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2022/06/23 Complete Paperless Solutions (3)
06/08/2022 Robert Harris Insurance Agency, Inc. Lic. #0216736 3150 Bristol St., Suite 200 Costa Mesa CA 92626 Arlene Rhodes (714) 619-4480 (714) 619-4481 arlene@reharris.com Complete Paperless Solutions 5130 E La Palma Ave Ste 206 Anaheim CA 92807-2078 Travelers Casualty Insurance Co of America 19046 Hartford Casualty Ins. Co.29424 Lloyds of London 22-23 Master Cert A Y Y 6808B847614 06/23/2022 06/23/2023 2,000,000 300,000 5,000 2,000,000 4,000,000 4,000,000 DEENC A 6808B847614 06/23/2022 06/23/2023 2,000,000 B Y Y 72WECZX9262 06/23/2022 06/23/2023 1,000,000 1,000,000 1,000,000 C Professional Liability Claims Made Policy ESK0839473561 06/23/2022 06/23/2023 Each Claim $2,000,000 Aggregate $2,000,000 Each Claim Deductible $10,000 City of Menifee, its officers, agents and employees are Additional Insureds with respects to the General Liability per the attached policy forms. CANCELLATION PROVISION: 30 Day Notice/ Except 10-Day Notice for Non-Payment of Premium. City of Menifee 29844 Haun Road Menifee CA 92586 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 THIS CERTIFICATE 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 OCCURRENCEDAMAGE 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 DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C 26 CFC Underwriting Limited is Authorized and Regulated by the Financial Conduct Authority ©1999-2019 CFC Underwriting Ltd, All Rights Reserved Technology (US) v3.1 c. any other law, regulation or statute relating to unsolicited communication, distribution, sending or transmitting of any communication via telephone or any other electronic or telecommunications device. However, this Exclusion will not apply to INSURING CLAUSE 1 (SECTION F only). 62.Vacant premises in respect of INSURING CLAUSES 4 and 5, resulting from premises left vacant for more than 60 consecutive days. 63.War arising directly or indirectly out of: a. war, invasion, acts of foreign enemies, hostilities or warlike operations (whether war is declared or not), civil war, rebellion, insurrection, civil commotion assuming the proportions of or mounting to an uprising, military or usurped power; or b. any action taken in controlling, preventing, suppressing or in any way relating to a. above. 64.Website content accessibility arising directly or indirectly out of the actual or alleged violation of any laws, regulations or guidelines relating to the accessibility of your website content. 65.Willful or dishonest acts of senior executive officers arising directly or indirectly out of any willful, criminal, malicious or dishonest act, error or omission by a senior executive officer as determined by final adjudication, arbitral tribunal or written admission. CCONDITIONS 1.What you must do in the event of a claim or cyber incident If any senior executive officer becomes aware of any incident which may reasonably be expected to give rise to a claim under this Policy you must: a. notify the claims managers (in respect of cyber incidents, a telephone call to our cyber incident response line will constitute notification) as soon as is reasonably practicable and follow their directions. However, in respect of INSURING CLAUSES 1 (SECTIONS A, B, C, D, E, G and H only) and 3 (SECTION G only) this notification must be made no later than the end of any applicable extended reporting period; and b. not admit liability for or settle or make or promise any payment or incur any costs and expenses without our prior written agreement (which will not be unreasonably withheld). If you discover a cyber event you may only incur costs without our prior written consent within the first 72 hours following the discovery and any third party costs incurred must be with a company forming part of the approved claims panel providers. All other costs may only be incurred with the prior written consent of the claims managers (which will not be unreasonably withheld). DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C 27 CFC Underwriting Limited is Authorized and Regulated by the Financial Conduct Authority ©1999-2019 CFC Underwriting Ltd, All Rights Reserved Technology (US) v3.1 2.Additional insureds We will indemnify any third party as an additional insured under this Policy, but only in respect of sums which they become legally obliged to pay (including liability for claimants' costs and expenses) as a result of a claim arising solely out of an act committed by you, provided that: a.you contracted in writing to indemnify the third party for the claim prior to it first being made against them; and b. had the claim been made against you, then you would be entitled to indemnity under this Policy. Before we indemnify any additional insured they must: a. prove to us that the claim arose solely out of an act committed by you; and b. fully comply with CONDITION 1 as if they were you. Where we indemnify a third party as an additional insured under this Policy, this Policy will be primary and non- contributory to the third party's own insurance, but only if you and the third party have entered into a contract that contains a provision requiring this. Where a third party is treated as an additional insured as a result of this Condition, any claim made by that third party against you will be treated by us as if they were a third party and not as an insured. 3.Agreement to pay claims (duty to defend) We have the right and duty to take control of and conduct in your name the investigation, settlement or defense of any claim. We will not have any duty to pay costs and expenses for any part of a claim that is not covered by this Policy. You may ask the claims managers to consider appointing your own lawyer to defend the claim on your behalf and the claims managers may grant your request if they consider your lawyer is suitably qualified by experience, taking into account the subject matter of the claim, and the cost to provide a defense. We will endeavor to settle any claim through negotiation, mediation or some other form of alternative dispute resolution and will pay on your behalf the amount we agree with the claimant. If we cannot settle using these means, we will pay the amount which you are found liable to pay either in court or through arbitration proceedings, subject to the limit of liability. We will not settle any claim without your consent. If you refuse to provide your consent to a settlement recommended by us and elect to continue legal proceedings in connection with the claim, any further costs and expenses incurred will be paid by you and us on a proportional basis, with 50% payable by us and 50% payable by you. As a consequence of your refusal, our liability for the claim, excluding costs and expenses, will not be more than the amount for which the claim could have been settled. 4.Calculation of business interruption losses In respect of INSURING CLAUSES 2 (SECTION G only) and 5, in the event of a claim for any financial loss sustained by you, you must provide the claims managers with your calculation of the financial loss including. a. how the loss has been calculated and what assumptions have been made; and DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C 28 CFC Underwriting Limited is Authorized and Regulated by the Financial Conduct Authority ©1999-2019 CFC Underwriting Ltd, All Rights Reserved Technology (US) v3.1 b. supporting documents including account statements, sales projections and invoices. If we are unable to agree with your calculation of the financial loss, we will appoint an independent expert agreed between you and us which will be paid for by us. If an independent expert cannot be agreed upon, one will be appointed by an arbitrator mutually agreed between you and us whose decision will be final and binding. Once an independent expert has been appointed, their calculation of any financial loss sustained by you will be final and binding. 5.Cancellation This Policy may be canceled with 30 days written notice by either you or us. If you give us notice of cancellation, the return premium will be in proportion to the number of days that the Policy is in effect. However, if you have made a claim under this Policy there will be no return premium. If we give you notice of cancellation, the return premium will be in proportion to the number of days that the Policy is in effect. We also reserve the right of cancellation in the event that any amount due to us by you remains unpaid more than 60 days beyond the inception date. If we exercise this right of cancellation it will take effect from 14 days after the date the written notice of cancellation is issued. The Policy Administration Fee will be deemed fully earned upon inception of the Policy. 6.Continuous cover If you have neglected, through error or oversight only, to report an incident discovered by you that might give rise to a claim under this Policy during the period of a previous renewal of this Policy issued to you by us, then provided that you have maintained uninterrupted insurance of the same type with us since the expiry of that earlier Policy, we will permit the matter to be reported under this Policy and we will indemnify you, provided that: a. the indemnity will be subject to the applicable limit of liability of the earlier Policy under which the matter should have been reported or the limit of liability, whichever is the lower; b.we may reduce the indemnity entitlement by the monetary equivalent of any prejudice which has been suffered as a result of the delayed notification; and c. the indemnity will be subject to all of the terms and conditions of this Policy, other than a. above. 7.Cross liability and severability In respect of INSURING CLAUSE 3 only, where there is more than one entity insured under this Policy, and subject to the limit of liability, any claim made by one insured entity against another insured entity will be treated as if they are a third party and knowledge possessed by one insured entity will not be imputed to any other insured entity. 8.Establishing loss of contents If you make a claim under this Policy for loss of contents, you must reasonably establish how and when the incident took place. This may include confirmation that the incident was reported to the appropriate law enforcement authorities and details of any investigation they undertook. DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C 29 CFC Underwriting Limited is Authorized and Regulated by the Financial Conduct Authority ©1999-2019 CFC Underwriting Ltd, All Rights Reserved Technology (US) v3.1 9.Extended reporting period In respect of INSURING CLAUSES 1 (SECTIONS A, B, C, D, E, G and H only) and 3 (SECTION G only), an extended reporting period of 60 days following the expiry date will be automatically granted at no additional premium. This extended reporting period will cover, subject to all other terms, conditions and exclusions of this Policy, claims first made against you during the period of the policy and reported to us during this extended reporting period. No claim will be accepted by us in this 60 day extended reporting period if you are entitled to indemnity under any other insurance, or would be entitled to indemnity under such insurance if its limit of liability was not exhausted. 10.Optional extended reporting period In respect of INSURING CLAUSES 1 (SECTIONS A, B, C, D, E, G and H only) and 3 (SECTION G only), if we or you decline to renew or cancel this Policy then you will have the right to have issued an endorsement providing an optional extended reporting period for the duration stated in the Declarations page which will be effective from the cancellation or non-renewal date. This optional extended reporting period will cover claims first made against you and reported to us during this optional extended reporting period but only in respect of any claim arising out of any act, error or omission committed prior to the date of cancellation or non-renewal and subject to all others terms, conditions and exclusions of this Policy. If you would like to purchase the optional extended reporting period you must notify us and pay us the optional extended reporting period premium stated in the Declarations page within 30 days of cancellation or non-renewal. The right to the optional extended reporting period will not be available to you where cancellation or non-renewal by us is due to non-payment of the premium or your failure to pay any amounts in excess of the applicable limit of liability or within the amount of the applicable deductible as is required by this Policy in the payment of claims. At the renewal of this Policy, our quotation of different premium, deductible, limits of liability or changes in policy language will not constitute non-renewal by us. 11.Fraudulent claims If it is determined by final adjudication, arbitral tribunal or written admission by you, that you notified us of any claim knowing it to be false or fraudulent in any way, we will have no responsibility to pay that claim, we may recover from you any sums paid in respect of that claim and we reserve the right to terminate this Policy from the date of the fraudulent act. If we exercise this right we will not be liable to return any premium to you. However, this will not affect any claim under this Policy which has been previously notified to us. 12.Innocent non-disclosure We will not seek to avoid the Policy or reject any claim on the grounds of non-disclosure or misrepresentation except where the non-disclosure or misrepresentation was reckless or deliberate. 13.Maintenance of employee automobile liability insurance It is a condition precedent to indemnity under INSURING CLAUSE 3 (SECTIONS H and I only) that all employees who operate an automobile in the course of your business activities will maintain in full force and effect for the period of the policy primary automobile liability insurance in an amount equal to, or greater than, the minimum primary automobile liability limits required in the state of registration of the automobile. If you make a claim under INSURING CLAUSE 3 (SECTIONS H and I only) and the employee has failed to meet these requirements then this Policy will only DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C 30 CFC Underwriting Limited is Authorized and Regulated by the Financial Conduct Authority ©1999-2019 CFC Underwriting Ltd, All Rights Reserved Technology (US) v3.1 respond to provide excess coverage as though the requirements had been met, whereby you agree to pay all sums within and up to the required minimum limit. 14.Mergers and acquisitions If you acquire an entity during the period of the policy whose annual revenue does not exceed 20% of the company's annual revenue, as stated in its most recent financial statements, cover is automatically extended under this Policy to include the acquired entity as a subsidiary. If you acquire an entity during the period of the policy whose annual revenue exceeds 20% of the company's annual revenue, as stated in its most recent financial statements, cover is automatically extended under this Policy to include the acquired entity as a subsidiary for a period of 45 days. We will consider providing cover for the acquired entity after the period of 45 days if: a.you give us full details of the entity within 45 days of its acquisition; and b.you accept any amendment to the terms and conditions of this Policy or agree to pay any additional premium required by us. In the event you do not comply with a. or b. above, cover will automatically terminate for the entity 45 days after the date of its acquisition. Cover for any acquired entity is only provided under this Policy for any act, error or omission committed on or after the date of its acquisition. No cover will be automatically provided under this Policy for any acquired entity: a. whose business activities are materially different from your business activities; b. that has been the subject of any lawsuit, disciplinary action or regulatory investigation in the 3 year period prior to its acquisition; or c. that has experienced a cyber event in the 3 year period prior to its acquisition, if the cyber event cost more than the highest deductible of this Policy. If during the period of the policy you consolidate, merge with or are acquired by another entity then all coverage under this Policy will terminate at the date of the consolidation, merger or acquisition unless we have issued an endorsement extending coverage, and you have agreed to any additional premium and terms of coverage required by us. 15.Our rights of recovery If we make any payment under this Policy then you must maintain all of your rights of recovery in respect of this payment against any third party and make these available to us where possible. We will not exercise any rights of recovery against employees or the estates, heirs, legal representatives or assigns of any employee in the event of their death, incapacity, insolvency or bankruptcy unless this is in respect of any fraudulent or dishonest acts or omissions as proven by final adjudication, arbitral tribunal or written admission by you. DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C 31 CFC Underwriting Limited is Authorized and Regulated by the Financial Conduct Authority ©1999-2019 CFC Underwriting Ltd, All Rights Reserved Technology (US) v3.1 Any recoveries will be applied in proportion to the amounts paid by you and us in relation to the claim under this Policy. 16.Prior subsidiaries Should an entity cease to be a subsidiary after the inception date, cover in respect of the entity will continue as if it was still a subsidiary during the period of the policy, but only in respect of an act, error, omission or event occurring prior to the date that it ceased to be a subsidiary. 17.Process for paying privacy breach notification costs Any privacy breach notification transmitted by you or on your behalf must be done with our prior written consent. We will ensure that notification is compliant with any legal or regulatory requirements and contractual obligations. No offer must be made for financial incentives, gifts, coupons, credits or services unless with our prior written consent which will only be provided if the offer is commensurate with the risk of harm. We will not be liable for any portion of the costs you incur under INSURING CLAUSE 2 (SECTION B only) that exceed the costs that you would have incurred had you gained our prior written consent. In the absence of our prior written consent we will only be liable to pay you the equivalent cost of a notification made using the most cost effective means permissible under the governing law. 18.Waiver of subrogation Notwithstanding CONDITION 15, we agree to waive our rights of recovery against any third party if, prior to the claim or incident which you reasonably expected to give rise to a claim, you entered into a contract that contains a provision requiring you to do this. 19.Choice of law and service of suit In the event of a dispute between you and us regarding this Policy, the dispute will be governed by the laws of the State of the United States of America shown as the choice of law stated in the Declarations page. We agree, at your request, to submit to the jurisdiction of a court of competent jurisdiction within the United States of America. Nothing in this Condition constitutes or should be understood to constitute a waiver of our rights to commence an action in any court of competent jurisdiction in the United States of America, to move an action to a United States District Court, or to seek a transfer of a case to another court as permitted by the laws of the United States of America or the laws of any State of the United States of America. It is further agreed that service of process in such suit may be made upon the law firm stated in the Declarations page and that in any suit instituted against us, we will abide by the final decision of such court or of any appellate court in the event of an appeal. The law firm stated in the Declarations page is authorized and directed to accept service of process on our behalf in any such suit and, at your request, to give a written undertaking to you that they will enter a general appearance on our behalf in the event such suit is instituted. Additionally, in accordance with the statute of any state, territory or district of the United States which makes such a provision, we hereby designate the Superintendent, Commissioner or Director of Insurance or other officer specified for that purpose in the statute, or his successor or successors in office, as our true and lawful attorney upon whom may be served any lawful process in any action, suit or proceeding instituted by you arising out of this Policy. The law DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C 32 CFC Underwriting Limited is Authorized and Regulated by the Financial Conduct Authority ©1999-2019 CFC Underwriting Ltd, All Rights Reserved Technology (US) v3.1 firm stated in the Declarations page is hereby designated as the firm to whom the above mentioned officer is authorized to mail such process or a copy thereof. DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C TABLE OF CONTENTS COMMERCIAL GENERAL LIABILITY COVERAGE FORM CG T100 0219 Bodily Injury and Property Damage Liability Personal and Advertising Injury Liability Medical Payments CG TO 340219 DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C COMMERCIAL GENERAL LIABILITY c.Method Of Sharing If all of the other insurance permits contributionby equal shares, we will follow this method also.Under this approach each insurer contributesequal amounts until it has paid its applicablelimit of insurance or none of the loss remains,whichever comes first. If any of the other insurance does not permitcontribution by equal shares, we will contributeby limits. Under this method, each insurer'sshare is based on the ratio of its applicable limitof insurance to the total applicable limits ofinsurance of all insurers. d.Primary And Non-Contributory Insurance If Required By Written Contract If you specifically agree in a written contract oragreement that the insurance afforded to aninsured under this Coverage Part must apply ona primary basis, or a primary and noncontributory basis, this insurance is primary toother insurance that is available to such insuredwhich covers such insured as a named insured,and we will not share with that other insurance,provided that: (1)The "bodily injury" or "property damage" forwhich coverage is sought occurs; and (2)The "personal and advertising injury" forwhich coverage is sought is caused by anoffense that is committed; subsequent to the signing of that contract or agreement by you. 5.Premium Audit a.We will compute all premiums for this CoveragePart in accordance with our rules and rates. b.Premium shown in this Coverage Part asadvance premium is a deposit premium only. Atthe close of each audit period we will computethe earned premium for that period and sendnotice to the first Named Insured. The due datefor audit and retrospective premiums is the dateshown as the due date on the bill. If the sum ofthe advance and audit premiums paid for thepolicy period is greater than the earnedpremium, we will return the excess to the firstNamed Insured. c.The first Named Insured must keep records ofthe information we need for premiumcomputation, and send us copies at such timesas we may request. 6.Representations By accepting this policy, you agree: a.The statements in the Declarations areaccurate and complete; b.Those statements are based upon representations you made to us; and c.We have issued this policy in reliance uponyour representations. The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. 7.Separation Of Insureds Except with respect to the Limits of Insurance. andany rights or duties specifically assigned in thisCoverage Part to the first Named Insured, thisinsurance applies: a.As if each Named Insured were the onlyNamed Insured; and b.Separately to each insured against whom claimis made or "suit" is brought. 8.Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of anypayment we have made under this Coverage Part,those rights are transferred to us. The insured mustdo nothing after loss to impair them. At our request,the insured will bring "suit" or transfer those rightsto us and help us enforce them. 9.When We Do Not Renew If we decide not to renew this Coverage Part, we willmail or deliver to the first Named Insured shown inthe Declarations written notice of the nonrenewalnot less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficientproof of notice. SECTION V -DEFINITIONS 1."Advertisement" means a notice that is broadcast orpublished to the general public or specific marketsegments about your goods. products or servicesfor the purpose of attracting customers orsupporters. For the purposes of this definition: a.Notices that are published include materialplaced on the Internet or on similar electronicmeans of communication; and b.Regarding websites, only that part of a websitethat is about your goods, products or servicesfor the purposes of attracting customers orsupporters is considered an advertisement. Page 16 of 21 © 2017 The Travelers Indemnity Company. All rights reserved. CG T100 0219 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTENDENDORSEMENTFORTECHNOLOGY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE -This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part. and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights. duties. and what is and is not covered. A.Non-Owned Watercraft -75 Feet Long Or Less B.Who Is An Insured -Unnamed Subsidiaries C.Who Is An Insured -Employees -SupervisoryPositions D.Who Is An Insured -Newly Acquired Or FormedLimited Liability Companies E.Who Is An Insured -Liability For Conduct OfUnnamed Partnerships Or Joint Ventures F.Blanket Additional Insured -Persons OrOrganizations For Your Ongoing Operations AsRequired By Written Contract Or Agreement G.Blanket Additional Insured -Broad Form VendorsH.Blanket Additional Insured -Controlling Interest PROVISIONS A.NON-OWNED WATER CRAFT -75 FEET LONGOR LESS 1.The following replaces Paragraph (2) ofExclusion 9 .. Aircraft, Auto Or Watercraft,in Paragraph 2. of SECTION I -COVERAGES -COVERAGE A - BODILYINJURY AND PROPERTY DAMAGELIABILITY: (2)A watercraft you do not own that is: (a)75 feet long or less: and (b)Not being used to carry any person orproperty for a charge; 2.The following replaces Paragraph 2.e. ofSECTION II -WHO IS AN INSURED: e.Any person or organization that. with yourexpress or implied consent, either uses or I.Blanket Additional Insured -Mortgagees,Assignees, Successors Or Receivers J.Blanket Additional Insured -GovernmentalEntities -Permits Or Authorizations Relating ToPremises K.Blanket Additional Insured -GovernmentalEntities -Permits Or Authorizations Relating ToOperations L.. Medical Payments -Increased Limit M.Blanket Waiver Of Subrogation N.Contractual Liability -Railroads O.Damage To Premises Rented To You is responsible for the use of a watercraft that you do not own that is: (1)75 feet long or less; and (2)Not being used to carry any person orproperty for a charge. B.WHO IS AN INSURED -UNNAMEDSUBSIDIARIES The following is added to SECTION II -WHO ISAN INSURED: Any of your subsidiaries. other than a partnershipor joint venture. that is not shown as a NamedInsured in the Declarations is a Named Insured if: a.You are the sole owner of, or maintain anownership interest of more than 50% in. suchsubsidiary on the first day of the policy period;and b.Such subsidiary is not an insured undersimilar other insurance. CG D417 0219 C 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 5 Includes copyrighted material of Insurance Services Office, Inc. wllh its permission. DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C COMMERCIAL GENERAL LIABILITY No such subsidiary is an insured for •bodily injury• or "property damage• that occurred, or "personal and advertising injury• caused by an offense committed: a.Before you maintained an ownership interestof more than 50% in such subsidiary; or b.After the date, if any, during the policy periodthat you no longer maintain an ownershipinterest of more than 50% in such subsidiary. For purpose s of Paragraph 1. of Section II -Who Is An Insured, each such subsidiary will be deemed to be designated in the Declarations as: a.A limited liability company; b.An organization other than a partnership, jointventure or limited liability company: or c.A trust: as indicated in its name or the documents thatgovern its structure. C.WHO IS AN INSURED -EMPLOYEES -SUPERVISORY POSITIONS The following is added to Paragraph 2.a.(1) ofSECTIO N H -WHO IS AN INSURED: Paragraphs (1)(a). (b) and (c) above do not applyto •bodily injury" to a co-"employee" while in thecourse of the co-"employee's" employment by youarising out of work by any of your "employees•who hold a supervisory position. D.WHO IS AN INSURED -NEWL V ACQUIREDOR FOR MED LIMITED LAIBILITV COMPANIESThe following replaces Paragraph 3. of SECTION11-WHO IS AN INSURED: 3.Any organization you newly acquire or form.other than a partnership or joint venture. andof which you are the sole owner or in whichyou maintain an ownership interest of morethan 50%, will qua�fy as a Named Insured ifthere is no other similar insurance available tothat organization. However: a.Coverage under this provision is affordedonly: (1)Until the 180th day after you acquireor form the organization or the end ofthe policy period, whichever is earlier,if you do not report such organizationin writing to us within 180 days afteryou acquire or form it: or (2) Until the end of the policy period.when that date is later than 180 daysafter you acquire or form suchorganization, if you report such organization in writing to us within 180 days after you acquire or form it: b.Coverage A does not apply to "bodilyinjury" or "property damage• that occurredbefore you acquired or formed theorganization; and c.Coverage B does not apply to "personaland advertising injury'' arising out of anoffense committed before you acquired orformed the organization. For the purposes of Paragraph 1. of Section II-Who Is An Insured, each such organizationwill be deemed to be designated in theDeclarations as: a.A limited liability company; b.An organization. other than a partnership,joint venture or limited liability company;or c.A trust; as indicated in its name or the documents that govern its structure. E.WHO IS AN INSURED -LAIBIL TV FORCONDUCT OF UNNAMED PARTNERSHIP SO RJOINT VENTURES The following replaces the last paragraph ofSECTION II -WHO IS AN INSURED: No person or organization is an insured withrespect to the conduct of any current or pastpartnership or joint venture that is not shown as aNamed Insured in the Declarations. Thisparagraph does not apply to any such partnershipor joint venture that otherwise qualifies as aninsured under Section II -Who Is An Insured. F.BLANKET ADDITIONAL INSURED -PERSONSOR ORGANIZATIONS FOR YOUR ONGOINGOPERATIONS AS REQUIRED BV WRITTENCONTRACT OR AGREEMENT The following is added to SECTION II -WHO ISAN INSURED: Any person or organization that is not otherwisean insured under this Coverage Part and that youhave agreed in a written contract or agreement toinclude as an additional insured on this CoveragePart is an insured. but only with respect to liabilityfor "bodily injury• or "property damage" that: a.Occurs subsequent to the signing of thatcontract or agreement; and b.Is caused, in whole or in part, by your acts oromissions in the performance of your ongoingoperations to which that contract or Page 2 of 5 C 2017 The Travelers Indemnity Company. Al rights reserved. CG D417 0219 Includes copyrighted material of Insurance Sefvices Office, Inc. with la pennlsslon. DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C COMMERCIAL GENERAL LIABILITY liability as mortgagee, assignee. successor or receiver for "bodily injury", "property damage" or "personal and advertising injury" that: a.Is "bodily injury" or "property damage" thatoccurs. or is "personal and advertising injury"caused by an offense that is committed.subsequent to the signing of that contract oragreement; and b.Arises out of the ownership, maintenance oruse of the premises for which that mortgagee,assignee, successor or receiver is requiredunder that contract or agreement to beincluded as an additional insured on thisCoverage Part. The insurance provided to such mortgagee, assignee. successor or receiver is subject to the following provisions: a.The limits of insurance provided to suchmortgagee, assignee, successor or receiverwill be the minimum limits that you agreed toprovide in the written contract or agreement,or the limits shown in the Declarations,whichever are less. b.The insurance provided to such person ororganization does not apply to: (1)Any "bodily injury" or "property damage"that occurs, or any "personal andadvertising injury" caused by an offensethat is committed. after such contract oragreement is no longer in effect: or (2)Any "bodily injury'', "property damage" or"personal and advertising injury" arisingout of any structural alterations. newconstruction or demolition operationsperformed by or on behalf of suchmortgagee, assignee, successor orreceiver. J.BLANKET ADDITIONAL INSUREDGOVERNMENTAL ENTITIES -PERMITS ORAUTHORIZATIONS RELATING TO PREMISES The following is added to SECTfON U -WHO ISAN INSURED: Any governmental entity that has issued a permitor authorization with respect to premises ownedor occupied by, or rented or loaned to, you andthat you are required by any ordinance. law,building code or written contract or agreement toinclude as an additional insured on this CoveragePart is an insured, but only with respect to liabilityfor "bodily injury", "property damage" or "personaland advertising injury" arising out of theexistence, ownership, use, maintenance, repair. construction, erection or removal of any of the following for which that governmental entity has issued such permit or authorization: advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees. hoist away openings, sidewalk vaults, elevators, street banners or decorations. K.BLANKET ADDITIONAL INSURED GOVERNMENTAL ENTITIES -PERMITS OR AUTHORIZATIONS RELATING TO OPERATIONS The following is added to SECTION II -WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to operations performed by you or on your behalf and that you are required by any ordinance, law. building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury". "property damage" or "personal and advertising injury" arising out of such operations. The insurance provided to such governmental entity does not apply to: a.Any "bodily injury". "property damage" or"personal and advertising injury" arising out ofoperations performed for the governmentalentity; or b.Any "bodily injury" or "property damage"included in the "products-completedoperations hazard". L.MEDICAL PAYMENTS-INCREASED LIMIT The following replaces Paragraph 7. of SECTIONIll -LIMITS OF INSURANCE: 7.Subject to Paragraph 5. above, the MedicalExpense Limit is the most we will pay underCoverage C for all medical expenses becauseof "bodily injury" sustained by any oneperson, and will be the higher of: a.$10,000; or b.The amount shown in the Declarations ofthis Coverage Part for Medical ExpenseLimit. M.BLANKET WAIVER OF SUBROGATION The following is added to Paragraph 8., TransferOf Rights Of Recovery Against Others To Us,of SECTION IV -COMMERCIAL GENERALLIABILITY CONDITIONS: If the insured has agreed in a contract oragreement to waive that insured's right arecovery against any person or organization, we Page 4 of 5 C 2017 The Travelers Indemnity Company. AU rights reserved. 1nc1udes copyrighted material of Insurance Services Office, Inc. with its permission. CG 0417 0219 DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Countersigned by Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date:05/14/22 Policy Expiration Date:06/23/23 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number:72 WEC ZX9262 Endorsement Number: Effective Date:06/23/22 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address:COMPLETE PAPERLESS SOLUTIONS LLC 5130 E LA PALMA AVE STE 206 ANAHEIM CA 92807 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from us DocuSign Envelope ID: DC1EB774-9FD0-482B-9464-CCE46CF1F79C