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2021/11/01 Copp Contracting, Inc.AC"Rif CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `.� 02/16/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Mini Lee NAME: The Liberty Company Insurance Brokers PHONE Ext : (949) 777-0577 WENo Lic #OD79653 ADDRESS: mlee@libertycompany.com 5955 De Soto Ave, Suite 250 INSURER(S) AFFORDING COVERAGE NAIC # Woodland Hills CA 91367 INSURERA: Greenwich Insurance Company 22322 INSURED State Compensation Ins Fund CA INSURER B : P ( ) 35076 Copp Contracting, Inc. INSURER C : Navigators Specialty Insurance Company 36056 6751 Stanton Avenue INSURER D : INSURER E : Buena Park CA 90621 INSURER F : COVERAGES CERTIFICATE NUMBER: 21-22 Master RFVLRlntd MI IMRFR- 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 TO WHICH THIS CERTIFICATE MAYBE 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A Y Y NPC1005298-00 11/01/2021 11/01/2022 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY ❑JET 7 LOC PRODUCTS -COMPIOPAGG $ 2,000,000 $ OTHER- AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ 1,000,000 Ea accdant ANY AUTO BODILY INJURY (Per person) $ A OWNED SCHEDULED AUTOS ONLY AUTOS Y NBA1005299-00 11/01/2021 11/01/2022 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per nt $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 x AGGREGATE $ 4,000,000 A EXCESS LIAB CLAIMS -MADE NEC6006670-11 11/01/2021 11/01/2022 DED I X1 RETENTION NIL S $ WORKERS COMPENSATION X FIE AND EMPLOYERS' LIABILITY Y / N STATUTE ERH E. L, EACH ACCIDENT $ 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? FYI N/A Y 9300770-2021-2 07/01/2021 07/01/2022 EL. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatoryfyes,d NH)and If yes, describe under be DESCRIPTION OF OPERATIONS below EL. DISEASE -POLICY LIMIT $ 1,000,000 Pollution Liability Aggregate $2,000,000 C SF21ECP000414NC 11/01/2021 11/01/2022 Each Occurrence $1,000,000 Deductible $2,500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: Operations of the named insured as per written contract. Proof of Insurance: Subject to all policy terms, conditions, limitations, and exclusions Certificate Holders is Additional Insured with respects to General Liability per form CG2010 1219 and CG2037 1219 required by written contract. GL Primary and Non -Contributory wording per endorsement CG2001 1219 applies. GL Blanket Waiver of Subrogation applies per endts XIL 436 12/08. Workers Comp Waiver of Subrogation wordings per endorsement form SCIF form 2572. l.H]N UE LGN 14U1V SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Menifee ACCORDANCE WITH THE POLICY PROVISIONS. 29844 Haun Road AUTHORIZED REPRESENTATIVE Menifee CA 92586 `Mtuu� @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: NPC-1005298-00 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 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 Com leted Operations Blanket as required by written contract. Blanket as required by written contract. 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 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: NPC-1005298-00 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 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) Location(s) Of Covered Operations Blanket as required by written contract. (Blanket as required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I A. Section 11 — 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 apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization 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 © Insurance Services Office, Inc., 2018 Page 1 of 2 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 applicable limits of insurance. not increase the Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 10 12 19 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 Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional 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 © Insurance Services Office, Inc., 2018 Page 1 of 1 ENDORSEMENT# This endorsement, effective 12:01 a.m. , forms a part of Policy No. issued to by THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY XL Plus Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read this endorsement carefully to determine rights, duties, and what is and is not covered. A. Reasonable Force — Bodily Injury or Property Damage B. Damage To Premises Rented To You Extension • Perils of fire, lightning, explosion, smoke, aircraft or vehicles, riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage • Limit increased to $300,000 C. Aircraft Chartered with Crew D. Non -Owned Watercraft E. Personal and Advertising Injury — Assumed by Insured Contract F. Increased Supplementary Payments • Cost for bail bonds increased to $5,000 • Loss of earnings increased to $1,000 per day G. Broadened Named Insured H. Blanket Additional Insured — Managers or Lessors of Premises I. Blanket Additional Insured — Lessor of Leased Equipment J. Injury to Co -Employees and Co -Volunteer Workers K. Knowledge and Notice of Occurrence or Offense L. Unintentional Omission M. Liberalization N. Blanket Waiver of Subrogation O. Incidental Medical Malpractice Injury P. Extension of Coverage — Bodily Injury Q. Coverage Territory Form XIL 436 1208 © 2008, XL America, Inc. Page 1 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. A. REASONABLE FORCE — BODILY INJURY OR PROPERTY DAMAGE Exclusion a. Expected Or Intended Injury of Part 2., Exclusions of Coverage A. Bodily Injury And Property Damage Liability of Section I — Coverages is deleted in its entirety and replaced by the following: [This insurance does not apply to:) Expected or Intended Injury or Damage "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. B. DAMAGE TO PREMISES RENTED TO YOU EXTENSION 1. The last paragraph of 2. Exclusions of Coverage A. Bodily Injury And Property Damage Liability of Section I - Coverages is deleted in its entirety and replaced by the following: Exclusions c. through n. do not apply to damages to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by fire, lightning, explosion, smoke, aircraft or vehicles, riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage. A separate limit of insurance applies to this coverage as described in Section III- Limits of Insurance. 2. This insurance does not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: a. Rupture, bursting, or operation of pressure relief devices; b. Rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from water; or c. Explosion of steam boilers, steam pipes, steam engines, or steam turbines. 3. Paragraph 6. of Section III- Limits of Insurance is deleted in its entirety and replaced by the following: 6.a. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises while rented to you, or temporarily occupied by you with permission of the owner, caused by fire, explosion, lightning, smoke, aircraft or vehicle, riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage. The Damage To Premises Rented To You Limit will apply to all damage proximately caused by the same 'occurrence", whether such damage results from fire, explosion, lightning, smoke, aircraft or vehicle or riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage or any combination of any of these. b. The Damage to Premises Rented to You Limit will be the higher of: (1) $300,000; or (2) The amount shown on the Declarations for Damage to Premises Rented to You Limit. Form XIL 436 1208 © 2008, XL America, Inc. Page 2 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 4. Paragraph 9.a. of the definition of "insured contract' under Section V- Definitions, is deleted in its entirety and replaced by the following: ["Insured contract' means:] a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, aircraft or vehicle, riot or civil commotion, vandalism, leakage from fire extinguishing equipment or water damage to premises while rented to you, or temporarily occupied by you with the permission of the owner is not an "insured contract'. 5. This Article B. does not apply if coverage for Damage to Premises Rented to You of Coverage A. Bodily Injury And Property Damage Liability of Section I — Coverages is excluded by endorsement. C. AIRCRAFT CHARTERED WITH CREW 1. The following is added to the exceptions contained in Exclusion g., Aircraft, Auto or Watercraft in Part 2., Exclusions of Coverage A. Bodily Injury And Property Damage of Section I — Coverages: [This exclusion does not apply to:) Aircraft chartered with crew to any insured. 2. This Article C. does not apply if the chartered aircraft is owned by any insured. 3. The insurance provided by this Article C. shall be excess over any valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance purchased specifically by you to be excess of this policy. D. NON -OWNED WATERCRAFT 1. The exception contained in Subparagraph (2) of Exclusion g. Aircraft. Auto or Watercraft in Part 2., Exclusions of Coverage A. Bodily Injury And Property Damage Liability of Section I — Coverages is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) 50 feet long or less; and (b) Not being used to carry persons or property for a charge; 2. This Article D. applies to any person who, with your expressed or implied consent, either uses or is responsible for the use of the watercraft. 3. This insurance provided by this Article D. shall be excess over any other valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance purchased specifically by you to be excess of this policy. E. PERSONAL AND ADVERTISING INJURY— ASSUMED BY INSURED CONTRACT 1. Exclusion e. Contractual Liability in Part 2., Exclusions of Coverage B. Personal And Advertising Injury Liability of Section I — Coverages is deleted in its entirety and replaced by the following: Form XIL 436 1208 © 2008, XL America, Inc. Page 3 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. [This insurance does not apply to:) e. Contractual Liability "Personal and Advertising Injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages: 1. That the insured would have in the absence of the contract or agreement; or 2. Assumed in a written contract or agreement that is an "insured contract'; provided the "personal and advertising injury" is caused by an offense which occurs subsequent to the execution of the contract or agreement. 2. Subparagraph f. of the definition of "insured contract' Section V.- Definitions is deleted in its entirety and replaced by the following: f. That part of any other contract or agreement pertaining to your business, including an indemnification of a municipality in connection for work performed for a municipality, under which you assume the tort liability of anther party to pay for "bodily injury", "property damage" or "personal and advertising injury" to a third party or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. 2. This Article E. does not apply if Coverage B. Personal And Advertising Injury Liability is excluded by endorsement. F. INCREASED SUPPLEMENTARY PAYMENTS Subparagraphs 1. b. and d. of Supplementary Payments — Coverages A And B of Section I - Coverages are amended as follows: 1. In Subparagraph b., the amount we will pay for the cost of bail bonds is increased up to $5,000. 2. In Subparagraph d., the amount we will pay for a loss of earnings is increased up to $1,000 a day. G. BROADENED NAMED INSURED 1. The Named Insured in Item 1. of the Declarations is as follows: The person or organizations named in Item 1. of the Declarations and any organization, other than a partnership or joint venture, over which you maintain ownership or majority interest on the effective date of the policy. However, coverage for any such organization will cease as of the date that you no longer maintain ownership of, or majority interest in, such organization. 2. This Article G. does not apply to any person or organization for which coverage is excluded by endorsement. Form XIL 436 1208 © 2008, XL America, Inc. Page 4 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. H. BLANKET ADDITIONAL INSURED — MANAGERS OR LESSORS OF PREMISES 1. Section II -Who Is An Insured is amended to include as an insured any person or organization with whom you have agreed in a written contract executed prior to loss (an "additional insured"), but only with respect to liability arising out of the ownership, maintenance or use of that part of any premises leased to you, subject to the following provisions: a. Limits of Insurance. The Limits of Insurance afforded to the "additional insured" shall be the limits you agreed to provide, or the limits shown on the Declarations, whichever is less. b. The insurance afforded to the "additional insured" does not apply to: (1) Any "occurrence" that takes place after you cease to be a tenant in that premises; (2) Any premises for which coverage is excluded by endorsement; or (3) Structural alterations, new construction or demolition operations performed by or on behalf of such "additional insured". 2. The insurance afforded to the "additional insured" is excess over any valid and collectible insurance available to such "additional insured", unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis. I. BLANKET ADDITIONAL INSURED — LESSOR OF LEASED EQUIPMENT 1. Section II -Who Is An Insured is amended to include an "additional insured" (as defined in Article H. above), but only with respect to their liability arising out of maintenance, operation or use by you of equipment leased to you by such "addftional insured", subject to the following provisions: a. Limits of Insurance. The Limits of Insurance afforded to the "additional insured" shall be the limits which you agreed to provide, or the limits shown on the Declarations, whichever is less. b. The insurance afforded to the "additional insured" does not apply to: (1) Any "occurrence" that takes place after the equipment lease expires; or (2) "Bodily injury" or "property damage" arising out of the sole negligence of such additional insured. 2. The insurance provided to the "additional insured" is excess over any valid and collectible insurance available to such "additional insured", unless you have a written contract for this insurance to apply on a primary or contributory basis. J. INJURY TO CO -EMPLOYEES AND CO -VOLUNTEER WORKERS 1. Section II- Who Is An Insured is amended to include your "employees" as insureds with respect to "bodily injury" to a co -"employee" in the course of the co -"employee's" employment by you, or to your "volunteer workers" while performing duties related to the conduct of your business, provided that this coverage for your "employees" does not apply to acts outside the scope of their employment by you or while performing duties unrelated to the conduct of your business. Form XIL 436 1208 © 2008, XL America, Inc. Page 5 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission, 2. Section II — Who Is An Insured is amended to include your "volunteer workers" as insureds with respect to "bodily injury" to a co -"volunteer worker" while performing duties related to the conduct of your business, or to your "employees" employment by you, provided that this coverage for your "volunteer workers" does not apply while performing duties unrelated to the conduct of your business. K. KNOWLEDGE AND NOTICE OF OCCURRENCE OR OFFENSE The following is added to Paragraph 2., Duties 1n The Event of Occurrence, Offense, Claim or Suit of the Section IV - Commercial General Liability Conditions: Notice of an 'occurrence" or of an offense which may result in a claim under this insurance shall be given as soon as practicable after knowledge of the 'occurrence" or offense has been reported to any insured listed under Paragraph 1, of Section II -Who Is An Insured or any "employee" (such as insurance, loss control, risk manager or administrator) designated by you to give such notice. Knowledge of any other "employee(s)" of an `occurrence" or of an offense does not imply that you also have such knowledge. Notice shall be deemed prompt if given in good faith as soon as practicable to your workers compensation insurer. This applies only if you subsequently give notice to us as soon as practicable after any insured listed under Paragraph 1. of Section II — Who Is An Insured or an "employee" (such as an insurance, loss control, or risk manager or administrator) designated by you to give such notice discovers that the `occurrence", offense or claim may involve this policy. L. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Representations, of Section IV- Commercial General Liability Conditions: The unintentional omission of, or unintentional error in, any information provided by you shall not prejudice your rights under this insurance. However, this Article L. does not affect our right to collect additional premium or to exercise our right of cancellation or nonrenewal in accordance with applicable state insurance laws or regulations. M. LIBERALIZATION The following is added to Section IV -Commercial General Liability Conditions: Liberalization After the issuance of this policy, if we adopt a change in our forms or rules which would broaden the coverage provided by any form that is a part of this policy without a premium charge, the broader coverage will apply to this policy. This extension is effective upon the approval of such broader coverage in your state. Form XIL 436 1208 © 2008, XL America, Inc. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 8 N. BLANKET WAIVER OF SUBROGATION The following is added to Section IV -Commercial General Liability Conditions: Waiver of Subrogation We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of premises owned or occupied or rented or loaned to you; ongoing operations performed by you or on your behalf, done under a contract with that person or organization; "your work"; or "your products". We waive this right where you have agreed to do so as part of a written contract, executed by you prior to loss. O. INCIDENTAL MEDICAL MALPRACTICE INJURY 1. For insurance applicable to this Article O, the definition of "bodily injury" in Section V - Definitions is amended to include, "Incidental Medical Malpractice Injury". 2. The following definition is added to Section V- Definitions: "Incidental medical malpractice injury" deans "bodily injury", mental anguish, sickness or disease sustained by a person, including death resulting from any of these at any time, arising out of the rendering of, or failure to render, the following services: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; b. The furnishing or dispensing of drugs or medical, dental or surgical supplies or appliances; c. First aid; or d. "Good Samaritan Services". As used in this Article O., "Good Samaritan Services" are those medical services rendered or provided in an emergency and for which no remuneration is demanded or received. 3. Paragraph 2.a.(1)(d) of Section II -Who Is An Insured does not apply to any registered nurse, licensed practical nurse, emergency medical technician or paramedic employed by you, but only while performing the services described in Paragraph 2. above and while acting within the scope of their employment by you. Any "employees" rendering "Good Samaritan Services" will be deemed to be acting within the scope of their employment by you. 4. The following exclusion is added to Paragraph 2. Exclusions of Coverage A. — Bodily Injury And Property Damage Liability of Section I — Coverages: [This insurance does not apply to:) Willful Violation of Penal Statute Liability arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuticals by or with the knowledge or consent of the insured. 5. For the purposes of determining the applicable Limits of Insurance, any act or omission, together with all related acts or omissions in the furnishing of services described in Paragraph 2.a. through 2.d. above to any one person, will be considered one "occurrence". 6. This Article O. does not apply if you are in the business or occupation of providing any of the services described in Paragraph 2. above. Form XIL 436 1208 © 2008, XL America, Inc. Page 7 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 7. The insurance provided by this Article O. shall be excess over any other valid and collectible insurance available to the insured, whether primary, excess, contingent or on any other basis, except for insurance purchased specifically by you to be excess of this policy. P. EXTENSION OF COVERAGE — BODILY INJURY The definition of "bodily injury" Section V- Definitions is deleted in its entirety and replaced by the following: 3. "Bodily injury" means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. Q. COVERAGE TERRITORY The definition of "coverage territory" Section V- Definitions is deleted in its entirety and replaced by the following: 4. "Coverage territory" means anywhere in the world. This insurance does not apply to: a. "bodily injury" or "property damage" that takes place; or b. "personal and advertising injury" caused by an offense committed outside the United States of America (including its possessions and territories), Canada and Puerto Rico, unless a "suit" on the merits (to determine the insured's responsibility to pay damages to which this insurance applies) is brought in the United States of America (including its possessions and territories), Canada or Puerto Rico. This insurance does not apply to damage, loss, cost or expenses in connection with any "suit" brought outside the United States of America (including its possessions and territories), Canada or Puerto Rico. Form XIL 436 1208 © 2008, XL America, Inc. Page 8 of 8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS HOME OFFICE SAN FRANCISCO EFFECTIVE JULY 1, 2021 AT 12 . 01 A.M. ALL EFFECTIVE DATES ARE AND EXPIRING JULY 1, 2022 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME COPP CONTRACTING, INC. 6751 STANTON AVE BUENA PARK, CA 90621 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. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TOTAL POLICY PREMIUM. C r. Mr. T)TTT.F PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION 9300770-21-2 RENEWAL SP 1-66-75-28 PAGE 1 OF NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAANFRFRANCISCO: �4 2572 AUTHORIZED REPRESENT IVE SCIF FORM 10217 (REV.4.2018) JULY 2, 2021 PRESIDENT AND CEO 1 OLD DP 217