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2022/01/19 Aztec Landscaping, Inc. (4)SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY 4/18/2022 Daisy Trudeau Ins. Services5015 Canyon Crest Dr. Ste. 207Riverside CA 92507 Diana Castanon 951-680-9600 888-261-9654 diana@daisytrudeauins.com License#: CA #0L52222 Nationwide Mutual Ins Co 23787 AZTEC-1 CompWest Insurance Company 12177Aztec Landscaping, Inc.dba Aztec Janitorial7980 Lemon Grove WayLemon Grove CA 91945 James River Insurance Company 12203 872632902 A X 1,000,000 X 300,000 10,000 1,000,000 2,000,000 X Y ACP3086461444 12/15/2021 12/15/2022 2,000,000 Employee Benefits 1,000,000 A 1,000,000 X X X ACP3086461444 12/15/2021 12/15/2022 A X X 5,000,000ACP308646144412/15/2021 12/15/2022 5,000,000 B XCW WCO 100009817 01 2/25/2022 2/25/2023 1,000,000 1,000,000 1,000,000 AC CrimeProfessional Liability ACP 3076461444121 AE 0193055-01 12/15/20211/19/2022 12/15/20221/19/2023 Employee DishonestyProf Liab AggProf Liab Ded $200,000$1,000,000$10,000 Limited Pollution coverage is in place per form CG22640413, Policy# ACP3086461444, Eff 12/15/21 to 12/15/22, Limit: $1,000,000- Ded: NILTHE CITY OF MENIFEE, ITS COUNCILMEMBERS, OFFICERS, AGENTS, AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED WHEREREQUIRED BY WRITTEN CONTRACT PER FORM ATTACHED WITH RESPECTS TO GENERAL LIABILITY. PRIMARY WORDING & NONCONTRIBUTORY APPLIES. City of MenifeeRFP #2022-10 Community Services Dept. Citywide Janitorial Services Dept. of Finance 29844 Haun Rd. Menifee CA 92586 DocuSign Envelope ID: CDA0AD32-5A91-4BC9-BEC6-5013B7B6BB7A COMMERCIAL GENERAL LIABILITY CG 72 461115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL V. ADDITIONAL INSURED -OWNERS1 LESSEES OR CONTRACTORS -AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL UABIUTY COVERAGE PART A. SecHon II -Who 19 An ln9ured i� nmt:-nrlt:-d 10include as ar1 addilior1al insurw. Ongoing Operations 1.Any person or organriation ror wnom you areperforming operations when you and suchperson or organization have agreed in writingin o. contract or ogfccmcnt that such personor organization be added as an additional1nsurea on your policy; ana :!. Ariy 01hc-r pertJon err organi2tllion you o,c required lo add as an additional insured under tne contract or agreement oescrroeo In Paragraph 1. above. such µerso11(st or orgar1iza1ion(s) is an add"ilionar Insureo only with respect to I1abIhty tor "boaIIy injury". "property damage" or "personal and advertising injury" caused, in whole or in part, by: a.Your acts or omrss,ons; or b.The o.cts or omissions of those £tcting onyour bel1alt; in the performance of your ongoing operations for the o.dditionol in�urcd. However. the insurance afforded to such additional insured described abo11e· a.Only applies to fhe extent permitted bylaw;and b.Will not be broader than that which �'Ouare required by the contract or agreementto provide for such additional insured. A pers.:in's or organization's statu$ as an additional insured for ongoing operations ends when your operations tor the person or organi,a1ion described in Paragraph 1. above are oomple1oo. With respect to insurance afforded to these additional insureds for ongoing operations, this insurance docs no1 npply to '·bodily injury" 01 "pn.:,perly damage" oc;c;u,Ying alle,. o.All work, including mo.tcriol, port� orequiµmer1l furnished i,1 00t1r1ec\ior1 wilhsuch work, on tne pro1ect {otner tnanservice, maintenance or repairs) to beporformad by or on bah�lf of thaadditional insured{s} at the location ot thecovered operations has been completedor b.that operation of "your work" out of whiehthe injury or damage arises has been putto its intended use by any person ororganin1tion other than �nothP.rcon1re.c\01 or suboon\re.ctor engaged inperforrni11y operalions lvr a µrincipal as apart ot the same pro1ect. B.Section H -Who Is An Insured is amended toillClul'.le as clll cl(t(JiliOllcll irl$urW. Products-Completed Operations Any person or organization with whom you haveaQreed in writinA in a contract or aQrooment thatsuch person or organization be added as anadditional insured on your policy with respect toliabilily for "bodily injury" Of "1:n·vµt:dy dct,ll<lg�"caused, in whole or in part, by ·your work"performed for such person or organization andinclucl9cl ir. th� ·products-comp!Qtlid op@rafonshazard". However. the insurance afforded tc suchadditional insured described above: a.Only applies to the extent permitted bylaw; and b.Will 110( be brooder lhan lhal which youare required by the contract or agreementto provide for such additional insured.c.With respeo( lo lhe insv.-dnoe �lfor\:led (t> theseaod1t1onar insureds, this rnsurance ooes not applyto "bodily injury", "property damage" or "personaland advQrtising injury" arising out of 1h9 r9nd9ri11g CG 72 46 1115 Includes copyrit;1hted material of Insurance Services Office. Inc. with its permission. Page 1 of 2 ACP GLD0308b4bl444 LKIS 18353 INSURED COPY 47 0021539 DocuSign Envelope ID: CDA0AD32-5A91-4BC9-BEC6-5013B7B6BB7A CG 72 4611 15 of, or lhe lailure lo render, any professional architec1uraI. engineering or surveying services, including: 1.The preparing, approving. or failing to prepareor approve, maps, shop drawings, opinions,reports. surveys. field orders. change ordersor drawings and specilicahons; or 2.Supervisory, inspection, architectural orengineering activities.This exclusion applies even if lhe claims againsl any insured allege negligence or other wrongdoing in the supervision, hiring, amploym�mt, training or monitoring at olh�rs by that insured, if \he "occurtenee" which caused the "bodily Injury· or �proper1y damage·, or the offense which caused the "personal and adve.rti!>ino injury". involved the rendering of. or the t::iiluro to rcndor, .1ny protcssiOn.ll architeclura/, engineering or surveying services. 0 With re!:poct to the in!lurnncc afforded to these addilionat insureds. Ille loUovving is added lo Sectron m -Limits Of Insurance: The mosl we will pay on behalf of 1he addi1fonal i11,;,1,m;n;l 1$ lht;: ;:'11llQ1,11ll QI ttl$1,1f�11Ct;1. 1.RP.(111irro hy 1hP. l"'.("ln1r"'l"'.t nr �or�mE>.ntdccoribcd in PQl'ogroph A.1. or Paragraph B.;vr' 2.Available under Ifie applicable Limils orInsurance shown in the Declarations: whiohovcr iG lcGG This endorsement shall not increase the applicable Limits. of Insurance shown in lhe Dool.:ir;:itiom;. E.With respect 10 the insurance afforded to theseadditional insureds, the tallowing is added to Seotion IV -Commeroial General LiabilityConditions. Condilion 4. Other Insurance andsupersedes any provision to the contrary: Primary And Noncont,ibutory Insurance This insurance is primary to and will not seek contribution from any other insurance ::tv::til::tblo to ::tn :.1ddttion:.1I incurcd undor your policy provided that (1)The aeld1hana1 insured 1s a Namedlncurod under cuoh other innumnoo; .:ind (2)You have agreed in writing in a contractor agreement that this insurance. wouldbe primnry and would not cocki;;onlribution from any other insuranceavailable to the additional insured. All 1erms and conditions oi this policy apply unless modtt1ed by this endorsement. Page 2 of 2 ACP GLDO3086461444 Includes copvric:ihted material of Insurance Services Office. Inc. with its permission. LKIS 18353 INSURED COPY CG 72 46 1115 47 0021540 DocuSign Envelope ID: CDA0AD32-5A91-4BC9-BEC6-5013B7B6BB7A COMMERCIAL GENERAL LIABILITY CG 73 23 1216 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ENHANCEMENT PLUS ENDORSEMENT INCLUDING MEDICAL PAYMENTS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Lost Key Coverage 1.Under Section I -Coverages, Coverage A Bodily Injury And Property DamageLiability, coverage is extended to include the following: If a customer's master or grand key, excluding electronic key card, is lost,damaged or stolen while in your care, custody or control we will pay the cost of replacing the keys, including the master lockand all keys used in the same lock, the cost of adjusting locks to accept the new keys, orthe cost to replace the locks, whichever isless. 2.Limit of Insurance -For the purpose of thiscoverage the most we will pay is $ 10,000per "occurrence". B.Voluntary Property Damage 1.Section I -Coverages,Coverage A BodilyInjury And Property Damage Liability coverages extendedo includethefollowing: At your request, we will pay for "property damage"to property of others caused by you and while in yourpossession,risingout of your business operations and occurring during thepolicyperiod. 2.Limit or Insurance -For the purpose of this coverage the most we will pay is $1,500 per"occurrence". C. Non-Owned Watercraft Under Section I -Coverages, Coverage ABodily Injury And Property Damage Liability,2.Exclusions, Exclusion g. Aircraft, Auto OrWatercraft Paragraph (2) (a) is replaced with: (a)Less than 51 feet long; and D.Expanded Property Damage Coverage 1.For the purposes of this endorsement only: Section I -Coverages, Coverage ABodily Injury And Property Damage Liability, 2. Exclusions, (=:l(clusion j.Damage To Property is amended as follows: a.Paragraphs (3), (5), and (6) are deletedin their entirety. b, Paragraph (4} is deleted in its entirety and replaced with: (4)Personal property in the care,custody, or control of the insured: (a)for storage or sale at premises you own, rent or occupy; or (b)while being transported by anyaircraft, "auto" or watercraftowned or operated by or rented to or loaned to any insured. c. Thg covgragg providgd by this endorsement does not apply to"property damage": (1)Arising out of the disappearance orloss of use of personal property; or (2)Included in the "products-completedoperations hazard". 2.Limit of Insurance -The most we will pay for loss arising out of any one "occurrence" is $5,000. 3.Deductible • Our obligation to pay for acovered loss applies only to the amount of loss in excess of $250. We will pay the deductible amount to effectsettlement of any claim or "suit" and, uponnotification of this action having been taken, you shall promptly reimburse us for thedeductible as has been paid by us. CG 73 231216 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 5 ACP GLDO3086461444 LKIS 18353 INSURED COPY 47 0021544 DocuSign Envelope ID: CDA0AD32-5A91-4BC9-BEC6-5013B7B6BB7A CG 73 231216 This insurance is primary to any expanded property damage coverage provided by a separate endorsement attached to this policy, and it will supplant any deductible in said endorsement c. Damage To Premises Rented To You 1.Under Section I-Coverages, Coverage ABodily Injury And Property Damage Liability, the last paragraph of 2.Exclusions is replaced with: If Damage To Premises Rented To You isnot otherwise excluded, Exclusions c.through n. do not apply to damage by fire, lightning, explosion, smoke, or sprinkler leakage to premises while rented to you ortemporarily occupied by you with permissionot the owner. 2.Under Section Ill -Limits Of Insurance,Paragraph 6 is replaced with: 6.Subject to 5. above, the Damage ToPremises 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 in the case of damage by fire,lightning, explosion, smoke or sprinkler leakage, while rented to you ortemporarily occupied by you with permission of the owner. The limit isincreased to $1,000,000. 3.Under Section IV -Conunerc:ial GeneralLiability Conditions, 4. Other Insurance, b. Excess Insurance (1) (a) (ii) is replacedwith: (ii)That is Fire, Lightning, Explosion, smoKeor Sprinkler leakage insurance for premises rented to you or temporarilyoccupied by you with permission of theowner. F.Supplementary Payments Under Section I -Coverages, SupplementaryPayments -Coverages A and B Paragraphs 1.b and 1.d. are replaced with: b.Up to $2,500 for cost of bail bonds required because of accidents or traffic law violationsarising out of the use of any vehicle to whichthe Bodily Injury Liability Coverage applies. We do not have to fumish these bonds. d.All reasonable expenses incurred by the insured at our request to assist us in theinvestigation or defense of the claim or "suit", including actual loss of earnings up to$500 a day because of time off from work. G.Newly Formed And Acquired organizations Under SECTION II -WHO IS AN INSURED Paragraph 3.a. is replaced with: a.Coverage undor this provision is affordedonly until the 18C1" day after you acquire or form the organization or the end of the policyperiod, whichever is earlier; H, Additional Insured -Automatic Status When Required In An Agreement Or Contract With You Soclion II -Who Is An lnsurod is amQndQd lo include: 1.Any person(s) or organization(s) described in Paragraph a. -d. below with whom youhave agreed in writing in a contract orwritten agreement that such person or organization be added as an additional insured on your policy during the policy period shown In the Declaratlons. 2, Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. The person or organization added as an insured by this endorsement is an insured only for liability due to: a.Lessors of Leased Equipment -with respect to their liability for "bodily injury","property damage", or "personal andadvertising injury", caused in whole or inpart by your maintenance, operation, or use of equipment leased to you by suchp,m:on(s) or organization(s). Thisinsurance does not apply to any"occurrence" which takes place after the equipment lease expires. However, their status as additional insured under this policy ends whentheir lease, contract, or agreement with you for such leased equipment expires. b.Managers or Lessors of Premises - with respect to liability arising out of the ownership, maintenance, or use of thatpart of thQ prQmisQs you own, rQnt,lease, or occupy. Page2 of 5 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CG 73 231216 A(I' \JLUO30864bl.444 LKIS 18353 INSURED COPY 47 0021545 DocuSign Envelope ID: CDA0AD32-5A91-4BC9-BEC6-5013B7B6BB7A This insurance does not apply to: (1)Any "occurrence" which takes place after you cease to be a tenant inthat premises. (2)Structural alterations, new con­struction, or demolition operationsperformed by or on behalf of theperson or organization. Howovor, their sto.tus o.s o.dditiono.l insured under this policy ends when you cease to be a tenant of such premises. c, State or Political Subdivision - Permits Relating to Premises - with respect to the following hazards for which the state or political subdivision has issued a permit or authorization in connection with premises you own, rent, or control and to which this insurance applies, (1)The existence, maintenance, repair, construction, erection, or removal ofadvertising signs, awnings, canopies, cellar entrances, coal no1es, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar exposures; or (2)The construction, erection, orremoval of elevators; or (:S) The ownership maintenanr;e or use of any elevators covered by this insurance. This insurance does not apply to: (1)"Bodily injury" or "property damage"or "personal or advertising injury"arising out of operations performedfor the �tate or municipality; or (2)"Bodily injury" or "property damage"included within the "products­completed operations hazard". However, such state or political subdivision's status as additional insured under this policy ends when the pQrmit Qnds. d.Owners, Lessees, or Contractors -with respect to liability for "bodily injury","property damage", or "personal andadvertising injury" caused in whole or inpart, by: CG 73 23 1216 (1) Your acts or omissions; or (2)The acts or omissions of those acting on your behalf; in theperformance of your ongoingoperations performed for thatadditional insured, whether the workis performed by you or on yourbehalf. The insurance does not apply to: (1)"Bodily injury'', "property damagefl,or "personal and advertising injury"arising out of the rendering of or the failure to render any professionalarchitectural, engineering, or surveyservices, including: (a) The preparing, approving, orfailing to prepare or approvemaps, shop drawings, opinions,reports, survey, field orders,change orders, or drawings andspecifications; or (b)Supervisory, inspection, archi­tectural or engineering activities. This exclusion applies even ifthe claims against any insuredallege negligence or otherwrongdoing in the supervision,hiring, employment, training or monitoring of others by thatinsured, if the "occurrence"which caused the "bodily injury"or "property damage", or theoffense which caused the"personal and advertising injuiy", involved the rendering of, or failure to render, any professional, architectural, engineering, or surveying �ervice�. (2) "Bodily injury" or "property damage"occurring after: (a)All work, including materials,parts, or equipment furnished inconnection with such work, onthe project (other than service,maintenance, or repairs) to be performed by or on behalf of the additional insured(s) at the location of the coveredoperations has been completed:or CG 73 23 12 16 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 5 with its permission. Al.I' uLLJO.i086461444 LKIS 18353 INSURED COPY 47 0021546 DocuSign Envelope ID: CDA0AD32-5A91-4BC9-BEC6-5013B7B6BB7A CG 73 231216 (b)That portion of "your work" outof which the injury or damagearises has been put to itsintended use by any person or organization other than anothercontractor or subcontractor engaged in performing operations for a principal as a part of the same project. However, a person or organization's status as additional insured under this policy ends when your operations for that additional insured are completed. With respect to the insurance afforded to such additional insureds a. - d. described above, the following is added to Section Ill -Limits Of Insuran ce: If coverage provided to the additional insured is required by a contract or ai:ireement, 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 shown in the Declarations: whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. However, the im,urance afforded to auch additional insureds a. -d. described above: 1. Only applies to the extent permitted bylaw; and 2.Will not be broader than that which youare required by the contract oragreement to provide for such additional insured. 3.Primary and Noncontributory -OtherInsurance Conditions The following is added to the OtherInsurance Condition and supersedes anyprovisions to the contrary: Primary and Noncontributory Insurance This insurance is primary to and will notseek contribution from any other insurance available to an additional insured under yourpolicy provided that: a. The additional insured is a NamedInsured under such other insurance; and b.You have agreed in writing in a contractor agreement that this insurance wouldbe primary and would not seekcontribution from any other insurance available to the additional insured. I.Employee Bodily Injury To Another Employee Under Section II -Who Is An Insured Thefollowing is added to Paragraph 2.a.(1): Paragraphs 2.a.(1) (a), (b) and (c) do not apply to "bodily injury" to a co·Memployee" in thecourse of the co-"employee's" employment by you, or to "bodily injury" to a co-"volunteer worker'' whilG performing dutiGs rGlated to the conduct of your business. J.Broad Form Named Insured Under Section II -Who Is An Insured Thefollowing is added to Paragraph 2.: e.Any business entity incorporated or organized under the laws of the United Stateof America (including any State thereof), itsterritories or possessions, or Canada (including any Province thereof) in which theNamed Insured shown in the Declarationsowns, e1ur1ng the poncy period, an Interest Of more than fifty percent. If other validcollectible insurance is available to any business entity covered by this solely by reason of ownership by the Named Insuredshown in the Declarations in excess of fifty percent, this insurance is excess over the other insurance, whether primary, excess,contingent, or on any other basis. K.Aggregate Limit Per Location Under Section Ill -Limits Of Insurance thefollowing is added to Paragraph 2: The General Aggregate Limit under Section IllLimits Of Insurance applies separately to each of your locations owned by or rented to you ortemporarily occupied by you with the permissionof the owner. For the purposes of this provision,location means premises involving the same orconnecting lots, or premises whose connectionis interrupted only by a public street, roadway, wateiway or railroad right-of-way. L.Aggregate Limit Per Project Under Section Ill -Limits Of Insurance The following paragraph is added to Paragraph 2: The General Aggregate Limit under Section IllLimita Of lnaurance applies separately to each of your construction projects away frompremises owned by or rented to you. Page4 of 5 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CG 73 231216 ACP GLDO3086461444 LKIS 18353 INSURED COPY 47 0021547 DocuSign Envelope ID: CDA0AD32-5A91-4BC9-BEC6-5013B7B6BB7A M. Medical Payments Under Section Ill -Limits Of Insurance, Paragraph 7. is replaced with: 7.Subject to 5. above, the higher of: a. $10,000; or b.The amount shown in the Declarationsfor Medical Expense Limit is the most we will pay under Coverage C for allmedical expenses because of "bodilyinjury" sustained by one person. This coverage does not apply if Coverage C -Medical Payments is excluded either bythe provisions of any coverage forms attached to the policy or by endorsement. N. Knowledge Of An Occurrence Under Section IV -Commercial GeneralLiability Conditions, the following is added to2.Duties In The Event Of Occurrence,Offense, Claim Or Suit: e.Knowledge of an occurrence, offense, claim or suit by an agent or employee of anyinsured shall not in itself constitute knowledge of the insured unless you, a partner, if you are a partnership; or anexecutive officer or insurance manager, if you are a corporation receives such noticeof an occurrence, offense, claim or suit fromthe agent or employee. f.The requirements in Paragraph b. will not be considered breached unless there isknowledge of occurrence as outlined inParagraph e. above.o.Unintentional Failure To Disclose Hazard Under section IV -commercial GeneralLiability Conditions, Condition 6.Representations the following paragraph is added: d.Your failure to disclose all hazards or prior "occurrences" or offenses existing as of the CG 73 23 1216 inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" or offenses is not intentional. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non­renewal. P.Waiver Of Subrogation Under Section IV -Commercial General Liability Conditions, 8. Transfer Of Rights OfRecovery Against Others To Us the following paragraph is added: If required by a written contract executed prior toloss, we waive any right of subrogation we mayhave against the contracting person ororganization because ot payments we make torinjury or damage arising out of your ongoing operations or "your work" done under a contractwith that person or organization and included inthe "products-completed operations hazard". Q, Liberalization Under Section IV -Commercial General Llablllty Conditions, the following paragraph Is added: 10, Liberalization If we revisG this coverage form to providG more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective in your state. R.Broadened Bodily Injury Definition (Mental Anguish) Under Section V -Definitions Definition 3. "Bodily Injury" is replaced with: 3."Bodily injury" means physical injury, sickness, or disease to a person and ifarising out of the foregoing, mental anguish,mental injury, shock, or humiliation, including death at any time resultingtherefrom. All terms and conditions of this policy apply unless modified by this endorsement. CG 73 231216 ACP GLDO3086461444 Includes copyrighted material of Insurance Services Office, Inc., with its permission. LKIS 18353 INSURED COPY Page 5 of 5 47 0021548 DocuSign Envelope ID: CDA0AD32-5A91-4BC9-BEC6-5013B7B6BB7A