2022/06/02 RRL Enterprises, Inc. DBA Midstate Automotive Equipment (3)IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADOITIONAL INSURED provisions or be endorsed.lf SUBRoGATION lS WAIVED, subiect lo the terms and condilions ofthe policy, certain policies may require an endorsement. A statement on
this cerlificate does not confer rights to the certificate holder in lieu of such €ndorsement(s).
[..53",5. .',r (sss) rzs6zsz
iil61lss mary.doig@dibu.com
rNsuRER(9) AFFORDTNc CoVERA6E
rNsuRri a General Casualty Company of
rNsuRER B Everesl Premier lnsurance Company '16045
Mary Doig
ffi,6,(5ss) 323-i871
RRL Enterprises, lnc. DBA Midstate Automotive Equipment
1865 Herndon Avenue Suite l3l
Clovis, CA 93611
pRooucER License * 0E02096
DiBuduo & D€Fendis lnsurance Broke.s, LLCg1 Bullard Avenu€Clovis, CA 93612
Wisconsin 24414
A(:ORI)
c RAGES
R R LENTE.O l
CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE NI.,'MBER:REVISION NUMBER
MD
6t2t2022
THIS CERTIFICATE IS ISSUED AS A MAITER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. IHIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AUEND, EXTENO OR ALTER THE COVERAGE AFFORDED BYTHEPOLICIES
BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
DESCRIPIION Of OPERATIONS / IOCATIOIIS / VEHICiES (ACORO 101 , AdatioMl R.m.rks S.h.dul., n.y b. lrbch.d n morc sp3@ l. r.qurcd)
Contract #
City ol Menileo and its of{ice6, emptoyees, agents and authorized volunleers are added as addilional insured as per AH CG8623 0917 and CG200'1 0413 and
H CA 8590 0917 and AH C8517 09'17 forns attached
CERTIFICATE HOLDER CANCELLATION
City of Menifee
29844 Haun Rd
Menifee CA 92586-6539
SHOULO ANY OF THE ABOVE DESCRIAEO POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, llOTlCE wlLL BE DELryERED lN
ACCORDANCE wlTH THE POLICY PROVISIONS.
AIJTHORIZED REPRESENTATIVE
@'1988-2015 ACORD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD
THIS IS IO CERTIFY THAT IHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMEO ABOVE FOR THE POLICY PERIOO
INDICATEO. NOTWTHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACTOROTHER DOCUMENTWITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUEJECT TO ALL THE TERMS
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOW\] MAY HAVE BEEN REOUCED AY PAID CLAIMS.
1,000,000
x
x
7t25t2o21 7 t25t2022 BAy,IBEJ?.:.":J,.,L""r
,1qG I I
X X 8PK000618702
X 8CA000359102
GEN'L AGGREGATE LIMITAPPLIES PER:
1,000,000
SCHEDULEO
POLICYEFT POLrcY EXPIMI'/QDIVYYYI ITT''DD/YYYN
BODILY lN.lURY (P.. aaide.l). I
COMBINED SINGLE LIMIT(Eaacad.nu
712512021 712512022 BoDrLy rNJuRy (pe,pern) $
X llfitoo. o,.r
X porrcy i8.o-
]JR
MED ExP (Anvoe petson) S
1,000,000
2,000,000
2,000,000
100,000
5,000
[***ri:#r
AUTOT'OBILE LIASIUTY
OWNEDAUTOS ONLY
CLAIMS.li|AOE
5
1,000,000
'1,000,000
1,000,000
7600021589221
EL OISFASE EAEMPLOYEE $
x
E L OISEASE. POLICY LIMIT
6t212O22 61212023 E t EACH acc oENr
B woRx ERs corlPENsAroNAND EUPf OYEES' f IABIUTY
ACORD 25 (2016/03)
l
A X . coM[ERcr^L GENERAL LraBrurY
cLArMs MADE X occuR
3
I
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GHANGES IN COMMERGIAL AUTO COVERAGE FORM
This endorsement modifies insurance provided under the following
BUSINESS AUTO COVERAGE FOR['
A. BROADENED WHO IS AN INSURED
Paragraph A.'1. 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
o!vn, hire or bonow in your business or
your personal affairs.
e. Any "employee" of yours is an "insured"
while using an "auto" hired or rented 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
status is an "insured" under Liability Co\A
erage, but only to the extent that peBon or
organization qualifies as an "insured" un-
der the Who is an lnsured Prousion con-
tained in Section ll of the co\,erage form.
The written contract or agreement must be
in effect during the policy period shown in
the Declarations and musl ha\E been exe-
cuted prior to the "bodily injury" or "proper-
ty damage."
B. LIABILITY COVERAGE EXTENSIONS SUPPLE-
MENTARY PAYMENTS
Paragraphs A.2.a. (2) and A.2.a. (4) Coverage
Extensions - Supplementary Payments of
SECTION ll - LIABILITY COVERAGE are deleted
and replaced with the following:
(2) Up to $5,000 for the cost of bail bonds
(including bonds for related traffc law
violations) required because of an "ac-
cident" we cor,er. We do not ha\e to
fumish these bonds.
(4) All reasonable expenses incuned by
the "insured" at our request, including
aclual loss of earnings up to $500 a
day because of time ofifrom work.
FELLOW EMPLOYEE COVERAGE
Paragraph 8.5. Fellow Enployee Exclusion con-
tained in SECTION ll - LIABILITY COVERAGE
does not apply if the "bodily injury" results fom the
use of a co\€red "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.
POLLUTION LIABILIry - BROADENED COV-
ERAGE FOR COVERED AUTOS
1. Liability Coverage is changed as follows:
a. Paragraph 8.11.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 La. Abo\e, Exclusion 8.6.
Care, Custody or Control of SECTION ll
LIABILITY does not apply.
Cha nges in Definitions
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:
1. 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-
toxiry or neutralize, or in any way re-
spond to, or assess the effects of "pol-
lutants"i or
c
D.
2
lncludes copyrighted material of lnsurance Senices Office, lnc.,
with its permission.AH CA 85 90 09 17
COMMERCIAL AUTO
AH CA 85 90 09 17
Page I of 6
2. Any claim or "suit" by or on behalf of a
go\ernmental authority for damages be-
cause of testing for, monitoring, cleaning
up, remoUng, containing, treating, detoxif,/-
ing or neutralizing, or in any way respond-
ing to or assessing the effects of'pollu-
tants".
"Co\,ered pollution cosl or expense" does not
include any cost or expense arisiog out of the
actual, alleged or threatened discharge, dis-
persal, seepage, migration, release or escape
of "pollutants":
a. Before the "pollutants" or any property
in which the "pollutants" are contained
are mo\,ed from the place where they
are accepted by the "insured" for
mo\€ment into or onto the co\,ered
',auto"; or
b. After the "pollutants" or any property in
which the "pollutants" are contained
are mo\ed ftom the co\ered "auto" to
the place where they are finally deli\.
ered, disposed of or abandoned by the
"insured".
Paragraphs a. and b. abo\€ do not apply
to "accidents" that occur away fom prem-
ises owned by or rented to an "insured"
with respect 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\€rtumed or
damaged as a result of the
mainlenance or use of a co\€red
'auto"; and
(2) The discharge, dispelsal, seep-
age, migration, release or escape
of the "pollutants'' is caused di-
rectly by such upset, o\€rtum or
damage.
This Pollution Liability Cov-.rage 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
form, other than a pa(nership, joint \enlure or lim-
ited liability company, and o\er which you maintain
ownership or majority interest, but only if there is
no similar insurance a\6ilable to that organization.
Howe\er:
'1. The cowrage does not apply to an "accident"
which occuned before you acquired or formed
the organization.
2. L,nless you notitr/ us to add co\€rage to your
policy, the co\,erage under this pro\,ision is af-
forded only until:
a. The 'l20th day afrer you acquire or form the
organization, or
b. The end of the policy period, whiche\er is
earlier.
F. EXTENDED TOWING
Paragraph 4.2. 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
co\€red "auto" is disabled. All labor must be per-
formed at the place of disablement. lf the "auto" is
of the pri%te passenger type, there will be no de-
ductible. tf the "aulo" is other than a private 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 Exlensions of SEC-
TION lll - PHYSICAL DAMAGE GOVERAGE is
amended as follows:
a. Tra nsportalion 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 Use Expenses
The amount we will pay for ioss of use is
increased to $75 per day and to a maxi-
mum limit of $1,000.
H. RENTAL REIMBURSEMENT
1. This co\,erage applies only to a co\,ered "auto"
described or designated in the Schedule or in
the Declarations as canying physical damage
co\€rage-
2. We will pay for rental reimbursement expenses
incuned by you for the rental ofan "auto" be-
cause of "loss" to a co\,ered "auto". Payment
applies in addition to the otherwise applicable
amount of co\,erage you ha\,e on each co\€red
"auto".
3. We will pay only for those expenses incuned
during ihe policy period beginning 24 hours af-
te. 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 Se^.,ices Offce, lnc.,
with its permission.Page 2 of 6 AH CA 85 90 09 17
a. The number ofdays reasonably required to
repair or replace the co\ered "auto". lf
"loss" is caused by thefi, lhis 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 actual expenses incuned;
or
b. $50 per day
5, This co\,erage does not apply while there are
spare or resen€ "autos' a\ailable to you for
your operations.
6. lf "loss" results ftom the total thefr of a co\€red
"auto" of the pri\ate passenger type, we will
pay under this co\€rage only that amounl of
your rental reimbursement expenses which is
not already prolided 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 SECTION 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 br "loss" to
any electronic equipment that recei\,es or
transmils audio, sual or data signals and
that is not designed solely Ior the repro-
duction of sound. This co\eEge applies
only if the equipment is permanently in-
stalled in the co\ered "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 the time
of the "loss", and such equipment is de-
signed to be solely operated by use of the
power from the'auto's" electrical system,
in or upon the co\ered 'auto".
b. We will pay with respect to a co\ered "au-
to" described in the Schedule i)r "loss" to
any accessories used wilh the electronic
equipment described in Paragraph l.a.
abo\€. Howe\er, this does not include
tapes, records or discs.
2. Exclusions
The exclusions that apply to SECTION lll -PHYSICAL DAMAGE, except ilr the exclusion
relating to Audio, Visual and Data Electronic
Equipment, also apply to co\erage prolided by
this endorsement. ln addition, the following ex-
clusions apply:
We will not pay, under this endorsement, for
either any electronic equipment or accessories
used with such el€clronic equipment that is;
a. Necessary for the normal operation ofthe
co\,ered "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-
menl is permanently installed in the
co\ered "auto'; 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 lnslirance
With respect to co\erage under this endorse-
menl, lhe Limit Of lnsrrance pmlision of
SECTION III _ PHYSICAL DAMAGE COV.
ERAGE is replaced by the following:
a. The most we will payforall 'loss'io audio,
Usual or data electronic equipment and
any accessories used with this equipment
as a result of any one "accident' is the
lesser of:
('l). The actual cash \alue of the damaged
or stolen properly as of the time of the
"loss";
(2). The cost of repairing or replacing the
damaged or stolen property with other
properly oI 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 bettermenl.
4. Deductible
No deductible applies to this co\,erage.
The insurance provided by this extension is excess
o\,er any other collectible insurance.
lncludes copyrighted material of lnsurance Se^,ices Offce, lnc.,
with its permissron.Page 3 of 6AH CA 85 90 09 17
K, TAPES, RECORDS AND DISCS COVERAGE
Exclusion B.4,a. of SECTION lll - PHYSICAL
DAMAGE COVERAGE is deleted and replaced by
the following:
a. Tapes, records, discs or other similar au-
dio, visual or data electronic de\,ices de-
signed for use with audio, \,risual or data
electronic equipment except when the
tapes, records, discs or other similar au-
dio, \,isual or data electronic de\,ices:
(l) Are your property or thal of a family
member, and
(2) Are in a co\ered "aulo" at the time of
"loss".
(a). The most we will pay for "loss" is
$200. No Physical Damage Co\F
erage deductible applies to this
co\€rage.
This extension pro\,ides co\erage only to a co\ered
"auto".
L. PHYSICAL OAIIAGE DEDUCTIBLE _ SINGLE
DEDUCTIBLE AND GLASS REPAIR
Paragraph D. Deductible in SECTION lll -PHYSICAL DAMAGE COVERAGE is deleted and
replaced by the following:
D. Deducdble
For each co\Ered "auto," our obligation lo pay
for, repair, retum or replace damaged or stolen
propedy will be reduced by the applicable de-
ductible shown in the Declarations. Any Com-
prehensi\,e Co\Erage deduclible shown in the
Declarations does not apply to "loss" caused
by fre or lightning.
When two or more co\ered'autos" sustain
"loss" in the same occurence, the total of all
the "loss" lor all the in\ol\ed co\ered "autos"
will be reduced by a single deductible, which
will be lhe 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 Comprehensi\e Co\erage on
this policy for a stolen owned "auto", we will
pay up to $600 for "personal effects" stolen
with the "auto".
2. "Personal effects" 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 insurance.
N. LOAN/LEASE PAYOFF COVERAGE
lhe 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\€red "auto'
shown in the Declarations, 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\erage Seclion of lhe policy; and
2- Any:
a. O\€rdue lease/loan payments at the lime
of the "loss';
b. Financial penalties imposed under a lease
for excessi\c 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, Health, Accident or Dasabality
lnsurance purchased with the loan or
lease, and
e, Carry-o€r balances from pre\,ious loans or
leases.
O. CUSTOM SIGNS AND DECORATIONS
ln the e\€nt of a total loss to a \€hicle insured for
auto physical damage co\erage on this policy, in
addition to the ACV of the \ehicle, we will pay the
actual cost to repair or repiace signage or cuslom
paint details up to $5,000.
P. HIRED AUTO PHYSICAL DAMAGE
lf hired "autos" are co\€red "autos" for Liability
Co\Erage and if Physical Damage Co\Erage of
Comprehensiw, Specifed Causes of Loss, or Col-
lision are pro\,ided under this Correrage 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. $50,000 per accident,
lncludes copyrighted material of lnsurance Senices Ofice, lnc.,
with its permission.Page 4 of 6 AH CA 85 S0 09 17
2. Actual Cash Value, or
3. The cost of repair.
The deductible will be equal to the largest deducti-
ble applicable to any owned "auto' for that co\€r-
age. No deductible applies to "loss" caused by fre
or lightning. This Hired Auto Physical Damage cor
erage is excess o\ier any other collectible insur-
ance. Subject lo lhe abo\e limit, deductible and
excess pro\isions, we will pro\,ide cowrage equal
to the broadest co\,erage applicable to any co\Ered
"auto' you own.
Q. DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT
oR LOSS
Subparagraphs A.z.a- ol SECTION lV - BUSI-
NESS AUTO CONDITIONS is deleted and re-
placed by:
a, ln the e\ent of "accidenl", claim, "suit" or
"loss", you, your insurance manager or any
other person you designate must gi\€ us or our
authorized representati\e prompt notice of
such "accident" or "loss". lnclude:
(l) How, when and where the "accident" or
"loss" occuned;
(2) The "insured's" name and address; and
(3) To the extent possible, the names and ad-
dresses of any injured persons and wit-
NESSES,
Kno,,lrledge of an ''accident' or "loss" by your
agent, seNant or "employee" shall not be consid-
ered knowledge by you unless you, your insurance
manager or any other person you designate has
recei\ed notice of the "accident" or "loss" fiom your
agent, sen€nt, or "employee,"
R. WAIVER OF SUBROGATION
SECTION IV _ BUSINESS AUTO CONDI-
TIoNS- A. 5- Tran$er of Rights of Recovery
Against Others to 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 agreement, but only to the ex-
tent that subrogalion is wai\,ed prior to the "acci-
dent" or "loss' under a contract with that person or
organization.
S. UNINTENTIONAL FAILURE TO OISCLOSE HAZ.
ARDS
Paragraph 8.2, Concealment, M isre p re se nta tio n
Or Fraud in SECTION lV - BUSINESS AUTO
CONDITIONS is amended by adding the following:
Any unintentional failure to disclose all exposures
or hazards existing as of lhe effecti\e date of the
Business Auto Co\erage Form or at any time dur-
ing the policy period will not in\alidate or ad\eBely
affect the co\erage 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 CONDITIONS is deleted and
replaced by the following:
b. For Hired Auto Physical Damage Co\,er-
age, the following are deemed to be co\F
ered "autos" you owt:
l. Any co\Ered "auto" you lease, hire,
rent or bonow: and
2. Any co\,ered "auto" hired or rented by
your "employee" under a contract in
that indi\,idual "employee's" name, with
your permission, while performing du-
ties related to the conduct of your
business.
Howe\,er, any "auto" that is leased, hired, rented or
bonowed with a dri\er is not a co\Ered "aulo".
U. POLICY PERIOD, COVERAGE TERRITORY
Paragraph 8.7. Policy Period, Coverage Territo-
ry of sEcTtoN tv - 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 lhe Dec-
larations; and
b. Within the co\€rage tenitory.
The coverage tenitory is:
a. The United States of America;
b. The tenitories and possessions of the
United States of America;
c. Puerto Rico:
d. Canada; and
e, Anywhere in the world it
('l) A co\€red "auto'' is leased, hired,
rented or bonowed for a period of 30
days or less; and
lncludes copyrighted material ot lnsurance Senrices Offce, lnc.,
with its permission.AH CA 85 90 09 17 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 coler "loss" to, or "accidents" in\ol\,ing, a
co\,ered "auto' while being transported belween
any of these places.
V. DEFINITION OF BODILY INJURY AMENDED
Paragraph C. of SECTION V - DEFINITIONS is
amended to include:
"Bodily lnjury" includes mental anguish or olher
mental injury resulting liom "bodily injury." Howeu
er, no co\eftige is pro\ided for mental anguish or
mental injury absent physical injury.
None of the exlensions provided under this co\Er-
age endorsement apply if cowrage is more specif-
cally identified elsewhere in the policy or endorse-
menls, for which a premium charge is made or a
higher limit is identifed. Under no circumslances is
any limit pro\,ided under this extension lo be com-
bined with a limit pro\,ided elsewhere in the policy
or endorsements.
lncludes copyrighted material of lnsurance Senices Ofrce, lnc.,
with its 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
This endorsement modilies insurance provided under the following
COMMERCIAL GENERAL LIABILIry COVERAGE PART
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 contracl 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 specifically identified elsewhere in
the policy.
1. ADDITIONAL INSURED - STATE OR
POLITICAL SUBDIVISIONS _ 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; or
(3) The ownership, maintenance, or useof any elevators covered by this
insurance.
b. A state or political subdivision is an
addilional 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 with a controlling
interest in you but only with respect to their
liability arising out of:
a. Their financial conlrol ofyou; 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 material of lnsurance Services OfIlce, lnc
wrth ils permission.AH CG 8617 09 17 Page 1 of 3
a. Any "occurrence" which takes place afteryou can cease to be a tenant in that
premises: or
b. Structural alterations, new construction or
demolition operations performed by or on
behalf of 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 struclural
alterations, new construction or demolition
operalions 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 with respectto liability arising out of the ownership,
maintenance or use of thal specilic part of theland leased to you and subject to the
following additronal exclusions.
This insurance does not apply to:
a. Any "occurrence" which takes place afler
you cease to lease that land; or
b. Structural alterations, new construction or
demolition operations performed by or on
behalf of such additional insured.
6. ADDITIONAL INSURED _ COOWNER OF
INSURED PREMISES
A co-owner oI a premises co-owned by you
and covered under this insurance but only
with respect to lhe co-owners liability as co-
owner of such premises.
7. ADDITIONAL INSURED - LESSOR OF
LEASED .EQUIPMENT
Any person or organization irom whom youIease equipment. Such person or
organization are insured only with respect lo
their liability arisinq out of the maintenance,
operation or use by you or equipmenl leasedto you by such person or organization. A
person's or organization's status as an
insured under this endorsemenl ends when
their 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
additional insured.
Any insurance provided to 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-
mmpleted operations hazard."
8. ADOITIONAL INSURED _ VENDORS
Any "vendo/', 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 vendor's
business, subject to 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 warranty unauthorized
by you;
(3) Any physical or chemical change in
the product made intentionally by the
vendori
(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 lhe 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
connection with the distribution or
sale of the products;
(6) Demonstration, installation, servicingor repair operations, except such
operations performed at the vendor's
premises in connection with the sale
of the product.
lncludes copyrighted material of lnsurance Services Offlce, lnc.
wrth rts permission.Page 2 of 3 AH CG 8617 09 17
(7) Products which, afler dislribution or
sale by you, have been labeled or
relabeled or used as a crntainer, part
or ingredient of any other thing or
substance by or for the vendor, or
(8) "Bodily injury" or "property damage"
arising oul of the sole negligence of
the vendor for its own acts or
omissions or those of its employees
or anyone else acting on lts behalf.
However, this exclusion does nol
apply to:
(a) The exceptions contained in Sub-
paraqraphs d. or f.; or
(b) Such inspections, adjustments,
tests or servicing as the vendor
has agreed to make or normally
undertakes lo make in the 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 inqredient, part or container,
entering into, accompanying or containing
such products.
B. As respects the coverage provided under this
endorsement, Paragraph. 4.b.(3.) SECTION IV -COMMERCIAL GENERAL LIABILITY
CONDITIONS is added:
4.b.(3.) This insurance as excess over any other
insurance covering 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 eilher primary or
primary and noncontributing.
:
lncludes copyrighted material of lnsurance Services Offlce, lnc
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COI\,,IPLETED 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 other insurance availableto an additional insured under your policy
provided that:
(l) 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 ihe
additional insured.
COMMERCIAL GENERAL LIABILITY
cG 20 01 04 13
cG 20 01 04 13 O lnsurance Services Office, lnc.,2012 Page 1 of 'l
COMMERCIAL GENERAL LIABILIry
AH CG 8623 09 17
PREMlER GENERAL LIABILITY COVERAGE
EXTENSION
This endorsement modilles insurance provided under the following
COIVMERCIAL GENERAL LIABILITY COVERAGE FORM
A. REASONABLE FORCE
Paragraph 2.a. Expected or lntended lnjury
under COVERAGE A - BODILY INJURY AND
PROPERTY DAMAGE LIABILITY of SECTION I
- COVERAGES within the COMMERCIAL
GENERAL LIABILITY COVERAGE FoRM is
replaced by:
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 injuqy''or "property damage" resulting from
the use of reasonable force to protect any
person or property.
B. CONTRACTUAL LIABILITY
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 injury" or "property damage'for which
the insured is obligated to pay damages by
reason of the assumption of liability in a con-
tract or agreement. This exclusion does not
apply to liability for damages:
('l) That the insured would have had in the
absence of the contract or agreement; or
(2) Assumed in a contract or agreement thatis an ''insured contract", provided the
"bodily injury' or "property damage" oc-
curs subsequent to the execution of the
conlract or aqreement.
C. NON OWNED 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 c€rry persons or prop-
erly for a charge.
D. ELECTRONIC DATA LIABILIry
1. Paragraph 2.p. Electronic Data under COV.
ERAGE A - BODILY INJTJRY AND PROP-
ERTY DAMAGE LIABILITY of SECTION I -COVERAGES within the COMMERCIAL
GENERAL LlABlLlry COVERAGE FORM is
replaced by:
p. Electronic Data
Damages arising out of lhe loss of, loss of
use of, damage lo, 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 lo
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 software,
hard or floppy disks, CD-ROMs, lapes, 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. "Properly damage" means:
a- Physical injury to tangible property,
including all resulting loss of use of
that property- All such loss of use
shall be deemed to occur at the time
of the physical injury that caused it, or
lncludes copyrighted material of lnsurance Services Office, lnc.,
with its permission.AH CG 8623 09 17 Page 1 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" thal
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
iniury to tangible property. All such
loss of "electronic data" shall be
deemed to occur at the time of the
"occurrence" that caused ii.
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 -BOOILY INJURY
AND PROPERTY DAMAGE LIABILITY of
SEcTloN 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", explosion; 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 limil
of insurance applies to this coverage as de-
scribed in SECTION lll - LIMITS OF lN-
SURANCE.
2. Parasraph 6. of SECTION lll - LIMITS OF
INSURANCE Within the COMMERCIAL
GENERAL LIABLITY COVERAGE FORM is
replaced by:
6. Subject to Paragraph 5. above, the Dam-
age To Premises Rented To You Limit is
the most we will pay in any one event un-
der COVERAGE A - BODILY INJURY
AND PROPERW DAMAGE LIABLITY
for damages because of "property dam-
age" from fire; smoke from a "hostile llre";
explosion; lightning; smoke resulling from
such explosion or lighlning; collision by
"mobile equipment" or leakage from fire
protection systems to premises while
rented to you or lemporarily occupied by
you with permission of the owner.
F. MEDICAL PAYMENTS
Paragraph l.a. under COVERAGE C -MEDICAL PAYMENTS of SECTION I - 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-
dent:
(1) On premises you own or rent;
(2) On ways next to premises you own or
rent, or
(3) Because of your operations:
provided that:
(a) The accident takes place in the "cov-
erage territory" and during the policy
period;
(b) The expenses are incurred and re-
ported to us within three years of lhe
dale 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:
SUPPLEMENTARY PAYMENTS - COVERAG-
ESAANOB
1. We will pay, with respect to any claim we
investigale or settle, or any "suit" against an
insured we defend:
a. All expenses we incur.
b. Up to $5,000 for cost of bail bonds re-
quired because of accidents or traffic law
violations 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 atlach-
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 time 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, lnc.,
with its permission.Page 2 of 6
AH CG 8623 09 17
g. All interest on the full amount of any
judgment 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 of 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 crnditions are met:
a. The 'suit" against the indemnitee seeks
damages for which the insured has as-
sumed the liability of the indemnitee in a
contract or agreement thal is an "insured
contract";
b. This insurance applies to such liability as- .
sumed by the insured;
c. The obligation to defend, or the cost of
the defense of, thal indemnitee, has also
been assumed by lhe insured in the same
"insured contract";
d. The allegations in the "suit' and the in-
formation 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
conduct and control the defense of that in-
demnitee against such "suit" and agree that
we can assign lhe same counsel to defend
the insured and the indemnitee; and
f. The indemnitee:
(1) Agrees in writing to:
(a) Cooperate with us in the investi-
gation, settlement or defense of
lhe "suit';
(b) lmmediately send us copies of
any demands, notices, sum-
monses or legal Papers received
in mnnection with the "suit":
(c) Notify any other insurer whose
coverage is available to the in-
demnitee: and
(d) Cooperate with us with respect
to coordinating other applicable
insurance available to the in-
demnilee; and
(2) Provides us with written authoriza-
tion to:
(a) Obtain remrds and other infor-
mation related to the'suit"; and
(b) Conduct and control the defense
of the indemnitee in such "suit".
Our obligation 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 the 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 of SECTION ll - WHO lS AN
INSURED within the COMMERCIAL GENERAL
LIABILITY COVERAGE FORM does not apply to
the following:
Your supervisory or management "employees" for
"bodily injury" only.
Damages owed lo an injured co]employee' or
"volunteer worker" will be reduced by any amount
paid or available lo the injured co-'employee" or
"volunteer worker' under any other 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 this policy the words "you'and "your'
refer to any corporation or other business organi-
zation, other than a joint venture, in which the flrst
Named lnsured has or acquires during the policy
period an ownership interest of more than 507o
and is subiect to the management control of the
firsl Named lnsured or its subsidiaries, and which
is domiciled within lhe United States of America
or ils lerritories or possessions.
K. AMENDMENT OF AGGREGATE LIMIT OF
INSURANCE
The General Aggregale Limit Of lnsurance refer-
enced in Paragraph 2- of SECTION lll - LIMITS
OF INSURANCE within the COMMERCIAL
GENERAL LIABILITY COVERAGE FORM
applies separately to:
1. Each of your "locations" owned by or rented
to you, and
AH CG 8623 09 17 lncludes copyrighted material of lnsurance Services Offlce, lnc.,
u,ith ilc ^d.mic.i^n
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 streel, roadway, waterway or
righlof-way of a railroad.
L. KNOWLEDGE OF OCCURRENCE
The following is added lo Paragraph 2. Duties ln
The Event Of Occurrence, Offense, Claim Or
Suit of SECTION lV - COMMERCIAL GENERAL
LIABILITY 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", offense, claim or "suit, from your agent,
servant, or'employee."
M. OTHER INSURANCE
Paragraph a.b.(1Xa) 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 lhe other insurance, whether pri-
mary, excess, contingent or on any other
basis:
(i) That is Fire, Extended Coverage,
Builders Risk; lnstallation Risk or sim-
ilar coverage for "your work";
(ii) That is insurance covering Fire;
smoke from a "hostile fire"; explosion;
lightning; smoke resulting from such
explosion or lightning; collision by
"mobile equipment" or leakage from
fire protection systems for premises
while rented lo you or lemporarily oc-
cupied by you with permission of the
owner; or
(iii) That is insurance lo cover your liability as a
tenanl for "property damage" to premises
while rented 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 aircBft, "autos", or wateacraft to the
extent not sublect to Paragraph 2.9. Air-
craft, Auto Or Watarcraft under COVER-
AGE A _BODILY INJURY ANO PROP-
ERTY DAMAGE LlABlLlw of SECTION I
- COVERAGES within the COMMERCIALGENERAL LIABILTTY COVERAGE
FORM.
N. UNINTENTIONAL FAILURE TO DISCLOSE
HAZARDS
The following is added to Paragraph
6. Representations of SECTION lV - COM-
MERCIAL GENERAL LIABILITY CONDITIONS
within the COMMERCIAL GENERAL LIABILITY
COVERAGE FORM:
Any unintentional failure to disclose all exposures
or hazards existing as of the effective date of the
Commercial General Liability Coverage Form or
at any time during the policy period will nol 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 Us 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 to the
"bodily injunf or "property damage" under a
contract with that person or organization.
P. LIMITED WORLDWIDE LIABILITY COVERAGE
The following is added to SECTION lV - CON-
DITIONS within the COMMERCIAL GENERAL
LIABILITY COVERAGE FORM:
lncludes copyrighted material of lnsurance Services Oflice, lnc.,
with its permission.Page 4 of 6
AH CG 8623 09 17
Expanded Coverage Territory
l. lf a "suit" is brought in a part of the "coverage
territory" that is outside the United States of
America (including its lenitories and posses-
sions), Puerto Rico or Canada, and we are
prevented by law, or otherwise, from defend-
ing the insured, the insured wili 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 to 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
territory" that is outside the United States of
America (including its tenitories 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 reimbursements 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 bec€me legally obligated to pay such
sums. All payments or reimbursements we
make for expenses under Supplementary
Payments will be made in U.S. currency at
the prevailing exchange rate at the time the
expenses were incurred.
3- Any disputes between you and us as to
whether there is coverage under this policy
must be flled in the courts of the United
States of America (including its territories and
possessions), Puerlo Rico or Canada.
4. The insured must fully maintain any coverage
required by law, regulation or olher governmen-
tal authority during the policy period, except 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 olher governmental autho -
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, lhe followingis added to Paragraph a.b.(l)(a) under Other
lnsurance of SECTION lV - COMMERCIAL
GENERAL LIABILITY CONDITIONS within the
COMMERCIAL GENERAL LIABILITY COVER-
AGE FORM:
lf the insured's liabilily to pay damages is deter-
mined in a "suit" brought outside the United
States of America (including its territories and
possessions), Puerto Rico or Canada; or
That is coverage required by law, regulation or
other govemmenlal authority in a parl of the
"coverage territory' that is outside the United
States of America (including its territories and
possessions), Puerto Rico or Canada.
For purposes of this coverage only, Paragraph 4.of SECTION V - DEFINITIONS within the
COMMERCIAL GENERAL LIABILITY COVER-
AGE FORM is replaced by:
4. "Coverage territory" means anylvhere 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 SECTION V - DEFINITIONS
wilhin the COMMERCIAL GENERAL LlABlLlry
cOvERAGE FORM is replaced by:
a. A contract for lease of premises. However,
that portion of the contract for a lease of
premises that indemnifles any person or or-
ganization for "property damage" by fire;
smoke from a "hostile fire", 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 temporarily 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 without additional premium charge, your
policy will aulomatically provide the coverage as
of lhe day the revision is effective in your state.
-
AH CG 8623 09 17 lncludes copyrighted material of lnsurance Services Offlce, lnc.,
.,,nr, ir^ ^^.-i--i^-
T. GOOD SAMARITAN SERVICES
l. Under SECTION ll - WHO lS AN INSURED,
paragraph 2.a.(lXd), the following is added:
This exclusion does not apply to your "em-
ployees" or "volunteer workers", other than an
employed or volunteer physician, rendering
"Good Samaritan services".
2. The following definition is added to SECTION
V - DEFINITIONS:
"Good Samaritan services" means any emer-
gency medical services for which no compen-
sation is demanded or received-
All other terms and conditions of lhis policy remain
unchanged.
lncludes copyrighted malerial of lnsurance Services Office, lnc.,
wilh its permission.Page 6 of 6
AH CG 8623 09 l7