2022/07/01 Cooperative Personnel Services (3),-l -
^CORI)"CERTIFICATE OF LIABILITY INSURANCE
IMPORTANT: lf the certificate holder is an ADDITIONAL lNSl,rRED, the policy(ies) must have ADDITIONAL INSUREO provisions or be endorsed.
lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer ri to the certificate holder in lieu of such endorsem
CERTIFICATE NUMBER: 7196691 7
Brianna Orchekowski
brianna.orchekows icbrokers.com
AFFORDING COVERAGE
TNSURERA I The Continental lnsurance Cofi
INSURER B: Ll s of London
rNsuRER c: Continenlal Ca
REVISION NUMBER
ffi
35289
85242
20443
20427
20474
COVERAGES
6t3012022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE OOES 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.
PHONE
PROOUC€R
Edgewood Partners lns. Center
10877 White Rock Road Suite 300
Sacramento - P&C Lic im829370
Rancho Cordova CA 95670
rNsuRER o: American Casuall of ReadiC
rNsuRER E : National Fire lnsurance Co of Harl{ord
INSUREO
Cooperative Personnel Services
DBA: CPS HR Consulting
2450 Del Paso Rd.. Ste. 220
Sacramento CA 95834
TYPE OF INSURANCE
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO AEOVE FOR THE POLICY PERIOOINDICAIED NOTWIIHSTANDING 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 DESCRIBEO HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIO CLAIMS,
EACH OCCURRENCE $ 1,000.000
DAMAGE TO RENIEOPREMISES lEa occunenc6l $ 1,000.000
MED EXP (Any on6 p6.son)$ 15,000
PERSONAL & AOV INJURY $ 1,000.000
GEN E RAL AGGR EGATE s2,000,000
PRODUCTS - COMP/OPAGG $ 2,000,000
COI\IM E RCIAL GE N ERAL fIAB ILITY
GEN'L AGGREGAIE LIMITAPPL ES PER
X
X
x
LOCJECT
6072390517 711t2022 71112023
$ 1.000,000
BODILY TNJURY lPsr oarson) | $
aoolLY INJURY (Por accidont)$
D
OWNED
AUTOS ONIY
HIREO
AUTOS ONLY
SCHEDULEO
AUIOS
NON,OWNEDX
AUTOM OBIt€ LIAB ILITY 6072390548 71112022 71112023
$
x X EACHOCCURRENCE $ 6,000,000UiiBREIIALIABOCCUR
CLAIMS-MAOE AGGREGAIE
OED X RETENTTON $ .i. ^n^
60723S0551 71112022 711t2023
a
$ 6.000.000
X STATUTE
oTll
ER Stoo Gao Aoolies
E L EACH ACC DENI
E L DISEASE, EA EMPLOYEE
$ 1.000,000
$ 1,000.000
lwoRKERs co PENsarroNIlro emprovrns r-llerrrrY
Iarvppopn,:ton plnLen errrcrt'rt
I oFF rcE R/MEMBER ExcLUDFD,
IDEScRIPIIoN oF oPERATIoNS b6|ow
C
E 6072390534
6072390520
7t1t2022 I7t1t2022 I
711t2023
71112023
E L OISEASE - POLICY LIM T $ 1,000,000
claims Made/R€lro Dat€ 10/13n989 PSL00394a2791 71112022 71112023 $3,000,000
$50,000
OESCRIPTION OF OPEFATIONS / LOCATIONS / VEHICLES IACORO I Ol, Addltrod.l R.m!.l. S.h.dsl., m.y b. .tt ch.d il mor. .prc. lr EquiEd)
Re: All contracts/written agreements between the Certificate Holder and the lnsured. Additional lnsured(s): City of Menifee, its otfic€rs, agents and employeesWhen reqlired by written contract, additional insured status wilh primary coverage applies to General Liability and Automobile Liabrlity and waiver ofsubrogation applies to General Liability, Automobile Liability and Workers' Compensation, all per tho attached endorsemenls.
CERTIFICATE HOLDER CANCELLATION
City of Menifee
29844 Haun Road
[.4enifee, CA 92586
SHOULO ANY OF THE ABOVE OESCRIBED POLICIES SE CANCELLEO BEFORE
THE EXPIRATION OAIE THEREOF. NOTICE WILL BE OELIVEREO IN
ACCORDANCE wlTH fHE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
O 1988-20'15 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03)
CLAIMS MADE
5
$X
G3-ffirrffi
CNA CNA PARAMOUNT
General Liability Extension Endorsement
,I. ADDITIONALINSUREDS
a. WHO lS AN INSURED is amended to include as an lnsured any person or organization described in paragraphs
A. through K. below whom a Named lnsured is required to add as an additional insured on this Coverage Part
under a written contract or written agreement, provided such contract or agreement:
(1) is currently in effect or becomes effective during the term of this Coverage Part; and
(2) was executed prior to:
(a) the bodily injury or property damage; or
(b) the offense that caused the personal and advertising injury,
for which such additional insured seeks coverage.
b. However, subject always to the terms and conditions of this policy, including the limits of insurance, the lnsurer
will not provide such additional insured with:
(1) a higher limit of insurance than required by such contract or agreement; or
(2) coverage broader than required by such contract or agreement, and in no event broader than that described
by the applicable paragraph A. through K, below.
Any coverage granted by this endorsement shall apply only to the extent permissible by law.
A. Controllinglnterest
Any person or organization with a controlling interest in a Named lnsured, but only with respect to such person or
organization's liability for bodily injury, property damage or personal and advertising inrury arising out of:
'1. such person or organization's financial control of a Named lnsured; or
2. premises such person or organization owns, maintains or controls while a Named lnsured leases or
occupies such premises;
provided that the coverage granted by this paragraph does not apply to structural alteralions, new construction or
demolition operations performed by, on behalf of, or for such additional insured.
B. Co-owner of lnsured Premises
A co-owner of a premises co-owned by a Named lnsured and covered under lhis insurance but only with respect
to such co-owner's liability for bodily injury, property damage or personal and advertising injury as co-owner
of such premises.
C. Grantor of Franchise
Any person or organization that has granted a franchise to a Named lnsured, but only with respect to such
person or organization's liability for bodily injury, property damage or personal and advertising injury as
grantor of a franchise to the Named lnsured.
D. Lessor of Equipment
Any person or organization from whom a Named lnsured leases equipment, but only with respect to liability for
bodily injury, property damage or personal and advertising injury caused, in whole or in part, by the Named
lnsured's maintenance, operation or use of such equipment, provided that the occurrence giving rise to such
bodily injury, property damage or the offense giving rise to such personal and advertising injury takes place
prior to the termination of such lease.
CNA74879XX (1-15) poticy No: 50723e0s17
Page 2 of 13
CONTINENTAL INSIJRANCE COMPANT
INSUTEd NAME: COOPERATIVE PERSONNEL SERVICES EffECtiVE DAIE: O7/OI/2022
Copynght CNA All Rights Ros€rv€d. lncludes copyrighted matorial of lnsuranco SoNices ffic€, lnc., with ils permission.
p,tl
H i.i.:
CNA CNA PARAMOUNT
General Liability Extension Endorsement
E. Lessor of Land
Any person or organization from whom a Named lnsuled leases land but only with respect to liability lor bodily
injury, property damage or personal and advertisin! injury arising out of the ownership, maintenance or use
of such land, provided that the occurrence giving rise b such bodily injury or property damage, or the offense
giving rise to such personal and advertising injury, takes place prior to the termination of such lease. The
coverage granted by this paragraph does not apply to structural alterations, new construction or demolition
operations performed by, on behalf of, or for such additirnal insured.
F. Lessor of Premises
An owner or lessor of premises leased to the Named lrEured, or such owner or lessor's real estate manager, but
only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of
the ownership, maintenance or use of such part of the premises leased to the Named Insured, and provided that
the occurrence giving rise to such bodily injury, property damage or the offense giving rise to such personal
and advertising iniury takes place prior to the termination of such lease. The coverage granted by this
paragraph does not apply to struclural alterations, new construction or demolition operations performed by, on
behalf of, or for such additional insured.
G. Mortgagee, Assignee or Receiver
A mortgagee, assignee or receiver of premises but onty with respect to such mortgagee, assignee or receiver's
liability for bodily injury, propefi damage or personal and advertising injury arising out of the Named
lnsured's ownership, maintenance, or use of a premises by a Named lnsured.
The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition
operations performed by, on behalf of, or for such additional insured.
H. State or Governmental Agency or Subdivision or Political Subdivisions - Permits
A state or governmental agency or subdivision or political subdivision that has issued a permit or authorization,
but only with respect to such state or governmental agency or subdivision or political subdivision's liability for
bodily injury, property damage or personal and advertising injury arising out of:
1. the following hazards in connection with premises a Named lnsured owns, rents, or controls and to which
this insurance applies:
a. the existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings,
canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk
vaults, street banners, or decorations and similar exposures; or
b. the construction, erection, or removal of elevators; or
c. the ownership, maintenance or use of any elevators covered by this insurancei or
2. the permitted or authorized operations performed by a Named lnsured or on a Named lnsured's behalf.
The coverage granted by this paragraph does not apply to:
a. Bodily iniury, property damage or personal and advertising injury arising out of operations performed
for the state or governmental agency or subdivision or political subdivision, or
b. Bodily injury or property damage included within the products-completed operations hazard.
With respect to this provision's requirement that additional insured status must be requested under a written
contract or agreement, the lnsurer will treat as a written contract any governmental permit that requires the
Named lnsured to add the governmental entity as an additional insured.
CNA74879XX (1-15) poticy No: 60723e0s17
Page 3 of 13
CONTINENTAL INSURANCE COMPANY
lnsured Name: coopERATrvE pERsoNNEL sERvrcEs Effective Date: o7 /oL/2022
Copynght CNA All Righls Reserved. lnctudes copyrighted malodal ot lnsuranc6 Services Office, lnc., with its permisgon
tr#
CNA CNAS3TOOXX
(Ed. 10-1s)
a. ls effective on the date of acquisition or formation of the organization, and applies until:
(1) The end of the policy period of this Coverage Form; or
(2) The next anniversary of this Coverage Form's inception date,
whichever is earlier; and
b. Does not apply to "bodily injury" or "property damage" caused by an "accident" that occurred before
you acquired or formed the organization.
3. Additional lnsureds Required By Wriften Contract
Any person or organization that you are required by written contract to make an additional insured under
this insurance is an "insured", but only with respecl to that person or organization's legal liability for acts
or omissions of a person who qualifies as an "insured" for Liability Coverage under Section ll - Who ls
An lnsured of this Coverage Form.
4. Employee-Hired Autos
Any "employee" of yours is an "insured" while operating with your permission an "auto" hired or rented
under a contract in that "employee's" name, while performing duties related to the conduct of your
business.
With respect to provisions A.1. and A.2. above, "policy" includes those policies that were in force on the
inception date of this Coveraqe Form, but:
i. Which are no longer in force; or
ii. Whose limits have been exhausted.
B. lncreased Loss of Earnings Allowance
Under SECTION ll - COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Coverage
Extensions is amended under Supplementary Payment subparagraph (4) to delete the $250 a day limit for
loss of earnings and replace it with a $500 a day limit.
C. Fellow Employee Coverage
Under SECTION ll - COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Exclusions is
amended to delete the exclusion entitled Fellow Employee.
AMENDMENTS TO PHYSICAL DAMAGE COVERAGE
A. lncreased Loss of Use Expense
Under SECTION lll - PHYSICAL DAMAGE COVERAGE, the paragraph entitled Coverage Extensions is
amended under Loss of Use Expenses to delete the maximum of $600, and replace it with a maximum of
$800.
B. Broadened Electronic Equipment Coverage
Under SECTION lll - PHYSICAL DAMAGE COVERAGE, the paragraph entitled Exclusions is amended to
delete paragraphs 5.a through 5.d. in their entirety, and replace them with the following:
5. Exclusions 4.c. and 4.d. above do not apply to "loss" to any electronic equipment that at the time of
"loss" is:
a. Permanently installed in or upon a covered "auto", nor to such equipment's antennas or other
accessories used with such equipment. A $100 deductible applies to this provision, and supersedes
any otherwise applicable deductible; or
b. Designed to be operated solely by use of the power from the "auto's" electrical system and is:
(1) Removable from a housing unit which is permanently installed in or upon the covered "auto";
(2) An integral part of the same unit housing any electronic equipment described in paragraphs a. or
b.(1) above; or
(3) Necessary for the normal operation of the covered "auto" or the monitoring of the covered
"auto's" operating system.
ffi
[.
CNAB3700XX (Ed. 10- 15)Page 2 of 3
Copyright, CNA All Rights Reserved.
CNA CNAS3TOOXX
(Ed. 10-15)
III. AMENDMENTS TO BUSINESS AUTO CONDITIONS
A. Knowledge of Accident or Loss
Under BUSINESS AUTO CONOITIONS, the Loss Condition entitled Duties ln the Event of Accident,
Claims, Suit, or Loss is amended to add the following subparagraph a.(4):
(4) lf your "employees" know of an "accident" or "loss", this will not mean that you have such knowledge until
such "accident" or "loss" is known to a natural person Named lnsured, to a partner, executive officer,
manager or member of a Named lnsured, or to an "employee" designated by any of the above to be your
insurance manager.
B. Knowledge of Documents
Under BUSINESS AUTO CONOITIONS, the Loss Condition entitled Duties ln the Event of Accident,
Claims, Suit, or Loss is amended to add the following subparagraph b.(6):
(6) lf your "employees" know of documents concerning a claim or "suit", this will not mean that you have
such knowledge until such documents are known to a natural person Named lnsured, to a partner,
executive officer, manager or member of a Named lnsured, or to an "employee" designated by any of the
above to be your insurance manager.
C. Waiver of Subrogation
Under BUSINESS AUTO CONDITIONS, the Loss Condition entitled Transfer Of Rights Of Recovery
Against Others To Us is amended to add the following:
We waive any right of recovery we may have, because of payments we make for injury or damage, against
any person or organization for whom or which you are required by written contract or agreement to obtain
this waiver from us
This injury or damage must arise out of your activities under a contract with that person or organization.
You must agree to that requirement prior to an "accident" or "loss."
D. Unintentional Failure To Disclose Hazards
Under BUSINESS AUTO CONDITIONS, the General Condition entitled Concealment, M isrepresentation
or Fraud is amended to add the following:
Your failure to disclose all hazards existing on the inception date of this Coverage Form shall not prejudice
you with respect to the coverage provided by this insurance, provided such failure or omission is not
intentional.
E. Primary and Non-Contributory When Required By Contract
Under BUSINESS AUTO CONDITIONS, the General Condition entitled Other lnsurance is amended to
add the following:
Notwithstanding provisions 5.a. through 5.d. above, the coverage provided by this Coverage Form shall be
on a primary and non-contributory basis when required to be so by a written contract entered into prior to
"accident" or "loss."
IV. AMENDMENTS TO DEFINITIONS
A. Broadened Bodily lnjury
Under DEFINITIONS, the definition of "bodily injury" is deleted and replaced by the foflowing:
"Bodily injury" means physical injury, sickness or disease sustained by a person, including death, mental
anguish or mental injury sustained by that person which results as a consequence of the physical injury,
sickness or disease.
All other terms and conditions of the Policy remain unchanged
[$
CNA83700XX (Ed. 10-1 5)
Copynghl, CNA All Rrghts Reserved
Page 3 of 3
CNA Workers Compensation And Employers Liability lnsurance
I
This endorsement changes the policy to which it is attached.
It is agreed that Part One - Workers' compgnsation lnsurance G. Recovery From Others and Part Two -
Employers' Liability lnsurance H. Recovery From Others are amended by adding the following:
We will not enforce our right to recover against persons or organizations. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
PREMIUM CHARGE - Refer to the Schedule of Operations
The charge will be an amount to which you and we agree that is a percentage of the total standard premium for
California exposure. The amount is 27o.
All other terms and conditions of the policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the policy issued by the designated lnsurers,
takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another
effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy
unless another expiration date is shown below.
r*
BLAITIKET WAIVER OF OUB BIGHT TO RECOVER FROM OTHERS
Form No: G-19160-8 l1 'l -1997)
Endorsement Effective Date: Endorsement Expiration Date:
Endorsement No:2j Page: 1 o, 1
Underwriting Company: American Casualty Company of Readang, Pennsylvania
i Copyright CNA All Rights Reserved
Policy No: WC 6072390520
Policy Effective Date:
o7 to1/2022
CNA Workers Compensation And Employers Liability lnsurance
WAIVEB OF OUB RIGHT TO RECOVEB FROM OTHERS ENOORSEMENT
We have the right to recover our payments from anyone liable tor an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule.
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Any person or organization for which the employer has agreed by written contract, executed prior to loss, may
execute a waiver of subrogation. However, ,or purposes of work performed by the employer in Missouri, this
waiver of subrogation does not apply to any construction group of classifications as designated by the waiver
of right to recover from others (subrogation) rule in our manual.
Schedule
Any Person or Organization on whose behalf you are required to obtain this waiver of our right to recover
from under a written contract or agreement.
The premium charge for the endorsement is retlected in the Schedule oI Operations.
All other terms and conditions of the policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the policy issued by the designated lnsurers,
takes elfect on the Polacy Effective Date of said policy at the hour stated in said policy, unless another
effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy
unless another expiration date is shown below.
HT
Form No: WC O0 03 13 (04-1984)
Endorsement Effective Date: Endorsemont Expiration Dat€
Endorsement No:4; Paqe: 1 of 1
Underwriting Company: Continental Casualty Company
Copyrlght 1983 National Council on Compensation lnsurance
Policy No: WC 607239O534
Policy Effective Date:
o7to1t2072
CNA CNA PARAMOUNT
General Liability Extension Endorsement
l. Trade Shou, Event Lessor
'1. With respect to a Named lnsured's participation in a kade show event as an exhibitor, presenter or
displayer, any person or organization whom the Named lnsured is required to include as an additional
insured, but only with respect to such person or organization's liability for bodily injury, property damage or
personal and advertising injury caused by:
a. the Named lnsured's acts or omissions; or
b. the acts or omissions of those acting on the Named lnsured's behalf,
in the performance of the Named lnsured's ongoing operations at the trade show event premises during the
trade show event.
2. The coverage granted by this paragraph does not apply to bodily inlury or property damage included
within the products-completed operations hazard.
J. Vendor
Any person or organization but only with respect to such person or organization's liability for bodily injury or
property damage arising out of your products which are distributed or sold in the regular course of such person
or organization's business, provided that:
l. The coverage granted by this paragraph does not apply to:
a. bodily injury or property damage for which such person or organization is obligated to pay damages by
reason of the assumption of liability in a contract or agreement unless such liability exists in the absence
of the contract or agreement;
b. any express warranty unauthorized by the Named lnsured;
c. any physical or chemical change in any product made intentionally by such person or organization;
d. repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the
substitution of parts under instructions from the manufacturer, and then repackaged in the original
container;
e. any failure to make any inspections, adjustments, tests or servicing that such person or organization has
agreed to make or normally undertakes to make in the usual course of business, in connection with the
distribution or sale of the products;
f. demonstration, installation, servicing or repair operations, except such operations performed at the such
person or organization's premises in connection with the sale of a product;
g. products which, after distribution or sale by the Named lnsured, have been labeled or relabeled or used
as a container, part or ingredient of any other thing or substance by or for such person or organization: or
h. bodily injury or property damage arising out of the sole negligence of such person or organization for
its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this
exclusion does not apply to:
(1) the exceptions contained in Subparagraphs d. or f. above; or
(2) such inspections, adjustments, tests or servicing as such person or organization has agreed with the
Named lnsured to make or normally undertakes to make in the usual course of business, in
connection with the distribution or sale of the products.
2. This Paragraph J. does not apply to any insured person or organization, from whom the Named lnsured has
acquired such products, nor to any ingredient, part or container, entering into, accompanying or containing
such products.
CNA74879XX (1-15) poticy No: 60723e0s17
Page 4 of 13
CONTINE}.ITAL INSI'RANCE COMPANY
lnsured Name: coopERATrvE PERSoNNEL SERVTCES Effective Date: 07 /01-/2022
Copyrighl CNA All Rights Reserved. lncludes copyrighled material of lflsurance Sewic€s Offce. lnc., with its pormission-
tr;nt
llEn
B
CNA CNA PARAMOUNT
General Liability Extension Endorsement
3. This Paragraph J. also does not apply:
a. to any vendor specillcally scheduled as an additional insured by endorsement to this Coverage Part;
b. to any of your products for which coverage is excluded by endorsement to this Coverage Part; nor
c. if bodily injury or property damage included within the products-completed operations hazard is
excluded by endorsement to this Coverage Part.
K. Other Person Or Organization
Any person or organization who is not an additional insured under Paragraphs A. through J. above. Such
additional insured is an lnsured solely for bodily injury, property damage or personal and advertising injury
for which such additional insured is liable because of the Named lnsured's acts or omissions.
The coverage granted by this paragraph does not apply to any person or organization:
1. for bodily injury, property damage, or personal and advertising injury arising out of the rendering or
failure to render any professional service;
2. for bodily injury or property damage included within the products-completed operations hazard; nor
3. who is specifically scheduled as an additional insured on another endorsement to this Coverage Part.
2. ADDITIONAL INSURED - PRIMARY ANO NON.CONTRIBUTORY TO ADDITIONAL INSURED'S INSURANCE
A. The Other lnsurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended
to add the following paragraph:
lf the Named lnsured has agreed in writing in a contract or agreement that this insurance is primary and non-
contributory relative to an additional insured's own insurance, then this insurance is primary, and the lnsurer will
not seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own
insurance means insurance on which the additional insured is a named insured.
B. With respect to persons or organizations that qualify as additional insureds pursuant to paragraph 1.K. of this
endorsement, the following sentence is added to the paragraph above:
Othen ise, and notwithstanding anything to the contrary elsewhere in this Condition, the insurance provided to
such person or organization is excess of any other insurance available to such person or organization.
3. BODILY INJURY - EXPANDED DEFINITION
Under DEFINITIONS the definition of bodily in,ury is deleted and replaced by the following:
Bodily inrury means physical injury, sickness or disease sustained by a person, including death, humiliation, shock,
mental anguish or mental injury sustained by that person at any time which results as a consequence of the physical
injury, sickness or disease.
4. BROAD KNOWLEDGE OF OCCURRENCE/ NOTICE OF OCCURRENCE
Under CONDITIONS, the condition entitled Duties in The Event of Occurrence, Offense, Claim or Suit is amended
to add the following:
A. BROAD KNOWLEDGE OF OCCURRENCE
The Named lnsured must give the lnsurer or the lnsurer's authorized representative notice of an occurrence,
oftense or claim only when the occurrence, offense or claim is known to a natural person Named lnsured, to a
partner, executive offlcer, manager or member of a Named lnsured, or to an employee designated by any of the
above to give such notice.
B. NOTICE OF OCCURRENCE
CNA74879XX (1-15) poticy No: 6o723sost7
Page 5 of '13
CONTINENTAL INSURi\NCE COMPANY
INSUTEd NAME: COOPERATIVE PERSONNEI, SERVICES EffECtiVE DAIE: 0.1 /07/2022
Copyright CNA All Rights Reserved. lncludes copyrighled mat€rial of lnsurance Services Office, lnc., wilh its permission.
gt{r
Ei.:l
CNA CNA PARAMOUNT
General Liability Extension Endorsement
not be deemed to be damages for personal and advertising injury and will not reduce the limits of
insurance.
D. This PERSONAL AND ADVERTISING INJURY - LIMITED CONTRACTUAL LIABILITY Provision does not
apply if Coverage B -Personal and Advertising lnjury Liability is excluded by another endorsement attached
to this Coverage Part.
17. PROPERTY DAMAGE - ELEVATORS
A. Under COVERAGES, Coverage A - Bodily lnjury and Property Damage Liability, the paragraph entitled
Exclusions is amended such that the Damage to Your Product Exclusion and subparagraphs (3), (4) and (6) of
the Damage to Property Exclusion do not apply to property damage that results from the use of elevators.
B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE - ELEVATORS Provision, the
Other lnsurance conditions is amended to add the following paragraph:
This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other
basis that is Property insurance covering property of others damaged from the use of elevators.
18. SUPPLEMENTARY PAYMENTS
The section entitled SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended as follows:
A. Paragraph 1.b. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a $5,000.
limit; and
B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a
$1,000. limit.
19. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
lf the Named lnsured unintentionally fails to disclose all existing hazards at the inception date of the Named
lnsured's Coverage Part, the lnsurer will not deny coverage under this Coverage Part because of such failure.
20. WAIVER OF SUBROGATION . BLANKET
Under CONDITIONS, the Transfer Of Rights Of Recovery Against Others To Us Condition is amended to add the
following:
The lnsurer waives any right of recovery the lnsurer may have against any person or organization because of
payments the lnsurer makes for injury or damage arising out of:
'1. the Named lnsured's ongoing operations; or
2. your work included in the products.completed operations hazard.
However, this waiver applies only when the Named lnsured has agreed in writing to waive such rights of recovery in
a written contract or written agreement, and only if such contracl or agreement:
l. is in effect or becomes effective during the term of this Coverage Part; and
2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise to the
claim.
All other terms and conditions of the Policy remain unchanged
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated lnsurers, takes
effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below,
and ex res concurrently with said Policy
CNA74879XX (1-15) poticy No: 60223e0517
Page 13 of '13
CONTINENTA], INSIJRANCE COMPANY
rnsured Name: coopERATrvE pERsoNNEL sERVrcEs Effective Date: 07 /01/2022
Copyrighl CNAAllRights Reserved. lncludes copyrighted materialot lnsurance SeNices Oflice, lnc , with ils permission.
Fn*Etf
Policy #6072390548
CNA
AMENDMENTS TO LIABILITY COVERAGE
A. Amendments to Who ls An lnsured
CNAS3TOOXX
(Ed. 10-15)
EXTENDED COVERAGE - BA PLUS _ FOR HIRED AND NON-OWNED AUTOS
It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows. lf
any other endorsement attached to this policy amends any provision also amended by this endorsement, then that
other endorsement controls with respect to such provision, and the changes made by this endorsement to such
provision do not apply.
TABLE OF CONTENTS
ffi
Under SECTION ll - COVEREO AUTOS LIABILITY COVERAGE, the paragraph entitled Who ts An
lnsured is amended to add the following:
1. Majority Owned Corporations
Any incorporated entity in which you own a majority of the voting stock on the inception date of this
Coverage Form is an "insured", but only if such entity is not an "insured" under any other liability "policy"
that provides "auto" coverage.
2. Newly Acquired Organizations
Any organization you newly acquire or form during the policy period, other than a limited liability
company, partnership or joint venture, and in which you maintain majority ownership interest is an
"insured", but only if such organization is not an "insured" under any other Iiability "policy" that provides
"auto" coverage. The insurance attorded by this provision:
CNA83700XX (Ed. 10-15)
Copyight. CNA All Rights Reserved
Page 1 of 3
I. AMENDMENTS TO LIABILITY COVERAGE
A. Who ls An lnsured
1. Majority Owned Corporations
2. Newly Acquired Organizations
3. Additional lnsureds Required By Written Contracts
4. Employee-HiredAutos
B. lncreased Loss of Earnings Allowance
C. Fellow Employee Coverage
II. AMENDMENTS TO PHYSICAL DAMAGE COVERAGE
A. lncreased Loss of Use Expense
B. Broadened Electronic Equipment Coverage
III. AMENDMENTS TO BUSINESS AUTO CONOITIONS
A. Knowledge of Accident or Loss
B. Knowledge of Documents
C. Waiver of Subrogation
D. Unintentional Failure To Disclose Hazards
E. Primary and Non-Contributory When Required By Contract
IV. AMENOMENTS TO DEFINITIONS
A. Broadened Bodily lnjury
CNA Workers Compensation And Employers Liability lnsurance
TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENTT
This endorsement applies only to the insurance provided by the policy because Texas is shown in ltem 3.A. of
the lnformation Page.
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule. but this waiver applies only with
respect to bodily injury arising out of the operations described in the Schedule where you are required by a
written contract to obtain this waiver Irom us.
This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
The premium Ior this endorsement is shown in the Schedule.
Schedule
Specific Waiver
Name of person or organization
Blanket Waiver
Any person or organization for whom the Named lnsured has agreed by written contract to furnish this
waiver.
2. Operations: All Texas Operations
3. Premium:
The premium charge for this endorsement shall be 2% percent of the premium developed on payroll in
connection with work per{ormed for the above person(s) or organization(s) arising out of the operations
described.
4. Advance Premium: Befer to Schedule of Operations
All other terms and conditions of the policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the policy issued by the designated lnsurers,
takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another
elfective date (the Endorsement Effective Date) is shown below, and expires concurently with said policy
unless another expiration date is shown below.
ffi
Policy No: WC 607239O534
Policy Effecrive Oatet 07lO1/2022
X
o Copyright 2O14 National CoLrncil on Compensaiion lnsurance, lnc. All Rights Reserved
Form No: wC 42 03 04 B (06-2014)
Endorsement Effective Date: Endorsement Expiration Datel
Endorsement Nor 89; Page: 1 of 1
, Underwriting Company: Continental Casualty Company