2022/10/01 A.M. Ortega Construction, Inc.,-\ -A<:()RI)"
COVERAGES
CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE NUMBER: 940325909 REVISION NUMBER
9t2212422
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 AMENO, EXTEND OR ALTER THE COVERAGE AFFORDEO BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE OOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: lf the ce.tificate holder is an ADDITIONAL INSURED, the policy(ios) must have ADOITIONAL INSURED provisions or be endorsed.
It SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, cefiain policies may require an endorsement. A statement on
this cortificate does not conter rights to the certificate holder in ligu of such endorsement(s).
Alliant lnsurance Services lnc
701 B Street 6th floor
San Diego CA 92101
INSURED
A.M Orteqa Construction,
10125 Channel Road
Lakeside CA 92040
Lrcensef 0O36861
AMORTEG,O2
lnc
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lJ3lfi. e,r, (eos) rzr szzs
E.MAILaDoRESS. Amanoa Lasllllo@al ranl Com
INSURER B
]NSURER E
INSURER(S)AFFORDI'IG COVERAGE
Executive Risk llllElrldE lnc
Federal lnsurancqcolnpany
35181
202A1
+
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTEO BELOW HAVE BEEN ISSUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWTHSTANDING ANY REOUIREIIENT TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO l /UICH THIS
CERTIFICATE IIIAY 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 SHO\A/I.I IIiIAY HAVE BEEN REDUCED BY PAID CLAII\iIS.
'lffl TypEoFrNsuRANcE i"""%ti[T "o.,""uru"." ,fifi,gBllit", ,fi9BBIrt{- LrMrrs
EACHOCCI]RRENCET-'IEFCEI-FtrNTFT)
PREM sES (Ea occurrence)
MED ExP (Any on6 person)
PERSONAL A AOV INJURY
GENERI.L AGGREGAT€
PROOUCTS COMP/OPAGG
DEDUC'TIBLE
$ 1 000.000
$ 100 000
$ 1.000.000
$ 2.000 000
52.000 000
5 5.000
54303214 1011t2022X
OTNER
101112023COMi]IERCIAL GENERAL TIABILIIY
currus vaoe X occun
GEN L AGGREGAIE LIM T APPL]ES PER
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COMBINEDSNGLELMT
BOD LY NJUFY (Per pe6on)
BOD LY INJURY (PEI ACCLdE'I)
PROPERTY DAMAGE
s I 000 000543032r 3
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s
sXx
10t112022 1011/2023
SCHEDULED
AUIOS
NON,OWNEDAUIOS ONLY
AUTOMOBILELIABILITY
OWNEO
AUTOS ONLY
I]IREDAUIOS ONLY
UMBRELLALIAB OCCI]R
EXCESS uA8 cLAtMS MAOE
DED RETENTION S
S
5
EACUOCCURRENCE
ACGREGATE
!!!L000
1.000 000
IIIORKERS COIIPENSATION
AI.ID EMPLOYERS' LIABILITY
ANYPROPRIETOR/PARTNER/EXEClJTIVE
OFFICER/MEMBER EXCLIJOED?
Df scR PT oN oF oPFRAT oN< h.*
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DISEASE POLCY LMIT
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54303215 oTu1ont2o2z rorlzozr x !ff;1,,15
D€SCRIPiON OF OPERAnONS / LOCATION S / VEHTCLES IACORD 10r, Addraon.li.mrl. Sch.dur., ruybe.r..h.d lrooE ip...r. r€quiEd)
Rer Encroachment Permit
City of Menifee is included as Additional lnsured
CERTIFICATE HOLDER CANCELLAIION
City of Menifee
Engineering Department
29844 Haun Road
Menifee CA 92586
SHOULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATIOI'I OATE THEREOF, NO]ICE WILL BE DELIVERED lN
ACCOROANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REP RESE N TATIVE
-?\
O 1988-2015 ACORD CORPORATION. Allrights reserved
The ACORD name and logo are registered marks oI ACORDACORD 25 (2016/03)
f] rre
POLICY NUMBER 54303214 COMi'ERCIAL GENERAL LIABILITY
cG 20 10 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE REAO 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 lnsured Person(s)
Or Organization(s)Location(s) Of Covered Operations
WHERE REQUIRED BY VIRITTEN CONTRACI AIL LOCATIONS WHERE REQUIRED BY WRITTEN
CONTRACT
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations
A. Ssction ll - Who ls An lnsured 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 thoso acting on your
behalf;
in the performance of your ongoing operations forthe additional insured(s) at the location(s)
designated above.
However:
1. The insurance atforded to such additional
insured only applies to the extent permitted by
law; and
2. lf 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 agrsement 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 prolect (other than service,
maintenance or repairs) to be performed by or
on behalf of the additional insured(s) at the
location of lhe covered operations has been
completed; or
2. That portion of "your work" out of which the
injury or damage arises has been pul lo 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 't2 19 O lnsurance Services Office, lnc., 2018 Page 1 ot 2
POLICY NUMBER: 54303274 COMMERCIAL GENERAL LIABILITY
cG 20 12 04 t3
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - STATE OR GOVERNMENTAL
AGENCY OR SUBDIVISION OR POLITICAL
SUBDIVISION - PERMITS OR AUTHORIZATIONS
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
State Or Governmental Agency Or Subdivision Or Political Subdivision
WIIERE REQUIRED BY WRITTEN CONTB,ACT
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations
A. Soction ll - Who ls An lnsured is amended to
include as an additional insured any stale or
governmental agency or subdivision or political
subdivision shown in the Schedule, subject to the
following provisions:
1. This insurance applies only with respect to
operations performed by you or on your behalf
for which the state or governmental agency or
subdivision or political subdivision has issued a
permit or authorization.
However:
a. The insurance afforded to such additional
insured only applies to the extent permitted
by lawi and
b. lf coverage provided to the additional
insured is required by a contract or
agreement, the insurance atforded 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.
2. This insurance does not apply to:
a. "Bodily injury", "property damage" or
"personal and advertising injury" arising outof operations performed for the federal
government, state or municipality; or
b. "Bodily injury" or "property damage"
included within the "products-completed
operations hazard".
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section lll - Limlts Of lnsurance:
lf 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
lnsurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the
applicable Limits of lnsurance shown in ths
Declarations.
cG 20 12 04 13 @ lnsurance Services Office, !nc.,2012 Page 1 of 1
C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section lll - Limits Of lnsurance:
lf 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 ol 2 @ lnsurance Services Office, lnc., 2018 cG 20 1012 19
POLICY NUMBER: 54303214 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 lnsured Person(s)
Or Organlzatlon(s)Location And Description Of Completed Operations
WIIEF.E REQUIRED BY T{RITTEN CONTRACT, BUT
ONLY 9IHEN TIIE CONTRACT SPECIFIES COVERAGE
EOR COMPLETED OPERATIONS
AII LOCATIONS WHERE REQUIRED BY IIRITTEN
CONTF,ACT
lnformation required to complete this Schedule, if not shown above, will be shown in the Oeclarations
A. Section ll - Who ls An lnsured 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 additjonal insured and
included in the "products-completed operations
hazatd".
However:
1. The insurance afforded to such additional
insured only applies to the extenl permitted
by law; and
2. lf coverage provided to the additional insured
is required by a contracl or agreement, lhe
insurance afforded to such additional insured
will not be broader lhan 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 lll - Limits Of lnsurance:
lf 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
lnsurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable
Limits of lnsurance shown in the Declarations.
cG 20 37 ',tz ',tg @ lnsurance Services Office, !nc.,2012 Page 1 of 'l
POLICY NUMBER, 54303274 COUMERCIAL GENERAL LIABILITY
cG 25 03 05 09
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESTGNATED CONSTRUCTION PROJECT(S)
GEN ERAL AGGREGATE LIMIT
Designated Construction Project(s):
ALL OF YOUR DESIGNATED CONSTRUCTION PROJECTS WHERE REQUIRED BY CONTRACT
lnformation required to complete this Schedule, if not shown above, will be shown in the Oeclarations
A. For all sums which the insured becomes legally
obligated to pay as damages caused by "occur-
rences" under Section I - Coverage A, and for all
medical expenses caused by accidents under
Section I - Coverage C, which can be attributed
only to ongoing operations at a single designated
construction project shown in the Schedule
above:
1. A separate Designated Construction Project
General Aggregate Limit applies to each des-
ignated construction project, and that limit is
equal to the amount of the General Aggregate
Limit shown in the Declarations.
2. The Designated Construction Project General
Aggregate Limit is the most we will pay for the
sum of all damages under Coverage A, ex-
cept damages because of "bodily injury" or
"property damage" included in the ''products-
completed operations hazard", and for medi-
cal expenses under Coverage C regardless of
the number of:
a. lnsureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits".
3. Any payments made under Coverage A for
damages or under Coverage C for medical
expenses shall reduce the Designated Con-
struction Project General Aggregate Limit for
that designated conslruction project. Such
payments shall not reduce the General Ag-
gregate Limit shown in the Declarations nor
shall they reduce any other Designated Con-
struction Project General Aggregate Limit for
any other designated construction project
shown in the Schedule above.
4. The limits shown in the Declarations for Each
Occurrence, Damage To Premises Rented To
You and Medical Expense continue lo apply.
However, instead of being subject to the
General Aggregate Limit shown in the Decla-
rations, such limits will be subject to the appli-
cable Designated Construction Project Gen-
eral Aggregate Limit.
cG 25 03 05 09 O lnsurance Services Office, lnc., 2008 Page'l ol 2 tr
This endorsement modifies insurance provided under the following:
COMI\4ERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
B. For all sums which the insured becomes legally
obligated to pay as damages caused by "occur-
rences" under section l- coverage A, and for all
medical expenses caused by accidents under
Section l- Coverage C, which cannot be at-
tributed only to ongoing operations at a single
designated construction project shown in the
Schedule above:
'1. Any payments made under Coverage A for
damages or under Coverage c for medical
expenses shall reduce the amount available
under the General Aggregate Limit or the
Products-completed Operations Aggregate
Limit, whichever is applicable; and
2. Such payments shall not reduce any Desig-
nated Construction Project Ganeral Aggre-
gate Limit.
C. When coverage for liability arising out of the
''products-compleled operations hazard" is pro-
vided, any payments for damages because of
"bodily injury" or "property damage" included in
the "products-completed operations hazard" will
reduce the Products-completed Operations Ag-
gregate Limit, and not reduce the General Ag-
gregate Limit nor the Designated Construction
Project General Aggregate Limit.
D. lf the applicable dosignated construction projecl
has been abandoned, delayed, or abandoned
and then restarted, or if the authorized conlract-
ing parties deviate from plans, blueprints, de-
signs, specifications or timetables, the project will
still be deemed to be the same construction pro-
ject.
E. The provisions of Section lll - Limits Of lnsur-
ance not otherwise modifled by this endorsement
shall continue to apply as stipulated.
@ lnsurance Services Office, lnc.,2008 cG25030509 trPage 2 ol 2
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY INSURANCE FOR
SCHEDULED ADDITIONAL INSURED
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDUTE
Additional lnsured:Location Of Covered Operations:
ATL LOCATIONSWITERE REQUIRED BY TIRITTEN CONTRACT
(lf no entry appears above, information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement.)
POLICYNUMBER: 54303274
With respect only to the Additional lnsured and at
the Location Of Covered Operations shown in the
Schedule, the following is added to SECTION lV -
COMMERCIAT GENERAT LIABITIW CONDITIONS,
Paragraph 4.Other lnsuranceand supersedes any
provision to thecontrary:
Primary And Noncontributory lnsurance
This insurance is primary to and will not
seekcontribution from any other insuranc€
available to the Additional lnsured with respect
to the Location Of Covered Operations shown in
the Schedule under thispolicyprovided that:
COi,IMERCIAL GENERAL LIABILITY
,t 0 -02-246't (Ed. 7-1 5)
(1) The Additional lnsured is a named
insuredunder such other insurance; and
(2) You have agreed in writing in a contract
oragreement that this insurance would
beprimary and would not seek
contributionfrom any other insu rance
availa ble to theAdditional lnsured.
'10-02-2461 (Ed. 7-15) lncludes copyrighted material of lnsurance Services office, lnc.,
with its permission.
Page I of 1
POLICY NU MBER: 54303213 COMMERCIAL AUTOMOBILE
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
This endorsement modifles the Business Auto Coverage Form1, EXTENDED CANCELLATION CONDITION
Paragraph A.2.b. - CANCELLATION - of the
COMMON POLICY CONDITIONS form lL 00 17 is
deleted and replaced with the following:b. 60 days before the effective date of cancellation if
we cancel for any other reason.2. BROAD FORM INSUREO
A. Subsidiaries and Newly Acqulred or Formed
Organizations As lnsureds
The Named lnsured shown in the Declarations is
amended to includel
1. Any legally incorporated subsidiary in which
you own more than 50o/o of the voting stock on
the effective date of the Coverage Form.
However, the Named lnsured does not include
any subsidiary that is an "insured' under any
other automobile policy or would be an
"insured" under such a policy but for its
termination or the exhaustion of its Limit of
lnsu rance,2. Any organization that is acquired or formed by
you and over which you maintain majority
ownership. However, the Named lnsured
does not include any newly formed or acquired
organization:
(a) That is an "insured" under any other
automobile policy;
(b) That has exhausted its Limit of lnsurance
under any other policy; or
(c) '180 days or more afler its acquisition or
formation by you, unless you have given
us written notice of the acquisition or
formation.
Coverage does not apply to "bodily injun/ or
"property damage" that results from an "accident"
that occurred before you formed or acquired the
organization.
B. Employees as lnsureds
Paragraph A.1. - WHO lS AN INSURED - of
SECTION ll - LIABILITY COVERAGE is amended to
add the following:d. Any'employee" of yours while using a
covered "auto'you don't own, hire or
borrow in your business or your personal
affairs.C. Lessors as lnsurods
Paragraph A.1. - WHO lS AN INSURED - of
SECTION ll- LIABILITY COVERAGE is
amended to add the following:e. The lessor of a covered "auto" while the
"auto" is leased to you under a written
agreement if:
(1) The agreement requires you to
provide direct primary insurance for
the lessori and
(2) The "auto" is leased without a driver.
Such leased "auto'will be considered a
covered "auto" you own and not a covered
"auto" you hire,
However, the lessor is an "insured" only
for "bodily injuqy''or "property damage"
resulting from the acts or omissions by:'1. You:2. Any of your "employees" or agents;
or3. Any person, except the lessor or
any "employee" or agent of the
lessor, operating an 'auto" with the
permission of any of 1, and/or 2.
above.D. Persons And Organizations As lnsureds
Under A Written lnsuied Contract
Paragraph A. l - WHO lS AN INSURED - of
SECTION ll - LIABILITY COVERAGE is
amended to add the following:f. Any person or organization with respecl to
the operation, maintenance or use of a
covered "auto", provided that you and
such person or organization have agreed
under an express provision in a wriften
"insured contract", written agreement or a
written permit issued to you by a
governmental or public authority to add
such person or organization to lhis policy
as an "insured".
However, such person or organization is
an "insured" only:
Form: 16-02-0292 (Rev. '1 1-16) Page I of 3
"lncludes copyrighted material of lnsurance Services Office, lnc. with its permission"
(1) with respect to the operation,
maintenance or use of a covered
"auto"; and
(2) for "bodily injury" or "property damage"
caused by an 'accident" which takes
place after:
(a) You executed the "insured
contract" or writlen agreement; or
(b) The permit has been issued to
you.3. FELLOW EMPLOYEE COVERAGE
EXCLUSION B.5. - FELLOW EMPLOYEE of
SECTION ll - LIABILITY COVERAGE does not apply.4. PHYSICAL DAMAGE - ADDITIONAL TEMPORARY
TRANSPORTATION EXPENSE COVERAGE
Paragraph A.4.a. - TRANSPORTATION EXPENSES
- of SECTION lll- PHYSICAL DAMAGE
COVERAGE is amended to provide a Iimit of $50 per
day for temporary transportation expense, subject to a
maximum limit of $1 ,000.5. AUTO LOAN/LEASE GAP COVERAGE
Paragraph A. 4. - COVERAGE EXTENSIONS - of
SECTION lll- PHYSICAL DAMAGE COVERAGE is
amended to add the following:
c. Unpaid Loan or Lease Amounts
ln the event of a total "loss" to a covered "auto'', we will
pay any unpaid amount due on the loan or lease for a
covered "auto" minus:1. The amount paid underthe Physical Damage
Coverage Section of the policy; and2. Any:a. Overdue loan/lease payments at the time of
the "loss";b. Financial penalties imposed under a lease for
excessive use, abnormal wear and tear or
high mileage;c. Security deposits not returned by the lessor:d. Costs for extended warranlies, Credit Life
lnsurance, Health, Accident or Disability
lnsurance purchased with the loan or leasei
ande. Carry-over balances from previous loans or
leases.
We will pay for any unpaid amount due on the loan or
lease if caused by:1. Other than Collision Coverage only if the
Declarations indicate that Comprehensive
Coverage is provided for any covered "auto":
2. Specified Causes of Loss Coverage only if the
Declarations indicate that Specified Causes of
Loss Coverage is provided for any covered "auto";
or3. Collision Coverage only if the Declarations indicate
that Collision Coverage is provided for any
covered "auto.
6. RENTAL AGENCY EXPENSE
Paragraph A. 4. - COVERAGE EXTENSIONS - of
SECTION III _ PHYSICAL DAMAGE COVERAGE
is amended to add the following:
d. Rental Expenso
We will pay the following expenses lhat you or
any of your "employees" are legally obligated
to pay because of a writlen contract or
agreement entered into for use of a rental
vehicle in the conducl of your business:
MAXIMUI\,4 WE WILL PAY FOR ANY ONE
CONTRACT OR AGREEMENT:
1 . $2,500 for loss of income incurred by the
rental agency during the period of time that
vehicle is out of use because of actual
damage to, or "loss" of, that vehicle, including
income lost due to absence of that vehicle for
use as a replacement,2. $2,500 for decrease in trade-in value of the
rental vehicle because of actual damage to
that vehicle arising out of a covered "loss"; and3. $2,500 for adminislrative expenses incurred
by the rental agency, as stated in the contract
or agreement.4. $7,500 maximum total amount for paragraphs
1..2. and 3. combined.7. EXTRA EXPENSE - BROADENED COVERAGE
Paragraph A.4. - COVERAGE EXTENSIONS - of
SECTION III _ PHYSICAL DAMAGE COVERAGE
is amended to add the following:e. Recovery Expense
We will pay for the expense of returning a
stolen covered "auto" to you.
8. AIRBAG COVERAGE
Paragraph 8.3.a. - EXCLUSIONS - of SECTION
lll - PHYSICAL DAMAGE COVERAGE does not
apply to the accidental or unintended discharge of
an airbag. Coverage is excess over any other
collectible insurance or warranty specifically
designed to provide this coverage.9. AUDIO, VISUAL AND DATA ELECTRONIC
EQUIPMENT . BROADENED GOVERAGE
Paragraph C.1.b. - LIMIT OF INSURANCE - of
SECTION lll- PHYSICAL DAMAGE is deleted
and replaced with the following:
b. $2,000 is the most we will pay for "loss" in any
one "accident" to all electronic equipment that
reproduces, receives or transmits audio, visual
or data signals which, at the time of "loss", is:
(1) Permanently inslalled in or upon the
covered "auto" in a housing, op€ning or
other location that is not normally used by
the "auto" manufacturer for the installation
of such equipment;
(2) Removable from a permanently installed
housing unit as described in Paragraph
2.a. above or is an integral part of that
equipment; or
(3) An integral part of such equipment.
IO. GLASS REPAIR _ WAIVER OF DEDUCTIBLE
Form: 16-02-0292(Rev. 11-16) Page2of3
"lncludes copyrighted material of lnsurance Services Office, lnc. with its permission"
Under Paragraph O. - DEOUCTIBLE - of
SECTION III_ PHYSICAL DAMAGE COVERAGE
the following is added:
No deductible applies to glass damage if the glass
is repaired rather lhan replaced.
11. TWO OR MORE OEDUCTIBLES
Paragraph D.- DEDUCTIBLE - of SECTION lll -
PHYSICAL DAI\,4AGE COVERAGE is amended to
add the following:
lf this Coverage Form and any other Coverage
Form or policy issued to you by us that is not an
aulomobile policy or Coverage Form applies lo the
same "accident", the iollowing applies:1. lf the deductible under this Business Auto
Coverage Form is the smaller (or smallest)
deductible, it will be waivedi or2. lf the deductible under this Business Auto
Coverage Form is not the smaller (or smallest)
deductible, it will be reduced by the amount of
the smaller (or smallest) deductible.
12. AMENDED DUTIES IN THE EVENT OF
ACCIDENT, CLAIM, SUIT OR LOSS
Paragraph A.2.a. - DUTIES lN THE EVENT OF
AN ACCIDENT, CLAIM, SUIT OR LOSS of
SECTION lV - BUSINESS AUTO CONDITIONS is
deleted and replaced with the following:a- ln the event of'accident", claim, "sui('or
"loss", you must promptly notify us when the
"accident" is known lo:
(1) You or your authorized representative, if
you are an individual;
(2) A partner, or any authorized
representative, if you are a partnership;
(3) A member, if you are a limited liability
company; or
(4) An executive otficer, insurance manager,
or authorized representative, if you are an
organization other than a partnership or
limited liability company.
Knowledge of an "accident", claim, "suit" or
"loss" by other persons does not imply that the
persons listed above have such knowledge.
Notice to us should include:
(1) How, when and where lhe 'accident" or
"loss" occurred;
(2) The "insured's" name and address; and
(3) To the extent possible, the names and
addresses of any injured persons or
witnesses.
13. WAIVER OF SUBROGATION
Paragraph A.5. - TRANSFER OF RIGHTS OF
RECOVERY AGAINST OTHERS TO US of
SECTION lV - BUSINESS AUTO CONDITIONS is
deleled and replaced with the following:5. We will waive the right of recovery we would
otherwise have against another person or
organization for "loss" to which this insurance
applies, provided the "insured" has waived
their rights of recovery against such person or
organization under a contract or agreement
that is entered into before such "loss".
To the extent that the "insured's" rights to
recover damages for all or part of any
payment made under this insurance has not
been waived, those rights are transferred to
us. That person or organization must do
eveMhing necessary to secure our rights and
must do nothing after "accident' or "loss" to
impair them. At our request, the insured will
bring suit or transfer those rights to us and
help us enforce them.
14. UNINTENTIONAL FAILURE TO DISCLOSE
HAZARDS
Paragraph B.2. - CONCEALMENT,
MISREPRESENTATION or FRAUD of SECTION
lV - BUSINESS AUTO CONDITIONS - is deleted
and replaced with the following:
lf you unintentionally fail to disclose any hazards
existing at the inception date of your policy, we will
not void coverage under this Coverage Form
because of such failure.
15. AUTOS RENTED BY EMPLOYEES
Paragraph 8.5. - OTHER INSURANCE of
SECTION IV _ BUSINESS AUTO CONDITIONS.
is amended to add the following:e. Any "auto" hired or rented by your "employee"
on your behalf and at your direction will be
considered an "auto" you hire. lf an
"employee's" personal insurance also applies
on an excess basis to a covered "auto" hired
or rented by your "employee" on your behalf
and at your direction, this insurance will be
primary to the "employee's' personal
insurance.
16. HIRED AUTO - COVERAGE TERRITORY
Paragraph 8.7.b.(5). - POLICY PERIOD,
COVERAGE TERRITORY of SECTION lV -
BUSINESS AUTO CONOITIONS is deleted and
replaced with the following:
(5) A covered ,auto" of the private passenger
type is leased, hired, rented or borrowed
without a driver for a period of 45 days or
less: and
17. RESULTANT MENTAL ANGUISH COVERAGE
Paragraph C. of - SECTION V - DEFINITIONS is
deleted and replaced by the following:
"Bodily injury" means bodily injury, sickness or
disease sustained by any person, including
mental anguish or death as a result of the 'bodily
injury" sustained by that person.
Form: 16-02-0292 (Rev. 11-'16) Page 3 of 3
"lncludes copyrighted material of lnsurance Services Office, lnc. with its permission"
POLICYNUMBER: 54303213 COMMERCIAL AUTO
16-{'2-0316 Ed. t014
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NON-CONTRIBUTORY LIABILITY
INSURANCE
This endorsement modifies insurance provided under the followinq
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated
below.
Named lnsured: A.M. Ortega Construction, lnc.
Endorsement Effective Oate: 101'l 12022
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
WHERE REQUIREO BY WRITTEN CONTRACT
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to ltem 5. - "Other
lnsurancc" of ltem B. - "General Condltlons" under
Section lV - "Business Auto Conditions":
e. Regardless of the provisions of Paragraph 5.a.
through d. above, fof any liability arising out of the
ownership, maintenance, use, rental, lease, loan, hire
or borrowing by an 'insured" of a covered "auto" for
which an "insured" is contractually obligated to
provide pnmary insurance coverage to a client, this
Coverage Form will be primary and non-contributory
with respect to the Persons or Organizations in the
schedule, regardless of the availability or existence of
other collectible insurance under any other Coverage
Form or policy that applies on a primary basis.
16-02-0316 Ed. t0 t4 Page 1 of 1