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2020/01/01 Solpac Construction Inc. Certicate of Liability Insurance DATE(MMIDDIYYYY) � CERTIFICATE OF LIABILITY INSURANCE IF 12/31/2019 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 NAME: T Norma Figueroa Alliant Insurance Services, Inc. 701 B Street PHONEAg .U0.619-849-3871 FAX No):619-699-2163 I Floor nooR;Es_s_t NFigueroa@alliant.com San Diego CA 92101 1NGURERS AFFORDING COVERAGE NAIC# INSURER A:Zurich American Insurance Comp 16535 INSURED SOLPINC-01 INSURER B: Solpac Construction Inc. Soltek Pacific Construction Co. INSURERC: 2424 Congress Street INSURERD: San Diego CA 92110 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:222799502 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. LTR TYPE OF INSURANCE ADDL BR POLICY NUMBER .mom 1CYE MMIDDY� LIMITS A X COMMERCIAL GENERAL LIABILITY GL05963827-12 1/1/2020 1/1/2021 EACH OCCURRENCE . $2,000,000 CLAIMS-MADE AMA P I OCCUR S Ea occurrence $300,000 X Contractual Liab MED EXP(Any one person) $10,000 X X,C,U PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY=jE O LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER Deductible $25,000 A AUTOMOBILE LIABILITY BAP5963825-12 1/1/2020 1/1/2021 COMBINEO SINGLE LIMIT $1,000,000 (Ea scgdant} X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED Ix NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY P a UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETEN71pN$ $ A WORKERS COMPENSATION WC5963828-12 1/1/2020 1/1/2021 X PERRT T OTH- AND EMPLOYERS'LIABILITY Y I N STAANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICERIMEMBEREXCLUDED? ❑ N/A (Mandatory in NH) E.L,DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:BIG LEAGUE DREAMS PERRIS VALLEY SPORTS PARK,RIVERSIDE,CA SOLTEK JOB#843 CITY OF MENIFEE IS NAMED AS ADDITIONAL INSURED PER THE ATTACHED CERTIFICATE HOLDER City of Meni ee CANCELLATION City Clerk 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 MENIFEE 29714 HAUN ROAD MENIFEE CA 92856 AUTHORIZED REPRESENTATIVE CCCI\ ed Cam,.. zD- � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 0 Additional Insured —Automatic — Owners, Lessees Or ZURICH Contractors Policy No. Eff.Date of PoL Exp.Date of PoL Eff.Date of End Producer No. Add'1,Preen Return Preen. GL05963827-12 01/01/2020 01/01/2021 1 76139000 INCL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured: SOLPAC CONSTRUCTION, INC . Address (including ZIP Code): 2424 CONGRESS ST SAN DIEGO, CA 92110 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. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. U-GL-1175-F M(04/13) Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. 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: GL05963827-12 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): A GENERAL AGGREGATE LIMIT APPLIES TO EACH CONSTRUCTION PROJECT WHERE THE NAMED INSURED IS PERFORMING OPERATIONS, HOWEVER, A GENERAL AGGREGATE LIMIT DOES NOT APPLY TO ANY CONSTRUCTION PROJECT WHERE THE NAMED INSURED IS PERFORMING OPERATIONS THAT ARE INSURED UNDER A WRAP UP OR ANY OTHER CONSOLIDATED OR SIMILAR INSURANCE PROGRAM. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical "occurrences"under Section I —Coverage A,and expenses shall reduce the Designated for all medical expenses caused by accidents Construction Project General Aggregate Limit under Section I —Coverage C, which can be for that designated construction project. Such attributed only to ongoing operations at a single payments shall not reduce the General designated construction project shown in the Aggregate Limit shown in the Declarations nor Schedule above: shall they reduce any other Designated 1. A separate Designated Construction Project Construction Project General Aggregate Limit General Aggregate Limit applies to each for any other designated construction project designated construction project, and that limit shown in the Schedule above. is equal to the amount of the General 4. The limits shown in the Declarations for Each Aggregate Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A,except General Aggregate Limit shown in the damages because of "bodily injury"or Declarations, such limits will be subject to the "property damage"included in the"products- applicable Designated Construction Project completed operations hazard", and for General Aggregate Limit. medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits"brought; or c. Persons or organizations making claims or bringing "suits". CG 25 03 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 2 ❑ B. For all sums which the insured becomes legally C. When coverage for liability arising out of the obligated to pay as damages caused by "products-completed operations hazard"is "occurrences"under Section I —Coverage A,and provided, any payments for damages because of for all medical expenses caused by accidents "bodily injury"or "property damage"included in under Section I —Coverage C, which cannot be the"products-completed operations hazard"will attributed only to ongoing operations at a single reduce the Products-completed Operations designated construction project shown in the Aggregate Limit, and not reduce the General Schedule above: Aggregate Limit nor the Designated Construction 1. Any payments made under Coverage A for Project General Aggregate Limit. damages or under Coverage C for medical D. If the applicable designated construction project expenses shall reduce the amount available has been abandoned, delayed, or abandoned under the General Aggregate Limit or the and then restarted, or if the authorized Products-completed Operations Aggregate contracting parties deviate from plans, blueprints, Limit, whichever is applicable; and designs, specifications or timetables, the project 2. Such payments shall not reduce any will still be deemed to be the same construction Designated Construction Project General project. Aggregate Limit. E. The provisions of Section III —Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09 ❑ POLICY NUMBER: GL05963827-12 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION THAT REQUIRES YOU TO WAIVE YOUR RIGHTS OF RECOVERY, IN A WRITTEN CONTRACT OR AGREEMENT WITH THE NAMED INSURED THAT IS EXECUTED PRIOR TO THE ACCIDENT OR LOSS . Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or 'Your work"done under a contract with that person or organization and included in the"products- completed operations hazard".This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ Policy number: GL05963827-12 IL 02 70 09 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES -- CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM(OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraphs 2. and 3. of the Cancellation 3. All Policies In Effect For More Than 60 Days Common Policy Condition are replaced ,by the a. If this policy has been in effect for more following: than 60 days, or is a renewal of a policy we 2. All Policies In Effect For 60 Days Or Less issued, we may cancel this policy only upon If this policy has been in effect for 60 days or the occurrence, after the effective date of less, and is not a renewal of a policy we have the policy, of one or more of the following: previously issued, we may cancel this policy by (1) Nonpayment of premium, including mailing or delivering to the first Named Insured, payment due on a prior policy we issued at the mailing address shown in the policy,and and due during the current policy term to the producer of record, advance written covering the same risks. notice of cancellation, stating the reason for (2) Discovery of fraud or material cancellation, at least: misrepresentation by: a. 10 days before the effective date of (a) Any insured or his or her cancellation if we cancel for: representative in obtaining this (1) Nonpayment of premium; or insurance; or (2) Discovery of fraud by: (b) You or your representative in (a) Any insured or his or her pursuing a claim under this policy. representative in obtaining this (3) A judgment by a court or an insurance; or administrative tribunal that you have (b) You or your representative in violated a California or Federal law, pursuing a claim under this policy. having as one of its necessary elements an act which materially increases any of b. 30 days before the effective date of the risks insured against. cancellation if we cancel for any other reason. IL 02 70 09 12 0 Insurance Services Office, Inc., 2012 rage 1 of 4 (4) Discovery of willful or grossly negligent B. The following provision is added to the acts or omissions, or of any violations of Cancellation Common Policy Condition: state laws or regulations establishing 7. Residential Property safety standards, by you or your representative, which materially This provision applies to coverage on real increase any of the risks insured property which is used predominantly for against. residential purposes and consisting of not 5 more than four dwelling units, and to coverage ( ) Failure b y you or your representative t on tenants' household personal property in a implement reasonable loss controll residential unit, if such coverage is written requirements, agreed to by you as a condition of policy issuance, or which under one of the following: were conditions precedent to our use of Commercial Property Coverage Part a particular rate or rating plan, if that Farm Coverage Part — Farm Property — Farm failure materially increases any of the Dwellings, Appurtenant Structures And risks insured against. Household Personal Property Coverage Form (6) A determination by the Commissioner of a. If such coverage has been in effect for 60 Insurance that the: days or less, and is not a renewal of (a) Loss of, or changes in, our coverage we previously issued, we may reinsurance covering all or part of cancel this coverage for any reason, except the risk would threaten our financial as provided in b.and c. below. integrity or solvency; or b. We may not cancel this policy solely (b) Continuation of the policy coverage because the first Named Insured has: would: (1) Accepted an offer of earthquake (i) Place us in violation of California coverage; or law or the laws of the state where (2) Cancelled or did not renew a policy we are domiciled; or issued by the California Earthquake (ii) Threaten our solvency. Authority (CEA) that included an earthquake policy premium surcharge. (7) A change by you or your representative However, we shall cancel this policy if the cthe activities or property the first Named Insured has accepted a new or commercial or industrial enterprise, renewal policy issued by the CEA that which results in a materially added,increased or changed risk, unless the includes an earthquake policy premium surcharge but fails to pay the earthquake added, increased or changed risk is policy premium surcharge authorized by the included in the policy. CEA. b. We will mail or deliver advance written c. We may not cancel such coverage solely notice of cancellation, stating the reason for because corrosive soil conditions exist on cancellation, to the first Named Insured, at the premises. This restriction (c.) applies the mailing address shown in the policy, only if coverage is subject to one of the and to the producer of record, at least: following, which exclude loss or damage (1) 10 days before the effective date of caused by or resulting from corrosive soil cancellation if we cancel for conditions: nonpayment of premium or discovery of (1) Commercial Property Coverage Part — fraud; or Causes Of Loss —Special Form; or (2) 30 days before the effective date of (2) Farm Coverage Part — Causes Of Loss cancellation if we cancel for any other Form — Farm Property, Paragraph D. reason listed in Paragraph 3.a. Covered Causes Of Loss —Special. Page 2 of 4 0 Insurance Services Office, Inc., 2012 IL 02 70 09 12 C. The following is added and supersedes any (2) The Commissioner of Insurance finds provisions to the contrary: that the exposure to potential losses will Nonrenewal threaten our solvency or place us in a hazardous condition. A hazardous 1. Subject to the provisions of Paragraphs C.2. condition includes, but is not limited to, and C.3. below, if we elect not to renew this a condition in which we make claims policy, we will mail or deliver written notice, payments for losses resulting from an stating the reason for nonrenewal, to the first earthquake that occurred within the Named Insured shown in the Declarations,and preceding two years and that required a to the producer of record, at least 60 days, but reduction in policyholder surplus of at not more than 120 days, before the expiration least 25%for payment of those claims; or anniversary date. or We will mail or deliver our notice to the first Named Insured, and to the producer of record, (3) We have: at the mailing address shown in the policy. (a) Lost or experienced a substantial 2. Residential Property reduction in the availability or scope This provision applies to coverage on real of reinsurance coverage; or property used predominantly for residential (b) Experienced a substantial increase purposes and consisting of not more than four in the premium charged for dwelling units, and to coverage on tenants' reinsurance coverage of our household property contained in a residential residential property insurance unit, if such coverage is written under one of policies; and the following: the Commissioner has approved a plan Commercial Property Coverage Part for the nonrenewals that is fair and Farm Coverage Part — Farm Property — Farm equitable, and that is responsive to the Dwellings, Appurtenant Structures And changes in our reinsurance position. Household Personal Property Coverage Form c. We will not refuse to renew such coverage a. We may elect not to renew such coverage solely because the first Named Insured has for any reason, except as provided in b., c. cancelled or did not renew a policy, issued and d. below. by the California Earthquake Authority, that b. We will not refuse to renew such coverage included an earthquake policy premium solely because the first Named Insured has surcharge. accepted an offer of earthquake coverage. d. We will not refuse to renew such coverage However, the following applies only to solely because corrosive soil conditions insurers who are associate participating exist on the premises. This restriction (d.) insurers as established by Cal. Ins. Code applies only if coverage is subject to one of Section 10089.16. We may elect not to the following, which exclude loss renew such coverage after the first Named or damage caused by or resulting from Insured has accepted an offer of corrosive soil conditions: earthquake coverage, if one or more of the (1) Commercial Property Coverage Part — following reasons applies: Causes Of Loss —Special Form; or (1) The nonrenewal is based on sound (2) Farm Coverage Part — Causes Of Loss underwriting principles that relate to the Form — Farm Property, Paragraph D. coverages provided by this policy and Covered Causes Of Loss —Special. that are consistent with the approved 3. We are not required to send notice of rating plan and related documents filed nonrenewal in the following situations: with the Department of Insurance as a. If the transfer or renewal of a policy, without required by existing law; any changes in terms, conditions or rates, is between us and a member of our insurance group. IL 02 70 09 12 0 Insurance Services Office, Inc., 2012 Page 3 of 4 b. If the policy has been extended for 90 days e. If the first Named Insured requests a or less, provided that notice has been given change in the terms or conditions or risks in accordance with Paragraph C.1. covered by the policy within 60 days of the c. If you have obtained replacement coverage, end of the policy period. or if the first Named Insured has agreed, in f. If we have made a written offer to the first writing, within 60 days of the termination of Named Insured, in accordance with the the policy, to obtain that coverage. timeframes shown in Paragraph CA., to d. If the policy is for a period of no more than renew the policy under changed terms or 60 days and you are notified at the time of conditions or at an increased premium rate, issuance that it will not be renewed. when the increase exceeds 250%. Page 4 of 4 © Insurance Services Office, Inc., 2012 IL 02 70 09 12 0 Coverage Extension Endorsement Z U RI C H Policy No. Eff.Date of Pol. Exp.Date of Pol. Eff.Date of End. Producer No. AWL Prem Retum Prem BAP5963825-12 01/01/2020 01/01/2021 76139000 INCL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who Is An Insured Provision in Section II—Covered Autos Liability Coverage: The following are also "insureds": a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any "employee" of yours is also an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or borrow to transport your clients or other persons in activities necessary to your business. c. Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a. and A.1.b. in this endorsement. d. Where and to the extent permitted by law, any person(s) or organization(s)where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. 2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance—Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form: Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form. B. Amendment—Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II — Covered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident"we cover. We do not have to furnish these bonds. (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. U-CA-424-F Cw(04-14) Page 1 of 6 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. C. Fellow Employee Coverage The Fellow Employee Exclusion contained in Section II—Covered Autos Liability Coverage does not apply. D. Driver Safety Program Liability and Physical Damage Coverage 1. The following is added to the Racing Exclusion in Section II—Covered Autos Liability Coverage: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. 2. The following is added to Paragraph 2. in the Exclusions of Section III — Physical Damage Coverage of the Business Auto Coverage Form and Paragraph 2.b. in the Exclusions of Section IV — Physical Damage Coverage of the Motor Carrier Coverage Form: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. E. Lease or Loan Gap Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Lease Or Loan Gap Coverage In the event of a total 'loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered "auto", less: a. Any amount paid under the Physical Damage Coverage Section of the Coverage Form; and b. Any: (1) Overdue lease or loan payments at the time of the "loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the loan or lease; and (5) Carry-over balances from previous leases or loans. F. Towing and Labor Paragraph A.2. of the Physical Damage Coverage Section is replaced by the following: We will pay up to $75 for towing and labor costs incurred each time a covered "auto" of the private passenger type is disabled. However, the labor must be performed at the place of disablement. G. Extended Glass Coverage The following is added to Paragraph A.3.a. of the Physical Damage Coverage Section: If glass must be replaced, the deductible shown in the Declarations will apply. However, if glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced. H. Hired Auto Physical Damage—Increased Loss of Use Expenses The Coverage Extension for Loss Of Use Expenses in the Physical Damage Coverage Section is replaced by the following: Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We will pay for loss of use expenses if caused by: U-CA-424-F CW(04-14) Page 2 of 6 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered "auto"; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of$3000. I. Personal Effects Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Personal Effects Coverage a. We will pay up to$750 for"loss"to personal effects which are: (1) Personal property owned by an "insured"; and (2) In or on a covered "auto". b. Subject to Paragraph a. above, the amount to be paid for"loss"to personal effects will be based on the lesser of: (1) The reasonable cost to replace; or (2) The actual cash value. c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered "auto". No deductible applies to this coverage. However, we will not pay for 'loss" to personal effects of any of the following: (1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other documents of value. (2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches, precious or semi-precious stones. (3) Paintings, statuary and other works of art. (4) Contraband or property in the course of illegal transportation or trade. (5) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. Any coverage provided by this Provision is excess over any other insurance coverage available for the same 'loss". J. Tapes, Records and Discs Coverage 1. The Exclusion in Paragraph B.4.a. of Section III — Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph 13.2.c. of Section IV — Physical Damage Coverage in the Motor Carrier Coverage Form does not apply. 2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical Damage Coverage Section: We will pay for 'loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices: (a) Are the property of an"insured"; and (b) Are in a covered "auto" at the time of"loss". The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical Damage Coverage Deductible Provision does not apply to such "loss". U-CA-424-F CW(04-14) Page 3 of 6 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. K. Airbag Coverage The Exclusion in Paragraph 113.3.a. of Section III—Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph B.4.a. of Section IV — Physical Damage Coverage in the Motor Carrier Coverage Form does not apply to the accidental discharge of an airbag. L. Two or More Deductibles The following is added to the Deductible Provision of the Physical Damage Coverage Section: If an accident is covered both by this policy or Coverage Form and by another policy or Coverage Form issued to you by us, the following applies for each covered "auto" on a per vehicle basis: 1. If the deductible on this policy or Coverage Form is the smaller(or smallest)deductible, it will be waived; or 2. If the deductible on this policy or Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller(or smallest)deductible. M. Physical Damage—Comprehensive Coverage—Deductible The following is added to the Deductible Provision of the Physical Damage Coverage Section: Regardless of the number of covered "autos"damaged or stolen, the maximum deductible that will be applied to Comprehensive Coverage for all "loss"from any one cause is $5,000 or the deductible shown in the Declarations, whichever is greater. N. Temporary Substitute Autos— Physical Damage 1. The following is added to Section I—Covered Autos: Temporary Substitute Autos—Physical Damage If Physical Damage Coverage is provided by this Coverage Form on your owned covered "autos", the following types of vehicles are also covered "autos"for Physical Damage Coverage: Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered "auto"you do own but is out of service because of its: 1. Breakdown; 2. Repair; 3. Servicing; 4. "Loss"; or 5. Destruction, 2. The following is added to the Paragraph A. Coverage Provision of the Physical Damage Coverage Section: Temporary Substitute Autos—Physical Damage We will pay the owner for "loss"to the temporary substitute "auto" unless the "loss" results from fraudulent acts or omissions on your part. If we make any payment to the owner, we will obtain the owner's rights against any other party. The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it replaces. O. Amended Duties In The Event Of Accident, Claim, Suit Or Loss Paragraph a. of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following: a. In the event of"accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or "loss" is known to you (if you are an individual), a partner(if you are a partnership), a member(if you are a limited liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any U-CA-424-F CW(04-14) Page 4 of 6 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. agent, servant or employee of the "insured"to notify us of any "accident", claim, "suit" or"loss" shall not invalidate the insurance afforded by this policy. Include, as soon as practicable: (1) How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written notice of the claim or"suit" including, but not limited to, the date and details of such claim or "suit"; (2) The "insured's" name and address; and (3) To the extent possible,the names and addresses of any injured persons and witnesses. If you report an "accident", claim, "suit" or "loss" to another insurer when you should have reported to us, your failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you. P. Waiver of Transfer Of Rights Of Recovery Against Others To Us The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. This waiver only applies to the person or organization designated in the contract. Q. Employee Hired Autos—Physical Damage Paragraph b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph f. of the Other Insurance—Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented under a written contract or written agreement entered into by an "employee" or elected or appointed official with your permission while being operated within the course and scope of that "employee's"employment by you or that elected or appointed official's duties as respect their obligations to you. However, any"auto"that is leased, hired, rented or borrowed with a driver is not a covered "auto". R. Unintentional Failure to Disclose Hazards The following is added to the Concealment, Misrepresentation Or Fraud Condition: However, we will not deny coverage under this Coverage Form if you unintentionally: (1) Fail to disclose any hazards existing at the inception date of this Coverage Form; or (2) Make an error, omission, improper description of"autos"or other misstatement of information. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to the acceptance of this policy. S. Hired Auto—World Wide Coverage Paragraph 7a.(5)of the Policy Period, Coverage Territory Condition is replaced by the following: (5) Anywhere in the world if a covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less, T. Bodily Injury Redefined The definition of"bodily injury" in the Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. U-CA-424-F CAN(Q4-14) Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. U. Expected Or Intended Injury The Expected Or Intended Injury Exclusion in Paragraph B. Exclusions under Section II—Covered Auto Liability Coverage is replaced by the following: Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. V. Physical Damage—Additional Temporary Transportation Expense Coverage Paragraph AA.a. of Section III—Physical Damage Coverage is replaced by the following: 4. Coverage Extensions a. Transportation Expenses We will pay up to $50 per day to a maximum of$1,000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". W. Replacement of a Private Passenger Auto with a Hybrid or Alternative Fuel Source Auto The following is added to Paragraph A. Coverage of the Physical Damage Coverage Section: In the event of a total "loss" to a covered "auto" of the private passenger type that is replaced with a hybrid "auto" or "auto" powered by an alternative fuel source of the private passenger type, we will pay an additional 10% of the cost of the replacement "auto", excluding tax, title, license, other fees and any aftermarket vehicle upgrades, up to a maximum of $2500. The covered "auto" must be replaced by a hybrid "auto" or an "auto" powered by an alternative fuel source within 60 calendar days of the payment of the "loss" and evidenced by a bill of sale or new vehicle lease agreement. To qualify as a hybrid "auto", the "auto" must be powered by a conventional gasoline engine and another source of propulsion power. The other source of propulsion power must be electric, hydrogen, propane, solar or natural gas, either compressed or liquefied. To qualify as an "auto" powered by an alternative fuel source, the "auto" must be powered by a source of propulsion power other than a conventional gasoline engine. An "auto" solely propelled by biofuel, gasoline or diesel fuel or any blend thereof is not an "auto" powered by an alternative fuel source. X. Return of Stolen Automobile The following is added to the Coverage Extension Provision of the Physical Damage Coverage Section: If a covered "auto" is stolen and recovered, we will pay the cost of transport to return the "auto" to you. We will pay only for those covered "autos"for which you carry either Comprehensive or Specified Causes of Loss Coverage. All other terms, conditions, provisions and exclusions of this policy remain the same. U-CA-424-F CAN(04-14) Page 6 of 6 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. POLICY NUMBER: BAP5963825-12 COMMERCIAL INSURANCE CANCELLATION BY US This endorsement changes the policy. Please read it carefully. This endorsement modifies insurance provided by the following: BOILER AND MACHINERY COVERAGE FORM BUSINESS AUTO COVERAGE FORM COMMERCIAL CRIME COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL INLAND MARINE COVERAGE FORM COMMERCIAL PROPERTY COVERAGE FORM FARM COVERAGE FORM GARAGE COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM MOTOR CARRIER COVERAGE FORM POLLUTION LIABILITY COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM TRUCKERS COVERAGE FORM SCHEDULE Number of Days'Notice: 60 (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium,the number of days required for notice of cancellation, as provided in paragraph 2,of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement,is increased to the number of days shown in the Schedule above. U-GU-299-B CW(4/94) Page 1 of 1 POLICY NUMBER: WC5963828-12 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed.4-84) 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 ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION WC 00 03 13 (Ed. 4-84) ©1983 National Council on Compensation Insurance. POLICY NUMBER: WC5963828-12 WORKERS'COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0 . 00 % of the California workers' compensation pre- mium otherwise due on such remuneration. Schedule Person or Organization Job Description ALL PERSONS AND/OR ALL CA OPERATIONS ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION WC 252(4-84) WC 04 03 06(Ed.4-84) Page 1 of 1 POLICY NUMBER: WC5963828-12 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 0406 01 A CALIFORNIA CANCELATION ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the information page. The cancelation condition in Part Six (Conditions) of the policy is replaced by these conditions: Cancellation i. The occurrence of a material change in the 1. You may cancel this policy. You must mail or deliv- ownership of your business; er advance written notice to us stating when the j. The occurrence of any change in your busi- cancelation is to take effect. ness or operations that materially increases the 2. We may cancel this policy for one or more of the hazard for frequency or severity of loss; following reasons: k. The occurrence of any change in your busi- a. Non-payment of premium; ness or operation that requires additional or b. Failure to report payroll; different classification for premium calculation; c. Failure to permit us toaudit payroll as required I. The occurrence of any change in your busi- by the terms of this policy or of a previous ness or operation which contemplates an activ- policy issued by us; ity excluded by our reinsurance treaties. d. Failure topay any additional premium resulting 3. If we cancel your policy for any of the reasons from an audit of payroll required by the terms of this policy or any previous policy issued by listed in (a) through (fl, we will give you 10 days advance written notice, stating when the cancel- us; ation is to take effect. Mailing that notice to you at e. Material misrepresentation made by you or your mailing address shown in item 1 of the Infor- your agent; mation Page will be sufficient to prove notice. If we cancel your policy for any of the reasons listed in f. Failure tocooperate with us in the investigation items (g) through (1), we will give you 30 days of a claim; advance written notice; however, we agree that in g. Failure to comply with Federal or State safety the event of cancelation and reissuance of a policy orders; effective upon a material change in ownership or operations, notice will not be provided. h. Failure to comply with written recommen- dations of our designated loss control repre- 4. The policy period will end on the day and hour sentatives; stated in the cancelation notice. POLICY NUMBER: WC5963828-12 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 27 06 01 C (Ed. 10-08) NEVADA CANCELLATION AND NONRENEWAL ENDORSEMENT This endorsement applies to the insurance provided by this policy, because Nevada is shown in Item 3.A. of the Information Page. Part Six—Conditions, D. Cancellation of the policy is replaced by the following: A. Midterm Cancellation 1. You may cancel this policy by mailing or delivering advance written notice to us stating when the cancellation is to take effect. 2. We will provide you not less than 10 days notice if this policy is cancelled because you failed to pay a premium or remit an amount due because of an endorsement for a deductible when due. 3. We will provide you not less than 30 days notice for any other cancellation reason permitted under Nevada law, including failure to pay additional premium charged due to an audit of any payroll under the terms of the current or previous policy. 4. No policy of industrial insurance that has been in effect for at least 70 days or that has been renewed may be cancelled, except on any one of the following grounds: a. A failure by the policyholder to pay a premium for the policy of industrial insurance when due, including the failure of the policyholder to remit an amount due because of an endorsement for a deductible; b. A failure by the policyholder to: (1) Report any payroll; (2) Allow the insurer to audit any payroll in accordance with the terms of the policy or any previous policy issued by the insurer; or (3) Pay any additional premium charged because of an audit of any payroll as required by the terms of the policy or any previous policy issued by the insurer; c. A material failure by the policyholder to comply with any federal or state order concerning safety or any written recommendation of the insurer's designated representative for loss prevention; d. A material change in ownership of the policyholder or any change in the policyholder's business or operations that: (1) Materially increases the hazard for frequency or severity of loss; (2) Requires additional or different classifications for the calculation of premiums; or (3) Contemplates an activity that is excluded by any reinsurance treaty of the insurer; e. A material misrepresentation made by the policyholder; or f. A failure by the policyholder to cooperate with the insurer in conducting an investigation of a claim. 5. We cannot cancel the policy when the referenced reasons are corrected by you within the time specified in the written notice of cancellation. B. Nonrenewal 1. We may elect not to renew the policy. We will provide to you a written notice of our intention not to renew at least 60 days before the expiration date. 2. We need not provide notice of our intention not to renew if you have accepted replacement coverage, if you have requested or agreed to nonrenewal, or if the policy is expressly designated as nonrenewable. C. Information About Claims Paid 1. If you request information for the renewal of the policy, we will provide you with information regarding claims paid on your behalf. 2. We will provide the information within 30 working days after we receive your written request. We may charge a reasonable fee for providing the information. 1 of 2 U Copyright 2008 National Council on Compensation Insurance,Inc.All Rights Reserved. WC 27 06 01 C WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY (Ed. 10-08) D. Notices 1. We will provide advance written notice of cancellation or nonrenewal as provided in A and B above. This notice must be served personally on or sent by first-class mail or electronic transmission to the employer. 2. Notices will state the effective date of the cancellation or nonrenewal and will be accompanied by a written explanation of the specific reasons for the cancellation or nonrenewal. 3. A written notice of cancellation is not required if we mutually agree with you to cancel the policy and reissue a new policy based upon a material change in the ownership or operation of your business. E. Compliance With Law 1. Any of these provisions that conflict with a law that controls the cancellation or renewal or nonrenewal of the insurance in this policy is changed by this statement to comply with the law. WC 27 06 01 C 2 of 2 (Ed.10-08) U Copyright 2008 National Council on Compensation Insurance,Inc.All Rights Reserved.