2022/12/01 Black Diamond Blade Co. Inc.,-,ACORD'
pRooucER License # 0757776
HUB lnternalional lnsurance Services lnc4695 MacArthur CounSuite 600Newport Beach, CA 92660
BLACDIA-21
CERTIFICATE OF LIABILITY INSURANCE
fi!ilElcr Dana O'Malley, CISR
iJ3.*,f.,.,e, 1zr+1 21o-7s03 7e03 [#, r"),ola) e17-3i86
imtEss dana.om-lley@hubinternational.com
INSURER{S) AFFOROING COVERAGE NAIC I
111su6sx 4 . The Travelers lndemhity Company of Conneclicut 256g2
lxsgp6x 6 . Travelers Property Casualty Company of America 25674
rNsuRER c , North Pacific lnsurance Company 23ggzBlack Diamohd Blade Co. lnc
234 E. "O" Street
Colton, CA 92324
11t30t2022THIS CERTIFICATE IS ISSUEO AS A MATTER
CERTIFICATE DOES NOT AFFIRMATIVELY ORBELOW. THIS CERTIFICATE OF INSURANCE
REPRESENTATIVE OR PRODUCER, AND THE CE
OF INFORI''ATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS}IEGATIVELY AMEND, EXTENO OR ALTER THE COVERAGE AFFORDEO BYTHEPOLICIESDOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER('), AUTHORIZEDRTIFICATE HOLDER.
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covE CERTIFICAT ER UMBETHIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED AELOW HAVE BEEN ISSUEDINDICATEO, NOTWITHSTANDING ANY REOUIREMENT. TERM OR CONOITiON OF EIY COITANCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICEXCLUSIONS ANDCONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY
TO THE INSUREO NAMED AAOVE FOR THE POLICY PERIOOCT OR OTHER DOCUMENT W|TH RESPECT TO WHICH THIS;IES DESCRIBEO HEREIN IS SUSJECTTOALL THE TERMS,PAID CLAIMS,
POUCY EFF POLICY EXP
EACH OCCURRENCE
DAMAGE TO RENTEOPREMISES (Eaoe!rercqI
MEO ExP (An!!ie peGgaL
PERSONAI qADV INJURY
GEN ERAI AGGREGATE
PROOUCTS. COMP/OP AGG
1,000,000
300,000
5,000
1,000,000
2,000,000
2,000,000
9t3012022 9t3012023
iF""i lx
GEN'L A6GREGATE LIII,IIT APPL ES PER
LOC
A X corvrmencw- eeNERAL uaBrLrry
cLAtMs-MAoE X occuR
O-THER:
X ary eLrro
OWNED
X lffi& o","
COMAINED SINGLE L MII(Ea accdenll s
913012022 913012023 BoDrLy INJU8! 1pe. p€con) s
1,000,000
BAAP 4246242214c
Y NON.OWNEO !
s
SCHEDULEO
A nurorroerue rtlsrrrry
BODILY iNJURY {Per a@denr)
(Pd accdonr)
L
L
$
QWC6000096
B
c x lFlruru l12t1t2022 12112023
E L, OISEASE, POLICY
9,000,000
9,000,000
OTH
1,000,000
1,000,000
1,000,000
EACH OCCI]RRENCE9/30/2022 9/30/2023 aGGREGATE
E L EACH ACCIDENI 9
E L OISEASE. EA EMPLOYEE S
X uugnerrt Laa X occun
EXCESS UAB CLAIMS-MADE
oau f *ara*rars o
WORI(ERS COMPENSATIONaND EMPLOYERS' LtABtLtTY Y/ NANY PROPRIETOFITPARTNER,'EXECUTIVE
OFF CERIMEMBER E^CLtiDFDT(M.ndrlory ln NH)
DESCRIPTIoN OF OPERAIIoNS, LOCAIIoNS , vEHlcLEs (AcoRO 1or. Addir'ohrt R.m.ri. Sch.dut., n.v b..n.ch.d it more snac. i.,.dur.d!
additiohallnsured wlth respect to genoralliablllty porcGD458 0219, ccD246 0419. primary and noncontiiu,it.ii'1"'.iri"i p"rccTloo 02i9. soparaiio; oflnsureds clause included, per CG0001 tOO1. 30 days notice ofcancellation applias per policy provision.
c HOLDER LLATION
City of ilcnifee and its officers, omployees, agents, andauthorized volunteers
298i14 Haun Road
Sun City, CA 92586
SHOULD ANY OF THE AEOVE DESCRIBEO POLICIES BE CANCELLEO BEFORETHE EXPIRATION DATE THEREOF, NOTICE wlLL BE DELIYEREO INACCOROANCE WITH THE POLICY PROVISIONS,
AUIHORIZED REPRESENTATIVE
ACORD 2s (2016/03)All rights reserved.
Nn*ru*,-
cuP314a52612214
the
ts
6303L480394TCT22
s
$
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@ 1988.2015 ACORD CORPORATTON.
The ACORD name and logo are registered marks ofACORD
POLICY NUMBER: 6303L480394TCT22
A Who ls An lnsured - Unnamed Subsidiaries
B. Who ls An lnsured - Employees And Volunteer
Workers - Bodily lnjury To CeEmptoyees And
Ccvolunteer Workers
C, Who ls An lnsured - Newly Acquired Or Formed
Limited Liabillty Companies
D. Blanket Additional lnsured - Broad Form Vendqs
E. Bla nket Add itional lnsured - Controlling lnlerest
F. Blanket Additional lnsured - lvlortgagees,
Assignees. Successors Or Receivers
G. Blanket Additional Insured - Governmental
Entities - Permits Or Adhorizations Relating To
Premises
PROMSIONS
A WHO IS AN INSURED - UNNAMED
SUBSIDIARIES
The following is added to SECTION ll - WHO lSAN INSURED:
Any of your subsidiaries, otfier than a partnership
or joint venture, that is not shown as a Named
lnsured in the Declarations is a Named lnsured if:a, You are the sole owner of. or maintain an
ownership interest of more than 50o/. in, such
subsadiary on the first day of the poticy period;
andb. Such subsidiary is not an insured under
similar other insurance.
No such subsidiary is an insured for "bodily injurly',
or "property damage" that occurred, or "personal
and advertising injury" caused by an ofiense
committed:
COt\,4MERC IAL GEN E RAL LtABtLlTy
H. Blanket Additional lnsured - Governmental
Entitjes - Permits Or Authorizations Relating To
Operations
l. Blanket Additional lnsured - Grantors Of
Franchises
J. lncidental Medjcal Malpractice
K. Medic€l Payments - lncreased Limit
L. Blanket Waiver Of Subrogation
M. Contractual Liability - Railroads
a. Befqe you maintained an ownership interes
of more than 50% in such subsidiary; or
b. After the date, if any, during the potiqy periodthat yqJ no longer maintain an ownership
intere$ of more than 50% in such subsidiary.
For purposes of Paragraph 1. of Secrion ll - Whols An lnsured, each s.rch subsidiary will be
deemed to be designated in the Declarations as:
a. A limiled liability company,
b. An organization dher than a partnership, joint
venture or limited liability company; or
c. A t'ust;
as indicated in its name or the documeds thatgovern its strudure.
This erdorsement modifies insurance provided under the icllowing:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
GENERAL DESCRIPTION OF COVERAGE -This endorsement broadens co\r'erage. However, coverage lor anyinjury, damage or medical e{oenses described in any of the provisions of this endorsement may be eicluded orlimited by another endorsemer( to this Co\r'erage Part, and these co\,erage broadening provisions do not apply tothe extent that coverage is excluded or limited by such an endorsement. tne tot'iowing listing is a generalco\€rage descriptisl only. Read all the provisions of this endorsement and the rest of y-ur poiicy carefully todetermine rights, duties, and what is and is not co\€red.
cG Dlt 58 02 't9 O 2017 The Travelers lndemnity Company A rights reserved.lncludes copyrighled malerial of lnsurance Services Office. lnc. with its oermission
Page I of 5
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ I'T CAREFULLY.
XTEND ENDORSEMENT FOR MANUFACTURERS AND
WHOLESALERS
COMMERCIAL GENERAL LIABILITY
B. WHO IS AN INSURED - EMPLOYEES AND
VOLUNTEER WORKERS - BODILY INJURY TOCO.EMPLOYEES AND CO.VOLUNTEER
WORKERS
The follovving is added to paragraph 2-a.(11 of
SECTION II - WHO IS AN INSURED:
Paragraphs (1)(a). (b) and (c) above do not apptyto "bodily injury" to a cc"employee" while in the
course of the cc"emdoyee's" employment by you
or performing duties related to the conduct ofyourbusiness, or to "bodily injuqy'' to your other"volunteer workers" while performing duties
related to the conduct of ycrJr busiless.
C. WHO IS AN INSURED _ NEWLY ACQUIRED
OR FORMED LIMITED UABILtrY COMPANIES
The following reptaces Paragraph 3. of SECTIONII_WHO IS AN INSURED:
3. Any organization )ou newly acquire or form,
other than a pa(nership or joint venture, and
of which you are the sole owner q in whictt
you maintain an ownership interest of more
than 50%, will qualify as a Named lnsured if
there is no other similar insurance available to
that organization. However:
a. Coverage under this provision is afforded
onlY:
(1) Until the 180th day after you acquire
or form the organization or the end of
the policy period, whichever is earlier,
if )ou do not report such organizatiorl
in writjng to us within 180 days afrer
you acquire or form it; or
(2) Until the end of the policy period,
when that date is later than 180 da!6after )acu acquire or form such
organization, if you report such
organization in writing to us within
'180 days afrer you acquire or form it;
b. Coverage A does not apply to "bodily
injury" or "property damage'that occurred
before you acquired or formed the
organization; and
c. Coverage B does not apply to "personal
and advertising injury" arising out of an
offense committed before ),ou acquired or
formed the organization.
For the purposes of Paragraph '1. of Section ll
- Who ls An lnsured, each such organizationwill be deemed to be designated in the
Declarations as:
a. A limited liability company;
b. An organization, other than a partnership,
joint venture or limited liability company;
or
C. A AuSt;
as indicated in its name or the documents
that govern its structure.
D. BLANKET ADDITONAL INSURED - BROAD
FORM VENDORS
The following is added to SECTION ll - WHO lS
AN INSURED:
Any person or organization that is a vendor and
that you have agreed in a written contrad or
agreement to include as an additional insured on
this Coverage Part is an insured, but only with
respecl to liability for "bodily injury" or ',property
damage'that
a. Occurs subsequent to the signing of that
contract or agreement; and
b- Arises out of ")acur products,' that are
distributed or sold in the regular course of
such vendor's business.
The insurance provided to such vendor is subject
to the following provsions:
a. The limits of insurance provided to such
vendor will be the minimum limits that you
agreed to provde in the written contract or
agreement, or the limits shown in the
Declarations, whichever are less.
b. The insurance provded to such \|endor does
not apply to:
(1) Any erpress warranty not authorized by
)4cu or any distribution or sale for a
purpose not authorized by you;
(2) Any change in "your products" made by
such vendor;
(3) Repackaging, unless unpacked sotety for
the purpose of inspection, demonstration,
testing, or the substitution of parts under
instructions from the manufadurer, and
then repackaged in the original container;
(4) Any failure to make such inspections,
adiustments, tests or servicing as
\endors agree to perform or normally
undertake to perform in the regular
course of business, in connection with the
dislribLrtion or sale of ")our products,';
Page 2 of 5 @2017 The Travelers lndemnity Company. A[ rights reserved.
Inc udes copyrighted malerial of lnsurance SeNices Office, tnc. with its permtssion
cG D4 58 02 't9
(5) Demonstration, installatjon, servicing or
repair operatjons, except such @erationsperformed at such \,rendo/s premises in
connection with the sale of ")cur
products"; or
(6) "Your products" that after di$ribution orsale by you, have been labeled orrdabeled or used as a container, part orir€redient of any other thing or substance
by or on behalf of such vendor.
Coverage under this provision does not apply to:a, Any person or dganization from whom youhave acquired "your produds,', or anyingredient, part or container entering into,
accompanying or containing such producis:
or
b. Any vendor for which co\rerage as an
additional insured specificalty is scheduted by
en dorse men t.
E. BLANKET ADD]TIONAL INSURED
CONTROLLING INTEREST
1. The following is added to SECTION ll - WHO
IS AN INSURED:
Any person or organization that has financialcontrol of you js an insured with respect toliability for'bodity injuqy'',,'property damage"
or "personal and advertising injury,,that arises
out of:
a. Such finarcial control: or
b. Such person's or qganization,s
ownership, maintenanc€ or use ofpremises leased to or occupied by you.
The insurance provided to such person ororganization does not apply to structural
alterations, new construction or demolition
operations performed by or on behalf of suchperson or organization.
2. The following is added to paragraph 4. of
SECTION II - WHO IS AN INSURED:
This paragraph does not apply to anypremises owner, manager or lessor that hasfinancial control of you.
F. BLANKET ADDITIONAL INSUREDMORTGAGEES, ASSIGNEES, SUCCESSORS
OR RECETVERS
The following is added to SECTION ll - WHO lS
AN INSURED:
Any person or organization that is a mortgagee,assignee, successor or receiver and that you
have agreed in a written contac{ or agreement toinclude as an additional insured on this CoveragePart is an insured, but only wih respect to its
COM[,,IERCIAL GENERAL LIABILITY
liability as mortgagee, assjgnee, successor orrecd\€r for "bodily injury', "property damage, or"personal and advertising injury. that
a. ls "bodily injuqy'' or "property damage', that
occurs, or is "personal and ad\ertisng injury,,caused by an offerEe that is committed.
sJbsequent to the signing of that contract q
agreement; and
b. Arises out of the ownership, maintenance q
use ofthe premises for which that mortgagee,
assignee, successor or receiver is requiredunder that contract tr agreement lo beincluded as an additional insured on this
Coverage ParL
The insurance provided to such mortgagee,assignee, successor or receiver is subjed to the
following provisions:
a. The limits cf insurance provided to suchmortgagee, assignee, successc s re@iver
will be the minjmum limib that )ou agreed toprovide in the writen contrad or agreement,or the limits shown in the Declarations,
whictlever are less.
b. The insurance proMded to such person q
organization does not apply to:
(1) Any "bodity injuny'' or "property damage,that occurs, or any "personal andadvertising injuly''caused by an offense
that is committed, after such contract q
agreernent is no longer in effect; or
(2) Any "bodily injuny'', "property damage, or"personal and advertising injury" arbingorjt of any structural alterations, newconstruction or demdition operationsperformed by or on behalf of suchmortgagee, assignee, successor q
rec€i\/er
G. BI.ANKET ADD]TIONAL INSUREO
GOVERNMENTAL ENTITIES - PERMITS OR
AUTHORIZATIONS RELATING TO PREMISES
The following is added lo SECTION Il - WHO lS
AN INSURED:
Any govemmental entity that has issued a permit
or authorizatim with respect to premises ownedor occupied by, or rented or loaned to, )ou andthat yqJ are required by any ordinance, law,
building code or written confact or agreernent to
include as an dditional insured on this Coverage
Part is an insured, but only with respect to liability
for "bodily iniury", "property damage, or,,personaland adveijsing injury" arising out of the
existence, ownership, use, maintenance, repair,
construclion, eredion or removal of any of the
following for which that governmental entity has
cG D4 58 02 19 O 2017 The Traveters tndemnity Company. A[ rights rsserved.lhcludes copyrighted maleriatof tnslrancs Services Ofiice. lnc. with its permisston
Page 3 of 5
CO[,4MERCIAL GENERAL LIABILITY
issued such permit or authorization: advertising
signs, awnings, canopies, cellar entrances, coalhdes, drivgr',/ays, manholes, marquees, hoist
away openings, Sidewalk vaulls, devators, street
banners or decoralions.
H BLANKET ADDIIONAL INSURED
GOVERNMENTAL ENNTES - PERMITS OR
AUTHOREATIONS RELATING TO OPER.
ATIONS
The following is added to SEGTION ll - WHO lS
AN INSURED:
Any govemmental entity that has issued a permitor authorization with respect to operations
performed by )ou or on your behalf and that you
are required by any trdinance, law, building code
or written contracl or agreement to include as an
additional insured on this Coverage Part is an
insured, but only with resped to liability for "bodity
injuqy'', "property damage" or "personal and
advertising injury" arising out of such operations.
The insurance provided to such governmental
entity does not apply to:
a. Any "bodily injuly'', "property damage" or
"personal and ad\r'ertising injury" arising out of
operations performed for the govemmental
entity; or
b- Any "bodily injuqy'' or "property damage"included in the "products-cqnpleted
operations hazard'.
I. BLANKET ADD]TIONAL INSURED
GRANTORS OF FRANCHISES
The following is added to SECTION ll - WHO lS
AN INSURED:
Any person or organizatim that grants a franchiseto you is an insured, but only with respec{ to
liability for "bodily injuqy'', "property damage" or
"personal and advertasng injury" arising oJt of
\our operations in the franchise granted by that
person or organization.
lf a written contracl or agreement exists between
)ou and such additional insured, the limits of
insurance provided to such insured will be the
mininum limits that you agreed to provide in the
written @ntret or agreement. or the limits shown
in the Declarations. whichever are less.
J. INCIDENTAL MEDICAL MALPRACTICE
1, The following replaces Paragraph b. of thedefinition of "occunence" in the
DEFINfflONS Sedion:
b. An ad or omission committed in providing
or failing to provide ''incidental medical
services", first aid or "Good Samaritan
services" to a person. unless ycu are in
the business or occupation of providing
professional health care services.
2. The fdlowing replaces the last paragraph of
Paragraph za.('ll d SECTION lt - WHO lS
AN INSURED:
Unless yc! are in the business or occupation
of providing professional heatth cai.e seMces,
Paragraphs (1Xa), (b), (c) and (d) above do
not apply to "bodily injury" arising out of
provjding or failing to provide:
(a) "lncidental medical services" by any of
)^cur "employees" who is a nurse, nurse
assistant, emergency medical technician.
paramedic, athletic trainer, audiologist,dietician, nutritionist, occupationaltherapist or occupational therapy
assistant, physical therapist q speech-
language pathologist; or
(b) First aid or "Good Samaritan services" by
any of your "employees" or "volunteer
workers", other than an employed or
\/olunteer dodor. Any such "employees"
or "\,rclunteer workers" providing or failingto provide first aid or "Good Samaritan
serMces" during their work hours for you
will be deemed to be acting within the
scope of their employment by you or
performirE duties related to the conduct
of your business.
3, The following replaces the last sentence of
Paragraph 5. d SECTION lll - LIMITS OF
INSURANCE:
For the purposes of determining the
applicable Each Occurrence Limit, all related
acts or omissions commifted in providing q
failing to provide "incidental medical
services", first aid or "Good Samaritan
services" to any one person will be deerned to
be one "occurrence".
4. The following exclusion is added to
Paragraph 2., Exclusions, of SECTION I -COVERAGES - COVERAGE A - BODILYINJURY AND PROPERTY DAMAGE
LIABILITY:
Sale Of Pharmaceuticals
"Bodily injuqy'' or "property damage" arisingout of the violation of a penal statute q
ordinance relatirE lo the sale ofpharmaceuticals committed by, q wath the
lglowledge or consent of, the insured.
Page 4 of 5 O 20T7 The Travelers lndemnily Company All riqhts reserued.
lncludes copyrighled mateialof lnsurance Services Office, tnc. with its permission
CG D/t 58 02 19
5. The foflowing is added to the DEFINITIoNS
Section:
"lncidental medical seryices', means:
a. Medical, surgical, dental, laboratory, x-rayor nursing Service or treatment, advice or
instruction, or the related fumishing offood or beverages; or
b. The furnishing or dispensing of drugs ormedical, dental, or surgical supplies or
appliances.
6. The following is added to paragraph 4.b.,Excess Insurance, of SECTION lV -COMMERCIAL GENERAL LIABILIry
CONDITIONS:
This insurance is excess over any valid and
collectible other insurance, whether primary,
excess, contingent or on any other basis, thatis available to any of your "employees,'for
"bodily injury" that arises out of providing or
failing to provide "incidental medical services',to any person to the extent not subject to
Paragraph 2.a.(1) of Sedion ll - Who ts An
lnsured.
K. MEDICAL PAYMENTS - INCREASED LIMIT
The following reptaces Paragraph 7. of SECTION
III - LIMITS OF INSIJRANCE:
7. Subject to Paragraph 5. above, the l\.4edical
Expense Limit is the most we will pay underCoverage C for all medical e)eenses
because of "bodily injuty'' sustained by any
one person, and will be the higher of:
COMN,,!ERCIAL GENERAL LIABILIry
a. $10,000; or
b. The amount shown in the Declarations of
this Coverage Part for [,4edical E)qcense
Limit
L. BLANKET WAIVER OF SUBROGATION
The following is added to Paragraph 8., Transfer
Of Rights Of Recovery Against Others To Us,of SECTION lV - COMMERCTAL GENERAL
LIABILITY COND]TIONS:
lf the insured has agreed in a contract or
agreement to waive that insured's right of
recovery against any person or orqanization, we
waive our right of recovery against such person or
organization, but only for payments we make
because cf:
a. "Bodily injury" or "property damage,' that
occurs: or
b. "Personal and advertising injury" c€used by
an offense that is committed;
subsequent to the execution of the contract or
agreement.
M. CONTRACTUAL LIABILITY - RAILROADS
'1. The follc,vr'ing replaces Paragraph c. of thedefinition of "insured contract,, in the
DEFINIfIONS Section;
c. Any easement or license agreement;
2. Paragraph f,(1) of the definition of ',insured
contract" in the DEFINITIONS Section is
deleted.
O2017 The Trave ers tndemnity Company. A[ rights reserved.lnc udes copyrighled material of lnsurance Services Office, tnc. with its permission
cG D4 58 02 ,19 Page 5 of 5
COMMERC IAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
(lncludes Products-Completed Operations lf Required By Contract)
This endorsement modifies insurance provided under the follci/ving
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS
The following is added to SECTTON ll - WHO tS AN
INSURED:
Any person or organization that yoJ agree in awritten contract or agreement to indude as anadditional insured on this Coverage part is an
insured, but only:
a. With respect to liability for ,,bodity injury', or
"property damage' that @curs, or for ',personal
injuly''caused by an offense that is committed,
subsequent to the signing of that contract oragreement and while that part of the contracl or
agreement is in effect: and
b. lf, and only to the extent that, such injury or
damage is caused by acts or omissions of ycu or
)our subcontractor in the performance of',)alur
work" to which the written contract or agreement
applies. Such person or organization does not
qualify as an additional insured with respect tothe independent acts or omissions of such
person or organization.
The insurance provided to such additional insured is
subjecl to the fdlowing provisions:
a. lf the Limits of lnsuranc€ of this Coverage part
shown in the Declarations exceed the minimumlimits required by the written contraci oragreement, the insuran@ proMded to the
additional insured will be limited to suchmininum required limits. For the purpGes of
determining whether this limitation appties, the
minirrum limits required by the written contracl or
agreement will be considered to include theminimlm limits of any Umbrella or Excessliability coverage required for lhe additjonal
insured by that written contract or agreement.This provision will not increase the limits of
insuranca described in Section lll - Limits Of
lnsurance.
b. The insurance provided to such additional
insured does not apply to:
(1) Any "bodity injury", "property damage,, or
"personal injury" arising out of the providing.or failure to provide, any professional
architeclural, engineering or surveying
services, including:
(a) The preparing, approving, or failing toprepare or approve, maps, shop
drawings, opinions, reports, surveys,field orders or change orders, or thepreparing, approving, or failirE toprepare or approve, drawings and
specifications; and
(b) Supervisory, inspection, architecturat or
en gineering actjvities.
(2) Any "bodity injuty'' or "property damage,,
caused by "!our work" and included in the"produds-completed operations hazatd,
unless the written contact or agreement
specifically requires !,ou to provide such
co\€rage for that additional insured during
the policy period.
c. The additional insured must comply with the
following duties:
(1) Give us written notice as soon as praciicable
of an "occurence" or an offense which may
resllt in a claim. To the extent possible, such
notice sfrould include:
(a) How, when and where the ,'occurence,,
or cffense took place;
(b) The names and address€s cf any injured
persons and wjtnesses; and
(c) The nature and location of any injury or
damage arising out of the .,occunence',
or offense.
(2) lfa claim is made or "suif is brought against
the additional insured:
cG D2 46 04 19 O 2018 The Travelers tndemntty Company. Afl rights reserved Page 1 ol 2
COI\,4MERCIAL GENERAL LIABILITY
(a) lmmediately record the specifics cf the
claim or "suit' and the date received; and
(b) Naify us as soon as practbable and see
to it that we receive written notice of the
claim or "suit" as soon as praqlicable.
(3) lmmediately send us copies of a tegat
papers received in conneciion with the claimor "suit", cooperate wih us in the
investigation or settlement cf the claim or
defense against the "suit', and otherwise
comply wifl all policy conditions.
(4) Tender the defense and indemnity of anyclaim or "suit' to any provider of other
insurance which would cover such additional
insured fc a loss we co\er. However, this
condition does not affect whether the
insurance provided to such additaonalinsured is primary to other insurance
available to such additional insured Which
covers that person or organization as a
named insured as described in Paragraph 4.,
Other lnsurance, of Seclion lV - Commercial
General Liability Conditions.
Page 2 af 2 O 2018 The Travelers lndemnity Company. A[ rights reserved cG D2 46 04 19
POLICY NUMBER: 6303L480394TC'f 22
CO[,4I\NERCIAL GENERAL LIABILITY
c. Method OfSharing
If all of the other insurance permits cmbihrtiql
by equal shares, we will follow this rnethod also.
Under this approach eeh insurer cmtributes
equal amounts until it has paid its applicable
limit of insurance or none of the loss remains.
whichever comes first.
lf any of the other insurance does not permit
contributifi by equal shaes, we will cqrtributeby limits. Under this method, erch insure/s
share is based on the ratio of its applic*le limitof insurance to the total applicable limits of
insurance of all insurers.
5. Premium Audit
a. We will ccrnpute all prerniums fq this Cc,erage
Part in accordance with qrr rules d rates.b. Premium sho,rr'n in this Co\,erage part as
ad\rance premium is a depcit premium only. At
the close of each audit period we will cornpute
the earned premium for that period and send
notice to the flrst Named lnsured. The due date
for audit and retrospecli\e prerniums is tlle date
sho,vn as the due date on the bill. lf the sum ofthe advance and audit premiums paid for thepoliqy period is greater than the earned
premium, we will return the ercess to the first
Named lnsured.
c. The first Named lnsured must keep records ofthe informatjon we need for prerrfum
cot'nputatlf,n, and send us copies at such tjmes
as we may request.
6. Representations
By accepting this pdicy, )(aJ agree:
a. The statements in the Declarations are
accurate and cqnpete;
b. Those s{aternents are based upon
representations )ou made to us; and
c. We ha\,e issued this pdiqy in reliance upon
)oul. representaticn s.
The unintentlral omission of, or unirtentional effor
in, any information provided by )ou whicfi we relied
upon in issuing this policy will not prejudice \qlrrights under this insurance. Howe\,er, this provision
does nci affect oilr right to collect additionalpremium or to e)€rcise our rights of cancdlatjm or
nmrens/val in accordance with applicable insurance
laws or regulations.
7. Separation Of lnsur€ds
Except with respect to the Limits of lnsurance, andany rights or duties specifically assigned in this
Co\,erage Part to the first Named lnsured. this
insurance applies:
a. As if each Named lnsured were the orily
Named lnsured; and
b. Separately to each insured against whqn claim
is made or "suit' is brcught.
8. Transfer Of Rights Of Recovery Againsi OthersTo Us
lf the insured has ri{Jhts to recc /q all or part of anyp4/rnent we ha\€ mde under this Co\€r4e part,
those rights are transfened to us. The insured must
do nothing after lcss to impair them. At our request,
the insured will bring "suit, or transfer those rights
to us and help us enforce thern.
9. When We Do Not Renary
lf we decide not to renelv this Co,erage part, we will
mail or deliver to the first Named lnsured shown inthe Declarations written notice of the nmrenewal
not less than 30 da)/s befqe the e)piration date.
lf notice is mailed, proof of mailing will be sufficient
proof cf notice.
SECTION V- DEFIN]TIONS
1. "Ad\ertisement" means a notice that is broadcad orpublished to the general public or specific ma.ket
segments about )qlr goods, producls or servicesfor the purpose of attracting customers orsupporters. For the purpGes of this definition:a. Notices that are published include materialplaced on the lnternet or on similar electronic
means of ccnmunicatitrt: and
b. Regarding websites, only that part of a website
that is about )our goods, products or servicesfor the purposes of attrrcting custotrrers or
supporters is considered an ad\,erlisement.
d.Primary And Non-contributory nsu rance tf
RequIed By Wriften Contract
lf you specificdly agree in a written conuact or
agreernent that the insurance afforded to an
insured under this Co\€rage part must applyona primay basis, or a prima-y and non-
contributory basis, this insurance is primary to
other insurance that is a\aildle to such insured
which co\€rs such insured as a named insured,
and we will not share with that other insurance,
proMded that:
(1) The "bodily injury' or "property danrage' for
which co\€rage is sought occurs; and
(2) The "persmat ard ach.ertising injuqy',for
which coverage is sought is calsed by an
offense that is ccrnmitted;
subsequent to the signing of that cmtract oragresnent by )ou.
Page 16 of 21 @ 2017 The Traveters lndemnity Company. A righls reservedlncludes copyrighled maleriat of tnsurance Services Offtce, tnc. with its Dermission
cG T1 00 02 19
COMMERCIAL GENERAL LIABILITY
c. Method Of Sharing
lf all of the other insurance permits contribution
by equal shares, we will follow this method also.
Under this approach each insurer contributes
equal amounts until it has paid its applicable
limit of insurance or none of the loss remains,
whichever comes first.
lf any of the other insurance does not permit
contribution by equal shares, we will contributeby limits. Under this mefrod, each insure/s
share is based on the ratio of its applicable limitof insurance to the total applicable limits of
insurance of all insurers.
d. Primary And Non.Contributory lnsurance tf
Required By Written Contract
lf you specifically agree in a written contract or
agreement that the insurance afforded to an
insured under this Coverage part must appv ona primary basis. or a primary and non-
contributory basis, this insurance is primary to
other insurance that is alailable to such insured
which covers such insured as a named insured,
and we will not share with that other insurance.
provided that:
(1) The "bodily injury' or "property damage,, for
which coverage is sought occurs; and
(2) The "personal and advertising injury,, for
which coverage is sought is caused by an
offense that is committed;
subsequent to the signing of that contract or
agreement by you.
5. Premium Audit
a. We will compute all premiums for this Co\erage
Part in accordance with our rules and rates.
b. Premium shown in this Co\€raoe part as
advance premium is a deposrt premium only. At
the close of each audat period we will compute
the earned premium for that period and send
notice to the first Named lnsured. The due date
for audit and retrospective premiums is the date
shown as the due date on the bill. tf the sum of
the advance and audit premiums paid for thepolicy period is greater than the earned
premium, we will return the excess to the flrst
Named lnsured.
c. The rirst Named lnsured must keep records ofthe information we need for premium
computation, and send us copies at such times
as we may request.
6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are
accurate and complete;
b. Those statements are based upon
representations you made to us; and
c. We have issued this policy in reliance upon
)our representations.
The unintentional omission of, or unintentional error
in, any information provided by you which we relied
upon in issuing this policy will not prejudice your
rights under this insurance. However, this provision
does not affect our right to collect additional
premium or to exercise our rights of cancellation or
nonrenewal in accordance with applicable insurance
laws or regulations.
7. Separation Of lnsureds
Except with respect to the Limits of lnsurance. and
any rights or duties specifcally assigned in this
Coverage Part to the first Named lnsured. this
insurance applies:
a. As if each Named lnsured were the only
Named lnsured: and
b. Separately to each insured against whom claim
is made or "suit" is brought.
8. Transfer Of Rights of Recovery Against Others
To Us
lf the insured has rights to recover all or part of any
payment we have made under this Coverage part,
those rights are transferred to us. The insured must
do nothing after loss to impajr them. At our request,
the insured will bring "suit' or transfer those rights
to us and help us enforce them.
9. When We Do Not Renew
lJ we decide not to renew this Coverage part, we will
mail or deliver to the first Named lnsured shown in
the Declarations written notice of the nonrenewal
not less than 30 days before the expiration date.
lf notice is mailed. proof of mailing will be sufficient
proof of notice.
SECTION V - DEFINITIONS
1. "Advertisement" means a notice that is broadcast orpublished to the general public or specific market
segments about your goods, products or servicesfor the purpose of attracting customers or
supporters. For the purposes of this definition:
a, Notices that are published include materialplaced on the lnternet or on similar electronic
means of communication: and
b. Regarding welsites, only that part of a website
that is about your goods, products or servicesfor the purposes of attracting customers or
supporters is considered an advertisement.
@ 2017 The Travelers lndemnty Company. All rights reserved.
lncludes copyrighted material of tns!rance Services Ofltce, tnc. with its permission
Page l6 of 21 cG T1 00 02 19
POLICY NUMBER: 6103L480394TCT22