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Insurance Certificates 2020/22 Bank of the WestSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY Paul Huelbig SEA-003622194-04 05/01/2022USF00956321 of Marsh Risk & Insurance Services SAN FRANCISCO, CA 94111 N 1 05/01/2021CYBER RISK LIABILITYA 06/17/2021 24,139,400 60,348,500 78-495 CALLE TAMPICO LA QUINTA, CA 92253 CITY OF LA QUINTA A EVIDENCE OF INSURANCE. 05/01/2021 CN102996569-BOW-CYBER-21-22 RETENTION $1,810,455 35300 05/01/2022 FOUR EMBARCADERO CENTER, SUITE 1100 MARSH RISK & INSURANCE SERVICES CALIFORNIA LICENSE NO. 0437153 BNP PARIBAS BANK OF THE WEST SAN RAMON, CA 94583 2527 Camino Ramon, NC-B07-2F-O USF00948421 ATTN: KARLA ROMERO, FINANCE DIRECTOR Allianz Global Risks US Insurance Company 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: Allianz Global Risks US Insurance Company� Limit: $24,139,400� � 22 Retention: $1,810,455� Limit: $60,348,500� San Francisco Primary� � Policy #USF00948421� Allianz Global Risks US Insurance Company� �� �� CYBER PROFESSIONAL LIABILITY� � Certificate of Liability Insurance CN102996569 � 1st Excess� Policy #USF00956321� �� � MARSH RISK & INSURANCE SERVICES� BNP PARIBAS� BANK OF THE WEST� SAN RAMON, CA 94583 2527 Camino Ramon, NC-B07-2F-O� 25 � Page 1 of 2 ACO06 /Ol /202R& CERTIFICATE OF LIABILITY INSURANCE °ATE,M202YY' 1 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 endorsements . PRODUCER COMA Willis Teerers watsca Certifioste Center Willis Towers Watson InsuranceSarvieq want, NAME: xnc. PHONE 1-877-965-7376 FAX 1-BBB-667-$376 C/o 26 Century Blvd 1 P.O. Sos 305791 pDOR . cerhlfLastesBwi2lis.con Nashville, Ta 31230SI91 06A INSURERS) AFFORDING COVERAGE NAICI _ MBURERA: Zurich American Insurance Company 16333 R18URED INSURERS: Asssieasl Zurich IoOns'"Ca Crnpsny 60142 Bank of the Nest 2521 Cain. Ramon, INSURERC: W-907-2F-0 INSURER D: San PA.., CA 94583 USA - INSURERE_ Cr3VFRAGFC CFRTIFICATC MIIURCC• W21159194 DrtmmnAI Muse CD. 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. TYPEOFINBURANCE POLICY NUMBER POLICY EFF pppqUJCCY EXP MM.DD Y MM�DP"/YYY LIMITS AUM IALOENERALLIABILRY EACH OCCURRENCE $ 1, 000, 000 CWM6•AMDE OCCUR mauff— _PRIE ES a S 11000,000 3 0 A MED EXP (An one Person) If GLO 1150574 03 06/01/2021 06/01/2022 PERSONAL 6 ADV INJURY rGENI S 1,000,000 GREGATE LIMoIT APPLIES PER: 6 2,000,000 GENERAL AGGREGATE ICYJECi JLDC PRODUCTS-COMPIOP AGO 6 2,000,000 5 ER AUTOMOBILE LIABILRY COMBINED SINGLE LIMITS Le soddenll 11000,000 X BODILY INJURY (Pen Panels) $ ANY AUTO A OWNED SCHEDULED ONLY Y MP 1150573 03 06/01/2021 06/01/2033AUFTAUTOS 1 BODILY INJURY (Par s6ol6sn0 S PPOPERTY AMAGE ar G n S. HIRED NON -OWNED AUTOS ONLY AUTOS ONLY S UMBRELLALWB OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAR CLMMSJAADE OED RETENTIONII WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS' LIABILITY B ANYPROPPIETORIPARTNEWEXECOTIVE YI OFRCERMEMBEREXCLUDED7 (Mandatory In NH) MIA. Y WC 1150572 03 06/01/2021 06/01/2022 E.L. EACH ACCIDENT s 1,000,000 E.L. DISEASE - EA EMPLOYE i 1,000,000 n yes. describe under DESCRIPTION OF OPERATIONStebe EL. DISEASE -POLICY WIT i 1,000,000 A 'Works Co•"nsatios and Y wC 1130573 03 06/01/2021 06/01/2023 S.L. Zenh accident $1,000,000 fmployerc Liability S.L. Oisaass-SA MVI $1,000,000 Per statute C.L. Disease -Poi Lot 01,000,000 DESCRIPTION OF OPERATIONS: LOCATIONS, VEHICLES (ACORD 101, Additional Remarks Schedule, may be MMrhed If more space Is repuked) Banking Services for the City of La Quints. The City and its officers, employees are included as Additiomal Insureds as respects to General Liability and Auto Liability. General Liability $hall be Primary and Nan -Contributory with any other insurance in forma for or whiob slay be Purchased by the Additional Insured$. I1ei 9 at 4A 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 QUZNTA Attn: Karla Romero, Finance AUTHORIZED REPRESENTATIVE Director Le, Quints, ts, C Tampico . e/ _ V puant a, CA 92253 !4,! (� ACORD 25 (2016/03) ® 1988-2016 ACORD CORPORATION. All rights The ACORD name and logo are registered marks of ACORD SR 10: 21164122 earl- 2113615 205 64M AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMEDINSURED aanA of the Neat Willis Towers Watson Insurance services Nest, Inc. 2MI Casino Ration, POUCY NUMBER NC-B01-2[b See Page 1 Ban Barron, CA 94583 UBA CARRIER NAIC CODE Be. Page 1 see Page 1 EFFECME DATE! sea Paae 1 The ACORD name and logo are registered marks of ACORD SR ID: 21164122 BATCH: 2113615 CERT: W21159194 A�� "® CERTIFICATE OF LIABILITY INSURANCE ATE D09/14/2020DIYYYv) 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 CONTACT NAME: MARSH RISK & INSURANCE SERVICES PHOFOUR EMBARCADERO CENTER, SUITE 1100 A/CNNo Ext : A/C No), E-MAIL CALIFORNIA LICENSE NO.0437153 SAN FRANCISCO, CA 94111 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: N/A N/A CN102996569-BOW-BPL20-20-21 INSURED BANK OF THE WEST INSURER B : INSURER C 2527 Camino Ramon INSURER D SAN RAMON, CA 94583 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: SEA-003622195-05 REVISION NUMBER: 1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE1:1 OCCUR DAMAGE TO PREMISES( a oNcur RENTED )$ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO - POLICY ❑ LOC PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY L $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N N/A E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ BANKERS PROFESSIONAL LIABILITY SEE ATTACHED 09/01/2020 09/01/2021 BANKERS PROF LIABILITY 20,000,000 Retention 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) * * * TO WHOM IT MAY CONCERN * * * EVIDENCE OF INSURANCE - BANKERS PROFESSIONAL LIABLILITY (E&O) CERTIFICATE HOLDER CANCELLATION CITY OF LA QUINTA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: KARLA ROMERO, FINANCE DIRECTOR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 78-495 CALLE TAMPICO ACCORDANCE WITH THE POLICY PROVISIONS. LA QUINTA, CA 92253 AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services Paul Huelbig ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN102996569 'O AGENCY MARSH RISK & INSURANCE SERVICES POLICY NUMBER CARRIER LOC M San Francisco ADDITIONAL REMARKS SCHEDULE NAMED INSURED BANK OF THE WEST 2527 Camino Ramon SAN RAMON, CA 94583 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance BANKERS PROFESSIONAL LIABILITY BPL PRIMARY CARRIER: NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA POLICY # 01-708-20-37 LIMIT OF LIABILILTY $10,000,000 RETENTION: $5000000 BPL 1 ST EXCESS CARRIER: ACE AMERICAN INS CO. POLICY # DOX G2457572A 012 LIMIT OF LIABILITY $10,000,000 Page 2 of 2 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Additional Insured — Automatic — Owners, Lessees Or Contractors 0 ZURICH Policy No. I Eff. Date of Pol. Fatp. Date of Pol. Eff. Date of End. Producer No. Add1. Prem Return Prom. GLO 1150574.03 06/01/2021 06/01/2022 06/01/2021 187-57-000 TBD @ Audit TBD @ Audit THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured Bank of the West Address: 2527 Camino Ramon, NC-B07-2F-0 San Ramon, CA 94583 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement. Such person or organization 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: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations or "your work" as included in the "products -completed operations hazard", which is the subject of the written contract or written agreement. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injury", "property damage" or 'personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b.S upervisory, 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. U-GL-I175-FFCW (04/13) Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 3 of 5 6488 C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV — Commercial General Liability Conditions: The additional insured must see to it that: 1. We are notified as soon as practicable of an 'occurrence" or offense that may result in a claim; 2. We receive written notice of a claim or "suit' as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit' will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non-contributory. D. For the purposes of the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section IV — Commercial General Liability Conditions: Primary and Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Named Insured under such other insurance; and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV — Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. F. With respect to the insurance afforded to the additional insureds under this endorsement, 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: 1. Required by the written contract or written agreement referenced in Paragraph A. of this endorsement: or 2. 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. All other terms and conditions of this policy remain unchanged. U-GL-1175-F CW (04/13) Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: GLO 1150574-03 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Wolters Kluwer Financial Services I Uniform Fors'"' 4 of 5 6488 POLICY NUMBER: BAP 1150575-03 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: Countersigned By: 6/1 /2021 Named Insured: Bank of the West (Authorized Representative) SCHEDULE Name of Person(s) or Organization(s): Any person or organization to whom or to which you are required to provide additional insured status in a written contract or written agreement executed prior to loss, except where such contract or agreement is prohibited by law. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section If of the Coverage Form. Copyright, Hawaii Insurance Bureau, Inc., 1999 Includes copyrighted material of the Insurance Services Office, Inc., with its permission CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1999 CA 1028 (2-99) Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed.04-84) 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 anyone not named in the Schedule. Schedule Only those persons or organizations for whom you are required to waive your rights of recovery under the terms of a written contract. 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. Insured WC 1150572-03 Bank of the West Insurance Company Countersigned by American Zurich Insurance Company Endorsement No. 1 Premium: Ti @ Audit WC124 (4-84) WC 00 03 13 Copyright 1983 National Council on Compensation Insurance, Inc. Page 1 of 1 Uniform FormsM 5 & 5 6488 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) 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 anyone not named in the Schedule. Schedule Only those persons or organizations for whom you are required to waive your rights of recovery under the terms of a written contract. 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 Insured Bank of the West Insurance Company American Zurich Insurance Company Effective Policy No. WC 1150572-03 Countersigned by Endorsement No. 1 Premium: TBD @ Audit WC124 (4-84) Page 1 of 1 WC 00 03 13 Copyright 1983 National Council on Compensation Insurance, Inc. Undorrn Fo"STM