2021/06/01 Golden Office Trailers, Inc.Client#: 1575954 PACIFMOB2
ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
5/27/2021
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 b -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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER ME: _ q Please email/fax all requests
PHVNE
USI Insurance Services NW _
601 Union St. Suite 1000 -I°i'c NO E,' 206 441-6300 AIC No ; 610 362-8518
Seattle, WA 98101
ss: megan.osterstrom@usl.00m
206 441-6300 INSURE S AFFORDING COVERAGE NAIC;)
_
INSURER A: National Union Fire Ins Co of Pitts, PA
19445
INSURED
Golden Office Trailers, Inc.
INSURER B : Navigators Specialty Insurance Co.
36056
PO Box 1404
INSURER C : New Hampshire Insurance Company
23841
Chehalis, WA 98532
INSURER D: Great American E & S Insurance Company
37532
INSURER E :
INSURER IF:.
—
COVERAGES CERTIFICATE NUMBER: GRP1
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 CONTRACTOR OTHER DOCUMENT WITH RESPECT
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO
TO WHICH THIS
ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE
BEEN REDUCED BY PAID
LW TYPE OF INSURANCE ADD US
XuyD POLICY NUMBER
gCLAIMS.
{IASOLpyD YY NMILE]DfYYYY
�1--_... 1 LIMITS
A �( COMMERCIAL GENERAL LIABILITY X X 9566289
6/01/2021 06/01/202 EACH OCCURRENCE
$1 000,000_
CLAIMS -MADE OCCUR
000
ES Ea0=ffem
$500
MED EXP (Army arre person)
s25 000
PERSONAL & ADV INJURY
$1,000,000_
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO -
POLICY LJ JECT X
GENERAL AGGREGATE
s2,000,vov
I I LOC
PRODUCTS - COMP/OP AGG
s2 00Q 00d
OTHER:
A AUTOMOBILE LIABILITY X X 5717955
6/01 /2021 06/01/202 (Es IN °�I'''cLE LTM
1,000 000
X ANY AUTO
OWNED SCHEDULED
BODILY INJURY (Per person)
$
AUTOS ONLY AUTOS
HIRED NON -OWNED
BODILY INJURY (Per accident)
$
AUTOS ONLY AUTOS ONLY
PROPERT!'tlAA�1AGE
ee acddenl
$
B UMBRELLA LIAB XTOCCUR X X SE21EXCZ08OA81C
6101/2021 06/01/202 EACH OCCURRENCE
s5 000�,000
X: EXCESS LIARLAIM&MADE
C WORKERS COMPENSATION 1.
AND EMPLOYERS' LIABILITY X 014195905: /Oi/202106/01/202 X( PER OTH- u
VOFFICERIMEMBER EXCLUDED? N / A Y PROPRIETORIPARTNERIEXECUYIN TIVE (AOS-Incl Stop Gap) E_L. EACH ACCIDENT $1,Q0
A (Mandatoryin NH) X 014195906: 6/01 /2021 06/01/2022 EL DISEASE - EA UAPLOYEE $1 00
It yyes, dauribe under
DESCRIPTION OF q?ERATION$ below CA ORI E.L. DISEASE- PO_W_CY LIMIT $1 00
D Pollution PCME69239400 /01/2021 06/01/20 1 M Occ/2M Agg/25K Ded.
D Professional PCME69239400 101 /2021 106/0112021M Act/1M Agg/25K Ded.
Combined POIiCV Policy A : 2M
DESCRIPTION OF OPERATIONS i LOCATIONS r VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached 11 more space is required)
The General Liability policy includes an automatic Additional Insured endorsement that provides Additional
Insured status to the Certificate Holder, only when there is a written contract that requires such status,
and only with regard to work performed on behalf of the named insured.
CERTIFICA
NCELLA
City of Menifee - Transportation Permits SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
29714 Haun Rd ACCORDANCE WITH THE POLICY PROVISIONS.
Menifee, CA 92586
AUTHORED REPRESENTATIVE
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S32214177/M32202408 S9KZP
This page has been left blank intentionally.
POLICY NUMBER:
GL 956-62-89
COMMERCIAL GENERAL LIABILITY
CG20101219
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s)
iy person or organization whom you become
ligated to include as an additional insured as a
;ult of any contract or agreement you
ve entered into.
Location(s) Of Covered Operations
Per the contract or agreement.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
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, but 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.
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. If coverage provided to the additional
insured is required by a contract or
agreement, the insurance afforded to such
additional insured will not be broader than
that which you are required by the contract
or agreement to provide for such additional
insured.
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not applyto "bodily injury" or
"property damage" occurringafter:
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 other than another contractor or
subcontractor engaged in performing
operations for a principal as a part of the
same project.
CG 20 10 12 19 0 Insurance Services Office, Inc.,2018 Pagel of2
C. With respect to the insurance afforded to these
additional insureds, the following is added to Section
III - Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable limits of
insurance;
whichever is less.
This endorsement shall not increase the
applicable limits of insurance.
Page 2 of 0 Insurance Services Office, Inc.,2018 CG 20 10 12 19
POLICY NUMBER:
GL 956-62-89
COMMERCIAL GENERAL LIABILITY
CG20371219
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location And Description Of Completed Operations
Any person or organization Per the contract or agreement.
whom you become obligated
to include as an additional
insured as a result of any
contract or agreement you
have entered into.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
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, but only
with respect to liability for "bodily injury" or
"property damage" caused, in whole or in part,
by "your work" at the location designated and
described in the Schedule of this endorsement
performed for that additional insured and
included in the "products -completed operations
hazard".
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. If coverage provided to the additional
insured is required by a contract or
agreement, the insurance afforded to such
additional insured will not be broader than
that which you are required by the contract
or agreement to provide for such additional
insured.
B. With respect to the insurance afforded to these
additional insureds, the following is added to Section
III - Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable limits of
insurance;
whichever is less.
This endorsement shall not increase the
applicable limits of insurance.
CG 20 37 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1
POLICY NUMBER:
GL 956-62-89
COMMERCIAL GENERAL LIABILITY
CG 20 01 12 19
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
LIQUOR LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance (2)You have agreed in writing in a contract or
Condition and supersedes any provision to the agreement that this insurance would be
contrary: primary and would not seek contribution from
Primary And Noncontributory Insurance any other insurance available to the additional
This insurance is primary to and will not seek
insured.
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
CG 20 01 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1
POLICY NUMBER:
G L 956-62-89
COMMERCIAL GENERAL LIABILITY
CG 24 04 12 19
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
SCHEDULE
Name Of Person(s) Or Organization(s):
Pursuant to applicable written contract or agreement you enter into.
Llnformation 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 against the person(s)
or organization(s) shown in the Schedule above
because of payments we make under this Coverage
Part. Such waiver by us applies only to the extent that
the insured has waived its right of recovery against
such person(s) or organization(s) prior to loss. This
endorsement applies only to the person(s) or
organization(s) shown in the Schedule above.
CG 24 04 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ENDORSEMENT #
Policy No. GL 956-62-89 issued to PACIFIC MOBILE STRUCTURES, INC.
By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
AMENDMENT OF LIMITS OF INSURANCE
(Per Project or Per Location Aggregate Limit)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
I. Your policy is amended to include either a Per Project General Aggregate Limit, a Per Location
General Aggregate Limit or a Per Project and Per Location General Aggregate Limit. Please select only
one of the following:
[ X ] Per Project General Aggregate Limit $2 000.000
[ ] Per Location General Aggregate Limit $
[ ] Per Project and Per Location General Aggregate Limit $._
IF NEITHER OF THESE BOXES ARE CHECKED, THIS ENDORSEMENT IS VOID. IF MORE THAN
ONE OF THE THESE BOXES ARE CHECKED, THIS ENDORSEMENT IS VOID.
II. SECTION III — LIMITS OF INSURANCE, is amended to include the following:
1. The Limits of Insurance and the rules below fix the most we will pay regardless of the number
of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or bringing "suits".
2. The General Aggregate Limit is the most we will pay for the sum of:
a. Medical expenses under Coverage C;
b. Damages under Coverage A, except damages because of "bodily injury" or "property
damage" included in the products -completed operations hazard; and
c. Damages under Coverage B.
3. The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage
A for damages because of "bodily injury" and "property damage" included in the "products -
completed operations hazard'.
4. Subject to 2. above, the Personal and Advertising Injury Limit is the most we will pay under
Coverage B for the sum of all damages because of all "personal and advertising injury"
sustained by any one person or organization.
86681 (9/04)
5. Subject to 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will
pay for the sum of.
a. Damages under Coverage A; and
b. Medical expenses under Coverage C
because of all "bodily injury" and "property damage" arising out of any one 'occurrence".
6. Subject to 5. above, the Damage to Premises Rented To You Limit is the most we will pay
under Coverage A because of "property damage" to any one premises, while rented to you,
or in the case of damage by fire, while rented to you or temporarily occupied by you with
permission of the owner.
7. Subject to 5. above, the Medical Expense Limit is the most we will pay under Coverage C for
all medical expenses because of "bodily/ injury" sustained by any one person.
8. Subject to 2., 4., 5., 6., and/or 7. above, the Per Project Aggregate Limit is the most we will
pay under Coverages A, B, and C combined for the sum of:
a. Damages under Coverage A;
b. Damages under Coverage B; and
c. Medical Expenses under Coverage C
arising out of any single Project described above.
9. Subject to 2., 4., 5., 6., and/or 7. above, the Per Location Aggregate Limit is the most we will
pay under Coverages A, B, and C combined for the sum of:
a. Damages under Coverage A;
b. Damages under Coverage B; and
C. Medical expenses under Coverage C
arising out of the any single Location described above.
The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period
and to any remaining period of less than 12 months, starting with the beginning of the policy
period shown in the Declarations, unless the policy period is extended after issuance for an
additional period of less than 12 months. In that case, the additional period will be deemed part of
the last preceding period for purposes of determining the Limits of Insurance.
III. The Limits of Insurance shown in the Declarations are deleted in their entirety and replaced by
the Limits of Insurance set forth below.
Limits of Insurance$
General Aggregate Limit
10,000.000
Each Occurrence Limit
$
1,000,000
Products -Completed Operations Aggregate Limit
$
2,000,000
Personal & Advertising Injury Limit
$
1,000,000
Damage to Premises Rented to You
$
500,000
Medical Expense Limit
$
25,000
Per Project General Aggregate Limit, Per Location
$
2,000.000
General Aggregate Limit or Per
Project and Per Location General Aggregate Limit
86681 (9/04)
IV. SECTION V — DEFINITIONS, is amended to include the following:
23. "Location" means premises involving the same or connecting lots, or premises whose connection
is interrupted only by a street, roadway, waterway, or right-of-way railroad.
All other terms and conditions of this policy remain the same.
Authorized Representative
86681 (9/04)
ENDORSEMENT
Policy No. CA 571-79-55 issued to PACIFIC MOBILE STRUCTURES, INC.
By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SCHEDULE
ADDITIONAL INSURED:
ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND TO PROVIDE
ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON OR ORGANIZATIONS
LIABILITY ARISING OUT OF THE USE OF A COVERED "AUTO".
I. SECTION II - COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to
add:
d. Any person or organization, shown in the schedule above, to whom you become obligated to include as
an additional insured under this policy, as a result of any contract or agreement you enter into which
requires you to furnish insurance to that person or organization of the type provided by this policy, but
only with respect to liability arising out of use of a covered "auto". However, the insurance provided will
not exceed the lesser of:
(1) The coverage and/or limits of this policy, or
(2) The coverage and/or limits required by said contract or agreement.
171 - -/- �
AUTHORIZED REPRESENTATIVE
87950 (9/14) Page 1 of 1
ENDORSEMENT
Policy No. CA 571-79-55 issued to PACIFIC MOBILE STRUCTURES, INC.
By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
INSURANCE PRIMARY AS TO CERTAIN ADDITIONAL INSUREDS
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
Section IV - Business Auto Conditions, B., General Conditions, S., Other Insurance, c., is
amended by the addition of the following sentence:
The insurance afforded under this policy to an additional insured will apply as primary insurance for such additional
insured where so required under an agreement executed prior to the date of accident. We will not ask any insurer that
has issued other insurance to such additional insured to contribute to the settlement of loss arising out of such
accident.
All other terms and conditions remain unchanged.
74445 (10/99)
/AU7TiR 2ZeREPR£SfkTATiVE
ENDORSEMENT
Policy No. CA 571-79-55 issued to PACIFIC MOBILE STRUCTURES, INC.
By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
Section IV - Business Auto Conditions, A. - Loss Conditions, S. - Transfer of Rights of Recovery Against Others
to Us, is amended to add:
However, we will waive any right of recover we have against any person or organization with whom you have entered into
a contract or agreement because of payments we make under this Coverage Form arising out of an "accident' or "loss" if:
(1) The "accident' or "loss" is due to operations undertaken in accordance with the contract existing between you and
such person or organization; and
(2) The contract or agreement was entered into prior to any "accident' or "loss".
No waiver of the right of recovery will directly or indirectly apply to your employees or employees of the person or
organization, and we reserve our rights or lien to be reimbursed from any recovery funds obtained by any injured
employee.
62897(6/95)
REPRESENTATIVE
AUTHORIZED
W AIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This endorsement changes the policy to which it is attached effective on inception date of the policy unless a different
date is indicated below.
(The following " attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy).
Policy No. WC 014-19-5905 Issued to PACIFIC MOBILE STRUCTURES, INC.
By NEW HAMPSHIRE INSURANCE COMPANY
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our
right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform
work under a written contract that requires you to obtain this agreement from us.
This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.
Schedule
ANY PERSON OR ORGANIZATION TO WHOM YOU BECOME OBLIGATED TO WAIVE YOUR RIGHTS OF
RECOVERY AGAINST, UNDER ANY CONTRACT OR AGREEMENT YOU ENTER INTO PRIOR TO THE
OCCURRENCE OF LOSS.
This form is not applicable in California, Kentucky, New Hampshire, New Jersey, North Dakota, Ohio, Tennessee,
Texas, Utah, or Washington. This form is not applicable in Missouri when there is a construction code on the policy and
there is Missouri premium or exposure.
WC 00 03 13 c
(Ed. 04/84) Countersigned by k
�
Authorized Representative
BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated
below.
(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the
policy).
Policy No. WC 014-19-5906
Issued to PACIFIC MOBILE STRUCTURES, INC.
By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce
our right against any person or organization with whom you have a written contract that requires you to obtain this agreement
from us, as regards any work you perform for such person or organization.
The additional premium for this endorsement shall be 2% of the total estimated workers compensation
premium for this policy.
WC 04 03 61
(Ed. 11/90)
Countersigned by
r
` I
Authorized Representative
This page has been left blank intentionally.
SE21 EXCZ08OA81 C
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF SUBROGATION
SCHEDULE
Name of Person or Organization;
As required by written contract or agreement.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to SECTION IV - CONDITIONS, 13. Transfer of Rights of Recovery Against Others.
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. This waiver applies only to the person or organization shown
in the Schedule above.
All other terms of the policy remain unchanged.
NAV-ECD-6012 (01/11) Navigators Specialty Insurance Company Page 1 of 1
Contains copyrighted material of the
Insurance Services Office, Inc. with its permission.
This page has been left blank intentionally.
SE21EXCZ08OA81C
Commercial Excess Liability Coverage Part
Various provisions of this policy restrict coverage. Read the entire policy carefully to determine
your rights, duties and what is and is not covered.
Throughout the policy the words "you" and "your' refer to the Named Insured. The words "we,"
"us" and "our" refer to the company providing this insurance. The word "insured" means any other
person or organization qualifying as such under SECTION II — WHO IS AN INSURED.
Other words and phrases that appear in quotations in this policy have special meanings. Refer to
SECTION V - DEFINITIONS.
SECTION I — COVERAGE
1. Insuring Agreement
A. Excess Liability
We will pay on behalf of the insured and in excess of "underlying limits" those sums
the insured becomes legally obligated to pay as damages for "loss" to which this
insurance applies. This insurance applies only if:
a. the "loss" is caused by an "event' that takes place in the coverage territory;
the "loss" occurs during the "policy period;" and
the "controlling underlying insurance" applies to the "loss."
2. If an aggregate limit of "controlling underlying insurance" is exhausted by the
payment of judgments or settlements to which this insurance applies, or would
have applied but for the amount of the damages, this insurance will apply in place
of the "controlling underlying insurance" until we have paid our applicable Limits of
Insurance.
3. When paragraph 2. above applies, ending the "controlling underlying insurance"
obligations to investigate and settle claims or defend suits against the insured, we
have the right and duty to investigate claims and defend suits which seek damages
to which this insurance applies. Our right and duty to defend end when we have
paid our applicable Limits of Insurance.
4. When paragraph 2. above does not apply, we have the right, but not the duty, to
participate in the investigation or settlement of any claim or the defense of any suit
against any insured.
5. We have the right, at our discretion, to settle any claim to which this insurance
applies.
6. As respects paragraphs 3. and 4. above, "defense expenses" we incur in the
investigation of any claim or defense of any suit will be paid in addition to the Limits
of Insurance except when such costs reduce the limits of "controlling underlying
insurance," in which case they will reduce our Limits of Insurance.
7. The amount we pay is limited. See SECTION III — LIMITS OF INSURANCE.
Navigators Specialty Insurance Company
Contains copyrighted material of the
NAV-EXC-001 (04/10) Insurance Services Office, Inc. with its permission. Page 1 of 7
2. Exclusions
The EXCLUSIONS sections of the "controlling underlying insurance- are made part of this
policy. If an inconsistency or contradiction exists between an Exclusion of this policy and an
Exclusion of the "controlling underlying insurance" the Exclusion of this policy will apply.
However, in no case will coverage be excluded by the "controlling underlying insurance"
and not excluded by this policy.
This insurance does not apply to any liability:
1. to which "controlling underlying insurance" does not apply;
2. for which coverage is provided by "controlling underlying insurance" at limits less than
the limits of insurance applicable to other coverage provided by the "controlling
underlying insurance" and less than "underlying limits;"
3. for "loss" which commenced prior to this "policy period," whether or not such "loss"
continues, progresses, changes or resumes during this "policy period;"
4. for damage to property you own, rent or occupy, including any costs or expenses
incurred by you or any other person, organization or entity, for repair, replacement,
enhancement, restoration or maintenance of such property for any reason, including
the prevention of injury to a person or damage to another's property;
5. for damage to personal property in the care, custody or control of any insured;
6. arising out of any "aircraft products;"
7. arising out of the actual, alleged, suspected or threatened inhalation of, ingestion of,
contact with, exposure to, existence of, or presence of "asbestos;"
8. arising out of the actual, alleged, suspected or threatened inhalation of, ingestion of,
contact with, exposure to, existence of, or presence of "fungi" or bacteria;
9. arising out of the actual, alleged, suspected or threatened inhalation of, ingestion of,
contact with, exposure to, existence of, or presence of "silica" or "silica related dust;"
10. arising out of any "employment practices" of any insured;
11. arising out of:
war, including undeclared or civil war;
warlike action by a military force, including action in hindering or defending
against an actual or expected attack, by any government, sovereign or other
authority using military personnel or other agents; or
insurrection, rebellion, revolution, usurped power, or action taken by
governmental authority in hindering or defending against any of these;
12. imposed under:
a. an uninsured or underinsured motorist, uninsured or underinsured boater,
Medical Payments, Personal Injury Protection, No -Fault or any similar law;
b. a workers compensation, disability benefits, unemployment compensation or any
similar law;
c. the Employee Retirement Income Security Act of 1974, any amendments thereto
or any similar law.
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SECTION II — WHO IS AN INSURED
The WHO 1S AN INSURED section of the "controlling underlying insurance" is made part of this
Policy. Any person or organization that is an insured in "controlling underlying insurance" is an
insured in this policy to the same extent.
SECTION III — LIMITS OF INSURANCE
The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay
regardless of the number of insureds, claims made or suits brought, or persons or organizations
making claims or bringing suits.
1. The General Aggregate Limit is the most we will pay for the sum of all damages to which
this insurance applies, except:
a. damages because of bodily injury or property damage included within any applicable
products -completed operations hazard; or
b. damages arising out of the ownership, operation, maintenance or use of an
automobile;
2. The Products -Completed Operations Aggregate Limit is the most we will pay for the sum
of all damages included within any applicable products -completed operations hazard;
3. Subject to paragraphs 1. and 2. above, the Each Event Limit is the most we will pay for
all damages that arise out of any one "event."
SECTION IV —CONDITIONS
The CONDITIONS sections of the "controlling underlying insurance" are made part of this
policy. If an inconsistency or contradiction exists between the Conditions of this policy and the
Conditions of the "controlling underlying insurance," the Conditions of this policy will apply.
1. Appeals
At our discretion we may appeal any judgment which would result in a payment under
this policy. When we do appeal, we will pay all costs associated with the appeal in
addition to the Limits of Insurance. Any such appeal will not increase our Limits of
Insurance.
2. Bankruptcy or Insolvency
Bankruptcy or insolvency of the insured or the insured's estate will not relieve us of our
obligations under this policy. Bankruptcy or insolvency of any company providing
"controlling underlying insurance" will not reduce the "underlying limits" or increase our
obligations under this policy. We will not be required to drop down or replace "controlling
underlying insurance."
3. Cancellation
a. The first Named Insured may cancel this policy at any time by providing us advanced
written notice of the cancellation date.
b. We may cancel this policy at any time by providing the first Named Insured written
notice of cancellation:
i. at least 10 days in advance if we cancel for non-payment of premium; or
ii. at least 30 days in advance if we cancel for any other reason:
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c. If the "controlling underlying insurance" is cancelled for any reason, this policy is also
cancelled. Reinstatement of the "controlling underlying insurance" does not reinstate
this policy unless reinstatement is endorsed hereon.
Return premium, if any, will be calculated per Condition 11. Premium. Proof of mailing will
be proof of notice.
4. Non -Renewal
a. We are not obligated to renew this policy. However, should we decide not to renew,
we will provide the first Named Insured written notice of our decision at least 30 days
prior to the expiration date shown in the Declarations.
b. We will not restrict the terms or increase premium of this policy at renewal unless we
have given the first Named Insured at least 30 days advanced notice of any such
changes. However, no notice will be provided or required if a restriction in this policy
results from a restriction applicable to "controlling underlying insurance."
c. The first Named Insured may non -renew this policy by:
i. providing advance written notice to us;
ii. rejecting our offer to renew; or
iii. failing to reply to our offer to renew.
Proof of mailing will be proof of notice.
5. Changes
This policy contains all of the agreements between you and us. This policy may only be
changed by endorsements we issue.
6. Duties When There is an "Event," Claim or Suit
a. You must see to it that we and any other insurers who could provide coverage are
notified as soon as practicable of any "event' which may be reasonably expected to
result in a claim under this policy. To the extent possible, notice should include:
i. how, when and where the "event' took place;
ii. the names and addresses of any injured persons and witnesses; and
iii. the nature and location of any injury or damage arising out of the "event."
If a claim is made or suit is brought against any insured which may be reasonably
expected to result in a claim under this policy, you must:
I. immediately record the specifics of the claim or suit and the date received; and
ii. notify us, and any other insurers who could provide coverage, as soon as
practicable.
c. You and any other involved insured must:
i. immediately send us, and any other insurers who could provide coverage, copies
of any demands, notices, summonses or legal papers received in connection with
a claim or suit which may be reasonably expected to result in a claim under this
policy;
ii. authorize us to obtain records and other information;
iii. cooperate with us in the investigation or settlement of the claim, issues relating to
coverage under this policy or defense against the suit; and
iv. assist us, upon our request, in the enforcement of any right against any person or
organization which may be liable to the insured because of the injury or damage
to which this insurance may apply.
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d. No insured will, except at that insured's own cost, voluntarily make a payment,
assume any obligation or incur any expense, other than first aid, without our consent.
Notice to us may be sent to our address shown in the Declarations.
7. Legal Action Against Us
No person or organization has a right under this insurance:
a. to join us as a party or otherwise bring us into a suit asking for damages from an
insured; or
b. to sue us on this insurance unless all of its terms have been fully complied with.
8. Maintenance of Controlling Underlying Insurance
During the "policy period" you must maintain "controlling underlying insurance" with
"underlying limits" at least equal to the amounts shown in the Declarations. The
"underlying limits" must be unimpaired at the beginning of this "policy period."
If you fail to maintain the "controlling underlying insurance" this policy will be invalid.
If you fail to maintain "underlying limits," we will only be liable to the extent we would have
been liable had you maintained the "underlying limits." Reduction of "underlying limits" by
the payment of judgments or settlements for "loss" to which this insurance applies, or
would have applied but for the amount of the damages, will not be considered a failure to
maintain "underlying limits."
9. Other Insurance
This insurance is excess over any insurance available to the insured except insurance
purchased specifically to apply in excess of this policy.
10. Payment of Damages
When the amount of damages payable under this policy has been determined by final
judgment or a written settlement agreement between the claimant and us, we will pay
that amount, up to our applicable Limits of Insurance, after the "controlling underlying
insurance" or the insured has paid the full amount of the "underlying limits."
11. Premium
The Premium shown in the Declarations is the premium for the coverage we provide for
the "policy period." The first Named Insured is responsible for the payment of all
premiums under this policy. If this policy is cancelled prior to its expiration date return
premium will be calculated as follows:
a. if cancelled by us:
[{(Premium) — (Minimum Earned Premium)} x (Pro Rata factor)]
b. if cancelled by you:
[{(Premium) — (Minimum Earned Premium)} x {(Pro Rata factor) x (.90)}].
12. Separation of Insureds
Except with respect to the Limits of Insurance and any rights or duties specifically
assigned in this policy to the first Named Insured, this insurance applies:
a. as if each Named Insured were the only Named Insured; and
b. separately to each insured against whom claim is made or suit is brought.
13. Transfer of Rights of Recovery Against Others
If an insured has rights to recover all or part of any payment we have made under this
insurance, the insured must preserve those rights and, at our request, pursue or transfer
those rights to us. The insured must do nothing after an "event" to impair them.
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14. Reformation of Underlying
If the "controlling underlying insurance" is reformed after an "event" to provide coverage
for a "loss," the terms of such reformation do not apply to this policy.
15. When we Defend
When we have a duty to defend an insured, the insured will cooperate with us in the
transfer of the defense to counsel of our choosing. If the law of the governing jurisdiction
permits an insured to select their own counsel to be paid for by us, we shall only be liable
for the reasonable and necessary defense costs of one law firm per insured at rates
customarily paid by us for the defense of similar claims in the jurisdiction where the claim
is pending.
16. Claims outside the U.S.A, it's Territories, Possessions or Canada
When we have the duty to defend an insured and are prevented by law or otherwise from
doing so, we will reimburse the insured for any reasonable and necessary expenses
incurred in the defense of a suit to which this insurance applies.
If the insured becomes legally obligated to pay damages to which this insurance applies
and we are prevented by law from paying such damages on behalf of the insured, we will
reimburse the insured, in U.S currency at the prevailing exchange rate at the time the
damages were paid, for such damages.
SECTION V — DEFINITIONS
The DEFINITIONS sections of the "controlling underlying insurance" are made part of this policy,
and apply to words or phrases used in this policy provided always that words or phrases in
quotations in this policy will have the meaning given them in this policy.
"Aircraft products" means:
a. an aircraft;
b. ground control or support equipment; or
c. any article, component or device made, sold, licensed, handled or distributed by any
insured that is used to achieve, control or maintain flight or landing of an aircraft.
"Asbestos" means the mineral in any form
"Controlling underlying insurance" means the policy listed in the Schedule of Underlying
Insurance shown in the Declarations, or its renewal or replacement, which applies to the
"loss," or would have applied but for:
a. an exclusion in that policy; or
b. the exhaustion or erosion of an aggregate limit of insurance;
If more than one policy is listed in the Schedule, the "controlling underlying insurance" is the
policy which applies to the "loss" or would have applied but for the reasons a. or b. listed
above.
"Defense expenses" means expenses we incur to investigate a claim or defend a suit.
Defense expenses include interest which accrues on our {portion of a judgment, after entry of
that judgment and after the insured or any underlying insurer has paid the full amount of their
portion of the judgment but before we have paid, offered to pay or deposited in the court the
part of the judgment that is within our applicable Limits of Insurance.
"Employment practices" means:
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a. dismissal, discharge or termination of employment, whether actual, constructive or
retaliatory;
b. failure or refusal to hire or promote;
c. discipline, demotion, coercion or retaliatory treatment;
d. failure to grant tenure;
e. negligent employment evaluation;
f. sexual or other workplace harassment, including quid pro quo and hostile work
environment;
g. employment discrimination;
h. invasion of privacy, violation of employment related civil rights, employment related
libel, slander or defamation;
i. creating or enforcing or failing to create or enforce employment related policies or
procedures; or
j. actual or alleged violations of the Family and Medical Leave Act of 1993 or its
amendments.
"Event" means an accident, incident, occurrence, offense, wrongful act or other "loss" causing
"event" defined by and to which the "controlling underlying insurance" applies.
"Fungi" means any type or form of fungus, including mold or mildew and any mycotoxins,
spores, scents or byproducts produced or released by fungi. But "fungi" does not include
mushrooms cultivated for human consumption.
"Loss" means bodily injury, property damage, personal and advertising injury or other loss
defined by and to which the "controlling underlying insurance" applies.
"Policy period" means the period of time between the effective date shown in the Declarations
and the earlier of the expiration date shown in the Declarations or the expiration date shown
in an endorsement to this policy.
`&lica" means silicon dioxide, occurring in crystalline, amorphous or impure forms, silica
particles, silica dust or silica compounds.
"Silica related dust" means a mixture or combination of silica and other dust particles.
"Underlying limits" means the amounts shown in the Declarations as the minimum limits of
insurance to be provided by "controlling underlying insurance."
In Witness Whereof, the issuing Company has caused this policy to be signed officially
below, and countersigned on the Declarations page by a duly authorized representative of
said Company.
Jam- I�
Stanley A. Galanski
President
Jeff L. Saunders
Vice President
Navigators Specialty Insurance Company
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SE21EXCZ08OA81C
COMMERCIAL EXCESS LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF CONDITIONS
OTHER INSURANCE
PRIMARY AND NON-CONTRIBUTING
This endorsement modifies insurance provided under the following:
COMMERCIAL EXCESS LIABILITY COVERAGE PART
SCHEDULE
When required by written contract executed before the "loss."
A. Section IV - Conditions, 9. Other Insurance is deleted and replaced by the following:
9. This insurance is excess over any other insurance available to the insured except:
a. insurance that is purchased specifically to apply in excess of this policy; or
b. insurance available to the person or organization shown in the Schedule of this
endorsement as an additional insured on the "controlling underlying insurance."
B. When this insurance applies on a primary and non-contributing basis, the Limits of Insurance
available for the additional insured will be the lesser of:
1. the amounts shown in item 3 of the Declarations of this policy; or
2. the amount of insurance you are required to provide the additional insured in the written
contract or agreement.
All other terms of the policy remain unchanged.
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