DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 2/28/2025
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.
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).
PRODUCER CONTACT
NAME:
Sterling Seacrest Pritchard, Inc. PHONE FAX
2500 Cumberland Pkwy (A/C, No, Ext): 678-424-6500 (A/C, No):
E-MAIL
Suite 400 ADDRESS:
Atlanta GA 30339 INSURER(S) AFFORDING COVERAGE NAIC #
License#: 70726 INSURER A : Zurich American Insurance Co 16535
ROYAFOO-01
INSURED INSURER B : SOMPO
Royal Food Service Co., LLC
INSURER C : SiriusPoint America Insurance Company
3720 Zip Industrial Boulevard
Atlanta GA 30354 INSURER D : Westchester Fire Insurance Co 21121
INSURER E : Westfield Specialty Insurance Company 16449
INSURER F :
COVERAGES CERTIFICATE NUMBER: 859826373 REVISION NUMBER:
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.
INSR ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY GLO 0081104-07 3/1/2025 3/1/2026 EACH OCCURRENCE $ 2,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 1,000,000
MED EXP (Any one person) $ 10,000
PERSONAL & ADV INJURY $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
X POLICY PRO-
JECT LOC PRODUCTS - COMP/OP AGG $ 4,000,000
OTHER: $
A COMBINED SINGLE LIMIT $ 2,000,000
AUTOMOBILE LIABILITY BAP 0081105-07 3/1/2025 3/1/2026 (Ea accident)
X ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
NON-OWNED
X HIRED
AUTOS ONLY
X AUTOS ONLY
PROPERTY DAMAGE
(Per accident) $
$
B X UMBRELLA LIAB OCCUR EXC30001522305 3/1/2025 3/1/2026 EACH OCCURRENCE $ 5,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
PER OTH-
A WORKERS COMPENSATION WC 0081103-07 3/1/2025 3/1/2026 X STATUTE ER
AND EMPLOYERS' LIABILITY Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE
N E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
C Excess $5M x $5M ($2.5M Sirus) TSX-001332-25 3/1/2025 3/1/2026 Each Occ/Agg 2,500,000
D Excess $5M x $5M ($2.5M West) G48698037 001 3/1/2025 3/1/2026 Each Occ/Agg 2,500,000
E Excess $5M x $10M XSL-00005R7-03 3/1/2025 3/1/2026 Each Occ/Agg 10,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Excess Liability $1M x Primary Auto Lability, Policy Number: EXT30054681001, Carrier: Endurance American Insurance Company, Eff Date: 3/1/25 Exp Date:
3/1/26, Each Occ/Agg $1,000,000
Excess $1M x $1M x Primary Auto Liability, Policy Number: LHA605367, Carrier: Landmark American Insurance, Eff Date: 3/1/25 Exp Date: 3/1/26, Each
Occ/Agg $1,000,000
Excess $1M x $2M x Primary Auto Liability, Policy Number: SCT1516725, Carrier: Certain Underwriters at Lloyd’s of London, Eff Date: 3/1/25 Exp Date: 3/1/26,
Each Occ/Agg $2,000,000
Excess $1M x $3M x Primary Auto Liability, Policy Number: USXTL0887025, Carrier: Upland Specialty Insurance Company, Eff Date: 3/1/25 Exp Date: 3/1/26,
Each Occ/Agg $3,000,000
See Attached...
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Dekalb County School District
1701 Mountain Industrial Blvd
Stone Mountain, GA 30083 AUTHORIZED REPRESENTATIVE
USA
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: ROYAFOO-01
LOC #:
ADDITIONAL REMARKS SCHEDULE Page 1 of 1
AGENCY NAMED INSURED
Sterling Seacrest Pritchard, Inc. Royal Food Service Co., LLC
3720 Zip Industrial Boulevard
POLICY NUMBER Atlanta GA 30354
CARRIER NAIC CODE
EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
Blanket additional insured status applies to certificate holder for auto liability when required by written contract or agreement via attached form U-CA-424-H
Blanket additional insured status applies to certificate holder for general liability when required by written contract or agreement via attached form U-GL-2162-A
Blanket waiver of subrogation applies to certificate holder for general liability when required by written contract or agreement via attached form U-GL-1345-C
Blanket waiver of subrogation applies to certificate holder for auto liability when required by written contract or agreement via attached form U-CA-424-H
Blanket waiver of subrogation applies to certificate holder for workers’ compensation when required by written contract or agreement via attached form WC 00 03
13
30 day notice of cancellation applies to certificate holder when required by written contract or agreement via attached forms U-CA-832-A, U-GL-15121-B, and
WC 99 06 43
ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Blanket Notification to Others of Cancellation
or Non-Renewal
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add’l. Prem Return Prem.
BAP 0081105-07 03/01/2025 03/01/2026 36415000 INCL
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Commercial Automobile Coverage Part
A. If we cancel or non-renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver
notification that such Coverage Part has been cancelled or non-renewed to each person or organization shown in a
list provided to us by the first Named Insured if you are required by written contact or written agreement to provide
such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been
sent to the first Named Insured. Such list:
1. Must be provided to us prior to cancellation or non-renewal;
2. Must contain the names and addresses of only the persons or organizations requiring notification that such
Coverage Part has been cancelled or non-renewed; and
3. Must be in an electronic format that is acceptable to us.
B. Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records
as of the date the notice of cancellation or non-renewal is mailed or delivered to the first Named Insured. We will mail
or deliver such notification to each person or organization shown in the list:
1. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or
2. At least 30 days prior to the effective date of:
a. Cancellation, if cancelled for any reason other than nonpayment of premium; or
b. Non-renewal, but not including conditional notice of renewal.
C. Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy
only. Our failure to provide such mailing or delivery will not:
1. Extend the Coverage Part cancellation or non-renewal date;
2. Negate the cancellation or non-renewal; or
3. Provide any additional insurance that would not have been provided in the absence of this endorsement.
D. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided
to us as described in Paragraphs A. and B. of this endorsement.
All other terms and conditions of this policy remain unchanged.
U-CA-832-A CW (01/13)
Page 1 of 1
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Coverage Extension Endorsement
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Policy No. BAP 0081105-07 Effective Date: 03/01/2025
This endorsement modifies insurance provided under the:
Business Auto Coverage Form
Motor Carrier Coverage Form
A. Amended Who Is An Insured
1. The following is added to the Who Is An Insured Provision in Section II – Covered Autos Liability Coverage:
The following are also "insureds":
a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts
performed within the scope of employment by you. Any “employee” of yours is also an “insured” while operating
an “auto” hired or rented under a contract or agreement in an “employee’s” name, with your permission, while
performing duties related to the conduct of your business.
b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don’t own, hire or borrow
to transport your clients or other persons in activities necessary to your business.
c. Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a. and A.1.b. in this endorsement.
d. Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract
or written agreement with you executed prior to any "accident", including those person(s) or organization(s)
directing your work pursuant to such written contract or written agreement with you, provided the "accident"
arises out of operations governed by such contract or agreement and only up to the limits required in the written
contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less.
2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other
Insurance – Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form:
Coverage for any person(s) or organization(s), where required by written contract or written agreement with you
executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained
by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond
the terms and conditions of the Coverage Form.
B. Amendment – Supplementary Payments
Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II – Covered Autos Liability Coverage
are replaced by the following:
(2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an
"accident" we cover. We do not have to furnish these bonds.
(4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day
because of time off from work.
C. Fellow Employee Coverage
The Fellow Employee Exclusion contained in Section II – Covered Autos Liability Coverage does not apply.
U-CA-424-H CW (10/21)
Page 1 of 6
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
D. Driver Safety Program Liability and Physical Damage Coverage
1. The following is added to the Racing Exclusion in Section II – Covered Autos Liability Coverage:
This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not
limited to, auto or truck rodeos and other auto or truck agility demonstrations.
2. The following is added to Paragraph 2. in B. Exclusions of Section III – Physical Damage Coverage of the
Business Auto Coverage Form and Paragraph 2.b. in B. Exclusions of Section IV – Physical Damage Coverage
of the Motor Carrier Coverage Form:
This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not
limited to, auto or truck rodeos and other auto or truck agility demonstrations.
E. Lease or Loan Gap Coverage
The following is added to the Coverage Provision of the Physical Damage Coverage Section:
Lease Or Loan Gap Coverage
In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered
"auto", less:
a. Any amount paid under the Physical Damage Coverage Section of the Coverage Form; and
b. Any:
(1) Overdue lease or loan payments at the time of the "loss";
(2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage;
(3) Security deposits not returned by the lessor;
(4) Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the
loan or lease; and
(5) Carry-over balances from previous leases or loans.
F. Towing and Labor
Paragraph A.2. of the Physical Damage Coverage Section is replaced by the following:
We will pay up to $75 for towing and labor costs incurred each time a covered "auto" that is a "private passenger type",
light truck or medium truck is disabled. However, the labor must be performed at the place of disablement.
As used in this provision, "private passenger type" means a private passenger or station wagon type "auto" and includes
an "auto" of the pickup or van type if not used for business purposes.
G. Extended Glass Coverage
The following is added to Paragraph A.3.a. of the Physical Damage Coverage Section:
If glass must be replaced, the deductible shown in the Declarations will apply. However, if glass can be repaired and
is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired
rather than replaced.
H. Hired Auto Physical Damage – Increased Loss of Use Expenses
The Coverage Extension for Loss Of Use Expenses in the Physical Damage Coverage Section is replaced by the
following:
Loss Of Use Expenses
For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for
loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We
will pay for loss of use expenses if caused by:
(1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered
"auto";
U-CA-424-H CW (10/21)
Page 2 of 6
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
(2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for
any covered "auto"; or
(3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto".
However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $3000.
I. Personal Effects Coverage
The following is added to the Coverage Provision of the Physical Damage Coverage Section:
Personal Effects Coverage
a. We will pay up to $750 for "loss" to personal effects which are:
(1) Personal property owned by an "insured"; and
(2) In or on a covered "auto".
b. Subject to Paragraph a. above, the amount to be paid for "loss" to personal effects will be based on the lesser of:
(1) The reasonable cost to replace; or
(2) The actual cash value.
c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered "auto".
No deductible applies to this coverage. However, we will not pay for "loss" to personal effects of any of the following:
(1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other
documents of value.
(2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches, precious
or semi-precious stones.
(3) Paintings, statuary and other works of art.
(4) Contraband or property in the course of illegal transportation or trade.
(5) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment.
Any coverage provided by this Provision is excess over any other insurance coverage available for the same "loss".
J. Tapes, Records and Discs Coverage
1. The Exclusion in Paragraph B.4.a. of Section III – Physical Damage Coverage in the Business Auto Coverage
Form and the Exclusion in Paragraph B.2.c. of Section IV – Physical Damage Coverage in the Motor Carrier
Coverage Form does not apply.
2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical
Damage Coverage Section:
We will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic
equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices:
(a) Are the property of an "insured"; and
(b) Are in a covered "auto" at the time of "loss".
The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical Damage
Coverage Deductible Provision does not apply to such "loss".
K. Airbag Coverage
The Exclusion in Paragraph B.3.a. of Section III – Physical Damage Coverage in the Business Auto Coverage Form
and the Exclusion in Paragraph B.4.a. of Section IV – Physical Damage Coverage in the Motor Carrier Coverage
Form does not apply to the accidental discharge of an airbag.
L. Two or More Deductibles
The following is added to the Deductible Provision of the Physical Damage Coverage Section:
U-CA-424-H CW (10/21)
Page 3 of 6
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
If an accident is covered both by this policy or Coverage Form and by another policy or Coverage Form issued to you
by us, the following applies for each covered "auto" on a per vehicle basis:
1. If the deductible on this policy or Coverage Form is the smaller (or smallest) deductible, it will be waived; or
2. If the deductible on this policy or Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the
amount of the smaller (or smallest) deductible.
M. Temporary Substitute Autos – Physical Damage
1. The following is added to Section I – Covered Autos:
Temporary Substitute Autos – Physical Damage
If Physical Damage Coverage is provided by this Coverage Form on your owned covered "autos", the following
types of vehicles are also covered "autos" for Physical Damage Coverage:
Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered
"auto" you do own but is out of service because of its:
1. Breakdown;
2. Repair;
3. Servicing;
4. "Loss"; or
5. Destruction.
2. The following is added to the Paragraph A. Coverage Provision of the Physical Damage Coverage Section:
Temporary Substitute Autos – Physical Damage
We will pay the owner for "loss" to the temporary substitute "auto" unless the "loss" results from fraudulent acts or
omissions on your part. If we make any payment to the owner, we will obtain the owner's rights against any other
party.
The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it
replaces.
N. Amended Duties In The Event Of Accident, Claim, Suit Or Loss
Paragraph a. of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following:
a. In the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of
the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or "loss"
is known to you (if you are an individual), a partner (if you are a partnership), a member (if you are a limited liability
company) or an executive officer or insurance manager (if you are a corporation). The failure of any agent, servant
or employee of the "insured" to notify us of any "accident", claim, "suit" or "loss" shall not invalidate the insurance
afforded by this policy.
Include, as soon as practicable:
(1) How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written notice
of the claim or "suit" including, but not limited to, the date and details of such claim or "suit";
(2) The "insured’s" name and address; and
(3) To the extent possible, the names and addresses of any injured persons and witnesses.
If you report an "accident", claim, "suit" or "loss" to another insurer when you should have reported to us, your failure
to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as
practicable after the fact of the delay becomes known to you.
O. Waiver of Transfer Of Rights Of Recovery Against Others To Us
The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition:
U-CA-424-H CW (10/21)
Page 4 of 6
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or
"loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. This waiver only
applies to the person or organization designated in the contract.
P. Employee Hired Autos – Physical Damage
Paragraph b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph f. of the Other
Insurance – Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced
by the following:
For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own:
(1) Any covered "auto" you lease, hire, rent or borrow; and
(2) Any covered "auto" hired or rented under a written contract or written agreement entered into by an "employee" or
elected or appointed official with your permission while being operated within the course and scope of that
"employee's" employment by you or that elected or appointed official’s duties as respect their obligations to you.
However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto".
Q. Unintentional Failure to Disclose Hazards
The following is added to the Concealment, Misrepresentation Or Fraud Condition:
However, we will not deny coverage under this Coverage Form if you unintentionally:
(1) Fail to disclose any hazards existing at the inception date of this Coverage Form; or
(2) Make an error, omission, improper description of "autos" or other misstatement of information.
You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided
to us prior to the acceptance of this policy.
R. Hired Auto – World Wide Coverage
Paragraph 7.b.(5) of the Policy Period, Coverage Territory Condition is replaced by the following:
(5) Anywhere else in the world if a covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less,
S. Bodily Injury Redefined
The definition of "bodily injury" in the Definitions Section is replaced by the following:
"Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish,
resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease.
T. Expected Or Intended Injury
The Expected Or Intended Injury Exclusion in Paragraph B. Exclusions under Section II – Covered Auto Liability
Coverage is replaced by the following:
Expected Or Intended Injury
"Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". This exclusion does not
apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property.
U. Physical Damage – Additional Temporary Transportation Expense Coverage
Paragraph A.4.a. of Section III – Physical Damage Coverage is replaced by the following:
4. Coverage Extensions
a. Transportation Expenses
We will pay up to $50 per day to a maximum of $1,000 for temporary transportation expense incurred by you
because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered
"autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for
temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending,
regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss".
U-CA-424-H CW (10/21)
Page 5 of 6
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
V. Replacement of a Private Passenger Auto with a Hybrid or Alternative Fuel Source Auto
The following is added to Paragraph A. Coverage of the Physical Damage Coverage Section:
In the event of a total "loss" to a covered "auto" of the private passenger type that is replaced with a hybrid "auto" or
"auto" powered by an alternative fuel source of the private passenger type, we will pay an additional 10% of the cost of
the replacement "auto", excluding tax, title, license, other fees and any aftermarket vehicle upgrades, up to a maximum
of $2500. The covered "auto" must be replaced by a hybrid "auto" or an "auto" powered by an alternative fuel source
within 60 calendar days of the payment of the "loss" and evidenced by a bill of sale or new vehicle lease agreement.
To qualify as a hybrid "auto", the "auto" must be powered by a conventional gasoline engine and another source of
propulsion power. The other source of propulsion power must be electric, hydrogen, propane, solar or natural gas,
either compressed or liquefied. To qualify as an "auto" powered by an alternative fuel source, the "auto" must be
powered by a source of propulsion power other than a conventional gasoline engine. An "auto" solely propelled by
biofuel, gasoline or diesel fuel or any blend thereof is not an "auto" powered by an alternative fuel source.
W. Return of Stolen Automobile
The following is added to the Coverage Extension Provision of the Physical Damage Coverage Section:
If a covered “auto” is stolen and recovered, we will pay the cost of transport to return the “auto” to you. We will pay only
for those covered “autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage.
All other terms, conditions, provisions and exclusions of this policy remain the same.
U-CA-424-H CW (10/21)
Page 6 of 6
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Blanket Notification to Others of Cancellation
or Non-Renewal
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Policy No. GLO 0081104-07 Effective Date: 03/01/2025
This endorsement applies to insurance provided under the:
Commercial General Liability Coverage Part
A. If we cancel or non-renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver
notification that such Coverage Part has been cancelled or non-renewed to each person or organization shown in a
list provided to us by the first Named Insured if you are required by written contact or written agreement to provide
such notification. Such list:
1. Must be provided to us prior to cancellation or non-renewal;
2. Must contain the names and addresses of only the persons or organizations requiring notification that such
Coverage Part has been cancelled or non-renewed; and
3. Must be in an electronic format that is acceptable to us.
B. Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records
as of the date the notice of cancellation or non-renewal is mailed or delivered to the first Named Insured. We will mail
or deliver such notification to each person or organization shown in the list:
1. Within 10 days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or
2. At least 30 days prior to the effective date of:
a. Cancellation, if cancelled for any reason other than nonpayment of premium; or
b. Non-renewal, but not including conditional notice of renewal,
unless a greater number of days is shown in the Schedule of this endorsement for the mailing or delivering of such
notification with respect to Paragraph B.1. or Paragraph B.2. above.
C. Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy
only. Our failure to provide such mailing or delivery will not:
1. Extend the Coverage Part cancellation or non-renewal date;
2. Negate the cancellation or non-renewal; or
3. Provide any additional insurance that would not have been provided in the absence of this endorsement.
U-GL-1521-B CW (01/19)
Page 1 of 2
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
General Liability Supplemental Coverage Endorsement
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Policy No. GLO 0081104-07 Effective Date: 03/01/2025
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
The following changes apply to this Coverage Part. However, endorsements attached to this Coverage Part will
supersede any provisions to the contrary in this General Liability Supplemental Coverage Endorsement.
A. Broadened Named Insured
1. The following is added to Section II – Who Is An Insured:
Any organization of yours, other than a partnership or joint venture, which is not shown in the Declarations, and
over which you maintain an ownership interest of more than 50% of such organization as of the effective date of
this Coverage Part, will qualify as a Named Insured. However, such organization will not qualify as a Named
Insured under this provision if it:
a. Is newly acquired or formed during the policy period;
b. Is also an insured under another policy, other than a policy written to apply specifically in excess of this
Coverage Part; or
c. Would be an insured under another policy but for its termination or the exhaustion of its limits of insurance.
Each such organization remains qualified as a Named Insured only while you maintain an ownership interest of
more than 50% in the organization during the policy period.
2. The last paragraph of Section II – Who Is An Insured does not apply to this provision to the extent that such
paragraph would conflict with this provision.
B. Newly Acquired or Formed Organizations as Named Insureds
1. Paragraph 3. of Section II – Who Is An Insured is replaced by the following:
3. Any organization you newly acquire or form during the policy period, other than a partnership or joint venture,
and over which you maintain an ownership interest of more than 50% of such organization, will qualify as a
Named Insured if there is no other similar insurance available to that organization. However:
a. Coverage under this provision is afforded only until the 180 th day after you acquire or form the
organization or the end of the policy period, whichever is earlier;
b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or
formed the organization; and
c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before
you acquired or formed the organization.
An additional premium will apply in accordance with our rules and rates in effect on the date you acquired or
formed the organization.
U-GL-1345-C CW (03/20)
Page 1 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
2. The last paragraph of Section II – Who Is An Insured does not apply to this provision to the extent that such
paragraph would conflict with this provision.
C. Insured Status – Employees
Paragraph 2.a.(1) of Section II – Who Is An Insured is replaced by the following:
2. Each of the following is also an insured:
a. Your "volunteer workers" only while performing duties related to the conduct of your business, or your
"employees", other than either your "executive officers" (if you are an organization other than a partnership,
joint venture or limited liability company) or your managers (if you are a limited liability company), but only for
acts within the scope of their employment by you or while performing duties related to the conduct of your
business. However, none of these "employees" or "volunteer workers" are insureds for:
(1) "Bodily injury" or "personal and advertising injury":
(a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if
you are a limited liability company), to a co-"employee" while in the course of his or her employment
or performing duties related to the conduct of your business, or to your other "volunteer workers"
while performing duties related to the conduct of your business;
(b) To the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as a
consequence of Paragraph (1)(a) above;
(c) For which there is any obligation to share damages with or repay someone else who must pay
damages because of the injury described in Paragraphs (1)(a) or (b) above; or
(d) Arising out of his or her providing or failing to provide professional health care services.
However:
Paragraphs (1)(a) and (1)(d) do not apply to your "employees" or "volunteer workers", who are not
employed by you or volunteering for you as health care professionals, for "bodily injury" arising out of
"Good Samaritan Acts" while the "employee" or "volunteer worker" is performing duties related to the
conduct of your business.
"Good Samaritan Acts" mean any assistance of a medical nature rendered or provided in an emergency
situation for which no remuneration is demanded or received.
Paragraphs (1)(a), (b) and (c) do not apply to any "employee" designated as a supervisor or higher in
rank, with respect to "bodily injury" to co-"employees". As used in this provision, "employees" designated
as a supervisor or higher in rank means only "employees" who are authorized by you to exercise direct or
indirect supervision or control over "employees" or "volunteer workers" and the manner in which work is
performed.
D. Additional Insureds – Lessees of Premises
1. Section II – Who Is An Insured is amended to include as an additional insured any person(s) or organization(s)
who leases or rents a part of the premises you own or manage who you are required to add as an additional
insured on this policy under a written contract or written agreement, but only with respect to liability arising out of
your ownership, maintenance or repair of that part of the premises which is not reserved for the exclusive use or
occupancy of such person or organization or any other tenant or lessee.
This provision does not apply after the person or organization ceases to lease or rent premises from you.
However, the insurance afforded to such additional insured:
a. Only applies to the extent permitted by law; and
b. Will not be broader than that which you are required by the written contract or written agreement to provide for
such additional insured.
2. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to
Section III – Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
U-GL-1345-C CW (03/20)
Page 2 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
a. Required by the written contract or written agreement referenced in Subparagraph D.1. above (of this
endorsement); or
b. Available under the applicable Limits of Insurance shown in the Declarations,
whichever is less.
This Paragraph D. shall not increase the applicable Limits of Insurance shown in the Declarations.
E. Additional Insured – Vendors
1. The following change applies if this Coverage Part provides insurance to you for "bodily injury" and "property
damage" included in the "products-completed operations hazard":
Section II – Who Is An Insured is amended to include as an additional insured any person or organization
(referred to throughout this Paragraph E. as vendor) who you have agreed in a written contract or written
agreement, prior to loss, to name as an additional insured, but only with respect to "bodily injury" or "property
damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's
business:
However, the insurance afforded to such vendor:
a. Only applies to the extent permitted by law; and
b. Will not be broader than that which you are required by the written contract or written agreement to provide for
such vendor.
2. With respect to the insurance afforded to these vendors, the following additional exclusions apply:
a. The insurance afforded the vendor does not apply to:
(1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the
assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages
that the vendor would have in the absence of the contract or agreement;
(2) Any express warranty unauthorized by you;
(3) Any physical or chemical change in the product made intentionally by the vendor;
(4) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the
substitution of parts under instructions from the manufacturer, and then repackaged in the original
container;
(5) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make
or normally undertakes to make in the usual course of business, in connection with the distribution or sale
of the products;
(6) Demonstration, installation, servicing or repair operations, except such operations performed at the
vendor's premises in connection with the sale of the product;
(7) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container,
part or ingredient of any other thing or substance by or for the vendor; or
(8) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or
omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not
apply to:
(a) The exceptions contained in Subparagraphs (4) or (6); or
(b) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally
undertakes to make in the usual course of business, in connection with the distribution or sale of the
products.
b. This insurance does not apply to any insured person or organization, from whom you have acquired such
products, or any ingredient, part or container, entering into, accompanying or containing such products.
c. This insurance does not apply to any of "your products" for which coverage is excluded under this Coverage
Part.
U-GL-1345-C CW (03/20)
Page 3 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
3. With respect to the insurance afforded to the vendor under this endorsement, the following is added to Section III
– Limits Of Insurance:
The most we will pay on behalf of the vendor is the amount of insurance:
a. Required by the written contract or written agreement referenced in Subparagraph E.1. above (of this
endorsement); or
b. Available under the applicable Limits of Insurance shown in the Declarations,
whichever is less.
This Paragraph E. shall not increase the applicable Limits of Insurance shown in the Declarations.
F. Additional Insured – Managers, Lessors or Governmental Entity
1. Section II – Who Is An Insured is amended to include as an insured any person or organization who is a
manager, lessor or governmental entity who you are required to add as an additional insured on this policy under
a written contract, written agreement or permit, but only with respect to liability for "bodily injury", "property
damage" or "personal and advertising injury" caused, in whole or in part, by:
a. Your acts or omissions; or
b. The acts or omission of those acting on your behalf; and
resulting directly from:
a. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit;
b. Ownership, maintenance, occupancy or use of premises by you; or
c. Maintenance, operation or use by you of equipment leased to you by such person or organization.
However, the insurance afforded to such additional insured:
a. Only applies to the extent permitted by law; and
b. Will not be broader than that which you are required by the written contract or written agreement to provide for
such additional insured.
2. This provision does not apply:
a. Unless the written contract or written agreement has been executed, or the permit has been issued, prior to
the "bodily injury", "property damage" or offense that caused "personal and advertising injury";
b. To any person or organization included as an insured under Paragraph 3. of Section II – Who Is An Insured;
c. To any lessor of equipment if the "occurrence" or offense takes place after the equipment lease expires;
d. To any:
(1) Owners or other interests from whom land has been leased by you; or
(2) Managers or lessors of premises, if:
(a) The "occurrence" or offense takes place after the expiration of the lease or you cease to be a tenant
in that premises;
(b) The "bodily injury", "property damage" or "personal and advertising injury" arises out of the structural
alterations, new construction or demolition operations performed by or on behalf of the manager or
lessor; or
(c) The premises are excluded under this Coverage Part.
3. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to
Section III – Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
a. Required by the written contract or written agreement referenced in Subparagraph F.1. above (of this
endorsement); or
U-GL-1345-C CW (03/20)
Page 4 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
b. Available under the applicable Limits of Insurance shown in the Declarations,
whichever is less.
This Paragraph F. shall not increase the applicable Limits of Insurance shown in the Declarations.
G. Damage to Premises Rented or Occupied by You
1. The last paragraph under Paragraph 2. Exclusions of Section I – Coverage A – Bodily Injury And Property
Damage Liability is replaced by the following:
Exclusions c. through n. do not apply to damage by "specific perils" to premises while rented to you or temporarily
occupied by you with permission of the owner. A separate Damage To Premises Rented To You Limit of
Insurance applies to this coverage as described in Section III – Limits Of Insurance.
2. Paragraph 6. of Section III – Limits Of Insurance is replaced by the following:
6. Subject to Paragraph 5. above, the Damage To Premises 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 one or more "specific perils" to any one premises, while rented to you or temporarily
occupied by you with permission of the owner.
H. Broadened Contractual Liability
The "insured contract" definition under the Definitions Section is replaced by the following:
"Insured contract" means:
a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies
any person or organization for damage by "specific perils" to premises while rented to you or temporarily occupied
by you with permission of the owner is not an "insured contract";
b. A sidetrack agreement;
c. Any easement or license agreement;
d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a
municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement pertaining to your business (including an indemnification of a
municipality in connection with work performed for a municipality) under which you assume the tort liability of
another party to pay for "bodily injury", "property damage", or "personal and advertising injury" arising out of the
offenses of false arrest, detention or imprisonment, to a third person or organization. Tort liability means a liability
that would be imposed by law in the absence of any contract or agreement.
Paragraph f. does not include that part of any contract or agreement:
(1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of:
(a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; or
(b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or
damage; or
(2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage
arising out of the insured's rendering or failure to render professional services, including those listed in
Paragraph (1) above and supervisory, inspection, architectural or engineering activities.
I. Definition – Specific Perils
The following definition is added to the Definitions Section:
"Specific perils" means:
a. Fire;
b. Lightning;
U-GL-1345-C CW (03/20)
Page 5 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
c. Explosion;
d. Windstorm or hail;
e. Smoke;
f. Aircraft or vehicles;
g. Vandalism;
h. Weight of snow, ice or sleet;
i. Leakage from fire extinguishing equipment, including sprinklers; or
j. Accidental discharge or leakage of water or steam from any part of a system or appliance containing water or
steam.
J. Limited Contractual Liability Coverage – Personal and Advertising Injury
1. Exclusion e. of Section I – Coverage B – Personal And Advertising Injury Liability is replaced by the following:
2. Exclusions
This insurance does not apply to:
e. Contractual Liability
"Personal and advertising injury" for which the insured has assumed liability in a contract or agreement.
This exclusion does not apply to:
(1) Liability for damages that the insured would have in the absence of the contract or agreement; or
(2) Liability for "personal and advertising injury" if:
(a) The "personal and advertising injury" arises out of the offenses of false arrest, detention or
imprisonment;
(b) The liability pertains to your business and is assumed in a written contract or written agreement in
which you assume the tort liability of another. Tort liability means a liability that would be
imposed by law in the absence of any contract or agreement; and
(c) The "personal and advertising injury" occurs subsequent to the execution of the written contract
or written agreement.
Solely for purposes of liability so assumed in such written contract or written agreement, reasonable
attorney fees and necessary litigation expenses incurred by or for a party other than an insured are
deemed to be damages because of "personal and advertising injury" described in Paragraph (a)
above, provided:
(i) Liability to such party for, or for the cost of, that party's defense has also been assumed in the
same written contract or written agreement; and
(ii) Such attorney fees and litigation expenses are for defense of that party against a civil or
alternative dispute resolution proceeding in which damages to which this insurance applies are
alleged.
2. Paragraph 2.d. of Section I – Supplementary Payments – Coverages A and B is replaced by the following:
d. The allegations in the "suit" and the information we know about the "occurrence" or offense are such that no
conflict appears to exist between the interests of the insured and the interests of the indemnitee;
3. The following is added to the paragraph directly following Paragraph 2.f. of Section I – Supplementary
Payments – Coverages A and B:
Notwithstanding the provisions of Paragraph 2.e.(2) of Section I – Coverage B – Personal And Advertising
Injury Liability, such payments will not be deemed to be damages for "personal and advertising injury" and will
not reduce the limits of insurance.
U-GL-1345-C CW (03/20)
Page 6 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
K. Supplementary Payments
The following changes apply to Supplementary Payments – Coverages A and B:
Paragraphs 1.b. and 1.d. are replaced by the following:
b. Up to $2,500 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use
of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds.
d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the
claim or "suit", including actual loss of earnings up to $500 a day because of time off from work.
L. Broadened Property Damage
1. Property Damage to Contents of Premises Rented Short-Term
The paragraph directly following Paragraph (6) in Exclusion j. of Section I – Coverage A – Bodily Injury And
Property Damage Liability is replaced by the following:
Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to premises (other than damage
by "specific perils"), including "property damage" to the contents of such premises, rented to you under a rental
agreement for a period of 14 or fewer consecutive days. A separate Limit of Insurance applies to Damage to
Premises Rented to You as described in Section III – Limits Of Insurance.
2. Elevator Property Damage
a. The following is added to Exclusion j. of Section I – Coverage A – Bodily Injury And Property Damage
Liability:
Paragraphs (3) and (4) of this exclusion do not apply to "property damage" arising out of the use of an
elevator at premises you own, rent or occupy.
b. The following is added to Section III – Limits Of Insurance:
Subject to Paragraph 5. above, the most we will pay under Coverage A for damages because of "property
damage" to property loaned to you or personal property in the care, custody or control of the insured arising
out of the use of an elevator at premises you own, rent or occupy is $25,000 per "occurrence".
3. Property Damage to Borrowed Equipment
a. The following is added to Exclusion j. of Section I – Coverage A – Bodily Injury And Property Damage
Liability:
Paragraph (4) of this exclusion does not apply to "property damage" to equipment you borrow from others at a
jobsite.
b. The following is added to Section III – Limits Of Insurance:
Subject to Paragraph 5. above, the most we will pay under Coverage A for damages because of "property
damage" to equipment you borrow from others is $25,000 per "occurrence".
M. Expected or Intended Injury or Damage
Exclusion a. of Section I – Coverage A – Bodily Injury And Property Damage Liability is replaced by the following:
a. Expected Or Intended Injury Or Damage
"Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does
not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or
property.
N. Definitions – Bodily Injury
The "bodily injury" definition under the Definitions Section is replaced by the following:
"Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish, mental
injury, shock, fright or death sustained by that person which results from that bodily injury, sickness or disease.
U-GL-1345-C CW (03/20)
Page 7 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
O. Insured Status – Amateur Athletic Participants
Section II – Who Is An Insured is amended to include as an insured any person you sponsor while participating in
amateur athletic activities. However, no such person is an insured for:
a. "Bodily injury" to:
(1) Your "employee", "volunteer worker" or any person you sponsor while participating in such amateur athletic
activities; or
(2) You, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited
liability company) while participating in such amateur athletic activities; or
b. "Property damage" to property owned by, occupied or used by, rented to, in the care, custody or control of, or
over which the physical control is being exercised for any purpose by:
(1) Your "employee", "volunteer worker" or any person you sponsor; or
(2) You, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited
liability company).
P. Non-Owned Aircraft, Auto and Watercraft
Exclusion g. of Section I – Coverage A – Bodily Injury And Property Damage Liability is replaced by the following:
g. Aircraft, Auto Or Watercraft
"Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of
any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation
and "loading or unloading".
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the
supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused
the "bodily injury" or "property damage" involved the ownership, maintenance, use or entrustment to others of any
aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured.
This exclusion does not apply to:
(1) A watercraft while ashore on premises you own or rent;
(2) A watercraft you do not own that is:
(a) Less than 51 feet long; and
(b) Not being used to carry persons for a charge;
(3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by
or rented or loaned to you or the insured;
(4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft;
(5) An aircraft that is hired or chartered by you or loaned to you, with a paid and licensed crew, and is not owned
in whole or in part by an insured; or
(6) "Bodily injury" or "property damage" arising out of:
(a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify
under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility
law or other motor vehicle insurance law where it is licensed or principally garaged; or
(b) The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of
"mobile equipment".
Q. Definitions – Leased Worker, Temporary Worker and Labor Leasing Firm
1. The "leased worker" and "temporary worker" definitions under the Definitions Section are replaced by the
following:
U-GL-1345-C CW (03/20)
Page 8 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
"Leased worker" means a person leased to you by a "labor leasing firm" under a written agreement between you
and the "labor leasing firm", to perform duties related to the conduct of your business. "Leased worker" does not
include a "temporary worker".
"Temporary worker" means a person who is furnished to you to support or supplement your work force during
"employee" absences, temporary skill shortages, upturns or downturns in business or to meet seasonal or short-
term workload conditions. "Temporary worker" does not include a "leased worker".
2. The following definition is added to the Definitions Section:
"Labor leasing firm" means any person or organization who hires out workers to others, including any:
a. Employment agency, contractor or services;
b. Professional employer organization; or
c. Temporary help service.
R. Definition – Mobile Equipment
Paragraph f. of the "mobile equipment" definition under the Definitions Section is replaced by the following:
f. Vehicles not described in Paragraph a., b., c. or d. above maintained primarily for purposes other than the
transportation of persons or cargo.
However, self-propelled vehicles with the following types of permanently attached equipment, exceeding a
combined gross vehicle weight of 1000 pounds, are not "mobile equipment" but will be considered "autos":
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction or resurfacing; or
(c) Street cleaning;
(2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower
workers; and
(3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical
exploration, lighting and well servicing equipment.
S. Definitions – Your Product and Your Work
The "your product" and "your work" definitions under the Definitions Section are replaced by the following:
"Your product":
a. Means:
(1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by:
(a) You;
(b) Others trading under your name; or
(c) A person or organization whose business or assets you have acquired; and
(2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or
products.
b. Includes:
(1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance,
use, handling, maintenance, operation or safety of "your product"; and
(2) The providing of or failure to provide warnings or instructions.
c. Does not include vending machines or other property rented to or located for the use of others but not sold.
U-GL-1345-C CW (03/20)
Page 9 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
"Your work":
a. Means:
(1) Work, services or operations performed by you or on your behalf; and
(2) Materials, parts or equipment furnished in connection with such work, services or operations.
b. Includes:
(1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance,
use, handling, maintenance, operation or safety of "your work"; and
(2) The providing of or failure to provide warnings or instructions.
T. Duties in the Event of Occurrence, Offense, Claim or Suit Condition
The following paragraphs are added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit
of Section IV – Commercial General Liability Conditions:
Notice of an "occurrence" or of an offense which may result in a claim under this insurance or notice of a claim or
"suit" shall be given to us as soon as practicable after knowledge of the "occurrence", offense, claim or "suit" has
been reported to any insured listed under Paragraph 1. of Section II – Who Is An Insured or an "employee"
authorized by you to give or receive such notice. Knowledge by other "employees" of an "occurrence", offense, claim
or "suit" does not imply that you also have such knowledge.
In the event that an insured reports an "occurrence" to the workers compensation carrier of the Named Insured and
this "occurrence" later develops into a General Liability claim, covered by this Coverage Part, the insured's failure to
report such "occurrence" to us at the time of the "occurrence" shall not be deemed to be a violation of this Condition.
You must, however, give us notice as soon as practicable after being made aware that the particular claim is a
General Liability rather than a Workers Compensation claim.
U. Other Insurance Condition
Paragraphs 4.a. and 4.b.(1) of the Other Insurance Condition of Section IV – Commercial General Liability
Conditions are replaced by the following:
4. Other Insurance
If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of
this Coverage Part, our obligations are limited as follows:
a. Primary Insurance
This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our
obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that
other insurance by the method described in Paragraph c. below. However, this insurance is primary to and
will not seek contribution from any other insurance available to an additional insured provided that:
(1) The additional insured is a Named Insured under such other insurance; and
(2) You are required by written contract or written agreement that this insurance be primary and not seek
contribution from any other insurance available to the additional insured.
Other insurance includes any type of self insurance or other mechanism by which an insured arranges for
funding of its legal liabilities.
b. Excess Insurance
(1) This insurance is excess over:
(a) Any of the other insurance, whether primary, excess, contingent or on any other basis:
(i) That is property insurance, Builder's Risk, Installation Risk or similar coverage for "your work";
(ii) That is property insurance purchased by you (including any deductible or self insurance portion
thereof) to cover premises rented to you or temporarily occupied by you with permission of the
owner;
U-GL-1345-C CW (03/20)
Page 10 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
(iii) That is insurance purchased by you (including any deductible or self insurance portion thereof) to
cover your liability as a tenant for "property damage" to premises rented to you or temporarily
occupied by you with permission of the owner;
(iv) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not
subject to Exclusion g. of Section I – Coverage A – Bodily Injury And Property Damage
Liability; or
(v) That is property insurance (including any deductible or self insurance portion thereof) purchased
by you to cover damage to:
Equipment you borrow from others; or
Property loaned to you or personal property in the care, custody or control of the insured arising
out of the use of an elevator at premises you own, rent or occupy.
(b) Any other primary insurance (including any deductible or self insurance portion thereof) available to
the insured covering liability for damages arising out of the premises, operations, products, work or
services for which the insured has been granted additional insured status either by policy provision or
attachment of any endorsement. Other primary insurance includes any type of self insurance or other
mechanism by which an insured arranges for funding of its legal liabilities.
(c) Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an
additional insured, in which the additional insured on our policy is also covered as an additional
insured on another policy providing coverage for the same "occurrence", claim or "suit". This
provision does not apply to any policy in which the additional insured is a Named Insured on such
other policy and where our policy is required by written contract or written agreement to provide
coverage to the additional insured on a primary and non-contributory basis.
V. Unintentional Failure to Disclose All Hazards
Paragraph 6. Representations of Section IV – Commercial General Liability Conditions is replaced by the
following:
6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are accurate and complete;
b. Those statements are based upon representations you made to us; and
c. We have issued this policy in reliance upon your representations.
Coverage will continue to apply if you unintentionally:
a. Fail to disclose all hazards existing at the inception of this policy; or
b. Make an error, omission or improper description of premises or other statement of information stated in this
policy.
You must notify us as soon as possible after the discovery of any hazards or any other information that was not
provided to us prior to inception of this Coverage Part.
W. Waiver of Right of Subrogation
Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Commercial General
Liability Conditions is replaced by the following:
8. Transfer Of Rights Of Recovery Against Others To Us
a. If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those
rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the
insured will bring "suit" or transfer those rights to us and help us enforce them.
b. If the insured waives its right to recover payments for injury or damage from another person or organization in
a written contract executed prior to a loss, we waive any right of recovery we may have against such person
or organization because of any payment we have made under this Coverage Part. The written contract will
U-GL-1345-C CW (03/20)
Page 11 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
be considered executed when the insured's performance begins, or when it is signed, whichever happens
first. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which
the insured has no contractual interest.
X. Liberalization Condition
The following condition is added to Section IV – Commercial General Liability Conditions:
Liberalization Clause
If we revise this Coverage Part to broaden coverage without an additional premium charge, your policy will
automatically provide the additional coverage as of the day the revision is effective in the state shown in the mailing
address of your policy.
All other terms, conditions, provisions and exclusions of this policy remain the same.
U-GL-1345-C CW (03/20)
Page 12 of 12
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Blanket Notification to Others of Cancellation
or Non-Renewal
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Policy No. GLO 0081104-07 Effective Date: 03/01/2025
This endorsement applies to insurance provided under the:
Commercial General Liability Coverage Part
A. If we cancel or non-renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver
notification that such Coverage Part has been cancelled or non-renewed to each person or organization shown in a
list provided to us by the first Named Insured if you are required by written contact or written agreement to provide
such notification. Such list:
1. Must be provided to us prior to cancellation or non-renewal;
2. Must contain the names and addresses of only the persons or organizations requiring notification that such
Coverage Part has been cancelled or non-renewed; and
3. Must be in an electronic format that is acceptable to us.
B. Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records
as of the date the notice of cancellation or non-renewal is mailed or delivered to the first Named Insured. We will mail
or deliver such notification to each person or organization shown in the list:
1. Within 10 days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or
2. At least 30 days prior to the effective date of:
a. Cancellation, if cancelled for any reason other than nonpayment of premium; or
b. Non-renewal, but not including conditional notice of renewal,
unless a greater number of days is shown in the Schedule of this endorsement for the mailing or delivering of such
notification with respect to Paragraph B.1. or Paragraph B.2. above.
C. Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy
only. Our failure to provide such mailing or delivery will not:
1. Extend the Coverage Part cancellation or non-renewal date;
2. Negate the cancellation or non-renewal; or
3. Provide any additional insurance that would not have been provided in the absence of this endorsement.
U-GL-1521-B CW (01/19)
Page 1 of 2
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Additional Insured – Automatic – Owners, Lessees Or
Contractors
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Policy No. GLO 0081104-07 Effective Date: 03/01/2025
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
A. Section II – Who Is An Insured is amended to include as an additional insured any person or organization whom you
are required to add as an additional insured under a written contract or written agreement executed by you, but only
with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" and subject to the
following:
1. If such written contract or written agreement specifically requires that you provide that the person or organization
be named as an additional insured under one or both of the following endorsements:
a. The Insurance Services Office (ISO) ISO CG 20 10 (10/01 edition); or
b. The ISO CG 20 37 (10/01 edition),
such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent
that "bodily injury", "property damage" or "personal and advertising injury" arises out of:
(1) Your ongoing operations, with respect to Paragraph 1.a. above; or
(2) "Your work", with respect to Paragraph 1.b. above,
which is the subject of the written contract or written agreement.
However, solely with respect to this Paragraph 1., insurance afforded to such additional insured:
(a) Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs
during the policy period and subsequent to your execution of the written contract or written agreement;
and
(b) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the
"products-completed operations hazard" unless the written contract or written agreement specifically
requires that you provide such coverage to such additional insured.
2. If such written contract or written agreement specifically requires that you provide that the person or organization
be named as an additional insured under one or both of the following endorsements:
a. The Insurance Services Office (ISO) ISO CG 20 10 (07/04 edition); or
b. The ISO CG 20 37 (07/04 edition),
such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent
that "bodily injury", "property damage" or "personal and advertising injury" is caused, in whole or in part, by:
(1) Your acts or omissions; or
(2) The acts or omissions of those acting on your behalf,
U-GL-2162-A CW (02/19)
Page 1 of 4
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
in the performance of:
(a) Your ongoing operations, with respect to Paragraph 2.a. above; or
(b) "Your work" and included in the "products-completed operations hazard", with respect to Paragraph
2.b. above,
which is the subject of the written contract or written agreement.
However, solely with respect to this Paragraph 2., insurance afforded to such additional insured:
(i) Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense
occurs during the policy period and subsequent to your execution of the written contract or written
agreement; and
(ii) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within
the "products-completed operations hazard" unless the written contract or written agreement
specifically requires that you provide such coverage to such additional insured.
3. If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that
you provide that the person or organization be named as an additional insured:
a. Under the ISO CG 20 10 (04/13 edition, any subsequent edition or if no edition date is specified); or
b. With respect to ongoing operations (if no form is specified),
such person or organization is then an additional insured only to the extent that "bodily injury", "property damage"
or "personal and advertising injury" is caused, in whole or in part by:
(1) Your acts or omissions; or
(2) The acts or omissions of those acting on your behalf,
in the performance of your ongoing operations, which is the subject of the written contract or written agreement.
However, solely with respect to this Paragraph 3., insurance afforded to such additional insured:
(a) Only applies to the extent permitted by law;
(b) Will not be broader than that which you are required by the written contract or written agreement to
provide for such additional insured; and
(c) Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs
during the policy period and subsequent to your execution of the written contract or written agreement.
4. If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that
you provide that the person or organization be named as an additional insured:
a. Under the ISO CG 20 37 (04/13 edition, any subsequent edition or if no edition date is specified); or
b. With respect to the "products-completed operations hazard" (if no form is specified),
such person or organization is then an additional insured only to the extent that "bodily injury" or "property damage"
is caused, in whole or in part by "your work" and included in the "products-completed operations hazard", which is
the subject of the written contract or written agreement.
However, solely with respect to this Paragraph 4., insurance afforded to such additional insured:
(1) Only applies to the extent permitted by law;
(2) Will not be broader than that which you are required by the written contract or written agreement to provide
for such additional insured;
(3) Only applies if the "bodily injury" or "property damage" occurs during the policy period and subsequent to
your execution of the written contract or written agreement; and
(4) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the
"products-completed operations hazard" unless the written contract or written agreement specifically
requires that you provide such coverage to such additional insured.
U-GL-2162-A CW (02/19)
Page 2 of 4
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
B. Solely with respect to the insurance afforded to any additional insured referenced in Section A. of this endorsement,
the following additional exclusion applies:
This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of
the rendering of, or failure to render, any professional architectural, engineering or surveying services including:
1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field
orders, change orders or drawings and specifications; or
2. Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision,
hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury"
or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or
the failure to render any professional architectural, engineering or surveying services.
C. Solely with respect to the coverage provided by this endorsement, the following is added to Paragraph 2. Duties In The
Event Of Occurrence, Offense, Claim Or Suit of Section IV – Commercial General Liability Conditions:
The additional insured must see to it that:
(1) We are notified as soon as practicable of an "occurrence" or offense that may result in a claim;
(2) We receive written notice of a claim or "suit" as soon as practicable; and
(3) A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by
another insurer under which the additional insured may be an insured in any capacity. This provision does not
apply to insurance on which the additional insured is a Named Insured if the written contract or written
agreement requires that this coverage be primary and non-contributory.
D. Solely with respect to the coverage provided by this endorsement:
1. The following is added to the Other Insurance Condition of Section IV – Commercial General Liability
Conditions:
Primary and Noncontributory insurance
This insurance is primary to and will not seek contribution from any other insurance available to an additional
insured provided that:
a. The additional insured is a Named Insured under such other insurance; and
b. You are required by written contract or written agreement that this insurance be primary and not seek
contribution from any other insurance available to the additional insured.
2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition under Section IV –
Commercial General Liability Conditions:
This insurance is excess over:
Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional
insured, in which the additional insured on our policy is also covered as an additional insured on another policy
providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any
policy in which the additional insured is a Named Insured on such other policy and where our policy is required
by a written contract or written agreement to provide coverage to the additional insured on a primary and non-
contributory basis.
E. This endorsement does not apply to an additional insured which has been added to this Coverage Part by an
endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies
specifically to that identified additional insured.
F. Solely with respect to the insurance afforded to an additional insured under Paragraph A.3. or Paragraph A.4. of this
endorsement, the following is added to Section III – Limits Of Insurance:
Additional Insured – Automatic – Owners, Lessees Or Contractors Limit
The most we will pay on behalf of the additional insured is the amount of insurance:
U-GL-2162-A CW (02/19)
Page 3 of 4
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
1. Required by the written contract or written agreement referenced in Section A. of this endorsement; 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.
All other terms, conditions, provisions and exclusions of this policy remain the same.
U-GL-2162-A CW (02/19)
Page 4 of 4
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
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.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
ALL PERSONS AND / OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN
CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE
ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED
UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON
AND/OR ORGANIZATION.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective 03-01-25 Policy No. WC 0081103-07 Endorsement No.
Insured ROYAL FOOD SERVICE COMPANY, INC. Premium $ INCL.
Insurance Company ZURICH AMERICAN INSURANCE COMPANY
Countersigned By
WC 00 03 13
(Ed. 4-84)
1983 National Council on Compensation Insurance.