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2019/09/01 Lew Edwards Group Certificate of Liability Insurance LEWEDWA-01 GHODGES ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1/1612020 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 License#OK07568 CONTACT Gail Hodges NAME: Cumbre Insurance Services, LLC PHONE FAX 3110 E.Guasti Road (A/C,No,Ext):(707)992-3743 (A/C,No):(909)484-2491 Suite 500 ADDRIESS:hodgesg@cumbreins.com Ontario,CA 91761 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Underwriters at Lloyd's, London Illinois 15792 INSURED INSURER B:Ohio Security Insurance Company 24082 Lew Edwards Group INSURER C:Republic Indemnity Company of America 22179 2301 Mastlands Drive INSURER D:Lloyd's Oakland,CA 94611 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR IN D WVD MM DD MM DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE FIVI X OCCUR LBW650089 2/6/2020 2/6/2021 DAMAGE TO RENTED 100,000 X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ Excluded GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICYEl JERCOT1:1 LOC PRODUCTS-COMP/OP AGG $ Excluded OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000 000 Ea accident $ X ANY AUTO X BAS57306007 9/1/2019 9/1/2020 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED L $ NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident) ccident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER 16644915 9/21/2019 9/21I2020 1,000,000 ANY PROPRIMBER/PARLUDEDXECUTIVE ❑ X E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT D Errors&Omissions W1613213190601 9/30/2019 9/30/2020 Per Claim 2,000,000 D Claims Made W1613213190601 9/30/2019 9/30/2020 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CITY OF MENIFEE,ITS OFFICERS,EMPLOYEES,AGENTS AND AUTHORIZED VOLUNTEERS ARE HEREBY NAMED AS ADDITIONAL INSURED-S WITH RESPECTS TO LIABIITY ARISING FROM THE NAMED INSURED'S OPERATIONS PER BW 000 859 08/2012.COVERAGE IS PRIMARY AND NON-CONTRIBUTORY PER BWO01 397 10 04.AUTOMOBILE ADDITIONAL INSURED,PRIMARY&NON CONTRIBUTORY PER AC 85 43 06 18. WORKER'S COMPENSATION WAIVER OF SUBROGATION PER WC 00 03 13 04-84.PROFESSIOAL LIABILITY RETRO-ACTIVE DATE 9/30/2009.PROFESSIONAL LIABILITY RETENTION$5,000 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Menifee THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. Sara Manwaring-City Clirk 29714 Haun Road Menifee,CA 92586 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY . PLEASE READ IT CAREFULLY . ADDITIONAL INSURED - OWNERS , LESSEES OR CONTRACTORS - SCHEDULED PERSON ORORGANIZATION This endorsement modifies insurance provided under the following : COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name of Additional Insured Person ( s) Or Organization ( s) : L ocation ( s) of Covered Operations ANY PERSON OR ORGANIZATION AS AS REQUIRED BY WRITTEN REQUIRED BY WRITTEN CONTRACT WITH THE INSURED A. SECTION II -WHO IS AN INSURED is amended to include as an additional insured the person (s) or organization (s) shown in the Schedule for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such a person or organization be added as an additional insured on your policy . 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 for the additional insured (s) at the location (s) designated above . A person ' s or organizations status as an additional insured under this endorsement ends when your operations for that additional insured are completed . B . With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to : Additional Insured Contractual Liability "Bodily injury" or "property damage" for which the "additional insured (s) " are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations or Work "Bodily injury" or "property damage" occurring after: (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 (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 . Negligence of Additional Insured "Bodily injury" or "property damage" directly caused by or resulting from the negligence of the "additional insured (s) ". ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED This endorsement is effective on the inception date of the policy unless otherwise stated below. (The information below is required only when this endorsement is issued subsequent to preparation of the policy) . Policy Number: LBW650089 Named Insured : LEW EDWARDS GROUP Endorsement Effective dater 02/06/2020 BW 000 859 Included copyrighted material of ISO Properties, INC . Page 1 of 1 08/ 2012 with its perm ission ENDORSEMENT 1 This Endorsement Changes the Policy - Please Read it Carefully PRIMARYAND NON =CONTRIBUTING INSURANCE (Third - Party' s Sole Negligence) This endorsement modifies insurance provided under the following : COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD LIABILITY COVERAGE PART BUSINESSOWNERS LIABILITY COVERAGE FORM The following is added to Section IV - Commercial General Liability Conditions, Paragraph 4 : Section IV: Commercial General Liability Conditions 4 , Other Insurance : d . Notwithstanding the provisions of sub - paragraphs a , b , and c of this paragraph 4 , with respect to the Third Party shown below, it is understood and agreed that in the event of a claim or "suit"arising out of the Named Insured ' s sole negligence , this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party below shall be excess and non -contributory . The Third Party to whom this endorsement applies is : Absence of a specifically named Third Party above means that the provisions of this endorsement apply "as required by written contractual agreement with any Third Party for whom you are performing work . " All other terms and conditions of this policy remain unchanged . This endorsement is effective on the inception date of the policy unless otherwise stated herein . (The information below is required only when this endorsement is issued subsequent to preparation of the policy . ) Policy Number: LBW650089 Named Insured : SEW EDWARDS GROUP Endorsement Effective Date : 02/06/2020 Endorsement Serial No . BW 001 397 1004 Includes copyrighted material of Insurance Services Office , Inc . with its permission Copyright, Insurance Services Office , Inc . 1994 COMMERCIAL AUTO AC 85 43 06 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following : BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement , the provisions of the policy apply unless modified by the endorsement. If the policy to which this endorsement is attached also contains a Business Auto Coverage Enhancement Endorsement with a specific state named in the title , this endorsement does not apply to vehicles garaged in that specified state . COVERAGEINDEX SUBJECT PROVISION NUMBER ACCIDENTAL AIRBAG DEPLOYMENT 12 ADDITIONAL INSURED BY CONTRACT , AGREEMENT OR PERMIT 3 AMENDED DUTIES IN THE EVENT OF ACCIDENT , CLAIM , SUIT OR LOSS 20 AMENDED FELLOW EMPLOYEE EXCLUSION 5 AUDIO , VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 14 BODILY INJURY REDEFINED 24 EMPLOYEES AS INSUREDS ( Including Employee Hired Auto) 2 EXTRA EXPENSE - BROADENED COVERAGE 10 GLASS REPAIR - WAIVER OF DEDUCTIBLE 16 HIRED AUTO COVERAGE TERRITORY 22 HIRED AUTO PHYSICAL DAMAGE (Including Employee Hired Auto) 6 LOAN / LEASE GAP (Coverage Not Available In New York) 15 NEWLY FORMED OR ACQUIRED SUBSIDIARIES 1 PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) 17 PERSONAL EFFECTS COVERAGE 11 PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8 PHYSICAL DAMAGE DEDUCTIBLE - VEHICLE TRACKING SYSTEM 13 PRIMARY AND NON-CONTRIBUTORY - WRITTEN CONTRACT OR WRITTEN AGREEMENT 23 RENTAL REIMBURSEMENT 9 SUPPLEMENTARY PAYMENTS 4 TOWING AND LABOR 7 TWO OR MORE DEDUCTIBLES 18 UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 19 WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US 21 SECTION II - LIABILITY COVERAGE is amended as follows : 1 . NEWLY FORMED OR ACQUIRED SUBSIDIARIES SECTION II - LIABILITY COVERAGE , Paragraph A. 1 . Who Is An Insured is amended to include the following as an " insured" : d . Any legally incorporated subsidiary of which you own more than 50 percent interest during the policy period . Coverage is afforded only for 90 days from the date of acquisition or formation . However, " insured" does not include any organization that: (1 ) Is a partnership or joint venture ; or (2 ) Is an "insured" under any other automobile policy except a policy written specificall y to apply in excess of this policy ; or (3 ) Has exhausted its Limit of Insurance or had its policy terminated under any other automobile policy . © 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of Insurance Services Office , Inc. , with its permission . Page 1 of 7 Coverage under this provision do does not apply to "bodily injury" or " property damage" that occurred before you acquired or formed the organization . 2 . EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE , Paragraph A. I . Who Is An Insured is amended to include the following as an " insured" : e. Any " employee" of yours while using a covered " auto" you do not own , hire or borrow but only for acts within the scope of their employment by you . Insurance provided by this endorsement is excess over any other insurance available to any " employee" . f. Any "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name , with your permission , while performing duties related to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the " employee" . 3 . ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION 11 - LIABILITY COVERAGE , Paragraph A. 1 . Who Is An Insured is amended to include the following as an " insured " : g . Any person or organization with respect to the operation , maintenance or use of a covered " auto" , provided that you and such person or organization have agreed in a written contract, written agreement, or permit issued to you by governmental or public authority , to add such person , or organization , or governmental or public authority to this policy as an " insured" . However, such person or organization is an " insured " : ( 1 ) Only with respect to the operation , maintenance or use of a covered "auto'; (2 ) Only for " bodily injury" or " property damage" caused by an "accident" which takes place after you executed the written contract or written agreement, or the permit has been issued to you ; and (3 ) Only for the duration of that contract, agreement or permit. The " insured" is required to submit a claim to any other insurer to which coverage could apply for defense and indemnity . Unless the " insured " has agreed in writing to primary noncontributory wording per enhancement number 24 , this policy is excess over any other collectible insurance . 4. SUPPLEMENTARY PAYMENTS SECTION II - LIABILITY COVERAGE , Coverage Extensions , 2 .a . Supplementary Payments , Paragraphs (2 ) and (4) are replaced by the following : (2 ) Up to $3 , 000 for cost of bail bonds (including bonds for related traffic violations ) required because of an "accident" we cover. We do not have to furnish these bonds . (4) All reasonable expenses incurred by the "insured" at our request , including actual loss of earnings up to $500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION ° In those jurisdictions where , by law, fellow " employees" are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule , or similar protection , the following provk sion is added : SECTION II - LIABILITY , Exclusion B. 5 . Fellow Employee does not apply if the " bodily injury" results from the use of a covered "auto" you own or hire if you have workers compensation insurance in force for all of your "employees" at the time of "loss" . This coverage is excess over any other collectible insurance . SECTION III - PHYSICAL DAMAGE COVERAGE is amended as follows : 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION III on PHYSICAL DAMAGE COVERAGE , is amended by adding the following : If hired " autos" are covered "autos" for Liability Coverage , and if Comprehensive , Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto" you own , then the Physical Damage coverages provided are extended to " autos" : © 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of Insurance Services Office , Inc. , with its permission . Page 2 of 7 a . You hire , rent or borrow; or b . Your "employee" hires or rents under a written contract or agreement in that " employee' s" name , but only if the damage occurs while the vehicle is being used in the conduct of your business , subject to the following limit and deductible : a . The most we will pay for " loss" in any one "accident" or "loss" is the smallest of: (1 ) $50 , 000 ; or (2 ) The actual cash value of the damaged or stolen property as of the time of the "loss" ; or (3 ) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality , minus a deductible . b . The deductible will be equal to the largest deductible applicable to any owned " auto" for that coverage . c. Subject to the limit , deductible and excess provisions described in this provision , we will provide coverage equal to the broadest coverage applicable to any covered " auto" you own . d . Subject to a maximum of $ 1 , 000 per "accident" , we will also cover the actual loss of use of the hired " auto" if it results from an "accident" , you are legally liable and the lessor incurs an actual financial loss . e. This coverage extension does not apply to : ( 1 ) Any "auto" that is hired , rented or borrowed with a driver; or (2 ) Any " auto" that is hired , rented or borrowed from your " employee" or any member of your "employee' s" household . Coverage provided under this extension is excess over any other collectible insurance available at the time of " loss" . 7 . TOWING AND LABOR SECTION III we PHYSICAL DAMAGE COVERAGE , Paragraph A .2 . Towing , is amended by the addition of the following : We will pay towing and labor costs incurred , up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type , " light truck" or " medium truck" is disabled : a . For private passenger type vehicles , we will pay up to $75 per disablement. b . For " light trucks" , we will pay up to $75 per disablement. " Light trucks" are trucks that have a gross vehicle weight (GVW) of 10 , 000 pounds or less . c . For " medium trucks" , we will pay up to $ 150 per disablement. " Medium trucks" are trucks that have a gross vehicle weight (GVW) of 10 , 001 - 20 , 000 pounds . However, the labor must be performed at the place of disablement. 8 . PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph AA.a . Coverage Extensions , Transportation Expenses of SECTION III - PHYSICAL DAMAGE COVERAGE , is amended to provide a limit of $50 per day and a maximum limit of $ 1 , 500 . 9 . RENTAL REIMBURSEMENT x SECTION III - PHYSICAL DAMAGE COVERAGE, A. Coverage , is amended by adding the following : a . We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an " auto" because of " accident" or " loss" , to an " auto" for which we also pay a " loss" under Comprehensive , Specified Causes of Loss or Collision Coverages . We will pay only for those ex- penses incurred after the first 24 hours following the " accident" or "loss" to the covered "auto . " b . Rental Reimbursement requires the rental of a comparable or lesser vehicle , which in many cases may be substantially less than $75 per day , and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality , up to a maximum of 30 days . c. We will also pay up to $ 500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered " auto" . This limit is excess over any other collectible insurance . © 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of Insurance Services Office , Inc. , with its permission . Page 3 of 7 d . This coverage does not apply unless you have a business necessity that other " autos" available for your use and operation cannot fill . e . 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 under Paragraph 4. Coverage Extension , f. No deductible applies to this coverage . g . The insurance provided under this extension is excess over any other collectible insurance . If this policy also provides Rental Reimbursement Coverage you purchased , the coverage provided by this Enhancement Endorsement is in addition to the coverage you purchased . For the purposes of this endorsement provision , materials and equipment do not include " personal effects" as defined in provision 11 . B . 10 . EXTRA EXPENSE BROADENED COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE , A. Coverage , we will pay for the expense of returning a stolen covered " auto" to you . The maximum amount we will pay is $ 1 , 000 . 11 . PERSONAL EFFECTS COVERAGE A . SECTION III - PHYSICAL DAMAGE COVERAGE , A. Coverage , is amended by adding the following : If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen , we will pay , without application of a deductible , up to $600 for " personal effects" stolen with the "auto . " The insurance provided under this provision is excess over any other collectible insurance . B . SECTION V - DEFINITIONS is amended by adding the following : For the purposes of this provision , " personal effects" mean tangible property that is worn or carried by an "insured . " " Personal effects" does not include tools , equipment , jewelry , money or securk ties . 12 . ACCIDENTAL AIRBAG DEPLOYMENT SECTION III - PHYSICAL DAMAGE COVERAGE , B . Exclusions is amended by adding the following : If you have purchased Comprehensive or Collision Coverage under this policy , the exclusion for " loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag . Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer' s warranty . However, we agree to pay any deductible applicable to the other coverage or warranty . 13 . PHYSICAL DAMAGE DEDUCTIBLE - VEHICLE TRACKING SYSTEM SECTION III - PHYSICAL DAMAGE COVERAGE , D . Deductible , is amended by adding the following : Any Comprehensive Deductible shown in the Declarations will be reduced by 50 % for any " loss" caused by theft if the vehicle is equipped with a vehicle tracking device such as a radio tracking device or a global position device and that device was the method of recovery of the vehicle . 14. AUDIO , VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE , B. Exclusions , Paragraph a. of the exception to exclu- sions 4. c . and 4. d . is deleted and replaced with the following : Exclusions 4. c . and 4. d . do not apply to a. Electronic equipment that receives or transmits audio , visual or data signals , whether or not de- signed solely for the reproduction of sound , if the equipment is : ( 1 ) Permanently installed in the covered "auto" at the time of the " loss" or removable from a housing unit that is permanently installed in the covered "auto" ; and (2 ) Designed to be solely operated by use from the power from the "auto' s" electrical system ; and (3 ) Physical damage coverages are provided for the covered " auto" . If the " loss" occurs solely to audio , visual or data electronic equipment or accessories used with this equipment , then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $ 100 deductible . © 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of Insurance Services Office , Inc. , with its permission . Page 4 of 7 15 , LOAN / LEASE GAP COVERAGE ( Not Applicable In New York) A . Paragraph C . Limit Of Insurance of SECTION III = PHYSICAL DAMAGE COVERAGE is amended by adding the following : The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any one "accident" is the greater of the : 1 . Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the 'loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the 'loss" ; b, Financial penalties imposed under a lease due to high mileage , excessive use or abnormal wear and tear; c . Costs for extended warranties , Credit Life Insurance , Health , Accident or Disability Insur- ance purchased with the loan or lease ; d , Transfer or rollover balances from previous loans or leases ; e. Final payment due under a 'Balloon Loan " ; f, The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered " auto" ; g . Security deposits not refunded by a lessor; h . All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto'; i , Any amount representing taxes ; j , Loan or lease termination fees ; or 2 . The actual cash value of the damage or stolen property as of the time of the 'loss" . An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the 'loss" . This adjustment is not applicable in Texas . B , Additional Conditions This coverage applies only to the original loan for which the covered "auto" that incurred the "loss" serves as collateral , or lease written on the covered "auto" that incurred the 'loss" . C . SECTION V - DEFINITIONS is changed by adding the following : As used in this endorsement provision , the following definitions apply : "Total loss" means a 'loss" in which the cost of repairs plus the salvage value exceeds the actual cash value . A " balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan , thereby requiring a large final payment . 16 , GLASS REPAIR - WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition M of the following : No deductible applies to glass damage if the glass is repaired rather than replaced . 17 , PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D . Deductible of SECTION III = PHYSICAL DAMAGE COVERAGE is amended by the addition of the following : The deductible does not apply to 'loss" caused by collision to such covered " auto" of the private passenger type or light weight truck with a gross vehicle weight of 10 , 000 lbs . or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is : a . In the charge of an "insured'; b. Legally parked ; and c , Unoccupied . © 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of Insurance Services Office , Inc. , with its permission . Page 5 of 7 The " loss" must be reported to the police authorities within 24 hours of known damage . The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations . This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or organization engaged in the automobile business . 18 . TWO OR MORE DEDUCTIBLES Under SECTION III - PHYSICAL DAMAGE COVERAGE , if two or more company policies or coverage forms apply to the same "accident" , the following applies to Paragraph D . Deductible a . If the applicable Business Auto deductible is the smaller (or smallest) deductible , it will be waived ; or b. If the applicable Business Auto deductible is not the smaller (or smallest) deductible it will be reduced by the amount of the smaller (or smallest) deductible ; or c . If the "loss" involves two or more Business Auto coverage forms or policies , the smaller (or smallest) deductible will be waived . For the purpose of this endorsement, company means any company that is part of the Liberty Mutual Group , SECTION IV - BUSINESS AUTO CONDITIONS is amended as follows : 19 . UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV- BUSINESS AUTO CONDITIONS , Paragraph B .2 . is amended by adding the following : If you unintentionally fail to disclose any hazards , exposures or material facts existing as of the incep- tion date or renewal date of the Business Auto Coverage Form , the coverage afforded by this policy will not be prejudiced . However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery , and we have the right to collect additional premium for any such hazard or exposure . 20 , AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM , SUIT OR LOSS SECTION IV - BUSINESS AUTO CONDITIONS , Paragraph A .2.a . is replaced in its entirety by the follow- ing : a . In the event of " accident" , claim , " suit" or "loss" , you must promptly notify us when it is known to : ( 1 ) You , if you are an individual ; (2 ) A partner, if you are a partnership ; (3) Member, if you are a limited liability company ; (4) An executive officer or the " employee" designated by the Named Insured to give such notice , if you are a corporation . To the extent possible , notice to us should include : (a ) How, when and where the "accident" or " loss" took place ; (b ) The " insured 's" name and address ; and (c) The names and addresses of any injured persons and witnesses . 21 . WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV - BUSINESS AUTO CONDITIONS , Paragraph A. 5 . Transfer Of Rights Of Recovery Against Others To Us , is amended by the addition of the following : If the person or organization has in a written agreement waived those rights before an "accident" or " loss" , our rights are waived also . 22 . HIRED AUTO COVERAGE TERRITORY SECTION IV - BUSINESS AUTO CONDITIONS , Paragraph B.7 . Policy Period , Coverage Territory , is amended by the addition of the following : f. For "autos" hired 30 days or less , the coverage territory is anywhere in the world , provided that the "insured ' s" responsibility to pay for damages is determined in a "suit" , on the merits , in the United States , the territories and possessions of the United States of America , Puerto Rico or Canada or in a settlement we agree to . © 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of Insurance Services Office , Inc. , with its permission . Page 6 of 7 This extension of coverage does not apply to an " auto" hired , leased , rented or borrowed with a driver. 23 . PRIMARY AND NON -CONTRIBUTING IF REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREE- MENT The following is added to SECTION IV - BUSINESS AUTO CONDITIONS , General Conditions , B. 5 , Other Insurance and supersedes any provision to the contrary : This Coverage Form' s Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an " insured " under your policy provided that: 1 . Such " insured" is a Named Insured under such other insurance ; and 2 . You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to such " insured" . SECTION V - DEFINITIONS is amended as follows : 24 . BODILY INJURY REDEFINED Under SECTION V - DEFINITIONS , Definition C . is replaced by the following : " Bodily injury" means physical injury , sickness or disease sustained by a person , including mental anguish , mental injury , shock, fright or death resulting from any of these at any time . © 2018 Liberty Mutual Insurance AC 85 43 06 18 Includes copyrighted material of Insurance Services Office , Inc. , with its permission . Page 7 of 7 ( Page 32 of 55 ) 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 State Person or Organization Job Description California City of Menifee All California operations Sara Manwaring - City Clerk performed by the Named Insured 29714 Haun Road on behalf of the Certificate Menifee , CA 92586 Holder. The premium charge for this endorsement shall be 5% of the premium developed in conjunction with the work for which this waiver is provided , subject to a minimum premium of $ 100 . This charge will be billed at the final audit . This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated . Republic Indemnity Company of America Company Number 19739 Insured Lew Edwards Group Policy Number 166449- 15 Endorsement Number 24 Endorsement Effective September 21 , 2019 Printed On September 09 , 2019 Countersigned by WC 00 03 13 (Ed . 04-84) © 1983 National Council on Compensation Insurance.