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2022/06/02 RRL Enterprises, Inc. DBA Midstate Automotive Equipment6t2t2022 ACORD' pRooucER License # 0E02096 DiBuduo & DeFendis lnsurance Brokers, LLC 5z[1 Bullard AvenueClovis, CA 93612 CERTIFICATE OF LIABILITY INSURANCE &?Xllcr Mary Doig fI3,'*'.. eo, (sss) rzr-6zaz EmEss. mary.doi9@dibu.com RRLENTE.Ol THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDEO BYTHEPOLICIES 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 certiflcate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions ot b€ endorsed- lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A stalement on this ce(ificale does not conler hts to the certificate holder in lieu of such endorseme [#, xo,(s5s) 323r871 CERTIFICATE NUMBER NSD WVq X X 8PK000618702 rNsu R ERlS) l!FF9RDTNG Co\€R^6E rNsuRER a - General Casualty Company of Wisconqin rNsuiEqB , Everest Premier lnsurance company RE ION NUMBER 24414 16045 RRL Enterprises, lnc. DBA Midstale Automotive Equipment 1865 Herndon Avenue Suite 131 Clovis, CA 93611 THIS IS TO CERTIFY THAT TI.]E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE FOR THE POLICY PERIOD INDICATEO. NOTWITHSTANOING ANY REOUIREMENT, TERM OR CONOIlION OF ANY CONTRACT OR OTHER DOCUMEN-T WITH RESPECT TO WHICH THIS CERTIFICATE MAY AE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, COVERAGES AX 7t25t2021 712512022 COgMERCIAf GEN€RAf LIAAIf ITY cLAtMs-l,rAoE X occuR 1,000,000 GEN'L AGGREGATE LIMIT APPI.IES PER: PoLrcY iE&x IEACH@qU88E!EL TI OAMAGE TO RENTEO IEBEUIIES IEq occ!|rdEEL l! UEO EXP (A.yoe DernJ t [ "ru*"^ro-r^rru..rGENERAT AGGBEGATE PRoouErsjgquqqef.q[ 100,000 5,000 1,000,000 2,000,000 2,oaa,aoo A tutorog[e tuetuw OWNEO SCHEDULED X 8CA00035S102 7600021549221 7 t25t2021 6t2J2022 6t2t2023 CANCELLATION COMSINEO SINGL€ LIMIT rEa acadlnll- -l I 7f25l2022 BoorLy tNJrJRy (pa p€MnJ t BoOILY INJURY (Pd aedenll t PROPERW DAMAGE(Par6ccld.nl) i x oEo CERTIFICATE ER 1,000,000 x HIRED Y NON-OWNED" ar,Tos oNL/ B woir(EFs cor.PErls^rrorr AN Y PROPRIETORTPARTNER/E )i EC UTIVEOIFICERT EMAERE\CLUDED?(U!nd.roryltrNHl I e{cl occunlBrql x PER OTH-SIAIUTE ER -E L EACH ACCIDENT E L.orsEASE - EA EUllqYqE t 1,000,000 1,000,000 1,000,000 OESCRIPIION OF OPERAnONS / LOCATIOIIS /VEtllcLES {ACOR D 101, AddarioEl R.m.rt. Schcd.t., hry & aiactcd it hoc .p.e l. EquiEd) Contracl # City of MoniIee and its ofticers, employees, agents and aulhorized volunteers are added as additional insurcd as per AH CG8623 0917 and CG2001 0413 and AH CA 8590 09'17 ahd AH C8617 0917 forms attached STiOULD ANY OF IHE ABOVE DESCRIBEO POLICIES BE CANCELLED BEFORE THE EXPIRAIION OATE THEREOF. NOTICE WLL BE DELIVERED IN ACCORDANCE WTH THE POLICY PROVISIONS. AUTHORlZED REPRESENIATIVE ACORD 2s (2016/03)@ 1988-2015 ACORO CORPORATION. All rights reserved The ACORD name and logo are registered marks o, ACORD City of Menifee 29844 Haun Rd Menifee CA 92586-6539 COMMERCIAL AUTO AH CA 85 90 09 '17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GHANGES IN COMMERCIAL AUTO COVERAGE FORM This endorsement modifies insurance pro\,ided under the following BUSINESS AUTO COVERAGE FORM A. BROAOENED WHO IS AN INSURED Paragraph A.l. who ls an lnsured of SECTION ll - LIABILITY COVERAGE is amended to include the following: d. Any "employee" of yours is an "insured" while using a co\ered "auto" you don't owrr, hire or borrow in your business or your personal affairs. e. Any "employee" of yours is an "insured" while using an "auto" hired or renled under a contract or agreement in that "employ- ee's" name, with your permission, while performing duties related to the conduct of your business. f. Each person or Organization to whom you are required by a written conlract or agreement to pro\,ide additional insured slatus is an "insured" under Liability Co\l erage, but only to the extent that person or organization qualifies as an "insured" un- der the who is an lnsured Pror,ision con- tained in Section ll of the co\€rage form. The written contract or agreement must be in effect during the policy period shown in the Declarations and must ha\€ been exe- cuted prior to the "bodily injury" or'proper ty damage." B. LIABILITY COVERAGE EXTENSIONS SUPPLE- MENTARY PAYMENTS Paragraphs A.z-a. (21 and A.2.a. (4) Coverage Extensions - Supplementary Payments of SECTION ll - LlABlLlry COVERAGE are deleted and replaced with the following: (2) Up to $5,000 for the cosi of bail bonds (including bonds for related traffc law violations) required because of an "ac- cident" we co\,er. We do not ha\e to fumish these bonds. (4) All reasonable expenses incuned by the "insured' at our request, including actual loss of eamings up to $500 a day because of time offftom work. C. FELLOW EMPLOYEE COVERAGE Paragraph 8.5. Fellow Enployee Exclusion con- tained in SECTION ll - LIABILITY COVERAGE does not apply if the "bodily injury' results fiom the use of a co\,ered "auto" you own or hire that is not a bus, motorcycle or \an used to transport em- ployees. This Fellow Employee Co\,erage is excess o\er any other collectible insurance. D. POLLUTION LIABILITY - BROADENED COV- ERAGE FOR COVEREO AUTOS 1. Liability Coverage is changed as follows: a. Paragraph B.l1.a. of the Pollution Exclu- sion in SECTION ll - LIABILITY COV- ERAGE applies only to liability assumed under a contract or agreement. b. With respect to the co\Erage afforded by Paragraph 1.a. Abo\e, Exclusion 8.6. Care, Cuslody or Control of SECTION ll LIABILITY does not apply. Changes in Def nitions For the purposes of this endorsement, Para- graph D- of SECTION V - DEFINITIONS is replaced by the following: D. "Co\ered pollution cost or expense" means any cost or expense arising out of l. Any request, demand, order or statuto- ry or regulatory requirement that any "insured" or others test for, monitor, clean up, remo\e, contain, treat, de- toxifr/ or neuiralize, or in any way re- spond to, or assess the efiects of "pol- lutants"; or 2 lncludes copyrighted material o, lnsurance Senices Offce, lnc., with its permission.AH CA 85 90 09 17 Page 'l of 6 2. Unless you notary us to add co\,erage lo your policy, the co\€rage under this pro\,ision is aI- forded only until: a. The '120th day afrer you acquire or form the organization, or b. The end of the policy period, whiche\,er is earlier. F. EXTENDED TOWING Paragraph A.2. Towing of SECTION lll - PHYS- ICAL DAMAGE COVERAGE is deleted and re- placed with the following: We will pay for towing and labor costs each time a cor,ered "auto" is disabled. All labor must be per- formed at the place of disablement. lf the "auto" is of the pri\ate passenger type, there will be no de- ductible. I the 'auto" is other than a pri\Ete pas- senger type, a $100 deductible will apply. The most we will pay under this EXTENDED TOW- ING co\erage is $750 per occunence. G. PHYSICAL DAMAGE COVERAGE EXTENSIONS Paragraph A.4. - Coverage Extensions of SEC- TION lll - PHYSICAL DAMAGE COVERAGE is amended as follows: a. Transportation Expenses The amount we will pay for temporary transportation expense is increased to $50 per day to a maximum of $3,000. b. Loss of lJse Expenses The amount we will pay br loss of use is increased to $75 per day and to a maxi- mum limit of $'1,000. H. RENTAL REIMBURSEMENT '1. This co\€rage applies only to a co\,ered "auto" described or designated in the Schedule or in the Declarations as carrying physical damage co\,erage. 2. We will pay for rental reimbursement expenses incuned by you for the rental of an "auto" be- cause of "loss" to a co\ered 'auto'. Payment applies in addition to the otheMise applicable amount of co\,erage you ha\,e on each co\Ered "auto". 3. We will pay only for those expenses incuned during the policy period beginning 24 hours af- ter the "loss' and ending, regardless of the pol- icy's expiration, with the lesser of the following number of days: lncludes copyrighted material of lnsurance Senices Offce, lnc., with its permission.Page 2 of 6 2. Any claim or "suit' by or on behalf of a go\emmental authority for damages be- cause of testing for, monitoring, cleaning up, remo\,ing, containing, treating, detoxif,/- ing or neutralizing, or in any way respond- ing to or assessing the effects of "pollu- tants'. ''Co\€red pollution cost or expense" does not include any cost or expense arising out of the actual, alleged or threalened discharge, dis- persal, seepage, migration, release or escape of "pollutants': a. Before the ''pollutants" or any property in which the "pollutants" are contained are mored from the place where they are accepted by the "insured" for mo\,ement into or onto the co\€red "auto'; or b. Afrer the "pollutants" or any property in which the "pollutants" are contained are mored fom the co\ered "auto" to the place where they are finally deli\F ered, disposed of or abandoned by the "insured'. Paragraphs a, and b. abo\e do nol apply to "accidents" that occur away ftom prem- ises owned by or rented to an "insured" with respecl to 'pollutants' not in or upon a co\ered "auto" if (l) The "pollutants" or any property in which the "pollutants" are con- tained are upset, o\ertumed or damaged as a result of the maintenance or use of a co\ered "auto"; and (2) The discharge, dispersal, seep- age, migration, release or escape of the "pollutants" is caused di- rectly by such upset, o\€rtum or damage. This Pollution Liabilily Co\erage is subject to an Annual Aggregate Limit of Liability of $100,000. E NEWLY ACQUIRED OR FORMED ORGANIZATIONS Throughout this policy, the words you and your al- so refer to any organization you newly acquire or f)rm, other than a partnership, joint \€nture or lim- ited liabjlity company, and over which you maintain owneBhip or majority interest, but only if there is no similar insurance a\ailable to that organization. Hower,er: l. The corcrage does not apply to an "accident" which occuned before you acquired or formed the organizalion. AH CA 85 90 09 17 a, The number of days reasonably required to repair or replace the co\€red "auto". lf "loss" is caused by thefr, this number of days is added to the number of days it takes to locate the co\€red "auto" and re- tum it to you; or b. 30 days. 4. Our payment is limited to the lesser of the fol- lowing amounts: a. Necessary and aclual expenses incured; or b. $50 per day 5. This co\,e.age does not apply while there are spare or resenie "autos" a\Bilable to you for your operations. 6. lf "loss" results ftom the total lheft of a co\.ered "auto" of the pri\6te passenger type, we will pay under this co\Erage only that amounl of your rental reimbuBement expenses which is not already provided for under the paragraph A.4. Coverage Extensions in SECTION lll -PHYSICAL DAMAGE COVERAGE No Deductible applies to this co\erage. I. AIRBAG COVERAGE Exclusion 8.3- in SEcTloN lll - PHYSICAL DAMAGE COVERAGE is amended to add: This exclusion does not apply to the accidental discharge of an airbag. J. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT '1. Coverage a. We will pay with respect to a co\ered 'au- to" described in the Schedule for "loss" to any electronic equipment that recei\es or transmits audio, \,isual or data signals and that is not designed solely for the repro- duction of sound. This co\Erage applies only if the equipmenl is permanently in- stalled in the co\€red "auto" at the time of the "loss" or the equipment is remo\able from a housing unit which is permanently installed in the co\ered .auto" at lhe time of the "loss", and such equipment is de- signed to be solely operated by use of the power fom the "auto's" electrical system, in or upon the co\€red "auto". b. We will pay with respect to a co\ered "au- to" described in the Schedule for "loss" to any accessories used with the electronic equipment described in Paragraph l.a. abo\E. Howe\er, this does not include tapes. records or discs. 2. Exclusions The exclusions that apply to SECTION lll -PHYSICAL DAMAGE, excepl for the exclusion relating to Audio, Visual and Data Electronic Equipment, also apply to co\erage proUded by this endorsement. In addition, the followinq ex- clusions apply: We will not pay, under this endorsement, for either any electronic equipment or accessories used with such electronic equipmenl that is: a. Necessary for the normal operation ofthe co\rered "auto' or the monitoring of the co\ered "auto's" operating system; or b. Both: (l). An integral part of the same unit hous- ing any sound reproducing equipment designed solely for the reproduction of sound if the sound reproducing equip- ment is permanently installed in the co\ered "aulo"; and (2). Permanently installed in the opening of the dash or console normally used by the manufacturer for the installation of a radio. 3. Limit Of lnsura nce With respect to co\erage under this endorse- ment, the Limit Of lnerrance pro\,ision of SECTION III _ PHYSICAL DAMAGE COV. ERAGE is replaced by the tollowing: a. The most we will payforall "loss" to audio, \,isual or data electronic equipment and any accessories used with this equipment as a resull of any one "accident" is the lesser of: (1). The actual cash \Elue of the damaged or stolen property as of the time of the "loss"; (2). The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality; or (3). $1,500. b. An adjustment for depreciation and physi- cal condition will be made in determining actual cash \alue at the time of the "loss". c, lf a repair or replacement results in better than like kind or quality, we will not pay for the amount of betterment. 4- Deductible No deductible applies to this co\erage. The insurance pro\,ided by this exlension is excess o\er any other collectible insurance. lncludes copyrighted material of lnsurance Se^,ices Offce, lnc., with its permission.AH CA 85 90 09 '17 Page 3 of 6 I( TAPES, RECORDS AND DISCS COVERAGE Exclusion B.4.a. of SECTION lll - PHYSICAL DAMAGE COVERAGE is deleted and replaced by the bllowing: a. Tapes, records, discs or other similar au- dio, lisual or data electronic de\,ices de- sagned for use with audio, \,isual or data electronic equipment except when the tapes, records, discs or other similar au- dio, \,isual or dala electronic de\,ices: (1) Are your propedy or that of a family member, and (2) Are in a corered "aulo'at the time of "loss". (a). The most we will pay for "loss" is $200, No Physical Oamage Co\r erage deductible applies to this co\€rage. This extension pro\,ides co\erage only to a co\ered "auto'. L. PHYSICAL DAII'AGE DEDUGTBLE - SINGLE DEDUCTIBLE AND GLASS REPAIR Paragraph D. Deductible in SECTION lll -PHYSICAL DAMAGE COVERAGE is deleted and replaced by the following: D. Deductible For each co\€red 'auto," our obligation to pay for, repair, relum or replace damaged or stolen property will be reduced by the applicable de- ductible shown in the Declarations. Any Com- prehensi\,e Co\erage deductjble shown in the Declarations does not apply to "loss' caused by fire or lightning. When two or more co\ered "aulos" sustain "loss" in the same occurrence, the total of all the "loss" for all the in\oh,ed co\ered'autos" will be reduced by a single deductible, which will be the largest of all the deductibles apply- ing to all such co\ered "autos." No deductible applies to glass damage if the glass is repaired rather than replaced. M. PERSONAL EFFECTS COVERAGE 1. lf you purchase Comp.ehensi\e Co\,erage on this policy for a stolen owned "auto", we will pay up to $600 for "personal efects" stolen with the "aulo". 2. "Personal efiects" as used in this extension means tangible property that is wom or canied by the 'insured". 'Personal effects' does not include tools, jewelry, money, securities, radar or laser detectors, or tapes, records, discs or similar audio, \,isual or data electronic equip- ment. No Deductible applies to this extension. The insurance pro\,ided by this extension is excess o\er any other collectible iosurance. N. LOAN/LEASE PAYOFF COVERAGE The SECTION lll - PHYSICAL DAMAGE COV- ERAGE is amended by the addition of the follow- ing: ln lhe e\ent of a total "loss" to a co\cred "aulo" shown in the Declaralions, we will pay any unpaid amount due on the lease or loan for a co\ered 'au- to", less: 1. The amount paid under the Physical Damage Co\€rage Section of the policy; and 2. Any: a. O\erdue lease/loan payments at the lime of the "loss"; b. Financial penalties imposed under a lease for excessi\€ use, abnormal wear and tear or high mileage. c. Security deposits not retumed by the les- soI d. Costs for extended warranties, Credit Life lnsurance, Heallh, Accident or Disability lnsurance purchased with the loan or lease; and e. Carry-o\€r balances ftom pre\,ious loans or leases. O. CUSTOM SIGNS AND DECORATIONS ln the e\ent of a total loss to a \ehicle insured tor auto physical damage colerage on this policy, in addition to the ACV of the \ehicle, we will pay the actual cost to repair or replace signage or custom paint details up to $5,000. P. HIRED AUTO PHYSICAL DAMAGE lf hired "autos' are co\ered 'autos" for Liabilily Co\erage and if Physical Damage Co\erage of Comprehensi\e, Specifed Causes of Loss, or Col- lision are pror,ided under this Co\erage Form for any "auto" you own, then the Physical Damage Co\erage's pro\,ided are extended to "autos' you hire of like kind and use subject to the following limit: The most we will pay for any one loss is the lesser of the following: 1. $50,000 per accident, lncludes copyrighted material of lnsurance Senices Offce, lnc., with its permission.Page 4 of 6 AH CA 85 90 09 17 2. Actual Cash Value, or 3. The cost of repair. The deductible will be equal to the largest deducti- ble applicable to any owned "auto" for that co\,er- age. No deductible applies to "loss" caused by fire or lightning. This Hired Auto Physical Damage co\ts erage is excess o\,er any other collectible insur- ance. Subject to the abo\e limit, deductible and excess pro\isions, we will pro\ide co\,erage equal to the broadest co\erage applicable lo any co\€red "auto' you own. q. Ix,flAS IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Subparagraptu A.2.a. of SECTION lV - BUSI- NESS AUTO CONDITIONS is deleted and re- placed by: a. ln the e\ent of "accident", claim, "suit" or "loss", you, your insurance manager or any other person you designate must gi\€ us or our authorized representati\e prompt notice of such "accident" or ''loss". lnclude: (l) How, when and where the "accident" or "loss" occuned; (2) The "insured's" name and address; and (3) To the extent possible, lhe names and ad- dresses of any injured persons and wit- nesses. Knowiedge of an "accident' or "loss" by your agent, senant or "employee" shall not be consid- ered knowledge by you unless you, your insurance manager or any olher person you designate has recei\ed notice of the "accident' or 'loss" from your agent, sen ant, or "employee." R, WAIVER OF SUBROGATION SECTION IV _ BUSINESS AUTO CONDI- TIONS- A. 5. Transfer of Rights of Recovery Againd Othersto Us is amended as follows: This condition does not apply to any person or or- ganization to which you wai\ed this condition by written contract or agreemenl, but only to the ex- tent that subrogation is wai\ed prior to the "acci- dent' or "loss" under a contract with that person or organization. S. UNINTENTIONAL FAILURE TO DISCLOSE HAZ- ARDS Paragraph 8.2, Concealment, M isle p re se nta tio n Or Fraud in SECTION lV - BUSINESS AUTO CONDITIONS is amended by adding the following: lncludes copyrighted material of lnsurance Senices Ofice, lnc., with its permission.AH CA 85 S0 09 17 Any uninlentional failure to disclose all exposures or hazards existing as of the effecti\e date of the Business Auto Co\erage Form or at any time dur- ing lhe policy period will not in\alidate or ad\ersely affect the corerage for such exposure or hazard. Howe\,er, you must report the undisclosed expo- sure or hazard to us as soon as reasonably possi- ble after its disco\ery. T. EXTENDED EMPLOYEE HIRED AUTO PHYSICAL DAMAGE Paragraph 8.5.b. Other lnsurance of SECTION lV - BUSINESS AUTO CONOITIONS is deleted and replaced by the following: b. For Hired Auto Physical Damage Co\er- age, the following are deemed lo be co\r ered "autos" you own: 1. Any co\ered "auto" you lease, hire, renl or bonow, and 2. Any co\,ered "auto" hired or rented by your "employee" under a contract in that indi\,idual 'employee's" name, wilh your permission, while performing du- ties related to the conduct of your business. Howe\,er, any "auto" that is leased, hired, rented or borrowed with a dd\er is not a corered "auto". U. POLICY PERIOD, COVERAGE TERRITORY Paragraph 8.7. Policy Period, Coverage Territo- ry of SECTION lV - BUSINESS AUTO CONDI- TIONS is deleted and replaced by: 7. Policy Period, Coverage Territory Under this Co\,erage Form, we co\Er "acci- dents" and "losses" occuning: a. During the policy period shown in the Dec- larations; and b. Within the co\erage tenitory. The co\erage lenitory is: a. The United States of America; b. The tenitories and possessions of the L,nited States of America; c. Puerto Rico: d. Canada; and e. Anywhere in the world if (1) A co\,ered 'auto" is leased, hired, rented or bonowed for a period of 30 days or less; and Page 5 of 6 (2) The 'insured's" responsibility lo pay damages is determined in a "suit" on the merits. in the United States of America, the tenitories and posses- sions of the United States of America, Puerlo Rico, or Canada or in a settle- ment we agree tO. We also co\.er "loss" to, or "accidents" in\Dlling, a co\ered "auto" while being transported between any of these places. V. DEFINITION OF BODILY INJURY AMENDED Paragraph C. of SECTION V - DEFINITIONS is amended to include: "Bodily lnjury' includes menlal anguish or other menlal injury resulting from "bodily injury." Howe\ts er, no coverage is provided for mental anguish or mental injury absent physical injury. None of the extensions pro\,ided under this co\er- age endorsement apply if co\erage is more specif- cally identified elsewhere in the policy or endorse- ments, for which a premium charge is made or a higher limit is identifed. Under no circumstances is any limit pro\ided under this extension to be com- bined with a limit pro\,ided elsewhere in the policy or endorsemenls. lncludes copyrighted material of lnsurance Senices Offce, lnc., wilh ils permission.Page 6 of 6 AH CA 85 90 09 17 COMMERCIAL GENERAL LIABILITY AH CG 8617 09 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NONCONTRACTOR'S ADDITIONAL INSUREDS ENDORSEMENT A- WHO lS AN INSURED (Section ll) is amended to include as an insured any person or organization(called additional insured) described in Paragraphs A.1. through A.8. below whom you are required to add as an additional insured on this policy under a written contract or written agreement; but the written contract or written agreement must be currently in effect or becoming effective during the term of this policy; executed prior to the 'bodily injury," "property damage" or "personal injury and advertising injury,' but this paragraph does not apply to any additional insured more specilically identifled elsewhere in the policy. I. ADDITIONAL INSURED _ STATE OR POLITICAL SUBD]VISIONS _ PERMITS A state or political subdivision subject to the following provisions: a. A state or political subdivision is an additional insured only with respect to the following hazards for which the state or political subdivision has issued a permit in connection, with premises you own, rent, or control to which this insurance applies: (1) The existence, maintenance, repair, construction, erection, or removal of adverlising signs, awnings, canopies, cellar entrances, coal holes, drive- ways, manholes, marquees, hoistaway openings, sidewalk vaults, street banners, or decorations and similar exposures; or (2) The construction, erection, or removal of elevators; ol. (3) The ownership, maintenance, or useof any elevators covered by this insurance. b. A state or political subdivision is an additional insured only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. This insurance does not apply to "bodily injury,' property damage" or ''personal and advertising injury" arising out of operations performed by or for you for the state or political subdivision. 2. ADDITIONAL INSURED _ CONTROLLING INTEREST Any person or organizations wilh a controlling interest in you but only wilh respecl to their liability arising out of: a. Their flnancial control of you; or b. Premises they own, maintain or conlrolwhile you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for such additional insured. 3. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES A manager or lessor of premises but only with respect to liability arising out of the ownership, maintenance or use of that specific part of the premises leased to you and subject to the following additional exclusions: This insurance does not apply to: lncludes copyrighted materialof lnsurance Services Offlc€, lnc wrth rts permission.AH CG 8617 09 't7 Page 1 of 3 This endorsement modifles insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART a. Any "occurrence" which takes place after you can cease to be a tenant in that premises: or b. Structural alterations, new construction or demolition operations performed by or on behalf oI such additional insured. 4. ADDITIONAL INSURED _ MORTGAGEE, ASSIGNEE OR RECEIVER A mortgagee. assignee or receiver but only with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance, or use of a premises by you. This insurance does not apply to structural alterations, new construction or demolition operations performed by or for such additional insured. 5. ADDITIONAL INSURED _ OWNERS OR, OTHER INTERESTS FROM WHOM LAND HAS BEEN LEASED An owner or other interest from whom land has been leased by you but only wilh respectto liability arising out of the ownership, maintenance or use of thal specillc part of the land leased to you and subject to the following additional exclusions. This insurance does not apply to: a. Any'occurrence" which takes place after you cease to lease that land; or b- Structural alterations, new construction or demolilion operations performed by or on behalf of such additional insured. 6. ADDITIONAL INSURED - COOWNER OF INSURED PREMISES A co-owner of a premises co-owned by you and covered under this insurance but only with respect to the co owners liability as co- owner of such premises. 7. ADDITIONAL INSURED _ LESSOR OF LEASED .EQUIPMENT Any person or organization lrom whom youlease equipment. Such person or organization are insured only with respect to their liability arising out of the maintenance, operation or use by you or equipment leasedto you by such person or organization. A person's or organizalion's status as an insured under this endorsemenl ends when lheir contract or agreement with you for such leased equipment ends. With respect to the insurance afforded these additional insureds, the following additional exclusions apply: This insurance does not apply: a. To any "occurrence" which takes place afler the equipment lease expires; or b. To "bodily injury" or "property damage" arising out of the sole negligence of such addilional insured Any insurance provided lo an additional insured designated under Paragraphs A.1. through A.8. above does not apply to "bodily injury" or "property damage" included within the "products- completed operations hazard." 8. ADDITIONAL INSIJRED _ VENDORS Any "vendor", but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or soldin the regular course of the vendo/s business, subject lo the following additional exclusions: a. The insurance afforded the vendor does not apply to: (1) "Bodily injury' or "property damage" for which the vendor is obligated topay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (2) Any express wananty unauthorized by you; (3) Any physical or chemical change in the product made intentionally by lhe vendor; (4) 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; (5) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in theusual course of business, in conneclion with lhe distribution or sale of the products; (6) Demonstration, installation, servicingor repair operations, except such operations performed at the vendor's premises in connection wilh the sale of the product. lncludes copyrighted material of lnsuranc€ Services Ofllce, lnc wilh its permission.Page 2 of 3 AH CG 8617 09 17 (7) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor, or (8) "Bodily injury' or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of ils employees or anyone else acting on lts behalf. However, this exclusion does not apply to: (a) The exceptions contained in Sub- paragraphs d. or f.; or (b) Such inspections, adiustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in lhe usual course of business, in connection with the distribution or sale of the products. b. This insurance does not apply to any insured person or organization, from whom-you have acquired such products,or any ingredient, part or container, entering into, accompanying or containing such products. B. As respects the coverage provided under this endorsement, Paragraph. 4.b.(3.) SECTION lV -COMMERCIAL GENERAL LIABILITY CONDITIONS is added: 4.b.(3.) This insurance is excess over any other insurance mvering the additional insured as an insured whether primary, excess, contingent or on any other basis, unless a written contract or written agreement specifically requires that this insurance be either primary or primary and noncontributing. lncludes copyrighted material of lnsurance Services Office, lnc with ils permission.AH CG 8617 09 17 Page 3 of 3 COMMERCIAL GENERAL LIABILITY cG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY _ OTHER INSURANCE CONDITION This endorsement modifles insurance provided under the following COMMERCIAL GENERAL LIABILIry COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other lnsurance Condition and supersedes any provision to the contrary: Primary And Noncontributory lnsurance This insurance is primary to and will not seek contribution from any olher insurance availableto an additional insured under your policy provided that: (1) The additional insured is a Named lnsured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. cG 20 01 04 t3 @ lnsurance Services Offlce, lnc.,2012 Page 'l of 1 COMMERCIAL GENERAL LIABILITY AH CG 8623 09 17 PREMIER GENERAL LIABILITY COVERAGE EXTENSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. REASONABLE FORCE Paragraph 2.a. Expected or lntended lnjury under COVERAGE A - BODILY INJURY AND PROPERry DAMAGE LIABILITY of SECTION I - COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced byl a. Expected or lntended lniury "Bodily injury" or "property damage" expected or intended from the standpoint of the in- sured. This exclusion does not apply to "bodi- ly injury" or "property damage" resulting from the use of reasonable force to protect any person or property. B. CONTRACTUAL LIASILITY Paragraph 2.b. Contractual Liability under COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I - COVERAGES WithiN thE COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: b. ContractualLiability "Bodily inlury" or "property damage" for which the insured is obligated to pay damages by reason of lhe assumption of liability in a con- tract or agreement. This exclusion does not apply to liability for damages: (1) Thal the insured would have had in the absence of the contract or agreement; or (2) Assumed in a contracl or agreement thatis an "insured contract'', provided the "bodily injury'' or "property damage" oc- curs subsequent to the execution of the contract or agreement. C. NON OWNEO WATERCRAFT Paragraph 2.9.(21 in the Aircraft, Auto Or Wa- tercraft exclusion under COVERAGE A -BODILY INJURY AND PROPERW DAMAGE LIABILITY of SECTION I - COVERAGES within thE COMMERCIAL GENERAL LIABILITY COV- ERAGE FORM is replaced by: (2) A watercraft you do not own that is: (a) less than 75 feet long: and (b) Not being used to carry persons or prop- erty for a charge. D. ELECTRONIC DATA LIABILITY 1. Paragraph 2.p. Electronic Data under COV- ERAGE A - BODILY INJURY AND PROP. ERTY DAMAGE LIABILTTY of SECTION I _ COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability lo access, or inability to manipulate "elec- tronic data. that does not result from physical injury to tangible property. However, this exclusion does not apply to liability for damages because of "bodily injury,'. 2. The following definition is added to SEC- TION V - DEFINITIONS: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications soflware, hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically con- trolled equipment. 3. For purposes of the coverage provided for "Electronic Data", Paragraph 17. in SEC- TION V - DEFINITIONS is replaced by: 17. "Property damage" means: a. Physical injury to tangible property, including all resulling loss of use of that property. All such loss of use shall be deemed to occur at the time oI the physical injury that caused il; or - lncludes copyrighted material of lnsurance Services Ofllce, lnc., with its permission.AH CG 8623 09 17 Page I of 6 b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the 'occurrence" that caused it; or c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate 'elec- tronic data", resulting from physical injury to tangible property. All suchloss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caUSed it. For purposes of this insurance, "electron- ic data" is not tangible property. E. DAMAGE TO PREMISES RENTED TO YOU 1. The last paragraph after the listed exclusions under COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I - COVERAGES within the COMMERCIAL GENERAL LIABILITY COV- ERAGE FORM is replaced by: Exclusions c. through n. do not apply to "property damage" by fire; smoke from a "hostile fire"; explosionl lightning; smoke re- sulting from such explosion or lightning; colli- sion by "mobile equipment' or leakage from fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as de- scribed in SECTION lll - LIMITS OF lN- SURANCE. 2. Paragraph 6. of SECTION lll - LIMITS OF INSURANCE within the COMMERCIAL GENERAL LlABLlry COVERAGE FORM is replaced by: 6. Subject to Paragraph 5. above, the Dam- age To Premises Rented To You Limit is the mosl we will pay in any one event un- der COVERAGE A - BODILY INJURY AND PROPERTY DAIIIAGE LIABLITY for damages because of "property dam- age" from fire: smoke from a "hostile fire"; explosion; lightning; smoke resulting from such explosion or lighlning; collision by "mobile equipment" or leakage from fire protection systems to premises while rented lo you or temporarily occupied by you with permission of the owner. F. MEDICAL PAYMENTS Paragraph l.a. under COVERAGE C -MEDICAL PAYMENTS of SECTION l- COV- ERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: a. We will pay medical expenses as described below for 'bodily injury" caused by an acci- denl: ('l) On premises you own or rent; (2) On ways nexl to premises you own or rent; or (3) Because of your operations: provided that: (a) The accident takes place in the "cov- erage lerritory" and during the policy period; (b) The expenses are incurred and re- ported to us within three years of lhe date of the accident; and (c) The injured person submits to exami- nation, at our expense, by physicians of our choice as often as we reason- able require. G. SUPPLEMENTARY PAYMENTS SUPPLEMENTARY PAYMENTS - COVERAG. ES A AND B of SECTION I - COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: STJPPLEMENTARY PAYMENTS _ COVERAG. ESAANDB l. We will pay, with respect to any claim we investigate or settle, or any'suit" against an insured we defend: a. AII expenses we incur. b. Up to $5,000 for cost of bail bonds re- quired because of accidents or trafllc law violalions arising out of the use of any vehicle to which the Bodily lnjury Liability Coverage applies. We do not have to fur- nish these bonds. c. The cost of bonds to release attach- ments, but only for bond amounts within the applicable limit of insurance. We do have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit', including actual loss of earnings up to $500 a day because of lime off from work. e, All costs taxed against the insured in any "suit". f. Prejudgment interest awarded against the insured on that part of the judgmenl we pay. lf we make an offer to pay the appli- cable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. lncludes copyrighted material of lnsurance Services Office, Inc., with its permission.Page 2 of 6 AH CG 8623 09 17 g. All interest on the full amount of any .iudgmenl that accrues after entry of the judgment and before we have paid, of- fered to pay, or deposited in court the part of the judgment that is within the applica- ble limit ol insurance. These payments will not reduce the limits of insurance. 2. lf we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the 'suit", we will defend that indem- nitee if all of the following conditions are met: a. The 'suil" against the indemnitee seeks damages for which the insured has as- sumed lhe liability of the indemnitee in a conlract or agreement that is an "insured conlract"; b. This insurance applies to such liability as- sumed by the insured; c. The obligation to defend, or lhe cost of the defense of, lhat indemnitee, has also been assumed by the insured in the same "insured contract"; d. The allegations in the "suit'and the in- formalion we know about the "occur- rence" are such that no conflict appears to exist between the interests of the in- sured and the interests of the indemnitee; e. The indemnitee and the insured ask us to mnduct and control the defense of that in- demnitee against such "suit" and agree that we can assign the same munsel to defend the insured and the indemnitee; and f. The indemnitee: (1) Agrees in writing to: (a) Cooperate wilh us in lhe investi- gation, settlemenl or defense of lhe "suit'; (b) lmmediately send us copies ofany demands, notices, sum- monses or legal papers received in connection wilh lhe ''suit"; (c) Notify any olher insurer whose coverage is available to the in- demnitee; and (d) Cooperate with us with respecl to coordinating other applicable insurance available to the in- dem nilee; and (2) Provides us with written authoriza- tion to: (a) Obtain records and olher infor- mation related to the "suit": and (b) Conduct and control the defense of the indemnitee in such "suit'. Our obligalion to defend an insured's indem- nitee and to pay for attorneys'fees and nec- essary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above. or lhe terms of the agreement described in Paragraph f. above, are no long- er met. H. FELLOW EMPLOYEE COVERAGE SUPERVISOR OR HIGHER Paragraph 2.a-(11 ol SECTION ll - WHO lS AN INSURED within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM does not apply to the following: Your supervisory or managemenl "employees" for "bodily injury" only. Damaqes owed to an injured co-"employee" or ''volunteer workef will be reduced by any amount paid or available lo ihe injured co-"employee" or "volunteer worker" under any olher valid and collectible insurance. I. NEWLY ACQUIRED ORGANIZATIONS Paragraph 3.a. of SECTION ll - WHO lS AN INSURED within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: a. Coverage under this provision is afforded only until the end of the current policy period. J. BROAD FORM NAMED INSURED The following is added to SECTION ll - WHO lS AN INSURED within the COMMERCIAL GEN- ERAL LIABILIry COVERAGE FORM: Throughout lhis policy the words "you'and "your" refer to any corporation or other business organi- zation, olher than a joint venture, in which the first Named lnsured has or acquires during the policy period an ownership interest of more than 50% and is subject to the managemenl control of the first Named lnsured or its subsidiaries, and which is domiciled within lhe United States of America or its lerrilories or possessions. K. AMENDMENT OF AGGREGATE LIMIT OF INSURANCE The General Aggregate Limit Of lnsurance refer- enced in Paragraph 2. of SECTION lll - LIMITSOF INSURANCE within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM applies separalely to: 1. Each of your "locations" owned by or rented to you; and - AH CG 8623 09 l7 lncludes copyrighted material of lnsurance Services Office, lnc., rlilh irc ^a16i--i^h 2. Each of your projects away from premises owned by or rented to you. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-oi-way of a railroad. L. KNOWLEOGE OF OCCURRENCE The following is added to Parag.aph 2. Duties ln The Evenl Of Occurrence, Offense, Claim Or Suit of SEcTloN lV - CoMMERCIAL GENERAL L|ABlLlry CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: Knowledge of an "occurrence", offense, claim or "suit" by your agent, servant or "employee" shall not be considered knowledge by you unless you, your insurance manager or any other person you designate has received notice of the "occur- rence", orfense, claim or "suit" from your agent, servant, or "employee." M. OTHER INSURANCE Paragraph a.b.(1)(a) in the Other lnsurance condition of SECTION lV - COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: (a) Any of the other insurance, whether pri- mary, excess, contingent or on any other basis: (i) That is Fire, Extended Coverage, Builders Riski lnstallation Risk or sim- ilar coverage for "your work"; (ii) That is insurance covering Fire; smoke rrom a "hostile fire"; explosion; lightning; smoke resulting from such explosion or lightningi collision by "mobile equipment" or leakage from flre protection systems for premises while rented to you or lemporarily oc- cupied by you with permission of the owner; or (iii) That is insuranc,e to cover your liability as a lenant for "property damage" to premises while renled to you or temporarily occupied by you with permission of the owner; or (iv) lf the loss arises oul of the maintenance or use of aircraft, "autos", or watercraft to the extent not subject io Paragraph 2.9. Air- craft, Auto Or Watercraft under COVER- AGE A -BODILY INJURY AND PROP. ERTY DAMAGE LIABILITY of SECTION I - COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM. N. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following is added to Paragraph 6. Representations of SECTION lV * COM- MERCIAL GENERAL LIABILIry CONDITIONS within the COMMERCIAL GENERAL LlABlLlry COVERAGE FORMi Any unintentional failure to disclose all exposures or hazards existing as of the effeclive date of the Commercial General Liability Coverage Form or at any time during the policy period will not invali- date or adversely affect the coverage for such exposure or hazard. However, you must report the undisclosed exposure or hazard to us as soonas reasonably possible after the exposure or hazard is discovered. O. WAIVER OF SUBROGATION The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To [Js of SECTION IV _ COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMER- CIAL GENERAL LIABILITY COVERAGE FORM: This condition does not apply to any person or organization to which you waived this condition by written contract or agreement, but only to the extent that subrogation is waived prior lo the "bodily injury" or "property damage" under a contract with lhat person or organization. P. LIMITED WORLDWIDE LIABILIry COVERAGE The following is added to SECTION lV - CON- DITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: lncludes copyrighted malerial of lnsurance Services Office, lnc., with its permission.Page 4 of 6 AH CG 8623 09 17 Expanded Coverage Territory 1. lf a 'suit" is brought in a part of the "coverage territory" lhat is outside the United States of America (including its territories and posses- sions), Puerto Rico or Canada, and we are prevented by law, or otherwise, from defend- ing the insured, the insured will initiate a de- fense of the "suit". We will reimburse the in- sured, under Supplementary Payments, for any reasonable and necessary expenses in- curred for the defense of a "suit" seeking damages lo which this insurance applies, that we would have paid had we been able to ex- ercise our right and duty to defend. lf the insured becomes legally obligated to pay sums because of damages to which this insurance applies in a part of the "coverage territonf that is outside the United States of America (including its territories and posses- sions), Puerto Rico or Canada, and we are prevented by law, or otherwise, from paying such sums on the insured's behalf, we will re- imburse the insured for such sums. 2. All payments or reimbursemenls we make for damages because of judgments or settle- ments will be made in U.S, currency at the prevailing exchange rate at the time the in- sured became legally obligated to pay such sums. All payments or reimbursements we make for expenses under Supplementary Payments will be made in U.S. cunency al the prevailing exchange rate at the time the expenses were incurred. 3. Any disputes between you and us as lo whether there is mverage under this policy must be filed in the courts of the United Stales of America (including its territories and possessions), Puerto Rico or Canada. 4. The insured must fully maintain any coverage required by law, regulation or other governmen- tal authority during the policy period, excepl for reduction of the aggregate limits due to pay- ments of claims, judgments or settlements. Failure lo maintain such coverage required by law, regulation or other governmental authori- ty will not invalidate this insurance. However, this insurance will apply as if the required coverage by law, regulation or other govern- mental authority was in full effect. For purposes of this coverage only, the following is added to Paragraph a.b.(1xa) under Other lnsurance of SECTION lV - COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM: lf the insured's liability lo pay damages is deter- mined in a "suit" brought oulside the United States ol America (including its territories and possessions), Puerto Rico or Canada; or Thal is coverage required by law, regulation or other governmental authority in a part of the "coverage territory' that is outside the United Slates of America (including its territories and possessions), Puerto Rico or Canada. For purposes of this coverage only, Paragraph 4.of SEcTloN v - DEFINITIONS within lhe COMMERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: 4. ''Coverage territory' means an) vhere in the world with the exception of any country or ju- risdiction which is subject to trade or other economic sanction or embargo by the United States of America. Q. BODILY INJURY REDEFINITION Paragraph 3. of SECTION V - DEFINITIONS within the cOMMERCIAL GENERAL LIABILITY COVERAGE FoRM is replaced by: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish, injury or illness or emotional distress and/or death resulting from any of these at any time. R. INSURED CONTRACT - LEASE OF PREMISES Paragraph 9.a. of SEcTloN V - DEFINITIoNS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: a. A contracl for lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or or- ganization for "property damage" by flre; smoke from a "hostile flre", explosion; light- ning; smoke resulting from such explosion or lightning; collision by "mobile equipment" or leakage from fire protection systems to prem- ises while rented to you or lemporarily occu- pied by you with permission of the owner is not an "insured contract". S. LIBERALIZATION lf we revise this endorsement to provide more coverage withoul additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. - - AH CG 8623 09 l7 lncludes copy,righted material of lnsurance Services Of1ice, lnc., '.,irh il. ^^rmi..i^^ T. GOOD SAMARITAN SERVICES l. Under SECTION ll - WHO lS AN INSURED, paragraph 2.a.(1Xd), the following is added: This exclusion does not apply to your "em- ployees" or "volunteer workers', other lhan an employed or volunteer physician, rendering ''Good Samaritan services". 2. The following delinition is added to SECTION V - DEFINITIONS: "Good Samaritan services" means any emer- gency medacal services for which no compen- salion is demanded or received. All other terms and conditions of this policy remain unchanged. lncludes copyrighted material of lnsurance Services Office, lnc., with its permission.Page 6 of 6 AH CG 8623 09 17 City of Menifee 29844 Haun Rd Menifee CA 92586-6539