Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
2023/01/19 Aztec Landscaping, Inc.SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:CONTACT
(A/C, No):FAX
E-MAILADDRESS:
PRODUCER
(A/C, No, Ext):PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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 AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
$
$
$
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?(Mandatory in NH)
DESCRIPTION OF OPERATIONS belowIf yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
EROTH-STATUTEPER
LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED $PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-JECT LOC
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIREDAUTOS ONLY
2/21/2023
Daisy Trudeau Ins.Services5015CanyonCrestDr.Ste.207RiversideCA92507
Diana Castanon
951-680-9600 888-261-9654
diana@daisytrudeauins.com
License#:CA #0L52222 Nationwide Mutual Ins Co 23787
AZTEC-1 CompWest Insurance Company 12177AztecLandscaping,Inc.DBA Aztec Janitorial7980LemonGroveWayLemonGroveCA91945
Peleus Insurance Company 34118
2027628876
A X 1,000,000
X 300,000
10,000
1,000,000
2,000,000
X
Y Y ACP3096461444 12/15/2022 12/15/2023
2,000,000
Employee Benefits 1,000,000
A 1,000,000
X
X X
Y Y ACP3096461444 12/15/2022 12/15/2023
A X X 5,000,000ACP309646144412/15/2022 12/15/2023
5,000,000
B XCWWCP1000098172/25/2023 2/25/2024
1,000,000
1,000,000
1,000,000
AC CrimeProfessionalLiability ACP3096461444121CTR0193055-02 12/15/20221/19/2023 12/15/20231/19/2024
Employee DishonestyProfLiabAggProfLiabDed
$200,000$1,000,000$10,000
Contractors Equipment-Leased/Rented Equip Coverage in place,Policy #ACP3096461444,Eff 12/15/22 to 12/15/23,Limit:$100,000-Ded:$1,000LimitedPollutioncoverageisinplaceperformCG22640413,Policy#ACP3096461444,Eff 12/15/22 to 12/15/23,Limit:$1,000,000-Ded:NILTHECITYOFMENIFEE,ITS COUNCILMEMBERS,OFFICERS,AGENTS,AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED,PRIMARYWORDING&NON CONTRIBUTORY APPLIES,WHERE REQUIRED BY WRITTEN CONTRACT WITH RESPECTS TO GENERAL LIABILITY PER FORMSCG73231216ANDCG72461115,AND WITH RESPECTS TO AUTO LIABILITY PER FORM AC7005 0316.
City of MenifeeDept.of Finance29844HaunRd.Menifee CA 92586
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
COMMERCIAL AUTO AC 70 05 03 16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO PROTECTION -GOLD
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SUMMARY OF COVERAGES
A.Effect of This Endorsement
B. Newly Acquired or Formed Entities
C. Employees as Insureds -Non owned Autos
D.Additional Insured by Contract, Permit or Agreement
E.Supplementary Payments -Bail Bonds
F.Supplementary Payments -Loss of Earnings
G.Personal Effects and Property of Others Extension
H.Prejudgment Interest Coverage
I.Fellow Employee -Officer, Managers and Supervisors
J_ Hired Auto Physical Damage
K.Temporary Substitute Autos-Physical Damage Coverage
L.Expanded Towing Coverage
M.Auto Loan or Lease Coverage
N.Original Equipment Manufacturer Parts -Leased Private Passenger Types
0. Deductible Amendments
P.Rental Reimbursement Coverage
Q. Expanded Transportation Expense
R.Extra Expense-Stolen Autos
S. Physical Damage Limit of Insurance
T. New Vehicle Replacement Cost
U.Physical Damage Coverage Extension
V. Transfer of Rights of Recovery Against Others To Us
W. Section IV -Business Auto Conditions-Notice of and Knowledge of Occurrence
X. Hired Car Coverage Territory
Y.Emergency Lock Out
Z.Cancellation Condition
AC 70 05 0316 Includes copyrighted material of Insurance Services Office, Inc. with its permission
A[P BAPD:10-9-b4b1444 LD9W 18352 INSURED COPY AC7005031600 0001
Page 1 of 7
47 0021966
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
COMMERCIAL AUTO AC 70 050316
A.1='.FFECT OF THIS 1=:NOORSl='.Ml=NT
Coverage provided under this policy is modifiedby the provisions of this endorsement. If there
is any conflict between the provisions of thisendorsement and the provlslon(s) of any statespecific endorsement also attached to this policy, then the provision(s) of the state-specificendorsement shall apply instead of the provisions of this endorsement that are in conflict,
but only to the extent of the conflict, and only to the extent necessary to bring such provisionsinto conformance with the state requirement(s)contained in the provision(s) of the state-specific
endorsement.
B.NEWLY ACQUIRED OR FORMED ENTITIES
The Named Insured shown in the Declarations isamended to include any organization you newly
acquire or form, other than a partnership, joint
venture, or limited liability company, and overwhich you maintain ownership or majority (morethan 50%) interest; if there is no other similar in
surance available to that organization. Coverageunder this provision is afforded until the 180th
day after you acquire or form the organization or
the end of the policy period, whichever is later.
C. EMPLOYEES AS INSUREDS -NONOWNEDAUTOS
The following is added lo paragraph A.1. Who Is
An Insured of SECTION II -COVERED AUTOSLIABILITY COVERAGE:
d.Any "employee" of yours is an "insured"
while using a covered "auto" you don't own,hire or borrow in your business or your personal affairs.
D, ADDITIONAL INSURED BY CONTRACT, PERMIT OR AGREEMENT
The following is added to A.1. Who Is An Insured of SECTION II -COVERED AUTOS LIABILITY COVERAGE:
Any person or organization that you are required to name as an additional insured in a
written contract or agreement that is executed or signed by you prior to a "bodily injury" or
"property damage" occurrence is an "insured" for Covered Auto L iabilily coverage. However, with respect to covered "autos", such
person or organization is an insured only to the extent that person or organization qualifies as an "insured" under A.1. Who is an Insured of
SECTION II -COVERED AUTOS LIABILITY COVERAGE:
If specifically required by the written contract or agreement referenced in the paragraph above,
any coverage provided by this endorsement to an additional insured shall be primary and any other valid and collectible insurance avail�
able to the additional insured shall be noncontributory with this insurance. If the written
contract does not require this coverage to be primary and the additional insured's coverage to
be non-contributory, then this insurance will be
excess over any other valid and collectible insurance available to the additional insured.
E.SUPPLEMENTARY PAYMENTS BAILBONDS
Supplementary Payments of SECTION II -
COVERED AUTOS LIABILITY COVERAGE is
revised as follows:
{2) Up to $2.500 for cost of bail bonds (includingbonds for related traffic law violations) required because of an "accident" we cover.
We do not have to furnish these bonds.
F.SUPPLEMENTARY PAYMENTS -LOSS OF
EARNINGS
Supplementary Payments of the SECTION II -
COVERED AUTOS LIABILITY COVERAGE isrevised as follows:
(4)All reasonable expenses incurred by the "insured" at our request, including actual loss
of earnings up to $500 a day becau:,e of ti me off from work.
G.PERSONAL EFFECTS AND PROPERTY OFOTHERS EXTENSION
1.The. Care, Custody or Control Exclusion of
SECTION II COVERED AUTOSLIABILITY COVERAGE, does not apply to"property damage" to property, other thanyour property, up to an amount not exceeding $250 in any one "accident". Coverage
is excess over any other valid and collectiblein5urance.
2.The following paragraph is added to A.4.Coverage Extensions of SECTION Ill -
PHYSICAL DAMAGE COVERAGE:
c. We will pay up to $500 for your property
that is lost or damaged as a result of acovered "loss", without applying a de
ductible. Coverage i3 excess over anyother valid and collectible insurance.
Page2 of 7 Includes copyrighted material of Insurance Services Office, Inc. with its permission AC 70 05 0316
ACP BAPD30·9·6461444 LD9W 18352 INSURED COPY AC7005031600 0001 47 0021967
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
H. PREJUDGMENT INTEREST COVERAGE
The following paragraph is added to SECTION II-COVERED AUTOS LIABILITY COVERAGE,
2.Coverage Extensions, a. SupplementaryPaymcntG:
(7)Prejudgment interest awarded against the"insured" on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance, we will not payany prejudgment interest based on that
period of time after the offer.
I. FELLOW EMPLOYEE OFFICERS,MANAGERS, AND SUPERVISORS
The Fellow Employee Exclusion in SECTION II
-COVERED AUTOS LIABILITY COVERAGE isreplaced as tollows;
A."Bodily injury" to any fellow "employee" of the "insured" arising out of and in the courseof thP. fP.llnw "P.mrlnyP.P.1s" P.mrlnymP.nt or
while performing duties related to the conduct of your business. This exclusion does
not apply to an "insured" who occupies a
pocition ac an officer, manager, or cuporvisor.
J. HIRED AUTO PHYSICAL DAMAGE
If covered "auto" designation symbols 1 or 8 apply to Liability Coverage and if at least one "au
to" you own is covered by this policy for Com
prehensive, Specified Causes of Loss, or Collision coverages, then the Physical Damagecoverages provided are extended to "autos" you
lease, hire, rent or borrow without a driver; andprovisions in the Business Auto Coverage Form
applicable to I !ired Auto Physical Damage apply
up to a limit of $100,000. The deductible will be equal to the largest deductible applicable to anyowned "auto" for that coverage. Any Comprehensive deductible does not apply to fire orlightning.
K.TEMPORARY SUBSTITUTE AUTOSPHYSICAL DAMAGE COVERAGE
The following is added to paragraph C. Certain
Trailers, Mobile Equipment And TemporarySubstitute Autos of SECTION I -COVEREDAUTOS:
If Physical Damage Coverage is provided by
this Coverage Form, the following types of vehicles are also covered "autos" for Physical Damage Coverage:
Any "auto" you do not own while used with the permission of its owner as a temporary
COMMERCIAL AUTO AC 70 05 03 16
substitute for a covered "auto'' you own that is out of service because of its:
a.Breakdown;
b.Repair;
C.Servicing;
d."Loss": or
e.Destruction
The coverage that applies is the same as
the coverage provided for the vehicle beingreplaced.
L.EXPANDED TOWING COVERAGE
1.We will pay up to:
a.$100 for a covered "auto" you own of
the private passenger type, or
b.$500 for a covered "auto" you own thatis not of the private passenger type,
for towing and labor costs incurred each time the covered "auto" is disabled. Howev
er, the labor must be performed at the place
of disablement.
2.This coverage applies only for an "auto"covered on this policy for Comprehensive orSpecified Causes of Loss Coverage andColllslon coverages.
3.Payment applies in addition to the otherwise
applicable amount of each coverage you
have on a covered "auto".
M.AUTO LOAN OR LEASE COVERAGE
1.In the event of a total "loss" to a covered"auto", we will pay any unpaid amount dueon the loan or lease, including up to a maximum of $500 for early termination fees orpenalties, for your covered "auto" less:
a.The amount paid under S�CTION Ill -PHYSICAL DAMAGE COVERAGE ofthis policy; and
b.Any:
1)Overdue lease/loan payments at the time of the "loss";
2)Financial penalties imposed under a
lca,;;c for cxcc,;;,;;ivc u,;;c, abnormalwear and tear or high mileage;
3)Security deposits not refunded by a
lessor;
4)Costs of extended warranties, CreditLife insurance, Health, Accident, or
Disability insurance purchased withthe lease; and
AC 70 05 0316 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 3 of 7
ACP BAPD30-9-6461444 LD9W 18352 INSURED COPY AC7005031600 0001 47 0021968
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
COMMERCIAL AUTO AC 70 05 0316
5)Carry-over balances from previousleases.
2.This coverage only applies to a "loss" whichis also covered under this policy for Com
prehensive, Specified Causes of Loss, orCollision coverage.
3.Coverage does not apply to any unpaidamount due on a loan for which the covered
"auto" is not the sole collateral.
N. ORIGINAL EQUIPMENT MANUFACTURERPARTS -LEASED PRIVATE PASSENGERTYPES
Under Paragraph C. Limit of Insurance ofSECTION Ill PHYSICAL DAMAGECOVERAGE, Section 4 is added as follows:
4.We will use new original equipment vehiclemanufacturer parts for any private passenger type covered "auto" where required bythe lease agreement which has a term of at
least six months. If a new original equipment vehicle manufacturer part is not in production or distribution we may use a like,
kind and quality replacement part.
0.DEDUCTIBLE AMENDMENTS
The following are added to the Deductible provision of SECTION Ill -PHYSICAL DAMAGE
COVERAGE:
If another policy or coverage form that is not an c1ulurnuuilt:: (JVli1,;y u, 1,;uvt::rayt:: fu11r1 i::.::.ut::u uythis company applies to the same "accident", the
following applies:
1.If the deductible under this coveraQe is thesmaller (or smallest) deductible, it will bewaived:
2.If the deductible under this coverage is notthe :smaller (or :smalle:st) deductible, it will be reduced by the amount of the smaller (orsmallest) deductible.
If a Comprehensive or Specified Causes of Loss Coverage "loss" from one "accident" involves two or more covered "autos", only the highest
deductible applicable to those coverages will be applied to the "accident." if the cause of the loss is covered for those vehicles. This provision only applies if you carry Comprehensive or Specified Causes of Loss Coverage for those vehicles, and does not Qxtend coverage to any covered "autos" for which you do not carry such
coverage.
No deductible applies to glass if the glass is repaired, in a manner acceptable to us, rather than
replaced.
P.RENTAL REIMBURSEMENT COVERAGE
1.This coverage applies only to a covered "au
to" for which Physical Damage Coverage is
provided on this policy.
2.We will pay for rental reimbursement ex
penses incurred by you for the rental of an"auto" because of "loss" to a covered "auto".Payment applies in addition to the otherwise
applicable amount of each coverage youhave on a covered "auto." No deductibles
apply to this coverage.
3.We will pay only for those expenses incurred
during the policy period beginning 24 hoursafter the "loss" and ending, regardless of the
policy's expiration, with the lesser of thefollowing number of days:
a.The number of days reasonablyrequired to repair or replace the covered"auto". If "loss" is caused by theft, this
number of days is added to the numberof days it takes to locate the covered
"auto" and return it to you.
b. The number of days shown in the
Schedule.
4.Our payment is limited to the lesser of thefollowing amounts:
a.Necessary and actual expenses
incurred.
b.$75 for any one day or for a maximumof 30 days.
5.This coverage does not apply while there
are spare or reserve "autos" available to youfor youroperation:s.
6.If "loss" results from the total theft of a cov
ered "auto" of the private passenger type,we will pay under this coverage only thatamount of your rental reimbursement expenses which is not already provided for un
der SECTION Ill -PHYSICAL DAMAGECOVERAGE Coverage Extension.
Q, EXPANDED TRANSPORTATION EXPENSE
Paragraph A.4.a. of SECTION Ill -PHYSICAL
DAMAGE COVERAGE is replaced by the following:
We will pay up to $50 per day to a maximum of $1500 for temporary transportation expense incum�d by you because of the total theft of a
Page4 of 7 Includes copyrighted material of Insurance Services Office, Inc with its permission. AC 70 05 03 16
ACP BAPDl0-9-6461444 LD9W 18352 INSURED COPY AC7005031600 0001 47 0021969
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
covered "auto" of the private passenger type. We will only pay for those covered "autos" for which you carry Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 24 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or wepay for its "loss".
R.EXTRA EXPENSE -STOLEN AUTOS
The following paragraph is added to CoverageExtensions of SECTION Ill -PHYSICALDAMAGE COVERAGE:
c.We will pay for up to $5,000 for the expenseof returning a stolen covered "auto" to you.
We will pay only for those c;overed "auto:s"for which you carry Comprehensive or Specified Causes of Loss Coverage
S. PHYSICAL DAMAGE LIMIT OF INSURANCE
Under SECTION Ill -PHYSICAL DAMAGECOVERAGE, Paragraph C., Limit of Insurance
is replaced by the following:c, Limit Of Insurance
1.The most we will pay for "loss" in any one"accident" is the lesser of:
a. Tho actual cash value oi tho damaged or stolen property as of the time of the
"loss", or
b.The cost of repairing or replacing thedamaged or stolen property.
2. $1500 is the most we will pay for "loss" inany one "accident" to all electronic equipment that reproduces, receives or transmits
audio, visual or data signals which, at thetime of "loss", is:
a. Permanently installed in or upon thecovered "auto" in a housing, opening orother location that is not normally usedby the "auto" manufacturer for the installation of such equipment.
b.Removable from a permanently installedhousing unit as described in Paragraph
2.a. above or is an integral part of thatequipment; or
c.An integral part of such equipment.
3.An adjustment for depreciation and physical
condition will be made in determining actualcash value in the event of a total "loss".
4.The cost of repairing or replacing may:
a.Be based on an estimate which includesparts turnished by the original equip-
COMMERCIAL AUTO AC 70 os 0316
ment manufacturer or other sources including non-original equipment manufacturers and
b.If a repair or replacement results in better than like kind or quality, we will not pay for the amount of the net improvement.
5.If we offer to pay the actual cash value ofthe damaged or stolen property, we willvalue auto advertising wraps, paint customization, and similar business related advertising modifications. in addition to the actualcash value of the property. Auto advertisingwraps, paint customization, and similarbusiness related advertising modificationswill be valued at the cost to replace them
with an adjustment made for depreciationand physical condition,
T.NEW VEHICLE REPLACEMENT COST
The following is added to the Limit of Insuranceprov1s1on of SECTION Ill PHYSICALDAMAGE COVERAGE:
S. The proviaiona of ptm19rapha 1. and 3. do not apply to a covered "auto" of the privatepassenger type or a vehicle with a grossvehicle weight rating of 20,000 pounds orlt!ss wllid1 is a "nt!w vat1iclt!."
In the event of a total "loss" to your new vehicle to which this coverage applies, we will
pay at your option:
a.The verifiable "new vehicle" purchase
price you paid for your damaged vehi•cle, not including any insurance or war
ranties purchased;
b.If it is available, the purchase price, asnegotiated by us, of a "new vehicle" ofthe same make, model, and equipmentor the most similar model available, notincluding any furnishings, parts, orequipment not installed by the manufacturer or manufacturers' dealership: or.
c.The market value of your damaged vehicle, not including any furnishings,parts, or equipment not installed by themanufacturer or manufacturer's dealership.
We will not pay for initiation or set up costs associated with loans or leases
As used in this endorsement, a "new vehicle" means an "auto" of which you are the original owner that has not been previ-
AC 70 05 03 16 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of7
ACP BAPD30·9·6461444 LD9W 18352
with its permission
INSURED COPY AC7005031600 0001 47 0021970
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
COMMERCIAL AUTO AC 70050316
ously titled and which you purchased less than 365 days before the date of the "loss".
U, PHYSICAL EXTENSIONS DAMAGE COVERAGE
Under SECTION Ill -PHYSICAL DAMAGE
COVERAGE. A. Coverage, Coverage Extensions, b, Loss of Use Expenses is replaced by the following:
b. Loss of Use Expenses
For Hired Auto Physical Damage, we willpay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without adriver, under a written rental contract oragreement. We will pay for loss of use expenses if caused by:
(1)Other than collision if the Declarations
indicate that Comprehensive Coverageis provided for any covered "auto";
(2)Specified Causes of Loss only if theDeclarations indicate that SpecifiedCauses of Loss Coverage is providedfor any covered "auto"; or
(3) Collision only if the Declarations indicate
that Collision Coverage is provided forany covered "auto."
However, the most we will pay for any expenses for loss of use is $50 per day, to a maximum of $1,500. The insurance provided by this provision is excess over any other collectible insurance.
V.TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US
The following is added to the Transfer Of RightsUf Hecovery Against utners lo us {;ond1t1on:
We waive any right of recovery we may
have against any person or organization to
the extent required of you by a written contract executed prior to any "accident" because of payments we make for damages under this coverage form.
W.NOTICE OF AND KNOWLEDGE OF OCCURRENCE
SECTION IV -BUSINESS AUTO
CONDITIONS, Paragraph A is amended as follows:
6.NOTICE OF AND KNOWLEDGE OFOCCURRENCE
a.Your obligation in the Duties in the Eventof Accident, Claim, Suit or Loss Condition relative to notification requirements
applies only when the •accident" or"loss" is known to:
(1)You, if you are an individual;
(2)A partner, if you are a partnership;
(3)A member, if you are a limited liability
company;or
(4)An executive officer or insurancemanager, lt you are a corporation.
b.Your obligation in the. Duties in the Eventof Accident, Claim, Suit or Loss Conditionrelative to providing us with documentsconcerning a claim or "suit" will not beconsidered breached unless the breachoccurs after such claim or "suit" is knownto:
(1)You, if you are an individual;
(2)A partner, if you are a partnership;
(3)A member, if you are a limited liability company; or
(4)An executive officer or insurancemanager, if you are a corporation.
X.HIRED CAR-COVERAGE TERRITORY
Item (5) of the Policy Period, Coverage TerritoryGeneralcondltlonss replaced by the ronowlng:
(5)Anywheren the worldif a covered "auto" isleased, hired, rented or borrowed without adriverfor a period of 30 days or less; and
Y.EMERGENCY LOCKOUT
We will reimburse you up to $100 for reasonableexpense incurred for the services of a locksmithto gain entry into your covered "auto" subject tothese provisions:
1.Your door key, electronic key or key entrypad has been lost, stolen or locked in your
covered "auto" and you are unable to entersuch "auto" , or
2.Your keyless entry device battery dies andyou are unable to enter such "auto" as a result,
3.Your key, electronic key or key entry padhas been lost or stolen and you havechanged the lock to prevent an unauthorizedentry; and
Page& of 7 Includes copyrighted material of Insurance Services Office, Inc with its permission. AC 7005 0316
ACP BAPD3D-9-b4bl444 LD9W 18352 INSURED COPY AC7005031600 0001 47 0021971
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
4.Original copies of receipts for services of alocksmith must be provided before reimbursement is payable.
Z.CANCELLATION CONDITION
Paragraph A.2. of the COMMON POLICYCONDITION -CANCELLATION applies
except as follows:
COMMERCIAL AUTO AC 70 os 0316
If we cancel for any reason other than nonpayment of premium, we will mail or deliver to the Flrst Named Insured written notice ofcancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states that require more than 60 days prior notice of cancellation.
AC 70050316 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page7 of7
ACP BAPD30·9·6461444 LD9W 18352 INSURED COPY AC7005031600 0001 47 0021972
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
COMMERCIAL GENERAL LIABILITY CG 72 461115
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL V.
ADDITIONAL INSURED -OWNERS1 LESSEES OR CONTRACTORS -AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL UABIUTY COVERAGE PART
A. SecHon II -Who 19 An ln9ured i� nmt:-nrlt:-d 10include as ar1 addilior1al insurw.
Ongoing Operations
1.Any person or organriation ror wnom you areperforming operations when you and suchperson or organization have agreed in writingin o. contract or ogfccmcnt that such personor organization be added as an additional1nsurea on your policy; ana
:!. Ariy 01hc-r pertJon err organi2tllion you o,c required lo add as an additional insured under tne contract or agreement oescrroeo In Paragraph 1. above.
such µerso11(st or orgar1iza1ion(s) is an add"ilionar Insureo only with respect to I1abIhty tor "boaIIy injury". "property damage" or "personal and advertising injury" caused, in whole or in part, by:
a.Your acts or omrss,ons; or
b.The o.cts or omissions of those £tcting onyour bel1alt;
in the performance of your ongoing operations for the o.dditionol in�urcd.
However. the insurance afforded to such additional insured described abo11e·
a.Only applies to fhe extent permitted bylaw;and
b.Will not be broader than that which �'Ouare required by the contract or agreementto provide for such additional insured.
A pers.:in's or organization's statu$ as an additional insured for ongoing operations ends when your operations tor the person or organi,a1ion described in Paragraph 1. above are oomple1oo.
With respect to insurance afforded to these additional insureds for ongoing operations, this insurance docs no1 npply to '·bodily injury" 01 "pn.:,perly damage" oc;c;u,Ying alle,.
o.All work, including mo.tcriol, port� orequiµmer1l furnished i,1 00t1r1ec\ior1 wilhsuch work, on tne pro1ect {otner tnanservice, maintenance or repairs) to beporformad by or on bah�lf of thaadditional insured{s} at the location ot thecovered operations has been completedor
b.that operation of "your work" out of whiehthe injury or damage arises has been putto its intended use by any person ororganin1tion other than �nothP.rcon1re.c\01 or suboon\re.ctor engaged inperforrni11y operalions lvr a µrincipal as apart ot the same pro1ect.
B.Section H -Who Is An Insured is amended toillClul'.le as clll cl(t(JiliOllcll irl$urW.
Products-Completed Operations
Any person or organization with whom you haveaQreed in writinA in a contract or aQrooment thatsuch person or organization be added as anadditional insured on your policy with respect toliabilily for "bodily injury" Of "1:n·vµt:dy dct,ll<lg�"caused, in whole or in part, by ·your work"performed for such person or organization andinclucl9cl ir. th� ·products-comp!Qtlid op@rafonshazard".
However. the insurance afforded tc suchadditional insured described above:
a.Only applies to the extent permitted bylaw; and
b.Will 110( be brooder lhan lhal which youare required by the contract or agreementto provide for such additional insured.c.With respeo( lo lhe insv.-dnoe �lfor\:led (t> theseaod1t1onar insureds, this rnsurance ooes not applyto "bodily injury", "property damage" or "personaland advQrtising injury" arising out of 1h9 r9nd9ri11g
CG 72 46 1115 Includes copyrit;1hted material of Insurance Services Office. Inc. with its permission. Page 1 of 2
ACP GLD0309b4bl444 LKIS 18353 INSURED COPY 47 0021539
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
CG 72 4611 15
of, or lhe lailure lo render, any professional architec1uraI. engineering or surveying services, including:
1.The preparing, approving. or failing to prepareor approve, maps, shop drawings, opinions,reports. surveys. field orders. change ordersor drawings and specilicahons; or
2.Supervisory, inspection, architectural orengineering activities.This exclusion applies even if lhe claims againsl any insured allege negligence or other wrongdoing in the supervision, hiring, amploym�mt, training or monitoring at olh�rs by that insured, if \he "occurtenee" which caused the "bodily Injury· or �proper1y damage·, or the offense which caused the "personal and adve.rti!>ino injury". involved the rendering of. or the t::iiluro to rcndor, .1ny protcssiOn.ll architeclura/, engineering or surveying services.
0 With re!:poct to the in!lurnncc afforded to these addilionat insureds. Ille loUovving is added lo Sectron m -Limits Of Insurance:
The mosl we will pay on behalf of 1he addi1fonal i11,;,1,m;n;l 1$ lht;: ;:'11llQ1,11ll QI ttl$1,1f�11Ct;1.
1.RP.(111irro hy 1hP. l"'.("ln1r"'l"'.t nr �or�mE>.ntdccoribcd in PQl'ogroph A.1. or Paragraph B.;vr'
2.Available under Ifie applicable Limils orInsurance shown in the Declarations:
whiohovcr iG lcGG
This endorsement shall not increase the applicable Limits. of Insurance shown in lhe Dool.:ir;:itiom;.
E.With respect 10 the insurance afforded to theseadditional insureds, the tallowing is added to
Seotion IV -Commeroial General LiabilityConditions. Condilion 4. Other Insurance andsupersedes any provision to the contrary:
Primary And Noncont,ibutory Insurance
This insurance is primary to and will not seek contribution from any other insurance ::tv::til::tblo to ::tn :.1ddttion:.1I incurcd undor your policy provided that
(1)The aeld1hana1 insured 1s a Namedlncurod under cuoh other innumnoo; .:ind
(2)You have agreed in writing in a contractor agreement that this insurance. wouldbe primnry and would not cocki;;onlribution from any other insuranceavailable to the additional insured.
All 1erms and conditions oi this policy apply unless modtt1ed by this endorsement.
Page 2 of 2
ACP GLDO3096461444
Includes copvric:ihted material of Insurance Services Office. Inc. with its permission.
LKIS 18353 INSURED COPY
CG 72 46 1115
47 0021540
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
COMMERCIAL GENERAL LIABILITY
CG 73 23 1216
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTORS ENHANCEMENT PLUS ENDORSEMENT
INCLUDING MEDICAL PAYMENTS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Lost Key Coverage
1.Under Section I -Coverages, Coverage A
Bodily Injury And Property DamageLiability, coverage is extended to include
the following:
If a customer's master or grand key,
excluding electronic key card, is lost,damaged or stolen while in your care,
custody or control we will pay the cost of
replacing the keys, including the master lockand all keys used in the same lock, the cost
of adjusting locks to accept the new keys, orthe cost to replace the locks, whichever isless.
2.Limit of Insurance -For the purpose of thiscoverage the most we will pay is $ 10,000per "occurrence".
B.Voluntary Property Damage
1.Section I -Coverages,Coverage A BodilyInjury And Property Damage Liability
coverages extendedo includethefollowing:
At your request, we will pay for "property
damage"to property of others caused by you and while in yourpossession,risingout of your
business operations and occurring during thepolicyperiod.
2.Limit or Insurance -For the purpose of this
coverage the most we will pay is $1,500 per"occurrence".
C. Non-Owned Watercraft
Under Section I -Coverages, Coverage ABodily Injury And Property Damage Liability,2.Exclusions, Exclusion g. Aircraft, Auto OrWatercraft Paragraph (2) (a) is replaced with:
(a)Less than 51 feet long; and
D.Expanded Property Damage Coverage
1.For the purposes of this endorsement only:
Section I -Coverages, Coverage ABodily Injury And Property Damage
Liability, 2. Exclusions, (=:l(clusion j.Damage To Property is amended as follows:
a.Paragraphs (3), (5), and (6) are deletedin their entirety.
b, Paragraph (4} is deleted in its entirety and replaced with:
(4)Personal property in the care,custody, or control of the insured:
(a)for storage or sale at premises
you own, rent or occupy; or
(b)while being transported by anyaircraft, "auto" or watercraftowned or operated by or rented
to or loaned to any insured.
c. Thg covgragg providgd by this
endorsement does not apply to"property damage":
(1)Arising out of the disappearance orloss of use of personal property; or
(2)Included in the "products-completedoperations hazard".
2.Limit of Insurance -The most we will pay
for loss arising out of any one "occurrence"
is $5,000.
3.Deductible • Our obligation to pay for acovered loss applies only to the amount of
loss in excess of $250.
We will pay the deductible amount to effectsettlement of any claim or "suit" and, uponnotification of this action having been taken,
you shall promptly reimburse us for thedeductible as has been paid by us.
CG 73 231216 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 5
ACP GLDO3096461444 LKIS 18353 INSURED COPY 47 0021544
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
CG 73 231216
This insurance is primary to any expanded
property damage coverage provided by a separate endorsement attached to this policy, and it will supplant any deductible in
said endorsement
c. Damage To Premises Rented To You
1.Under Section I-Coverages, Coverage ABodily Injury And Property Damage
Liability, the last paragraph of 2.Exclusions is replaced with:
If Damage To Premises Rented To You isnot otherwise excluded, Exclusions c.through n. do not apply to damage by fire,
lightning, explosion, smoke, or sprinkler
leakage to premises while rented to you ortemporarily occupied by you with permissionot the owner.
2.Under Section Ill -Limits Of Insurance,Paragraph 6 is replaced with:
6.Subject to 5. above, the Damage ToPremises Rented To You Limit is the
most we will pay under Coverage A for
damages because of "property damage"to any one premises, while rented to
you, or in the case of damage by fire,lightning, explosion, smoke or sprinkler
leakage, while rented to you ortemporarily occupied by you with
permission of the owner. The limit isincreased to $1,000,000.
3.Under Section IV -Conunerc:ial GeneralLiability Conditions, 4. Other Insurance, b.
Excess Insurance (1) (a) (ii) is replacedwith:
(ii)That is Fire, Lightning, Explosion, smoKeor Sprinkler leakage insurance for
premises rented to you or temporarilyoccupied by you with permission of theowner.
F.Supplementary Payments
Under Section I -Coverages, SupplementaryPayments -Coverages A and B Paragraphs
1.b and 1.d. are replaced with:
b.Up to $2,500 for cost of bail bonds required
because of accidents or traffic law violationsarising out of the use of any vehicle to whichthe Bodily Injury Liability Coverage applies.
We do not have to fumish these bonds.
d.All reasonable expenses incurred by the
insured at our request to assist us in theinvestigation or defense of the claim or
"suit", including actual loss of earnings up to$500 a day because of time off from work.
G.Newly Formed And Acquired organizations
Under SECTION II -WHO IS AN INSURED
Paragraph 3.a. is replaced with:
a.Coverage undor this provision is affordedonly until the 18C1" day after you acquire or
form the organization or the end of the policyperiod, whichever is earlier;
H, Additional Insured -Automatic Status When Required In An Agreement Or Contract With
You
Soclion II -Who Is An lnsurod is amQndQd lo
include: 1.Any person(s) or organization(s) described
in Paragraph a. -d. below with whom youhave agreed in writing in a contract orwritten agreement that such person or
organization be added as an additional
insured on your policy during the policy period shown In the Declaratlons.
2, Any other person or organization you are required to add as an additional insured
under the contract or agreement described in Paragraph 1. above.
The person or organization added as an insured by this endorsement is an insured only for liability due to:
a.Lessors of Leased Equipment -with
respect to their liability for "bodily injury","property damage", or "personal andadvertising injury", caused in whole or inpart by your maintenance, operation, or use of equipment leased to you by such
p,m:on(s) or organization(s). Thisinsurance does not apply to any"occurrence" which takes place after the
equipment lease expires.
However, their status as additional
insured under this policy ends whentheir lease, contract, or agreement with
you for such leased equipment expires.
b.Managers or Lessors of Premises -
with respect to liability arising out of the
ownership, maintenance, or use of thatpart of thQ prQmisQs you own, rQnt,lease, or occupy.
Page2 of 5 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CG 73 231216
A(I' \JLUO30964bl.444 LKIS 18353 INSURED COPY 47 0021545
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
This insurance does not apply to:
(1)Any "occurrence" which takes place after you cease to be a tenant inthat premises.
(2)Structural alterations, new construction, or demolition operationsperformed by or on behalf of theperson or organization.
Howovor, their sto.tus o.s o.dditiono.l insured under this policy ends when you
cease to be a tenant of such premises.
c, State or Political Subdivision -
Permits Relating to Premises - with respect to the following hazards for
which the state or political subdivision has issued a permit or authorization in connection with premises you own, rent, or control and to which this insurance applies,
(1)The existence, maintenance, repair, construction, erection, or removal ofadvertising signs, awnings, canopies, cellar entrances, coal no1es, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or
decorations and similar exposures; or
(2)The construction, erection, orremoval of elevators; or
(:S) The ownership maintenanr;e or use of any elevators covered by this insurance.
This insurance does not apply to:
(1)"Bodily injury" or "property damage"or "personal or advertising injury"arising out of operations performedfor the �tate or municipality; or
(2)"Bodily injury" or "property damage"included within the "productscompleted operations hazard".
However, such state or political subdivision's status as additional
insured under this policy ends when the
pQrmit Qnds.
d.Owners, Lessees, or Contractors -with respect to liability for "bodily injury","property damage", or "personal andadvertising injury" caused in whole or inpart, by:
CG 73 23 1216
(1) Your acts or omissions; or
(2)The acts or omissions of those acting on your behalf; in theperformance of your ongoingoperations performed for thatadditional insured, whether the workis performed by you or on yourbehalf.
The insurance does not apply to:
(1)"Bodily injury'', "property damagefl,or "personal and advertising injury"arising out of the rendering of or the
failure to render any professionalarchitectural, engineering, or surveyservices, including:
(a) The preparing, approving, orfailing to prepare or approvemaps, shop drawings, opinions,reports, survey, field orders,change orders, or drawings andspecifications; or
(b)Supervisory, inspection, architectural or engineering activities.
This exclusion applies even ifthe claims against any insuredallege negligence or otherwrongdoing in the supervision,hiring, employment, training or
monitoring of others by thatinsured, if the "occurrence"which caused the "bodily injury"or "property damage", or theoffense which caused the"personal and advertising
injuiy", involved the rendering of, or failure to render, any professional, architectural, engineering, or surveying
�ervice�.
(2) "Bodily injury" or "property damage"occurring after:
(a)All work, including materials,parts, or equipment furnished inconnection with such work, onthe project (other than service,maintenance, or repairs) to be performed by or on behalf of the additional insured(s) at the location of the coveredoperations has been completed:or
CG 73 23 12 16 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 5
with its permission.
Al.I' uLLJO.i096461444 LKIS 18353 INSURED COPY 47 0021546
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
CG 73 231216
(b)That portion of "your work" outof which the injury or damagearises has been put to itsintended use by any person or
organization other than anothercontractor or subcontractor engaged in performing operations for a principal as a part of the same project.
However, a person or organization's status as additional insured under this policy ends when your operations for that additional insured are completed.
With respect to the insurance afforded to such additional insureds a. - d. described above, the following is added to Section Ill -Limits Of Insuran ce:
If coverage provided to the additional insured is required by a contract or ai:ireement, the most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement;or
2. Available under the applicable Limits of Insurance shown in the Declarations:
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
However, the im,urance afforded to auch additional insureds a. -d. described above:
1. Only applies to the extent permitted bylaw; and
2.Will not be broader than that which youare required by the contract oragreement to provide for such additional insured.
3.Primary and Noncontributory -OtherInsurance Conditions
The following is added to the OtherInsurance Condition and supersedes anyprovisions to the contrary:
Primary and Noncontributory Insurance
This insurance is primary to and will notseek contribution from any other insurance
available to an additional insured under yourpolicy provided that:
a. The additional insured is a NamedInsured under such other insurance; and
b.You have agreed in writing in a contractor agreement that this insurance wouldbe primary and would not seekcontribution from any other insurance
available to the additional insured.
I.Employee Bodily Injury To Another Employee
Under Section II -Who Is An Insured Thefollowing is added to Paragraph 2.a.(1):
Paragraphs 2.a.(1) (a), (b) and (c) do not apply
to "bodily injury" to a co·Memployee" in thecourse of the co-"employee's" employment by
you, or to "bodily injury" to a co-"volunteer worker'' whilG performing dutiGs rGlated to the conduct of your business.
J.Broad Form Named Insured
Under Section II -Who Is An Insured Thefollowing is added to Paragraph 2.:
e.Any business entity incorporated or
organized under the laws of the United Stateof America (including any State thereof), itsterritories or possessions, or Canada
(including any Province thereof) in which theNamed Insured shown in the Declarationsowns, e1ur1ng the poncy period, an Interest Of
more than fifty percent. If other validcollectible insurance is available to any
business entity covered by this solely by reason of ownership by the Named Insuredshown in the Declarations in excess of fifty
percent, this insurance is excess over the
other insurance, whether primary, excess,contingent, or on any other basis.
K.Aggregate Limit Per Location
Under Section Ill -Limits Of Insurance thefollowing is added to Paragraph 2:
The General Aggregate Limit under Section IllLimits Of Insurance applies separately to each
of your locations owned by or rented to you ortemporarily occupied by you with the permissionof the owner. For the purposes of this provision,location means premises involving the same orconnecting lots, or premises whose connectionis interrupted only by a public street, roadway, wateiway or railroad right-of-way.
L.Aggregate Limit Per Project
Under Section Ill -Limits Of Insurance The
following paragraph is added to Paragraph 2:
The General Aggregate Limit under Section IllLimita Of lnaurance applies separately to each
of your construction projects away frompremises owned by or rented to you.
Page4 of 5 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CG 73 231216
ACP GLDO3096461444 LKIS 18353 INSURED COPY 47 0021547
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04
M. Medical Payments
Under Section Ill -Limits Of Insurance, Paragraph 7. is replaced with:
7.Subject to 5. above, the higher of:
a. $10,000; or
b.The amount shown in the Declarationsfor Medical Expense Limit is the most
we will pay under Coverage C for allmedical expenses because of "bodilyinjury" sustained by one person.
This coverage does not apply if Coverage C
-Medical Payments is excluded either bythe provisions of any coverage forms
attached to the policy or by endorsement.
N. Knowledge Of An Occurrence
Under Section IV -Commercial GeneralLiability Conditions, the following is added to2.Duties In The Event Of Occurrence,Offense, Claim Or Suit:
e.Knowledge of an occurrence, offense, claim
or suit by an agent or employee of anyinsured shall not in itself constitute
knowledge of the insured unless you, a
partner, if you are a partnership; or anexecutive officer or insurance manager, if
you are a corporation receives such noticeof an occurrence, offense, claim or suit fromthe agent or employee.
f.The requirements in Paragraph b. will not
be considered breached unless there isknowledge of occurrence as outlined inParagraph e. above.o.Unintentional Failure To Disclose Hazard
Under section IV -commercial GeneralLiability Conditions, Condition 6.Representations the following paragraph is
added:
d.Your failure to disclose all hazards or prior
"occurrences" or offenses existing as of the
CG 73 23 1216
inception date of the policy shall not prejudice the coverage afforded by this
policy provided such failure to disclose all hazards or prior "occurrences" or offenses is
not intentional. This provision does not
affect our right to collect additional premium
or exercise our right of cancellation or nonrenewal.
P.Waiver Of Subrogation
Under Section IV -Commercial General
Liability Conditions, 8. Transfer Of Rights OfRecovery Against Others To Us the following
paragraph is added:
If required by a written contract executed prior toloss, we waive any right of subrogation we mayhave against the contracting person ororganization because ot payments we make torinjury or damage arising out of your ongoing
operations or "your work" done under a contractwith that person or organization and included inthe "products-completed operations hazard".
Q, Liberalization
Under Section IV -Commercial General Llablllty Conditions, the following paragraph Is added:
10, Liberalization
If we revisG this coverage form to providG more
coverage without additional premium charge, your policy will automatically provide the
additional coverage as of the day the revision is
effective in your state.
R.Broadened Bodily Injury Definition (Mental
Anguish)
Under Section V -Definitions Definition 3.
"Bodily Injury" is replaced with:
3."Bodily injury" means physical injury,
sickness, or disease to a person and ifarising out of the foregoing, mental anguish,mental injury, shock, or humiliation,
including death at any time resultingtherefrom.
All terms and conditions of this policy apply unless modified by this endorsement.
CG 73 231216
ACP GLDO3096461444
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
LKIS 18353 INSURED COPY
Page 5 of 5
47 0021548
DocuSign Envelope ID: 7B0F9481-A1E8-403D-81BB-EFEAE034BC04