance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 2. The following is added to Paragraph 4.a. of SEC- TION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance provided to the additional insured is excess over any valid and collectible 'other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured for a loss we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided to the ad- ditional insured under this Coverage Part must apply on a primary basis or a primary and non- contributory basis, this insurance is primary to "other insurance" available to the additional in- sured which covers that person or organization as a named insured for such loss, and we will not share with that 'other insurance". But this insur- ance provided to the additional insured still is ex- cess over any valid and collectible 'other insur- ance", whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any 'other insurance". 3. The following is added to SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDITIONS: Duties Of An Additional Insured As a condition of coverage provided to the addi- tional insured: a. The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CG D4 14 04 08 0 2008 The Travelers Companies, Inc Page 1 of 2 COMMERCIAL GENERAL LIABILITY L 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. b. If a claim is made or "suit" is brought against the additional insured, the additional insured must: I. Immediately record the specifics of the claim or "suit' and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. c. The additional insured must immediately send us copies of all legal papers received in con- nection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and oth- erwise comply with all policy conditions. d. The additional insured must tender the de- fense and indemnity of any claim or "suit' to any provider of other insurance which would cover the additional insured for a loss we cover. However, this condition does not affect whether this insurance provided to the addi- tional insured is primary to that other insur- ance available to the additional insured which covers that person or organization as a named insured. 4. The following is added to the DEFINITIONS Sec- tion: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or or- ganization as an additional insured on this Cover- age Part, provided that the "bodily injury" and "property damage" occurs and the "personal in- jury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period Page 2 of 2 © 2008 The Travelers Companies, Inc CG D4 14 04 08 Policy Number: P8107J365332TIL18 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS —INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: 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 busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 © 2015 The Travelers Indemnity Company All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS —INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO You agree to maintain all required or (2) In or on your covered "auto". compulsory insurance in any such coun- This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered "auto". local law. Your failure to comply with No deductibles apply to this Personal Property compulsory insurance requirements will not invalidate the coverage afforded by coverage. this policy, but we will only be liable to the K. AIRBAGS same extent we would have been liable The following is added to Paragraph B.3., Exclu- had you complied with the compulsory in- sions, of SECTION III — PHYSICAL DAMAGE surance requirements. COVERAGE: (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE. - We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY Exclusion 3.a. does not apply to 'loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one 'loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph AA., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for "loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or "loss", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 © 2015 The Travelers Indemnity Company All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc with its permission COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col - The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal. SECTION IV — BUSINESS AUTO CONDITIONS: Page 4 of 4 © 2015 The Travelers Indemnity Company All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO POLICY NUMBER: P8107J365332TIL18 ISSUE DATE: 11/09/2018 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR LIABILITY COVERAGE - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE OF ADDITIONAL INSURED PERSONS OR ORGANIZATIONS AS PER WRITTEN CONTRACT OR AGREEMENT PROVISIONS 1. The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — LIABILITY COVERAGE: This includes any person or organization designated in the Schedule Of Additional Insured Persons Or Organizations who you are required under a written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Liability Coverage, but only for damages to which this insurance applies and only to the extent of that designated person's or organization's liability for the conduct of another "insured". 2. The following is added to Paragraph 5., Other Insurance, in B., General Conditions, of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which the person or organization designated in the Schedule Of Additional Insured Persons Or Organizations is the first named insured when the written contract or agreement between you and that designated person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non-contributory. CA T4 42 08 17 © 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Policy Number: P6307J366586TIL18 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ARCHITECTS, ENGINEERS AND SURVEYORS INDUSTRYEDGE sm ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Broadened Named Insured B. Incidental Medical Malpractice C. Reasonable Force — Bodily Injury Or Property Damage D. Non -Owned Watercraft — Increased To Up To 75 feet E. Aircraft Chartered With Pilot F. Extension Of Coverage — Damage To Premises Rented To You G. Personal Injury —Assumed by Contract H. Increased Supplementary Payments I. Additional Insured — Owner, Manager Or Lessor Of Premises J. Additional Insured — Lessor Of Leased Equip- ment K. Additional Insured — State Or Political Subdivisions — Permits Relating To Premises L. Additional Insured — State Or Political Subdivisions — Permits Relating To Operations PROVISIONS A. BROADENED NAMED INSURED — UNNAMED SUBSIDIARIES The Named Insured in Item 1. of the Declarations is amended as follows: The person or organization named in Item 1. of the Declarations and any organization, other than a partnership, joint venture, limited liability com- pany or trust, of which you are the sole owner or in which you maintain the majority ownership in- terest on the effective date of the policy. How- M. Who Is An Insured — Newly Acquired Or Formed Organizations N. Injury To Co -Employees And Co -Volunteer Workers O. Medical Payments Limit P. Knowledge And Notice Of Occurrence Or Offense Q. Other Insurance Condition R. Unintentional Omission S. Waiver Of Transfer Of Rights Of Recovery Against Others To Us When Required By Contract T. Amended Bodily Injury Definition U. Amended Insured Contract Definition — Rail- road Easement V. Additional Definition — Written Contract Re- quiring Insurance ever, coverage for any such additional organiza- tion will cease as of the date, if any, during the policy period, that you no longer are the sole owner of, or maintain the majority ownership in- terest in, such organization. B. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to the definition of "oc- currence" in the DEFINITIONS Section: Unless you are in the business or occupation of providing professional health care services, "occurrence" also means an act or omission CG D4 15 05 08 (Rev. 10-08) © 2008 The Travelers Companies, Inc Page 1 of 8 COMMERCIAL GENERAL LIABILITY committed by any of your "employees" who is employed by you as a registered nurse, li- censed practical nurse, emergency medical technician or paramedic, in providing or failing to provide "incidental medical services" or "Good Samaritan services" to a person. 2. The following is added to the DEFINITIONS Section: a. "Incidental medical services" means medical, surgical, dental, laboratory, x-ray or nursing service, treatment, advice or instruction; the related furnishing of food or beverages; the furnishing or dispens- ing of drugs or medical supplies or appli- ances; or first aid. b. "Good Samaritan services" means those medical services rendered or provided in C an emergency and for which no remu- neration is demanded or received. 3. The following is added to Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED Paragraphs (1) (a), (b), (c) and (d) above do not apply to any of your "employees" who are employed by you as a registered nurse, li- censed practical nurse, emergency medical technician or paramedic but only while per- forming the services described in Paragraph 1. above and while acting within the scope of their employment by you. Any such "employ- ees" rendering "incidental medical services" or "Good Samaritan services" will be deemed to be acting within the scope of their employ- ment by you. 4. The following exclusion is added to Para- graph 2. Exclusions of SECTION I — COV- ERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuti- cals committed by or with the knowledge or consent of the insured. for "bodily injury" that arises out of providing or failing to provide "incidental medical ser- vices" or "Good Samaritan services", except for insurance purchased specifically by you to apply in excess of the Limits of Insurance shown in the Declarations for this Coverage Part. 6. The following is added to Paragraph 5. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applica- ble Each Occurrence Limit, all related acts or omissions committed by any of your "employ- ees" in providing or failing to provide "inciden- tal medical services" or "Good Samaritan ser- vices" to any one person will be deemed to be one 'occurrence". REASONABLE FORCE PROPERTY DAMAGE — EXCEPTION TO EXPECTED OR INTENDED IN- JURY EXCLUSION The following replaces Exclusion a., Expected Or Intended Injury, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: a. Expected Or Intended Injury Or Damage "Bodily injury" or "property damage" expected or intended from the standpoint of the in- sured. This exclusion does not apply to "bod- ily injury" or "property damage" resulting from the use of reasonable force to protect any person or property. D. NON -OWNED WATERCRAFT — INCREASED TO UP TO 75 FEET 1. The following replaces Paragraph (2) of Ex- clusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: (2) A watercraft you do not own that is: (a) Less than 75 feet long; and (b) Not being used to carry any person or property for a charge. 2. The following is added to SECTION II — WHO 5. The following is added to Paragraph 4.b., Ex- IS AN INSURED: cess Insurance, of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDI- Any person who, with your expressed or im- TIONS: plied consent, either uses or is responsible for the use of a nonowned watercraft that is less This insurance is excess over any valid and than 75 feet and not being used to carry per - collectible 'other insurance", whether primary, son or property for a charge is included as an excess, contingent or on any other basis, that insured under this Coverage Part. is available to you or any of your "employees" Page 2 of 8 © 2008 The Travelers Companies, Inc. CG D4 15 05 08 (Rev. 10-08) E. AIRCRAFT CHARTERED WITH PILOT The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft that is: (a) Chartered with a pilot to any insured; and (b) Not owned by any insured. F. EXTENSION OF COVERAGE — DAMAGE TO PREMISES RENTED TO YOU 1. The following replaces the last paragraph of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAM- AGE LIABILITY: Exclusions c. through n. do not apply to dam- age to premises while rented to you, or tem- porarily occupied by you with permission of the owner, caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water. A separate limit of insurance applies to this coverage as described in SECTION III — LIM- ITS OF INSURANCE 2. The insurance under this Provision F. does not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: a. Rupture, bursting, or operation of pres- sure relief devices; b. Rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from wa- ter; or c. Explosion of steam boilers, steam pipes, steam engines, or steam turbines. 3. The following replaces Paragraph 6. of SEC- TION III — LIMITS OF INSURANCE COMMERCIAL GENERAL LIABILITY of the owner, caused by: fire; explosion; light- ning; smoke resulting from such fire, explo- sion, or lightning; or water. The Damage To Premises Rented To You Limit will apply to all "property damage" proximately caused by the same 'occurrence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or light- ning; or water; or any combination of any of these causes. The Damage To Premises Rented To You Limit will be the higher of: a. $300,000; or b. The amount shown for the Damage To Premises Rented To You Limit in the Declarations for this Coverage Part. 4. The following replaces Paragraph a. of the definition of "insured contract' in the DEFINI- TIONS Section: a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for damage to premises while rented to you, or tempo- rarily occupied by you with permission of the owner, caused by: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water is not an "insured contract"; G. PERSONAL INJURY — ASSUMED BY CON- TRACT The following replaces Exclusion e., Contractual Liability in Paragraph 2. of SECTION I — COV- ERAGES — COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY: "Advertising injury" for which the insured has as- sumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement. H. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGES: Subject to 5. above, the Damage To Prem- b. Up to $2,500 for cost of bail bonds re- ises Rented To You Limit is the most we will quired because of accidents or traffic law pay under Coverage A for the sum of all violations arising out of the use of any damages because of "property damage" to vehicle to which the Bodily Injury Liability any one premises while rented to you, or Coverage applies. We do not have to fur - temporarily occupied by you with permission nish these bonds. CG D4 15 05 08 (Rev 10-08) © 2008 The Travelers Companies, Inc Page 3 of 8 COMMERCIAL GENERAL LIABILITY 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGES: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. I. ADDITIONAL INSURED — OWNER, MANAGER OR LESSOR OF PREMISES 1. The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you have agreed in a "written contract requiring insur- ance" to include as an additional insured on this Coverage Part is an insured, but: a. Only with respect to liability for "bodily in- jury" or "property damage" that occurs, or "personal injury" caused by an offense committed, after you have entered into that "written contract requiring insurance"; and performed by or on behalf of such additional insured; or (3) Any premises for which coverage is excluded by another endorsement to this Coverage Part. 3. This Provision I. does not apply on any basis to any person or organization for which cov- erage as an additional insured specifically is added by another endorsement to this Cover- age Part. J. ADDITIONAL INSURED— LESSOR OF LEASED EQUIPMENT 1. The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you have agreed in a "written contract requiring insur- ance" to include as an additional insured on this Coverage Part is an insured, but: a. Only with respect to liability for "bodily in- jury" or "property damage" that occurs, or "personal injury" caused by an offense committed, after you have entered into that "written contract requiring insurance"; and b. Only if the "bodily injury", "property dam- b. Only if the "bodily injury", "property dam- age" or "personal injury" is caused, in age" or "personal injury" is caused, in whole or in part, by acts or omissions of whole or in part, by acts or omissions of you or any person or organization per - you or any person or organization per- forming operations on your behalf, and forming operations on your behalf, in the arises out of the ownership, maintenance maintenance, operation or use of equip- or use of that part of any premises leased ment leased to you by such additional in- to you under that "written contract requir- sured. ing insurance". 2. The insurance provided to such additional in- 2. The insurance provided to such additional in- sured under this Provision I. is subject to the sured under this Provision J. is subject to the following provisions: following provisions: a. The limits of insurance afforded to such a. The limits of insurance afforded to suchadditional additional insured shall be the limits insured shall be the limits which you agreed to provide in the "writ- which you agreed to provide in the "writ - ten contract requiring insurance", or the ten contract requiring insurance", or the limits shown in the Declarations for this limits shown in the Declarations for this Coverage Part, whichever are less; and Coverage Part, whichever are less; and b. The insurance afforded to such additional b. The insurance afforded to such additional insured does not apply: insured does not apply to: (1) Any "bodily injury" or "property dam- (1) To any "bodily injury" or "property "personal age" age" that occurs, or "personal injury" that occurs, or in - caused by an offense committed, af- jury" caused by an offense commit - ter you cease to be a tenant in that ted, after the equipment lease ex - premises; pires; or (2) Any structural alterations, new con- (2) If the equipment is leased with an operator. struction or demolition operations Page 4 of 8 © 2008 The Travelers Companies, Inc. CG D4 15 05 08 (Rev. 10-08) 3. This Provision J. does not apply on -any basis to any person or organization for which cov- erage as an additional insured specifically is added by another endorsement to this Cover- age Part. K. ADDITIONAL INSURED — STATE OR POLITI- CAL SUBDIVISIONS — PERMITS RELATING TO PREMISES The following is added to SECTION II — WHO IS AN INSURED: Any state or political subdivision that has issued a permit in connection with premises owned or oc- cupied by, or rented or loaned to, you, is an in- sured, but only with respect to "bodily injury", "property damage", "personal injury" or "advertis- ing injury" arising out of the existence, ownership, use, maintenance, repair, construction, erection or removal of advertising signs, awnings, cano- pies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, side- walk vaults, elevators, street banners or decora- tions for which that state or political subdivision has issued such permit. L. ADDITIONAL INSURED — STATE OR POLITI- CAL SUBDIVISIONS — PERMITS RELATING TO OPERATIONS The following is added to SECTION II — WHO IS AN INSURED: Any state or political subdivision that has issued a permit is an insured, but only with respect to "bod- ily injury", "property damage", "personal injury" or "advertising injury" arising out of operations per- formed by you or on your behalf for which that state or political subdivision has issued such permit. However, no such state or political subdi- vision is an insured for: 1. "Bodily injury", "property damage", "personal injury" or "advertising injury" arising out of op- erations performed for that state or political subdivision; or 2. "Bodily injury" or "property damage" included within the "products — completed operations hazard". M. WHO IS AN INSURED — NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following replaces Paragraph 4.a. of SEC- TION II —WHO IS AN INSURED: COMMERCIAL GENERAL LIABILITY riod, whichever is earlier. Any such newly ac- quired or formed organization that you report in writing to us within 180 days after you ac- quire or form the organization will be covered under this provision until the end of the policy period, even if there are more than 180 days remaining until the end of the policy period. N. INJURY TO CO -EMPLOYEES AND CO - VOLUNTEER WORKERS The following is added to SECTION II — WHO IS AN INSURED: 1. Your "employees" are insureds with respect to "bodily injury" to a co -"employee" in the course of the co -"employee's" employment by you, or to your "volunteer workers" while per- forming duties related to the conduct of your business, provided that this coverage for your "employees" does not apply to acts outside the scope of their employment by you or while performing duties unrelated to the conduct of your business. 2. Your "volunteer workers" are insureds with respect to "bodily injury" to a co -"volunteer worker" while performing duties related to the conduct of your business, or to your "employ- ees" in the course of the "employee's" em- ployment by you, provided that this coverage for your "volunteer workers" does not apply while performing duties unrelated to the con- duct of your business. 3. Subparagraphs 2.a.(1)(a), (b) and (c) and 3.a. of SECTION II — WHO IS AN INSURED do not apply to "bodily injury" for which insur- ance is provided by 'paragraph 1. or 2. above. O. MEDICAL PAYMENTS LIMIT The following replaces paragraph 7. of SECTION III — LIMITS OF INSURANCE: Subject to S. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sus- tained by any one person, and will be the higher of: a. $10,000; or b. The amount shown on the Declarations for Medical Expense Limit. P. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE a. Coverage under this provision is afforded only The following is added to Paragraph 2. Duties In until the 180th day after you acquire or form The Event of Occurrence, Offense, Claim Or the organization or the end of the policy pe- CG D4 15 05 08 (Rev. 10-08) © 2008 The Travelers Companies, Inc Page 5 of 8 COMMERCIAL GENERAL LIABILITY Suit of SECTION IV — COMMERCIAL GENERAL ance" by the method described in c. LIABILITY CONDITIONS: below. Notice of an "occurrence" or of an offense which b. Excess Insurance may result in a claim must be given as soon as This insurance is excess over any of practicable after knowledge of the "occurrence" or the "other insurance", whether pri- offense has been reported to you, one of your mary, excess, contingent or on any "executive officers" (if you are a corporation), one other basis: of your partners who is an individual (if you are a (1) That is Fire, Extended Coverage, partnership), one of your managers (if you are a Builder's Risk, Installation Risk, limited liability company), one of your trustees or similar coverage for "your who is an individual (if you are a trust), or an work"; "employee" (such as an insurance, loss control or (2) That is Fire insurance for prem- risk manager or administrator) designated by you ises rented to you or temporarily to give such notice. occupied by you with permission Knowledge by any other "employee" of an "occur- of the owner; rence" or offense does not imply that you also (3) That is insurance purchased by have such knowledge. you to cover your liability as a Notice of an "occurrence" or of an offense which tenant for "property damage" to may result in a claim will be deemed to be given premises rented to you or tempo - as soon as practicable to us if it is given in good rarily occupied by you with per - faith as soon as practicable to your workers' com- mission of the owner; or pensation, accident, or health insurer. This ap- (4) If the loss arises out of the main - plies only if you subsequently give notice of the tenance or use of aircraft, "occurrence" or offense to us as soon as practi- "autos", or watercraft to the ex - cable after you, one of your "executive officers" (if tent not subject to Exclusion g. of you are a corporation), one of your partners who Section I — Coverage A — Bodily is an individual (if you are a partnership), one of Injury And Property Damage Li - your managers (if you are a limited liability com- ability; or pany), one of your trustees who is an individual (if (5) That is available to the insured you are a trust), or an "employee" (such as an in- when the insured is an additional surance, loss control or risk manager or adminis- insured under any other policy, trator) designated by you to give such notice dis- including any umbrella or excess covers that the "occurrence" or offense may in- policy. volve this policy. When this insurance is excess, we Q. OTHER INSURANCE CONDITION will have no duty under Coverages A 1. The following replaces Paragraph 4., Other or B to defend the insured against "other Insurance"suit" Insurance of SECTION IV —COMMERCIAL if any provider of in - surance" has a duty to defend the in- sured against that "suit". If no pro- 4. Other Insurance vider of "other insurance" defends, If valid and collectible "other insurance" is we will undertake to do so, but we will available to the insured for a loss we be entitled to the insured's rights cover under Coverages A or B of this against all those providers of "other Coverage Part, our obligations are limited insurance". as follows: When this insurance is excess over a. Primary Insurance "other insurance", we will pay only our share of the amount of the loss, if This insurance is primary except any, that exceeds the sum of: when b. below applies. If this insur- ance is primary, our obligations are (1) The total amount that all such not affected unless any of the "other "other insurance" would pay for insurance" is also primary. Then, we the loss in the absence of this in - will share with all that "other insur- surance; and Page 6 of 8 © 2008 The Travelers Companies, Inc CG D4 15 05 08 (Rev. 10-08) (2) The total of all deductible and self -insured amounts under that "other insurance". We will share the remaining loss, if any, with any 'other insurance" that is not described in this Excess Insur- ance provision. c. Method Of Sharing If all of the 'other insurance" permits contribution by equal shares, we will follow this method also. Under this approach each provider of insurance contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, which- ever comes first. If any of the 'other insurance" does not permit contribution by equal shares, we will contribute by limits. Under this method, the share of each provider of insurance is based on the ratio of its applicable limit of insur- ance to the total applicable limits of insurance of all providers of insur- ance. 2. The following definition is added to SECTION V — DEFINITIONS: "Other insurance": a. Means insurance, or the funding of losses, that is provided by, through or on behalf of: (1) Another insurance company; (2) Us or any of our affiliated insurance companies, except when the Non cumulation of Each Occurrence Limit section of Paragraph 5. of LIMITS OF INSURANCE (Section III) or the Non cumulation of Personal and Advertis- ing Injury limit sections of Paragraph 4. of LIMITS OF INSURANCE (Sec- tion III) applies; (3) Any risk retention group; (4) Any self-insurance method or pro- gram, other than any funded by you and over which this Coverage Part applies; or (5) Any similar risk transfer or risk man- agement method. b. Does not include umbrella insurance, or excess insurance, that you bought spe- cifically to apply in excess of the Limits of COMMERCIAL GENERAL LIABILITY Insurance shown on the Declarations of this Coverage Part. R. UNINTENTIONAL OMISSION 1. The following is added to Paragraph 6. Rep- resentations of SECTION IV — COMMER- CIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or uninten- tional error in, any information provided by you which we relied upon in issuing this policy shall not prejudice your rights under this in- surance. 2. This Provision R. does not affect our right to collect additional premium or to exercise our right of cancellation or nonrenewal in accor- dance with applicable insurance laws or regu- lations. S. WAIVER OF TRANSFER OF RIGHTS OF RE- COVERY AGAINST OTHERS TO US WHEN REQUIRED BY CONTRACT The following is added to Paragraph 8. Transfer of Rights of Recovery Against Others to Us of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS: We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage", "personal injury" or "advertising injury" arising out of: 1. Premises owned by you, temporarily occu- pied by you with permission of the owner, or leased or rented to you; 2. Ongoing operations performed by you, or on your behalf, under a contract or agreement with that person or organization; 3. "Your work"; or 4. "Your products". We waive these rights only where you have agreed to do so as part of a "written contract re- quiring insurance" entered into by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury" offense or "advertising injury" offense is committed. T. AMENDED BODILY INJURY DEFINITION The following replaces the definition of "bodily injury" in the DEFINITIONS Section: "Bodily injury" means bodily injury, mental an- guish, mental injury, shock, fright, disability, hu- miliation, sickness or disease sustained by a per- CG D4 15 05 08 (Rev 10-08) © 2008 The Travelers Companies, Inc. Page 7 of 8 COMMERCIAL GENERAL LIABILITY son, including death resulting from any of these at "Written contract requiring insurance" means that any time. part of any written contract or written agreement U. AMENDED INSURED CONTRACT DEFINITION under which you are required to include a person — RAILROAD EASEMENT or organization as an additional insured on this Coverage Part, provided that the "bodily injury" 1. Subparagraph c. of the definition of "insured and "property damage" occurs, and the " ersonal contract" in the DEFINITIONS Section is re- injury" iscaused by an offense committed: placed by the following: a. After the signing and execution of the contract c. Any easement or license agreement; or agreement by you; 2. Subparagraph f.(1) of the definition of "in- b. While that art of the contract or agreement is �� n the sured contract iDEFINITIONS Section p g in effect; and is deleted. V. ADDITIONAL DEFINITION — WRITTEN CON- c. Before the end of the policy period. TRACT REQUIRING INSURANCE The following definition is added to the DEFINI- TIONS Section: Page 8 of 8 © 2008 The Travelers Companies, Inc. CG D4 15 05 08 (Rev. 10-08) POLICY NUMBER: P6307J366586TIL18 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV), Paragraph 4. (Other Insurance), is amended as follows: 1. The following is added to Paragraph a. Primary Insurance: 2. However, if you specifically agree in a written con- tract or written agreement that the insurance pro- vided to an additional insured under this 3. Coverage Part must apply on a primary basis, or a primary and non-contributory basis, this insur- ance is primary to other insurance that is avail- able to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: a. The "bodily injury" or "property damage" for which coverage is sought occurs; and b. The "personal injury" or "advertising injury" for which coverage is sought arises out of an of- fense committed subsequent to the signing and execution of that contract or agreement by you. The first Subparagraph (2) of Paragraph b. Ex- cess Insurance regarding any other primary in- surance available to you is deleted. The following is added to Paragraph b. Excess Insurance, as an additional subparagraph under Subparagraph (1): That is available to the insured when the insured is added as an additional insured under any other policy, including any umbrella or excess policy. CG DO 37 04 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved. Page 1 of 1 TRAVELERS WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 00 03 13 (00) - 002 POLICY NUMBER: UB-OL663678-18-43-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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 any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. INCLUDING: CONT.-JOB DESCRIPTION: PROFESSIONAL SERVICES FOR CITY ENGINEERING AND TRAFFIC ENGINEERING SERVICES. DATE OF ISSUE: 12-19-18 STASSIGN: PAGE 1 OF T� A�rr C��A�k WORKERS COMPENSATION LG 1 N G AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 03 76 ( A) - 002 POLICY NUMBER: UB-OL663678-18-43-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. INCLUDING: CONT.-JOB DESCRIPTION: PROFESSIONAL SERVICES FOR CITY ENGINEERING AND TRAFFIC ENGINEERING SERVICES. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: 12-19-18 STASSIGN: Page 1 of 1