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2022/08/31 Nancy K. Bohl, Inc.
ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTRINSDWVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION$ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 10/27/2022 License # 0757776 23787 Nancy K. Bohl, Inc. D.B.A The Counseling Team International 20351 SW Acacia Street Floor 2 Newport Beach, CA 92660 19100 25674 A 1,000,000 X ACP GLO 3019795490 8/31/2022 8/31/2023 1,000,000 20,000 1,000,000 3,000,000 3,000,000 1,000,000A X ACP BA 3019795490 8/31/2022 8/31/2023 5,000,000B ACP CAA 3019795490 8/31/2022 8/31/2023 5,000,000 10,000 C UB7T831211 8/11/2022 8/11/2023 1,000,000 1,000,000 1,000,000 A *Professional Liab ACP GLO 3019795490 8/31/2022 See below for limits A *Abuse Liability ACP GLO 3019795490 8/31/2022 8/31/2023 See below for limits Professional Liability | Occurrence Form | $1,000,000 Per Claim/$3,000,000 Aggregate Abuse Liability | Occurrence Form | $1,000,000 Per Claim/$3,000,000 Aggregate Cyber Liability | Arch Specialty Insurance Company| Policy #C-4MQ8-186530-CYBER-2022A | Effective: 5/20/2022 to 5/20/2023 | $2,000,000 Aggregate *Umbrella Underlying Policies: General Liability | Professional Liability | Abuse Liability | Auto Liability | Workers Compensation SEE ATTACHED ACORD 101 The City of Menifee 29844 Haun Road Menifee, CA 92586 TRUEREC-01 CZHANG9 HUB International Insurance Services Inc. 1525 Faraday Avenue Suite 150 Carlsbad, CA 92008 Jyoti Phillips jyoti.phillips@hubinternational.com Nationwide Mutual Insurance Company AMCO Insurance Company Travelers Property Casualty Company of America X 8/31/2023 X X X X X X X DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC FORM NUMBER: EFFECTIVE DATE: The ACORD name and logo are registered marks of ACORD ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE FORM TITLE: Page of THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ACORD 101 (2008/01) AGENCY CUSTOMER ID: LOC #: AGENCY NAMED INSURED POLICY NUMBER CARRIER NAIC CODE © 2008 ACORD CORPORATION. All rights reserved. HUB International Insurance Services Inc. TRUEREC-01 SEE PAGE 1 1 SEE PAGE 1 ACORD 25 Certificate of Liability Insurance License # 0757776 1 SEE P 1 Nancy K. Bohl, Inc. D.B.A The Counseling Team International 20351 SW Acacia Street Floor 2 Newport Beach, CA 92660 SEE PAGE 1 CZHANG9 1 Description of Operations/Locations/Vehicles: Re: Behavioral Health and Wellness Services The City of Menifee, its officers, agents and employees are named as additional insureds with respects to General Liability per form CG8128 0118 and Auto Liability per form AC7005 0316. All forms valid where required by written contract. DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC COMMERCIAL AUTO AC 70 05 03 16 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. BUSINESS AUTO PROTECTION -GOLD This endorsement modifies insuranceprovided under the following: BUSINESS AUTO COVERAGE FORM SUMMARY OF COVERAGES A.Effect of This Endorsement B.Newly Acquired or Formed Entities C.Employees as Insureds –Nonowned Autos D.Additional Insured by Contract,Permit or Agreement E.SupplementaryPayments –Bail Bonds F.SupplementaryPayments –Loss of Earnings G.Personal Effects and Property of Others Extension H.Prejudgment Interest Coverage I.Fellow Employee –Officer,Managers and Supervisors J.Hired Auto Physical Damage K.Temporary Substitute Autos –Physical Damage Coverage L.Expanded Towing Coverage M.Auto Loan or Lease Coverage N.Original Equipment Manufacturer Parts –Leased Private PassengerTypes O.Deductible Amendments P.Rental Reimbursement Coverage Q.Expanded Transportation Expense R.Extra Expense –Stolen Autos S.Physical Damage Limit of Insurance T.New Vehicle Replacement Cost U.Physical Damage Coverage Extension V.Transfer of Rights of Recovery Against Others To Us W.Section IV –Business Auto Conditions –Notice of and Knowledge of Occurrence X.Hired Car Coverage Territory Y.Emergency Lock Out Z.Cancellation Condition AC 70 05 03 16 Page 1 of 7Includes copyrighted material of Insurance Services Office,Inc. with its permission ACP BA 30-1-9795490 L82S 20273 INSURED COPY AC7005031600 0001 47 0020203 DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC COMMERCIAL AUTO AC 70 05 03 16 If specifically required by the written contract orA.EFFECT OF THIS ENDORSEMENT agreement referenced in the paragraph above,Coverage provided under this policy is modified any coverage provided by this endorsement tobytheprovisionsofthisendorsement.If there an additional insured shall be primary andisanyconflictbetweentheprovisionsofthisanyothervalidandcollectibleinsuranceavail-endorsement and the provision(s)of any state-able to the additional insured shall be non-specific endorsement also attached to this poli-contributory with this insurance.If the writtency,then the provision(s)of the state-specific contract does not require this coverage to beendorsementshallapplyinsteadoftheprovi-primary and the additional insured’s coverage tosionsofthisendorsementthatareinconflict,be non-contributory,then this insurance will bebutonlytotheextentoftheconflict,and only to excess over any other valid and collectible insur-the extent necessary to bring such provisions anceavailable to the additional insured.into conformance with the state requirement(s) contained in the provision(s)of the state-specific endorsement.E.SUPPLEMENTARY PAYMENTS –BAIL BONDSB.NEWLY ACQUIRED OR FORMED ENTITIES Supplementary Payments of SECTION II –The Named Insured shown in the Declarations is COVERED AUTOS LIABILITY COVERAGE isamendedtoincludeanyorganizationyounewly revised as follows:acquire or form,other than a partnership,joint venture,or limited liability company,and over (2)Up to $2,500 for cost of bail bonds (including which you maintain ownership or majority (more bonds for related traffic law violations) than 50%)interest;if there is no other similar in-required because of an “accident” we cover. surance available to that organization.Coverage We do not have to furnish these bonds.thunderthisprovisionisaffordeduntilthe180 F.SUPPLEMENTARY PAYMENTS –LOSS OFdayafteryouacquireorformtheorganizationorEARNINGStheendofthepolicyperiod,whichever is later.Supplementary Payments of the SECTION II –C.EMPLOYEES AS INSUREDS –NONOWNED COVERED AUTOS LIABILITY COVERAGE isAUTOSrevisedasfollows: The following is added to paragraph A.1.Who Is (4)All reasonable expenses incurred by the “in-An Insured of SECTION II –COVERED AUTOS sured”at our request,including actual lossLIABILITYCOVERAGE:of earnings up to $500 a day because of d.Any "employee"of yours is an "insured"time off from work. while using a covered "auto"you don't own,G PERSONAL EFFECTS AND PROPERTY OF.hire or borrow in your business or your per-OTHERS EXTENSIONsonalaffairs.1.The.Care,Custody or Control Exclusion ofD. ADDITIONAL INSURED BY CONTRACT,SECTION II –COVERED AUTOSPERMITORAGREEMENTLIABILITYCOVERAGE,does not apply to The following is added to A.1.Who Is An In-"property damage"to property,other than sured of SECTION II –COVERED AUTOS your property,up to an amount not exceed- LIABILITY COVERAGE:ing $250 in any one "accident".Coverage is excess over any other valid and collectibleAnypersonororganizationthatyouarere- insurance.quired to name as an additional insured in a written contract or agreement that is executed 2.The following paragraph is added to A.4. or signed by you prior to a “bodily injury”or Coverage Extensions of SECTION III – “property damage”occurrence is an “insured”PHYSICAL DAMAGE COVERAGE: for Covered Auto L iability coverage.How-c.We will pay up to $500 for your propertyever,with respect to covered “autos”,such that is lost or damaged as a result of apersonororganizationisaninsuredonlytocovered“loss”,without applying a de-the extent that person or organization qualifies ductible.Coverage is excess over anyasan“insured”under A.1.Who is an Insured of other valid and collectible insurance.SECTION II –COVERED AUTOS LIABILITY COVERAGE: Page 2 of 7 AC 70 05 03 16Includes copyrighted material of Insurance Services Office,Inc. with its permission ACP BA 30-1-9795490 L82S 20273 INSURED COPY AC7005031600 0001 47 0020204 DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC COMMERCIAL AUTO AC 70 05 03 16 H.PREJUDGMENT INTEREST COVERAGE substitute for a covered "auto"you own that is out of service because of its:The following paragraph is added to SECTION II –COVERED AUTOS LIABILITY COVERAGE,a.Breakdown; 2.Coverage Extensions,a.Supplementary b.Repair; Payments:c.Servicing;(7)Prejudgment interest awarded against the d."Loss";or“insured”on that part of the judgment we e.Destructionpay.If we make an offer to pay the appli- cable limit of insurance,we will not pay The coverage that applies is the same as any prejudgment interest based on that the coverage provided for the vehicle being period of time after the offer.replaced. I FELLOW EMPLOYEE –OFFICERS,. MANAGERS, AND SUPERVISORS L EXPANDED TOWING COVERAGE. The Fellow Employee Exclusion in SECTION II 1.We will pay up to:–COVERED AUTOS LIABILITY COVERAGE is a.$100 for a covered "auto"you own ofreplacedasfollows;the private passengertype,orA."Bodily injury"to any fellow "employee"of b.$500 for a covered "auto"you own thatthe "insured"arising out of and in the course is not of the private passenger type,of the fellow "employee's" employment or for towing and labor costs incurred eachwhileperforming duties related to the con- time the covered "auto"is disabled.Howev-duct of your business.This exclusion does er,the labor must be performed at the placenotapplytoan"insured"who occupies a of disablement.position as an officer,manager,or supervi- sor.2.This coverage applies only for an "auto" covered on this policy for Comprehensive orJHIREDAUTOPHYSICALDAMAGE. Specified Causes of Loss Coverage andIfcovered"auto" designation symbols 1 or 8 ap-Collision Coverages.ply to Liability Coverage and if at least one "au- 3.Payment applies in addition to the otherwiseto"you own is covered by this policy for Com- applicable amount of each coverage youprehensive,Specified Causes of Loss,or Colli- have on a covered “auto”.sion coverages,then the Physical Damage coverages provided are extended to "autos"you M AUTO LOAN OR LEASE COVERAGE. lease,hire,rent or borrow without a driver;and 1. In the event of a total "loss"to a coveredprovisionsintheBusinessAutoCoverageForm"auto", we will pay any unpaid amount dueapplicabletoHiredAuto Physical Damage apply on the loan or lease, including up to a max-up to a limit of $100,000.The deductible will be imum of $500 for early termination fees orequaltothelargestdeductible applicable to any penalties,for your covered "auto"less:owned "auto"for that coverage.Any Compre-a.The amount paid under SECTION III –hensive deductible does not apply to fire or PHYSICAL DAMAGE COVERAGE oflightning.this policy;andK.TEMPORARY SUBSTITUTE AUTOS –b.Any:PHYSICAL DAMAGE COVERAGE 1)Overdue lease/loan payments at theThefollowingisaddedtoparagraphC.Certain time of the "loss";Trailers,Mobile Equipment And Temporary 2)Financial penalties imposed under aSubstituteAutosofSECTIONI-COVERED lease for excessive use, abnormalAUTOS: wear and tear or high mileage;If Physical Damage Coverage is provided by 3)Security deposits not refunded by athisCoverageForm,the following types of lessor;vehicles are also covered "autos"for Physi- cal Damage Coverage:4) Costs of extended warranties,Credit Life insurance,Health,Accident,orAny"auto"you do not own while used with Disability insurance purchased withthepermissionofitsownerasatemporary the lease;and AC 70 05 03 16 Page 3 of 7Includes copyrighted material of Insurance Services Office,Inc., with its permission ACP BA 30-1-9795490 L82S 20273 INSURED COPY AC7005031600 0001 47 0020205 DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC COMMERCIAL AUTO AC 70 05 03 16 5)Carry-over balances from previous No deductible applies to glass if the glass is re- leases.paired,in a manner acceptable to us, rather than replaced.2.This coverage only applies to a "loss" which is also covered under this policy for Com-P.RENTAL REIMBURSEMENT COVERAGE prehensive,Specified Causes of Loss,or 1.This coverage applies only to a covered "au-Collision coverage.to"for which Physical Damage Coverage is 3.Coverage does not apply to any unpaid provided on this policy. amount due on a loan for which the covered 2.We will pay for rental reimbursement ex- “auto”is not the sole collateral.penses incurred by you for the rental of an N.ORIGINAL EQUIPMENT MANUFACTURER "auto"because of "loss"to a covered "auto". PARTS –LEASED PRIVATE PASSENGER Payment applies in addition to the otherwise TYPES applicable amount of each coverage you have on a covered "auto." No deductiblesUnderParagraphC.Limit of Insurance of apply to this coverage.SECTION III –PHYSICAL DAMAGE COVERAGE,Section 4 is added as follows:3.We will pay only for those expenses incurred during the policy period beginning 24 hours4.We will use new original equipment vehicle after the "loss"and ending, regardless of themanufacturerpartsforanyprivatepassen-policy's expiration,with the lesser of thegertypecovered“auto”where required by following number of days:the lease agreement which has a term of at least six months.If a new original equip-a.The number of days reasonably ment vehicle manufacturer part is not in pro-required to repair or replace the covered duction or distribution we may use a like,"auto".If "loss"is caused by theft,this kind and quality replacement part.number of days is added to the number of days it takes to locate the coveredO.DEDUCTIBLE AMENDMENTS "auto"and return it to you.The following are added to the Deductible provi-b.The number of days shown in thesionofSECTIONIII–PHYSICAL DAMAGE Schedule.COVERAGE: 4.Our payment is limited to the lesser of theIfanotherpolicyorcoverageformthatisnotan following amounts:automobile policy or coverage form issued by this company applies to the same “accident”,the a.Necessary and actual expenses following applies:incurred. 1.If the deductible under this coverage is the b.$75 for any one day or for a maximum smaller (or smallest)deductible,it will be of 30 days. waived:5.This coverage does not apply while there 2.If the deductible under this coverage is not are spare or reserve "autos"available to you the smaller (or smallest)deductible,it will be for your operations. reduced by the amount of the smaller (or 6.If "loss"results from the total theft of a cov-smallest)deductible.ered "auto"of the private passenger type, If a Comprehensive or Specified Causes of Loss we will pay under this coverage only that Coverage “loss”from one “accident”involves amount of your rental reimbursement ex- two or more covered “autos”,only the highest penses which is not already provided for un- deductible applicable to those coverages will be der SECTION III –PHYSICAL DAMAGE applied to the “accident,”if the cause of the loss COVERAGE Coverage Extension. is covered for those vehicles.This provision only Q EXPANDED TRANSPORTATION EXPENSE. applies if you carry Comprehensive or Specified Paragraph A.4.a.of SECTION III –PHYSICALCausesofLossCoverageforthosevehicles,DAMAGE COVERAGE is replaced by the follow-and does not extend coverage to any covered ing:“autos”for which you do not carry such We will pay up to $50 per day to a maximum ofcoverage. $1500 for temporary transportation expense in- curred by you because of the total theft of a Page 4 of 7 AC 70 05 03 16Includes copyrighted material of Insurance Services Office,Inc with its permission. ACP BA 30-1-9795490 L82S 20273 INSURED COPY AC7005031600 0001 47 0020206 DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC COMMERCIAL AUTO AC 70 05 03 16 covered "auto"of the private passenger type.ment manufacturer or other sources in- We will only pay for those covered "autos"for cluding non-original equipment manu- which you carry Comprehensive or Specified facturers and Causes of Loss Coverage.We will pay for tem-b.If a repair or replacement results in bet- porary transportation expenses incurred during ter than like kind or quality,we will notthe period beginning 24 hours after the theft and pay for the amount of the net improve- ending, regardless of the policy's expiration,ment.when the covered "auto"is returned to use or we 5.If we offer to pay the actual cash value ofpayforits"loss".the damaged or stolen property, we willR.EXTRA EXPENSE –STOLEN AUTOS value auto advertising wraps, paint customi- The following paragraph is added to Coverage zation,and similar business related advertis- Extensions of SECTION III –PHYSICAL ing modifications,in addition to the actual DAMAGE COVERAGE:cash value of the property.Auto advertising wraps, paint customization,and similarc.We will pay for up to $5,000 for the expense business related advertising modificationsofreturningastolencovered“auto”to you.will be valued at the cost to replace themWewillpayonlyforthosecovered“autos” with an adjustment made for depreciationforwhichyoucarryComprehensiveorSpec-and physical condition.ified Causes of Loss Coverage T.NEW VEHICLE REPLACEMENT COSTS.PHYSICAL DAMAGE LIMIT OF INSURANCE The following is added to the Limit of InsuranceUnderSECTIONIII–PHYSICAL DAMAGE provision of SECTION III –PHYSICALCOVERAGE,Paragraph C.,Limit of Insurance DAMAGE COVERAGE:is replaced by the following: 5.The provisions of paragraphs 1.and 3.doC.Limit Of Insurance not apply to a covered “auto“of the private1.The most we will pay for “loss”in any one passenger type or a vehicle with a gross“accident”is the lesser of:vehicle weight rating of 20,000 pounds or a.The actual cash value of the damaged less which is a “new vehicle.” or stolen property as of the time of the In the event of a total “loss” to your new ve-“loss”,or hicle to which this coverage applies,we will b.The cost of repairing or replacing the pay at your option: damaged or stolen property.a.The verifiable “new vehicle”purchase 2.$1500 is the most we will pay for “loss”in price you paid for your damaged vehi-any one “accident”to all electronic equip-cle,not including any insurance or war- ment that reproduces,receives or transmits ranties purchased; audio,visual or data signals which, at the b.If it is available,the purchase price,astimeof“loss”,is:negotiated by us,of a “new vehicle”of a.Permanently installed in or upon the the same make,model,and equipment covered “auto”in a housing,opening or or the most similar model available,nototherlocationthatisnotnormallyusedincludinganyfurnishings,parts,or by the “auto”manufacturer for the in-equipment not installed by the manufac- stallation of such equipment.turer or manufacturers’ dealership; or . b.Removable from a permanently installed c.The market value of your damaged ve- housing unit as described in Paragraph hicle,not including any furnishings, 2.a.above or is an integral part of that parts,or equipment not installed by theequipment;or manufacturer or manufacturer’s dealer- c.An integral part of such equipment.ship. 3. An adjustment for depreciation and physical We will not pay for initiation or set up costs condition will be made in determining actual associated with loans or leases cash value in the event of a total “loss”.As used in this endorsement,a “new 4.The cost of repairing or replacing may:vehicle”means an “auto”of which you are the original owner that has not been previ-a. Be based on an estimate which includes parts furnished by the original equip- AC 70 05 03 16 Page 5 of 7Includes copyrighted material of Insurance Services Office,Inc., with its permission ACP BA 30-1-9795490 L82S 20273 INSURED COPY AC7005031600 0001 47 0020207 DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC COMMERCIAL AUTO AC 70 05 03 16 ously titled and which you purchased less a.Your obligationin the Duties in the Event than 365 days before the date of the “loss”.of Accident,Claim,Suit or Loss Condi- tion relative to notification requirements applies only when the “accident” orU.PHYSICAL DAMAGE COVERAGE “loss”is known to:EXTENSIONS (1) You,if you are an individual;Under SECTION III –PHYSICAL DAMAGE (2)A partner,if youare a partnership;COVERAGE,A.Coverage,Coverage Exten- sions,b.Loss of Use Expenses is replaced by (3)A member,if you are a limited liability the following:company;or b.Loss of Use Expenses (4) An executive officer or insurance manager,if you are a corporation.For Hired Auto Physical Damage,we will pay expenses for which an “insured”be-b.Your obligation in the. Duties in the Event comes legally responsible to pay for loss of of Accident,Claim,Suit or Loss Condition use of a vehicle rented or hired without a relative to providing us with documents driver,under a written rental contract or concerning a claim or “suit”will not be agreement.We will pay for loss of use ex-considered breached unless the breach penses if caused by:occurs after such claim or “suit”is known to:(1)Other than collision if the Declarations indicate that Comprehensive Coverage (1) You,if you are an individual; is provided for any covered “auto”;(2)A partner,if you are a partnership; (2) Specified Causes of Loss only if the (3)A member,if you are a limitedDeclarations indicate that Specified liability company;orCausesofLossCoverageisprovided(4) An executive officer or insuranceforanycovered“auto”;or manager,if you are a corporation.(3)Collision only if the Declarations indicate that Collision Coverage is provided for X.HIRED CAR –COVERAGE TERRITORYanycovered“auto.” Item (5) of the Policy Period,Coverage TerritoryHowever,the most we will pay for any GeneralConditionss replacedby the following:expenses for loss of use is $50 per day,to a maximum of $1,500.The insurance provided (5)Anywheren theworldif a covered “auto”is by this provision is excess over any other leased,hired,rented or borrowed without a collectible insurance.driverfor a period of 30 days or less;and V.TRANSFER OF RIGHTS OF RECOVERY Y.EMERGENCY LOCKOUT AGAINST OTHERS TO US We will reimburse you up to $100 for reasonable The following is added to the Transfer Of Rights expense incurred for the services of a locksmith Of Recovery Against Others To Us Condition:to gain entry into your covered “auto”subject to these provisions:We waive any right of recovery we may have against any person or organization to 1.Your door key,electronic key or key entry the extent required of you by a written con-pad has been lost,stolen or locked in your tract executed prior to any “accident”be-covered “auto”and you are unable to enter cause of payments we make for damages such “auto”,or under this coverage form.2.Your keyless entry device battery dies and W.NOTICE OF AND KNOWLEDGE OF you are unable to enter such "auto"as a re- OCCURRENCE sult, 3.Your key,electronic key or key entry padSECTIONIV–BUSINESS AUTO has been lost or stolen and you haveCONDITIONS,Paragraph A is amended as changed the lock to prevent an unauthorizedfollows: entry;and6.NOTICE OF AND KNOWLEDGE OF OCCURRENCE Page 6 of 7 AC 70 05 03 16Includes copyrighted material of Insurance Services Office,Inc with its permission. ACP BA 30-1-9795490 L82S 20273 INSURED COPY AC7005031600 0001 47 0020208 DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC COMMERCIAL AUTO AC 70 05 03 16 4.Original copies of receipts for services of a If we cancel for any reason other than non- locksmith must be provided before reim-payment of premium,we will mail or deliver bursement is payable.to the First Named Insured written notice of cancellation at least 60 days before the ef-Z.CANCELLATION CONDITION fective date of cancellation.This provision Paragraph A.2.of the COMMON POLICY does not apply in those states that require CONDITION –CANCELLATION applies more than 60 days prior notice of cancella- except as follows:tion. AC 70 05 03 16 Page 7 of 7Includes copyrighted material of Insurance Services Office,Inc., with its permission ACP BA 30-1-9795490 L82S 20273 INSURED COPY AC7005031600 0001 47 0020209 DocuSign Envelope ID: 19D1CC8D-288A-4530-B5E2-773FDAC588FC