Client#: 1680025 79REDMOMAC
DATE (MM/DD/YYYY)
ACORD TM CERTIFICATE OF LIABILITY INSURANCE 2/11/2025
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 any rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER NAME: Melanie Arrington
McGriff Insurance Services LLC PHONE FAX
(A/C, No, Ext): 770 471-7100 (A/C, No): 770 477-6908
741 W. Lanier Ave., Suite 100 E-MAIL
ADDRESS: certificate@mcgriff.com
Fayetteville, GA 30214-GA INSURER(S) AFFORDING COVERAGE NAIC #
770 471-7100 INSURER A : Frankenmuth Insurance Company 13986
INSURED INSURER B : Accident Fund Ins Co of America 10166
William J Redmond & Son Inc
INSURER C :
Po Box 636
INSURER D :
Moreland, GA 30259-0635
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 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 INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY 6733080 11/03/2024 11/03/2025 EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 1,000,000
MED EXP (Any one person) $ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
PRO-
POLICY JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000
OTHER: $
A AUTOMOBILE LIABILITY 6733079 11/03/2024 11/03/2025 COMBINED SINGLE LIMIT
(Ea accident) $ 1,000,000
X ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
X AUTOS ONLY X AUTOS ONLY (Per accident) $
X Drive Oth Car $
A X UMBRELLA LIAB X OCCUR 6733080 11/03/2024 11/03/2025 EACH OCCURRENCE $ 2,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000
DED X RETENTION $10000 $
WORKERS COMPENSATION PER OTH-
B AND EMPLOYERS' LIABILITY
AFWCP100050154 09/08/2024 09/08/2025 X STATUTE ER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N 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
A Property of Other 6733080 11/03/2024 11/03/2025 200,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
**See Attached Endorsements**
19217 08/19 Diamond Liability Premier
18202 11/18 Additional Insured - Owners, Lessees Or Contractors (including Products-Completed Operations)
19364 08/22 Diamond Auto Premier Endorsement Coverage Schedule
19348 08/22 Diamond Auto Premier Endorsement
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
DeKalb County School District THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
1701 Stone Mountain Industrial ACCORDANCE WITH THE POLICY PROVISIONS.
Blvd.
Stone Mountain, GA 30083 AUTHORIZED REPRESENTATIVE
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S36464760/M35525350 RUMAN
This page has been left blank intentionally.
William J Redmond & Son Inc
6733080
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DIAMOND LIABILITY PREMIER
This is a summary of coverage with page references of the various additional coverages and coverage extensions
provided by this endorsement. However, this summary does not provide any actual coverage. Please refer to the
endorsement provisions for changes to your policy.
SECTION 1 – ADDITIONAL INSURED COVERAGES
Broad Form Vendors Page 3
Controlling Interest Page 4
Co-owners Of Insured Premises Page 4
Grantor Of Franchise Page 4
Grantor Of Licenses Page 4
Owners Or Other Interests From Whom Land Has Been Leased Page 4
Lessor Of Leased Equipment Page 4
Manager Of Lessors Of Premises Page 4
Mortgagee, Assignee Or Receiver Page 4
State Or Governmental Agency Or Subdivision Or Political Subdivision Page 5
Architect, Engineer Or Surveyor Engaged By You Page 5
Architect, Engineer Or Surveyor Not Engaged By You Page 5
Concessionaires Page 5
Primary and Noncontributory Insurance Page 5
Waiver Of Transfer Of Rights Of Recovery Against Others To Us Page 5
SECTION 2 – COVERAGE EXTENSIONS
Bodily Injury – Expanded Definition Page 6
Personal and Advertising Injury – Broadened Page 6
Amendment -- Aggregate Limits Of Insurance Page 6
Borrowed Equipment Page 6
Duties in the Event of Occurrence, Claim or Suit Page 6
Unintentional Failure To Disclose Hazards Page 7
Damage To Premises Rented To You - Expanded Coverage Page 7
Health Care Services Page 7
Medical Payments $10,000 Page 8
Mobile Equipment Page 8
Newly Formed Or Acquired Organization Page 8
Extended Non-Owned Watercraft up to 76 feet Page 8
Supplementary Payments (Bail Bonds $5,000 / Loss of Earning $1,000) Page 8
Liberalization Provision Page 8
19217 08 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 17
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DIAMOND LIABILITY PREMIER
SECTION 3 – ADDITIONAL COVERAGES
Voluntary Property Damage Expense Coverage Page 8
Schedule of Limits
Each Occurrence Limit $25,000 Annual Aggregate Limit $25,000
Limited Product Withdrawal Expense Coverage Page 9
Schedule of Limits
Annual Aggregate Limit $100,000 Deductible $2,500
Participation Percentage 20%
Employee Benefits Liability Coverage Page 13
Schedule of Limits
Each Employee Limit $1,000,000 Annual Aggregate Limit $3,000,000
Deductible $1,000
SECTION 4 – OPTIONAL COVERAGES
If shown as included in the Schedule of Coverages below, the following Optional Coverages are further modified
by the terms, exclusions, and conditions applicable to the Commercial General Liability Coverage.
o Hired and Non-owned Auto Liability Coverage Page 16
Schedule of Limits
Limit $1,000,000
19217 08 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 17
William J Redmond & Son Inc
6733080
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DIAMOND LIABILITY PREMIER
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SECTION 1 - ADDITIONAL INSURED COVERAGES This coverage does not increase the applicable
Limits of Insurance shown in the Declarations.
This endorsement is subject to the provisions
F. The insurance coverage provided by this
applying to the Commercial General Liability
endorsement is limited to:
Coverage form, except as described below.
1. Broad Form Vendors
A. Section II – Who Is An Insured is amended to a. Any vendor, but only with respect to
include any person(s) or organization(s) when you "bodily injury" or "property damage"
and such person(s) or organization(s) have arising out of "your products" which are
agreed in a written contract or written agreement distributed or sold in the regular course of
that such person(s) or organization(s) be added the vendor's business, subject to the
as an additional insured on your policy provided following additional exclusions:
that the written contract or written agreement is: i. "Bodily injury" or "property damage"
1. Executed in writing before the beginning of for which the vendor is obligated to
the policy period or during the policy period pay damages by reason of the
and assumption of liability in a contract or
agreement. This exclusion does not
2. Prior to an “occurrence” or offense which this
apply to liability for damages that the
insurance applies.
vendor would have in the absence of
B. The insurance provided to such additional insured the contract or agreement;
only applies to the extent permitted by law and
ii. Any express warranty unauthorized by
the insurance afforded to such additional insured
you;
will not be broader than that which you are
required by the written contract or written iii. Any physical or chemical change in
agreement to provide for such additional insured. the product made intentionally by the
vendor;
C. This insurance only applies if the person or
organization is not specifically named as an iv. Repackaging, unless unpacked solely
additional insured under any other provision or for the purpose of inspection,
endorsement of this policy. demonstration, testing, or the
substitution of parts under instruction
D. Any insurance provided to any additional insured
from the manufacturer, and then
does not apply to “bodily injury”, “property
repackaged in the original container;
damage”, or “personal and advertising injury”
arising out of their sole negligence or willful v. Any failure to make such inspection,
misconduct or that of their agents, “employees”, adjustments, tests or servicing as the
or any other representative of the additional vendor has agreed to make or
insured. normally undertakes to make in the
usual course of business in
E. With respect to the insurance provided to these
connection with the sale of the
additional insureds, the following is added to
product;
Section III – Limits of Insurance:
vi. Demonstration, installation, servicing
The most we will pay on behalf of the additional
or repair operations, except such
insured is
operations performed as part of the
1. The amount of insurance required by the initial set up at the vendor's premises
contract or agreement; or in connection with the sale of the
2. Available under the applicable Limit of product;
Insurance shown in the Declarations;
whichever is less.
19217 08 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 17
vii. Products which, after distribution or 6. Owners Or Other Interests From Whom
sale by you, have been labeled or Land Has Been Leased but only with respect
relabeled or used as a container, part to liability arising out of the ownership,
or ingredient in anything or substance maintenance or use of that part of the land
by or for the vendor. leased to you.
viii. "Bodily injury" or "property damage" However, this insurance does not apply to:
arising out of the sole negligence of a. any “occurrence” which takes place after
the vendor for its own acts or you cease to lease that land.
omissions or those of its employees or
anyone else acting on its behalf. b. any structural alterations, new
However, this exclusion does not construction or demolition operations
apply to the exceptions contained in performed for, by or on behalf of the
subparagraphs iv or vi; or such additional insured.
inspections, adjustments, test or 7. Any Lessor Of Leased Equipment is any
servicing as the vendor has agreed to person(s) or organization(s) from whom you
make or normally undertakes to make lease equipment. Such person(s) or
in the usual course of business, in organization(s) is an insured only with respect
connection with the distribution or sale to liability for "bodily injury", "property
of the products. damage" or "personal and advertising injury"
ix. This insurance does not apply to any caused, in whole or in part, by your
insured person or organization, from maintenance, operation or use of equipment
whom you have acquired such leased to you by such person(s) or
products, or any ingredient, part or organization(s).
container, entering into, A person's or organization's status as an
accompanying or containing such additional insured under this endorsement
products. ends when their contract or agreement with
2. Any individuals or entities that have you for such leased equipment ends. With
Controlling Interest in your business, but respect to the insurance afforded to these
only with respect to their liability arising out of: additional insureds, this insurance does not
apply to any "occurrence" which takes place
a. Their financial control of you; or after the equipment lease expires.
b. Premises they own, maintain or control 8. Manager Or Lessors Of Premises, but only
while you lease or occupy these with respect to liability arising out of the
premises. This insurance does not apply ownership, maintenance or use of that part of
to structural alterations, new construction the premises leased to you.
and demolition operations by or for that
person or organization. This insurance does not apply to:
3. Any Co-owners Of Insured Premises but a. any "occurrence" which takes place after
only with respect to their liability as co-owner you cease to be a tenant in that premises,
of the premises insured by this policy. or
4. Any Grantor Of Franchise but only with b. for structural alterations, new construction
respect to their liability as grantor of franchise or demolition operations performed by or
to you. on behalf of the person(s) or
organization(s).
5. Any Grantor Of Licenses but only with
respect to their liability as grantor of licenses 9. Mortgagee, Assignee Or Receiver but only
to you. Their status as additional insured with respect to their liability as mortgagee,
ends when: assignee, or receiver and arising out of the
ownership, maintenance or use of the
a. The license granted to you by such premises by you.
person(s) or organization(s) expires; or
This insurance does not apply to structural
b. Your license is terminated or revoked by alterations, new construction and demolition
such person(s) or organization(s) prior to operations performed by or for the additional
the expiration of the license as stipulated insured.
by the contract or agreement.
19217 08 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 17
10. State Or Governmental Agency Or With respect to the insurance afforded to these
Subdivision Or Political Subdivision additional insureds, the following exclusion
however this insurance applies only with applies:
respect to operations performed by you or on i. This insurance does not apply to “bodily
your behalf for which the state or governmental injury”, “property damage” or “personal and
agency or subdivision has issued a permit or advertising injury” arising out of the
authorization. This insurance does not apply rendering of or the failure to render any
to “bodily injury”, “property damage”, or professional services, including:
“personal and advertising” arising out of
operations performed for the federal (1) The preparing, approving, or failing
government, state or municipality; or “bodily to prepare or approve, maps,
injury” or “property damage” included within drawings, opinions, reports,
the product-completed operations hazard”. surveys, change orders, designs or
specifications; or
11. Architect, Engineer Or Surveyor Engaged
By You but only with respect to liability for (2) Supervisory, inspection or
“bodily injury”, “property damage” or “personal engineering services.
and advertising injury” caused by, in whole or This exclusion applies even if the claims
in part, by your acts or omissions or the acts or against any insured allege negligence or
omissions of those acting on your behalf in other wrongdoing in the supervision,
connection with your premises or in the hiring, employment, training or monitoring
performance of your ongoing operations. of others by that insured, if the
This insurance does not apply to “bodily "occurrence" which caused the "bodily
injury”, “property damage” arising out of the injury" or "property damage", or the
rendering or the failure to render any offense which caused the "personal and
professional services by or for you; including: advertising injury", involved the rendering
of or the failure to render any professional
a. The preparing, approving, or failing to services.
prepare or approve, maps, shop drawings,
opinions, reports, surveys, field orders, 13. Concessionaires trading under your name,
change orders or drawings and but only with respect to their liability as a
specifications; or concessionaire trading under your name.
b. Supervisory, inspection, architectural or G. Primary and Noncontributory Insurance
engineering activities. The following is added to the Other Insurance
This exclusion applies even if the claims Condition and supersedes any provision to the
against the insured allege negligence or other contrary:
wrongdoing in the supervision, hiring, This insurance is primary to and will not seek
employment training, or monitoring of others contribution from any other insurance available to
by this additional insured, if the “occurrence” an additional insured under your policy provided
which caused the “bodily injury” or “property that:
damage’ involved the rendering or the failure
1. the additional insured is a Named Insured
to render any professional services by or for
under such other insurance, and you have
you.
agreed in writing in a contract or agreement
12. Architect, Engineer Or Surveyor Not that this insurance would be primary; and
Engaged By You but only with respect to
2. would not seek contribution from any other
liability for “bodily injury”, “property damage” or
insurance available to the additional insured.
“personal and advertising injury” caused by, in
whole or in part, by H. Waiver Of Transfer Of Rights Of Recovery
Against Others To Us
a. your acts or omissions; or
The following is added to Paragraph 8. Transfer
b. the acts or omissions of those acting on
of Rights of Recovery Against Others To Us of
your behalf in the performance of your
Section IV – Conditions:
ongoing operations performed by you or
on your behalf. Such architects, We waive any right of recovery we may have
engineers or surveyors, while not engaged against any person or organization because of
by you, are contractually required to be payments we make for injury or damage arising
added as an additional insured to your out of your ongoing operations or “your work”
policy. included in the “products-completed operations
hazard” when you have assumed liability for such
injury or damage under an “insured contract”.
19217 08 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 17
SECTION 2 - COVERAGE EXTENSIONS 3. Paragraphs 1. and 2. above do not apply if
Coverage B. Personal and Advertising
This endorsement is subject to the provisions Injury Liability is excluded either by the
applying to the Commercial General Liability provision of the Commercial General Liability
Coverage Form, except as described below. Coverage form or by endorsement.
C. AMENDMENT - AGGREGATE LIMITS OF
A. BODILY INJURY – EXPANDED DEFINITION
INSURANCE
ENDORSEMENT
The General Aggregate Limit under Section III –
Under Section V – Definitions, the definition of
Limits Of Insurance applies separately to each of
bodily injury is deleted and replaced by the your:
following:
1. Projects away from premises owned by or
Bodily injury means physical injury, sickness or rented to you; and
disease sustained by a person, including death,
humiliation, shock, mental anguish or mental 2. "Locations" owned by or rented to you.
injury sustained by that person at any time which "Location" means premises involving the
results as a consequence of the physical injury, same or connecting lots, or premises whose
sickness or disease. connection is interrupted only by a street,
roadway, waterway or right-of-way of a
B. PERSONAL AND ADVERTISING INJURY –
railroad.
BROADENED
D. BORROWED EQUIPMENT
1. Paragraph 14.b. of Section V -- Definitions
is replaced by the following: 1. Exclusion j. Damage to Property of Section I
– Coverage A Bodily Injury And Property
b. Malicious prosecution or abuse of Damage Liability is amended as follows:
process
Paragraph (4) of this exclusion does not apply
2. Definition 14 of Section V -- Definitions is to "property damage" to borrowed equipment
amended by the addition of the following: while not being used to perform operations at
h. Wrongful discrimination or humiliation that the job site for damage by aircraft; civil
results in injury to the feelings or commotion; explosion; falling objects; fire;
reputation of a natural person, but only if hail; leakage from fire extinguishing
equipment; lightning; riot; sinkhole collapse;
such discrimination or humiliation is:
smoke; sonic boom; vandalism; vehicles;
(1) Not the result of acts, policy or volcanic action; water damage; weight of ice,
procedures, or omissions of: snow or sleet; and windstorm.
a) The insured; 2. This insurance is excess over any other valid
and collectible property insurance (including
b) Any executive officer, director, any deductible portion thereof) available to
stockholder, partner or member the insured whether primary, excess,
of the insured; or contingent or on any other basis.
c) anyone acting at the direction of E. DUTIES IN THE EVENT OF OCCURRENCE,
anyone listed in (a) and (b) above CLAIM OR SUIT
done with the intent or the
reasonable expectation that such Section IV – Commercial General Liability
Conditions is changed by the following:
acts or omissions will result in
wrongful discrimination or 1. The requirement in condition 2.a. of that you
humiliation to another person; must see to it that we are notified of an
and “occurrence” applies only when the
“occurrence” is known to:
(2) Not directly or indirectly related to
employment related practices, or the a. You, if you are an individual;
prospective employment or b. A partner, if you are a partnership; or
termination of employment or c. An executive officer or insurance manager
demotion of any personal or if you are a corporation.
person(s) by an insured.
(3) Not arising out of any “advertisement”
by you.
19217 08 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 17
2. The requirement in condition 2.b. that you c. The Damage to Premises Rented to You
must see to it that we receive notice of a limit in paragraph 6. of Section III - Limits
claim or “suit” will not be considered breached of Insurance is replaced by a new
unless the breach occurs after such claim or Damage to Premises Rented to You and
“suit” is know to: Fire, Lightning, Explosion, Smoke and
Leakage from Fire Protective Systems
a. You, if you are an individual; Damage Limit, which will be subject to all
b. A partner, if you are a partnership; or of the terms of Section III - Limits of
Insurance.
c. An executive officer or insurance manager
if you are a corporation. 3. This new Damage Limit is amount shown in
the Declarations for the Damage to Premises
F. UNINTENTIONAL FAILURE TO DISCLOSE Rented to You Limit and is the most we will
HAZARDS pay, subject to paragraph 5 of Section III
Section IV – Commercial General Liability Limits of Insurance, under Coverage A for
Conditions paragraph 6. Representations is damages because of "property damage" to
changed to add the following: any one premises, while rented to you or, in
the case of damage by fire, lightning,
If you unintentionally fail to disclose any hazards
explosion, smoke and leakage from fire
existing at the inception date of your policy, we
protective systems, while rented to you or
will not deny coverage under the Coverage Form
temporarily occupied by you with permission
solely because of such failure. However, this
of the owner.
provision does not affect our right to collect
additional premium or exercise our right of 4. Paragraph 9.a. of the definition of "insured
cancellation or non-renewal. contract" in Section V – Definitions is
replaced by the following:
This provision does not apply to any known injury
or damage which is excluded under any other a. A contract for a lease of premises.
provision of this policy. However, that portion of the contract for a
lease of premises that indemnifies any
G. DAMAGE TO PREMISES RENTED TO YOU - person or organization for damage by fire,
EXPANDED COVERAGE lightning, explosion, smoke and leakage
1. The last paragraph of Paragraph 2., from fire protective systems or
Exclusions of Section I – Coverage A – subsequent damages resulting from such
Bodily Injury And Property Damage fire, lightning, explosion, smoke and
Liability is replaced by the following: leakage from fire protective systems while
rented to you or temporarily occupied by
Exclusions c. through n. do not apply to
you with permission of the owner is not
damage by fire, lightning, explosion, smoke or
an "insured contract";
subsequent damages resulting from such fire,
lightning, explosion, smoke or leakage from H. HEALTH CARE SERVICES
fire protective systems to premises rented to
1. The definition of "bodily injury" in Section V -
you or temporarily occupied by you with
Definitions is amended to include injury
permission of the owner. The insurance
arising out of the rendering or failure to render
provided by this paragraph is subject to the
medical or paramedical services to persons
Limit displayed in the Declarations. This limit
by any physician, dentist, nurse, emergency
will apply to all damage proximately caused
medical technician or paramedic who is
by the same event, whether such damage
employed by you to provide such services.
results from fire, lightning, explosion, smoke
or leakage from fire protective systems or any 2. Section II - Who Is An Insured, paragraph
combination of the five. 2.a.(1)(d) does not apply to nurses,
emergency medical technicians or
2. The word fire is changed to fire, lightning,
paramedics referred to in a. above.
explosion, smoke and leakage from fire
protective systems where it appears in: 3. Section I – Coverage A Bodily Injury and
Property Damage Liability Exclusion e.
a. the Limits of Insurance section of the
Employer’s Liability Paragraph (1) does not
declarations of the Commercial General
apply to injury to the emotions or reputation of
Liability Coverage form; and
a person arising out of the rendering of such
b. Paragraph 6. of Section III - Limits of services.
Insurance; and
19217 08 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 17
4. Health Care Services coverage does not N. LIBERALIZATION PROVISION
apply if you are engaged in the business or
occupation of providing any of the services The following condition is added to Section IV –
referred to in 1. above. Commercial General Liability Conditions:
If we adopt any revision that would broaden the
I. MEDICAL PAYMENTS coverage under this policy without additional
1. In Paragraph a.(3)(b) of the insuring premium within 45 days prior to or during the
agreement of Coverage C – Medical policy period, the broadened coverage will apply
Payments (Section I – Coverage), one year immediately to this policy.
is changed to three years.
2. Paragraph 2.a., Exclusions, of Coverage C
SECTION 3 - ADDITIONAL COVERAGES
(Section I) is replaced by the following:
We will not pay expenses for “bodily injury”: A. VOLUNTARY PROPERTY DAMAGE EXPENSE
a. To any insured, except volunteer workers COVERAGE
who are not paid a fee, salary or other
1. Insuring Agreement
compensation.
a. We will reimburse you for "property
3. The Medical Expense Limit in Paragraph 7. of damage" claims directly arising from
Section III – Limits of Insurance is replaced
"your work" for a "client".
by a new Medical Expense Limit, which will
be subject to all the terms of Section III – The amount of such reimbursement is
Limits of Insurance. The new Medical limited as described in the Limits Of
Expense Limit is an additional $10,000 in Insurance section. No other obligation or
excess of Medical Expense Limit provided by liability to pay sums or perform acts or
the Coverage Part. services is covered.
J. MOBILE EQUIPMENT b. This insurance applies only if:
Under the Section V - Definitions, Paragraph (1) "Your work" was performed by you
f.(1)(a), (b) and (c) of Mobile Equipment does not or an "employee" and was done with
apply to self-propelled vehicles of less than 1,000 the express knowledge of the
pounds gross vehicle weight. insured;
(2) "Your work" was performed during
K. NEWLY FORMED OR ACQUIRED
the policy period;
ORGANIZATION
(3) You reasonably determine, and “we”
1. In paragraph 3.a. of Section II -- Who Is An agree, that payment in the amount
Insured, 90th day is changed to 180th day. of the "property damage" to the
2. This provision does not apply if coverage for "client" for "your work" is necessary;
newly formed or acquired organizations is (4) You have received a notarized
excluded either by the provision of the notification of a demand for
Commercial General Liability Coverage Form remuneration from the "client" by
or by an applicable endorsement. mail within 90 days after the work
L. EXTENDED NON-OWNED WATERCRAFT was performed.
Paragraph (2) of Exclusion g. of Section I – c. This insurance only applies to “property
Coverage A Bodily Injury And Property damage” while “your work” is being
Damage Liability is deleted and replaced with performed.
the following: d. We shall have no duty nor obligation to
A watercraft you do not own that is less than 76 defend the insured or perform acts or
feet long and not being used by you to carry services.
persons or property for a charge. 2. Exclusions
M. SUPPLEMENTARY PAYMENTS This insurance does not apply to:
In the Supplementary Payments – Coverages A a. "Your work" performed at any location
and B provision: owned by, rented or leased to the
insured;
1. The limit for cost of bail bonds is increased
from $250 to $5,000. b. Work performed by a subcontractor; or
2. The limit for loss of earnings is increased from c. Property damage (other than “your work”)
$250 a day to $1,000 a day. excluded under Bodily Injury And
Property Damage Liability in the
Coverages section.
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3. The following is added to the Section III – 1. Insuring Agreement
Limits of Insurance: a. We will reimburse you for "product
The most we will reimburse you for the sum of withdrawal expenses" incurred by you
all damages covered under the Voluntary because of a "product withdrawal" to
Property Damage Expense Coverage which this insurance applies.
because of "your work" is displayed in the The amount of such reimbursement is
Schedule of this endorsement. The Annual limited as described in paragraph 3. Limit
Aggregate Limit starts with the beginning of Of Insurance. No other obligation or
the policy period shown in the Declarations. liability to pay sums or perform acts or
This coverage is excess if there is any other services is covered.
Voluntary Property Damage Expense
Coverage attached to this policy by b. This insurance applies to a "product
endorsement. withdrawal" only if the "product
withdrawal" is initiated in the “coverage
4. The following condition replaces the territory" during the policy period
Duties In The Event Of Occurrence, because:
Offense, Claim Or Suit Condition (Section
IV – Commercial General Liability i. You determine that the "product
Conditions) for the Voluntary Property withdrawal" is necessary; or
Damage Expense Coverage: ii. An authorized government entity has
You must notify us as soon as possible of the ordered you to conduct a "product
notification from your "client" of a demand for withdrawal".
remuneration for "property damage" resulting c. We will reimburse "product withdrawal
from "your work". The notice should include: expenses" only if:
a. A notarized letter from the "client" of the i. The expenses are incurred within one
work deemed necessary to be changed; year of the date the "product
b. The names and addresses of the affected withdrawal" was initiated;
"clients" ii. The expenses are reported to us
c. A written description by you of how, when within one year of the date the
and where the event occurred; and expenses were incurred.
d. A cancelled check or money order d. The initiation of a "product withdrawal"
written to the "client". will be deemed to have been made only
at the earliest of the following times:
“You” must submit to examination under oath
in matters connected with the loss as often as i. When you first announced, in any
“we” reasonably request and give “us” sworn manner, to the general public, your
statements of the answers. If more than one vendors or to your employees (other
person is examined, “we” have the right to than those employees directly
examine and receive statements separately involved in making the determination)
and not in the presences of others. your decision to conduct or
participate in a "product withdrawal".
At our request, give us complete inventories This applies regardless of whether
of the damaged and undamaged property. the determination to conduct a
Include quantities, costs, values and amount "product withdrawal" is made by you
of the loss claimed. You are required to or is requested by a third party; or
cooperate with us in the review of the
reimbursement. ii. When you first received, either orally
or in writing, notification of an order
5. Definition: "Client" means an individual, from an authorized government entity
company or organization with whom you have to conduct a "product withdrawal".
a written contract or work order for your
services for a described premise and have e. "Product withdrawal expenses" incurred
billed for your service. to withdraw "your products" which contain
the same or substantially similar "defects"
B. LIMITED PRODUCT WITHDRAWAL EXPENSE will be deemed to have arisen out of the
COVERAGE same "product withdrawal".
This coverage is subject to the provisions f. With respect to products of which "your
applying to the Commercial General Liability product" is a component part, we will only
Coverage Form, except as provided below. reimburse you the amount to replace,
repair or repurchase "your product".
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2. Exclusions i. Banned from the market by an
authorized government entity prior to
This insurance does not apply to "product the policy period; or
withdrawal expenses" arising out of:
ii. Distributed or sold by you subsequent
a. Breach Of Warranty And Failure To to any governmental ban.
Conform To Intended Purpose
h. Defense Of Claim
Any "product withdrawal" initiated due to
the failure of "your products" to The defense of a claim or "suit" against
accomplish their intended purpose, you for liability arising out of a "product
including any breach of warranty of withdrawal".
fitness, whether written or implied. This i. Third-party Damages, Fines And
exclusion does not apply if such failure Penalties
has caused or is reasonably expected to Any compensatory damages, fines,
cause "bodily injury" or physical damage penalties, punitive or exemplary or other
to tangible property other than "your non-compensatory damages imposed
product". upon the insured.
b. Infringement Of Copyright, Patent, j. Pollution-related Expenses
Trade Secret, Trade Dress Or
Trademark Any loss, cost or expense due to any:
Any "product withdrawal" initiated due to i. Request, demand, order, statutory or
copyright, patent, trade secret, trade regulatory requirement that any
dress or trademark infringements. insured or others test for, monitor,
clean up, remove, contain, treat,
c. Deterioration, Decomposition Or detoxify or neutralize, or in any way
Chemical Transformation respond to, or assess the effects of,
Any "product withdrawal" initiated due to "pollutants"; or
the transformation of a chemical nature, ii. Claim or suit by or on behalf of a
deterioration or decomposition of "your governmental authority for damages
product". This exclusion does not apply if because of testing for, monitoring,
it is caused by: cleaning up, removing, containing,
i. An error in manufacturing, design, or treating, detoxifying or neutralizing, or
processing; in any way responding to, or
ii. Transportation of "your product"; or assessing the effects of, "pollutants".
iii. "Product tampering". 3. Limit of Insurance
d. Goodwill, Market Share, Revenue, a. The Aggregate Limit of Insurance shown
Profit Or Redesign in the Schedule of Limits and the rules
below fix the most we will pay regardless
The costs of regaining goodwill, market of the number of:
share, revenue or "profit" or the costs of
redesigning "your product". i. Insureds;
e. Expiration Of Shelf Life ii. "Product withdrawals" initiated;
Any "product withdrawal" initiated due to iii. Number of "your products" withdrawn;
expiration of the designated shelf life of b. Deductible And Participation
"your product". Percentage Provisions
f. Known Defect i. Deductible
A "product withdrawal" initiated due to a We will only pay for the amount of:
"defect" in "your product" known to exist (1) "Product withdrawal
by the Named Insured or the Named expenses" which are in
Insured's "executive officers", prior to the excess of the deductible
date when this Limited Product amount, shown in the
Withdrawal Expense Coverage was first Schedule of Limits of this
issued to you or prior to the time "your endorsement. The deductible
product" leaves your control or applies separately to each
possession. "product withdrawal". The
g. Governmental Ban limits of insurance will not be
A recall when "your product" or a reduced by the amount of this
component contained within "your deductible.
product" has been:
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(2) We may, or will if required by ii. If a "product withdrawal" is initiated,
law, pay all or any part of any you must:
deductible amount, if (1) Immediately record the
applicable. Upon notice of our specifics of the "product
payment of a deductible withdrawal" and the date it
amount, you shall promptly was initiated; and
reimburse us for the part of
the deductible amount we (2) Notify us as soon as
paid. practicable. You must see to it
that we receive written notice
ii. Participation Percentage of the "product withdrawal" as
You agree to participate in the soon as practicable.
payment of "product withdrawal iii. You must promptly take all
expenses" which are in excess of the reasonable steps to mitigate the
deductible, to the extent of the expenses associated with a "product
Participation Percentage indicated in withdrawal". Any "profit" that you
the Schedule of Limits of this receive from mitigating the expenses
endorsement. The Participation will be deducted from the amount of
Percentage applies separately to reimbursement that you will receive
each "product withdrawal". You also for "product withdrawal expenses".
agree that the cost of your
participation in the loss will be borne iv. You and any other involved insured
entirely by you when due and you must:
will not obtain insurance to cover it (1) Immediately send us copies of
The Limit of Insurance of this pertinent correspondence
Coverage applies separately to each received in connection with
consecutive annual period and to the “product withdrawal”;
any remaining period of less than 12
(2) Authorize us to obtain records
months, starting with the beginning
and other information; and
of the policy period shown in the
Declarations. (3) Cooperate with us in our
investigation of the “property
4. Product Withdrawal Conditions
withdrawal”.
a. Duties In The Event Of A Product
b. Concealment Or Fraud
Withdrawal
We will not provide coverage for “product
i. You must see to it that we are notified
withdrawal expense” to you, or any other
as soon as practicable of any actual,
insured, who at any time:
suspected or threatened "defect" in
"your product", or any governmental i. Engaged in fraudulent conduct; or
investigation, that may result in a ii. Intentionally concealed or
"product withdrawal" or a claim. To misrepresented a material fact
the extent possible, notice should concerning a "product withdrawal" or
include: "product withdrawal expenses"
(1) How, when and where the incurred by you.
"defect" was discovered; c. Other Insurance
(2) The names and addresses of This coverage is excess if there is any
any injured persons and other Limited Product Withdrawal
witnesses; and Expense Coverage attached to this policy
(3) The nature, location and by endorsement.
circumstances of any injury or 5. The following definitions are added to
damage arising out of use or Section V - Definition:
consumption of "your
product". a. "Coverage territory" means anywhere in
the world with the exception of any
country or jurisdiction which is subject to
trade or other economic sanction or
embargo by the United States of America.
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b. "Defect" means a defect, deficiency or e. "Product withdrawal expenses" means
inadequacy that creates a dangerous those reasonable and necessary extra
condition. expenses, listed below, paid and directly
c. "Product tampering" is an act of related to a "product withdrawal":
intentional alteration of "your product" i. Cost of replacing "your product",
which has caused or is reasonably repairing the "defect" in "your
expected to cause "bodily injury" or product" or repurchasing "your
physical injury to tangible property other product" for your initial purchase
than "your product". When "product price, whichever is less;
tampering" is known, suspected or ii. Costs of notification;
threatened, a "product withdrawal" will be
limited to those batches of "your product" iii. Costs of stationery, envelopes,
which are known or suspected to have production of announcements and
been tampered with. For the purposes of postage or facsimiles;
this insurance, electronic data is not iv. Costs of overtime paid to regular non-
tangible property. salaried employees and costs
For the purposes of this insurance, electronic incurred by such employees,
data is not tangible property. including costs of transportation and
accommodations;
"Electronic data" means information, facts or
programs stored as or on, created or used on, v. Costs of computer time;
or transmitted to or from computer software, vi. Costs of hiring independent
hard or floppy disks, CD- ROMs, tapes, contractors and other temporary
drives, cells, data processing devices or any employees;
other media which are used with electronically vii. Costs of transportation, shipping or
controlled equipment. packaging;
d. "Product withdrawal" means the recall or viii. Costs of warehouse or storage
withdrawal: space; or
i. From the market; or ix. Costs of proper disposal of "your
ii. From use by any other person or products", or products that contain
organization; of "your products", or "your products", that cannot be
products which contain "your reused, not exceeding your initial
products", because of known or purchase price or your cost to
suspected "defects" in "your product", produce the products.
or known or suspected "product f. "Profit" means the positive gain from
tampering", which has caused or is business operation after subtracting for all
reasonably expected to cause "bodily expenses.
injury" or physical injury to tangible
property other than "your product". g. "Your product" means:
For the purposes of this insurance, i. Any goods or products, other than
electronic data is not tangible real property, manufactured, sold,
property. handled, distributed or disposed of
by:
"Electronic data" means information,
facts or programs stored as or on, (1) You;
created or used on, or transmitted to (2) Others trading under your
or from computer software, hard or name; or
floppy disks, CD- ROMs, tapes,
drives, cells, data processing devices (3) A person or organization
or any other media which are used whose business or assets you
with electronically controlled have acquired; and
equipment. ii. Containers (other than vehicles),
materials, parts or equipment
furnished in connection with such
goods or products.
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C. EMPLOYEE BENEFITS LIABILITY COVERAGE d. Insufficiency Of Funds
This endorsement is subject to the provisions Damages arising out of an insufficiency of
applying to the Commercial General Liability funds to meet any obligations under any
Coverage Form, except as provided below. plan included in the "employee benefit
1. Insuring Agreement program".
a. We will pay those sums that the insured e. Inadequacy Of Performance Of
becomes legally obligated to pay as Investment/Advice Given With Respect
damages because of any act, error or To Participation
omission, of the insured, or of any other Any "claim" based upon:
person for whose acts the insured is
legally liable, to which this insurance i. Failure of any investment to perform;
applies. We will have the right and duty to ii. Errors in providing information on
defend the insured against any "suit" past performance of investment
seeking those damages. However, we will vehicles; or
have no duty to defend the insured iii. Advice given to any person with
against any "suit" seeking damages to respect to that person's decision to
which this insurance does not apply. We participate or not to participate in any
may, at our discretion, investigate any plan included in the "employee
report of an act, error or omission and benefit program".
settle any "claim" or "suit" that may result.
But: f. Workers' Compensation And Similar
Laws
i. The amount we will pay for damages
is limited as described in Paragraph Any "claim" arising out of your failure to
5. (Section III – Limits Of comply with the mandatory provisions of
Insurance); and any workers' compensation,
unemployment compensation insurance,
ii. Our right and duty to defend ends social security or disability benefits law or
when we have used up the applicable any similar law.
limit of insurance in the payment of
judgments or settlements. No other g. ERISA
obligation or liability to pay sums or Damages for which any insured is liable
perform acts or services is covered because of liability imposed on a fiduciary
unless explicitly provided for under by the Employee Retirement Income
Supplementary Payments. Security Act of 1974, as now or hereafter
b. This insurance applies to damages only if amended, or by any similar federal, state
the act, error or omission, is negligently or local laws.
committed in the "administration" of your h. Available Benefits
"employee benefit program"; Any "claim" for benefits to the extent that
2. Exclusions such benefits are available, with
This insurance does not apply to: reasonable effort and cooperation of the
insured, from the applicable funds
a. Dishonest, Fraudulent, Criminal Or accrued or other collectible insurance.
Malicious Act
i. Taxes, Fines Or Penalties
Damages arising out of any intentional,
dishonest, fraudulent, criminal or Taxes, fines or penalties, including those
malicious act, error or omission, imposed under the Internal Revenue
committed by any insured, including the Code or any similar state or local law.
willful or reckless violation of any statute. j. Employment-Related Practices
b. Bodily Injury, Property Damage, Or Damages arising out of wrongful
Personal And Advertising Injury termination of employment,
"Bodily injury", "property damage" or discrimination, or other employment-
"personal and advertising injury". related practices.
c. 3rd Party Failure To Perform A 3. For the purposes of the coverage provided by
Contract this endorsement all references to
Supplementary Payments – Coverages A and
Damages arising out of failure of B are replaced by Supplementary Payments –
performance of contract by any insurer. Coverages A, B and Employee Benefits
Liability.
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4. For the purposes of the coverage provided by c. Subject to the Aggregate Limit, the Each
this endorsement, Paragraphs 2. and 3. of Employee Limit is the most we will pay for
Section II – Who Is An Insured are replaced all damages sustained by any one
by the following: "employee", including damages sustained
a. Each of the following is also an insured: by such "employee's" dependents and
beneficiaries, as a result of:
i. Each of your "employees" who is or
was authorized to administer your i. An act, error or omission; or
"employee benefit program". ii. A series of related acts, errors or
ii. Any persons, organizations or omissions negligently committed in
"employees" having proper temporary the "administration" of your
authorization to administer your "employee benefit program".
"employee benefit program" if you However, the amount paid under this
die, but only until your legal endorsement shall not exceed, and
representative is appointed. will be subject to, the limits and
iii. Your legal representative if you die, restrictions that apply to the payment
but only with respect to duties as of benefits in any plan included in the
such. That representative will have all "employee benefit program". The
your rights and duties under this Limits of Insurance of this
Endorsement. endorsement apply separately to
each consecutive annual period and
b. Any organization you newly acquire or to any remaining period of less than
form, other than a partnership, joint 12 months, starting with the
venture or limited liability company, and beginning of the policy period shown
over which you maintain ownership or in the Declarations of the policy to
majority interest, will qualify as a Named which this endorsement is attached.
Insured if no other similar insurance
applies to that organization. However: 6. Deductible
i. Coverage under this provision is a. Our obligation to pay damages on behalf
afforded only until the 90th day after of the insured applies only to the amount
you acquire or form the organization of damages in excess of the deductible
or the end of the policy period, amount stated in the Schedule as
whichever is earlier. applicable to Each Employee. The limits
of insurance shall not be reduced by the
ii. Coverage under this provision does amount of this deductible.
not apply to any act, error or omission
that was committed before you b. The deductible amount stated in the
acquired or formed the organization. Schedule applies to all damages
sustained by any one "employee",
5. Limits of Insurance including such "employee's" dependents
For the purposes of the coverage provided by and beneficiaries, because of all acts,
this endorsement, Section III – Limits Of errors or omissions to which this
Insurance is replaced by the following: insurance applies.
a. The Limits of Insurance shown in the c. The terms of this insurance, including
Schedule and the rules below is the most those with respect to:
we will pay regardless of the number of: i. Our right and duty to defend any
i. Insureds; "suits" seeking those damages; and
ii. "Claims" made or "suits" brought; ii. Your duties, and the duties of any
other involved insured, in the event of
iii. Persons or organizations making
an act, error or omission, or "claim"
"claims" or bringing "suits";
apply irrespective of the application of
iv. Acts, errors or omissions; or the deductible amount.
v. Benefits included in your "employee d. We may pay any part or all of the
benefit program". deductible amount to effect settlement of
b. The Aggregate Limit is the most we will any "claim" or "suit" and, upon notification
pay for all damages because of acts, of the action taken, you shall promptly
errors or omissions negligently committed reimburse us for such part of the
in the "administration" of your "employee deductible amount as we have paid.
benefit program".
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7. For the purposes of the coverage provided by b. Other Insurance
this endorsement, Conditions 2. and 4. of
Section IV – Commercial General Liability This coverage is excess if there is any
Conditions are replaced by the following: other Employee Benefit Liability attached
to this policy by endorsement.
a. Duties In The Event Of An Act, Error
Or Omission, Or "Claim" Or "Suit" 8. For the purposes of the coverage provided by
this endorsement, the following definitions are
i. You must see to it that we are notified added to the Section V - Definitions:
as soon as practicable of an act, error
or omission which may result in a a. "Administration" means:
"claim". To the extent possible, notice i. Providing information to "employees",
should include: including their dependents and
(1) What the act, error or beneficiaries, with respect to eligibility
omission was and when it for or scope of "employee benefit
occurred; and programs";
(2) The names and addresses of ii. Handling records in connection with
anyone who may suffer the "employee benefit program"; or
damages as a result of the iii. Effecting, continuing or terminating
act, error or omission. any "employee's" participation in any
ii. If a "claim" is made or "suit" is benefit included in the "employee
brought against any insured, you benefit program". However,
must: "administration" does not include
handling payroll deductions.
(1) Immediately record the
specifics of the "claim" or b. "Cafeteria plans" means plans authorized
"suit" and the date received; by applicable law to allow employees to
and elect to pay for certain benefits with pre-
tax dollars.
(2) Notify us as soon as
practicable. You must see to it c. “Claim" means any demand, or "suit",
that we receive written notice made by an "employee" or an
of the "claim" or "suit" as soon "employee's" dependents and
as practicable. beneficiaries, for damages as the result of
an act, error or omission.
iii. You and any other involved insured
must: d. "Employee benefit program" means a
program providing some or all of the
(1) Immediately send us copies of following benefits to "employees",
any demands, notices, whether provided through a "cafeteria
summonses or legal papers plan" or otherwise:
received in connection with
the "claim" or "suit"; i. Group life insurance, group accident
or health insurance, dental, vision
(2) Authorize us to obtain records and hearing plans, and flexible
and other information; spending accounts, provided that no
(3) Cooperate with us in the one other than an "employee" may
investigation or settlement of subscribe to such benefits and such
the "claim" or defense against benefits are made generally available
the "suit"; and to those "employees" who satisfy the
(4) Assist us, upon our request, in plan's eligibility requirements;
the enforcement of any right ii. Profit sharing plans, employee
against any person or savings plans, employee stock
organization which may be ownership plans, pension plans and
liable to the insured because stock subscription plans, provided
of an act, error or omission to that no one other than an "employee"
which this insurance may also may subscribe to such benefits and
apply. such benefits are made generally
iv. No insured will, except at that available to all "employees" who are
insured's own cost, voluntarily make eligible under the plan for such
a payment, assume any obligation or benefits;
incur any expense without our iii. Unemployment insurance, social
consent. security benefits, workers'
compensation and disability benefits;
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iv. Vacation plans, including buy and sell b. Non-owned Auto Liability
programs; leave of absence
programs, including military, The insurance provided under Section I -
maternity, family, and civil leave; Coverage A Bodily Injury and Property
tuition assistance plans; Damage Liability applies to “bodily
transportation and health club injury” or “property damage” arising out of
subsidies. the use of any “non-owned auto” in your
business by any person for the limits
9. For the purposes of the coverage provided by provided in the Schedule of Limits of this
this endorsement, Definitions 5. and 18. in endorsement.
Section V - Definitions Section are replaced
by the following: 2. With respect to the insurance provided by this
endorsement: Subparagraphs c., e., g., h., j.,
a. "Employee" means a person actively k., l., m., and n. of paragraph 2. Exclusions
employed, formerly employed, on leave of of Section I - Coverage A Bodily Injury and
absence or disabled, or retired. Property Damage Liability are deleted in
"Employee" includes a "leased worker". their entirety and the following exclusions are
"Employee" does not include a added:
"temporary worker".
This insurance does not apply to:
b. "Suit" means a civil proceeding in which
damages because of an act, error or a. “Bodily injury”:
omission to which this insurance applies i. To an “employee” of the insured
are alleged. "Suit" includes: arising out of and in the course of
i. An arbitration proceeding in which employment by the insured or
such damages are claimed and to performing the duties related to the
which the insured must submit or conduct of the insured business or
does submit with our consent; or ii. To the spouse, child, parent, brother
ii. Any other alternative dispute or sister of that “employee” as a
resolution proceeding in which such consequence of 1.a.(1) above.
damages are claimed and to which This exclusion applies:
the insured submits with our consent.
(1) Whether the insured may be
liable as an employer or in
SECTION 4 – OPTIONAL COVERAGES any other capacity; and
(2) To any obligation to share
If shown as included in the Schedule of Coverages, damages with or repay
the following Optional Coverage may also apply. someone else who must pay
These coverages are subject to the terms, exclusions damages because of injury.
and conditions applicable to the Commercial General
Liability Coverage and this endorsement. This exclusion does not apply to:
(1) Liability assumed by the insured
A. HIRED AND NON-OWNED AUTO LIABILITY under an “insured contract”; or
COVERAGE (2) “Bodily injury” arising out of and
in the course of domestic
1. Insurance is provided only for these
employment by the insured
coverages, but only if you do not have any
unless benefits for such injury
other insurance available to you which affords
are in whole or in part either
the same or similar coverage.
payable or required to be
a. Hired Auto Liability provided under any workers’
The insurance provided under Section I – compensation law.
Coverage A Bodily Injury and Property b. “Property damage” to:
Damage Liability applies to “bodily
i. Property owned or being transported
injury” or “property damage” arising out of
by, or rented or loaned to the
the maintenance or use of a “hired auto”
insured; or
by you or your “employees” in the course
of your business for the limits provided in ii. Property in the care, custody or
the Schedule of Limits of this control of the insured.
endorsement.
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3. Section II – Who is an Insured is replaced (2) Maintenance or use of a
by the following: “hired auto” by you or your
Each of the following is an insured under this “employee” in the course of
insurance to the extent set forth below. your business; or
a. You; (3) Use of any “non-owned auto”
in your business by any
b. Any other person using a “hired auto” with person other than you.
your permission;
5. Definitions
c. With respect to a “non-owned auto”, any
partner or “executive officer” of yours, any a. The following additional definitions apply:
“employee” of yours; but only while such i. “Auto business” means the business
“non-owned auto” is being used in your or occupation of selling, repairing,
business; and servicing, storing or parking “autos”.
d. Any other person or organization, but only b. Paragraph 9. “Insured contract” is
with respect to their liability because of changed by the addition of the following:
acts or omissions of an insured under a., ii. “Insured contract” means the part of
b., or c. above. any contract or agreement entered
None of the following is an insured: into as part of your business, by you
e. Any person engaged in the business of or any of your employees pertaining
his or her employer with respect to “bodily to the rental or lease of any “auto”.
injury” to any co-“employee” of such iii. Does not include that part of any
person injured in the course of contract or agreement:
employment or to the spouse, child, (1) That pertains to the loan, lease
parent, brother or sister of that co- or rental of an “auto” to you or
“employee” as a consequence of such any of your employees, if the
“bodily injury”, or for any obligation to “auto” is loaned, leased or
share damages with or repay someone rented with a driver; or
else who must pay damages because of
the injury; (2) That holds a person or
organization, engaged in the
f. Any partner or “executive officer” with business of transporting
respect to any “auto” owned by such property by “auto” for hire,
partner or officer or a member of his or harmless for your use of a
her household; covered “auto” over a route or
g. Any person while employed in or territory that that person or
otherwise engaged in duties in organization is authorized to
connection with an “auto business” serve by public authority.
including an “auto business” you operate. a. “Hired auto” means any “auto” you lease,
h. The owner or lessee (of whom you are a hire, rent or borrow. This does not
sublessee) of a “hired auto” or the owner include any “auto” you lease, hire, rent or
of a “non-owned auto” or any agent or borrow from any of your “employees”,
“employee” of any such owner or lessee; partners (if you are a partnership),
i. Any person or organization with respect members (if you are a limited liability
to the conduct of any current or past company) or members of their
partnership or joint venture that is not households.
shown as a Named Insured in the b. “Non-owned auto” means any “auto” you
Declarations. do not own, lease, hire, rent or borrow
4. Section III – Limits of Insurance Paragraph that is used in connection with your
2.b. is replaced by the following: business. This includes any “auto” owned
by your “employees” or partners (if you
a. Damages under Coverage A and are a partnership), members (if you are a
Coverage B, except damages because limited liability company) or members of
of: their households but only while used in
i. Injury and damage included in the your business or your personal affairs.
“products-completed operations
hazard”; or
(1) “Bodily injury” or “property
damage” arising out of the:
19217 08 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 17 of 17
This page has been left blank intentionally.
William J Redmond & Son Inc
6733080
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED – OWNERS, LESSEES OR
CONTRACTORS – AUTOMATIC STATUS WHEN
REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU
(INCLUDING PRODUCTS-COMPLETED OPERATIONS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II – Who Is An Insured is amended to a. The preparing, approving, or failing to
include as an additional insured any person or prepare or approve, maps, shop drawings,
organization for whom you are performing opinions, reports, surveys, field orders,
operations or have performed operations when change orders or drawings and
you and such person or organization have agreed specifications; or
in writing in a contract or agreement that such b. Supervisory, inspection, architectural or
person or organization be added as an additional engineering activities.
insured on your policy. Such person or
organization is an additional insured only with This exclusion applies even if the claims against
respect to liability for "bodily injury", "property any insured allege negligence or other wrongdoing
damage" or "personal and advertising injury" in the supervision, hiring, employment, training or
caused, in whole or in part, by: monitoring of others by that insured, if the
"occurrence" which caused the "bodily injury" or
1. Your acts or omissions or the acts or omissions "property damage", or the offense which caused
of those acting on your behalf in the the "personal and advertising injury", involved the
performance of your ongoing operations for the rendering of or the failure to render any
additional insured. professional architectural, engineering or
2. “Your work” performed for the additional surveying services.
insured and included in the “products- 2. Any person(s) or organization(s) for whom you
completed operations hazard”. are performing operations or have performed
However, the insurance afforded to such operations that is an additional insured on a
additional insured: specifically named endorsement attached to
1. Only applies to the extent permitted by law; this policy.
and C. With respect to the insurance afforded to these
2. Will not be broader than that which you are additional insureds, the following is added to
required by the contract or agreement to Section III – Limits Of Insurance:
provide for such additional insured. The most we will pay on behalf of the additional
B. With respect to the insurance afforded to these insured is the amount of insurance:
additional insureds, the following additional 1. Required by the contract or agreement you
exclusions apply: have entered into with the additional insured;
This insurance does not apply to: or
1. "Bodily injury", "property damage" or "personal 2. Available under the applicable Limits of
and advertising injury" arising out of the Insurance shown in the Declarations;
rendering of, or the failure to render, any whichever is less.
professional architectural, engineering or This endorsement shall not increase the
surveying services, including: applicable Limits of Insurance shown in the
Declarations.
18202 11 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1
This page has been left blank intentionally.
William J Redmond & Son Inc
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William J Redmond & Son Inc
6733079
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DIAMOND AUTO PREMIER ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
This endorsement is subject to the provisions applying to the Business Auto Coverage Form, except as described
below.
SECTION 1 – WHO IS AN INSURED EXTENSIONS 3. Employees as Insureds
AND ADDITIONAL INTEREST COVERAGES Your "employees" are insureds while using a
A. SECTION II – LIABILITY COVERAGE, Para- covered "auto" in your business or your
graph A. Coverage, 1. Who Is An Insured is personal affairs, provided you do not own, hire,
changed by adding the following: or borrow that "auto".
1. Subsidiaries As Insureds 4. Hired Auto Liability For Employees
Any legally incorporated subsidiary in which An "employee" of yours is an "insured" while
you own more than 50% of the voting stock on operating an "auto" hired or rented under a
the effective date of this Coverage. However, contract or agreement in that "employee’s"
the Named Insured does not include any name, with your permission, while performing
subsidiary that is an "insured" under any other duties related to the conduct of your business.
automobile policy or would be an "insured" 5. Automatic Additional Interest
under such a policy but for its termination or Any person or organization whom you are
the exhaustion of its Limits of Insurance.
required to add as an Additional Insured on
2. Automatic Insured Status for Newly Formed this policy under a written contract or written
or Acquired Organizations agreement in effect on the date of the
Any organization that is newly acquired or "accident"; and signed by all parties prior to the
formed by you and over which you maintain "accident".
majority ownership will qualify as a Named This person or organization is an Additional
Insured if there is no other similar insurance Insured to the extent you are liable for an
available to that organization. However: "accident" caused in whole or in part, using a
a. Coverage under this provision is afforded covered "auto" being driven by you or any
only until the 180th day after you acquire or "insured".
form the organization or the end of the B. Primary and Noncontributory – Other
policy period, whichever is earlier; and Insurance Condition
b. Coverage does not apply to: SECTION IV – BUSINESS AUTO CONDITIONS,
(1) Newly formed or acquired joint ventures Paragraph B.5. Other Insurance Condition is
or partnerships; changed. The following is added to the and
supersedes any provision to the contrary:
(2) "Bodily injury" or "property damage"
resulting from an "accident" that 1. This insurance is primary to and will not seek
occurred before you formed or acquired contribution from any other insurance available
the organization; and to an Additional Insured under your policy
provided that:
(3) Any insured under any other automobile
liability policy or would be an insured a. The Additional Insured is a Named Insured
under such a policy but for the under such other insurance; and
termination of coverage or the b. You have agreed in writing in a contract or
exhaustion of policy liability limits of agreement that this insurance would be
insurance. primary and would not seek contribution
from any other insurance available to the
Additional Insured.
19348 08 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 12
2. Regardless of the written contract or written C. Coverage for Certain Operations In Connection
agreement between you and an Additional with Railroads
Insured, this insurance is excess over any With regards to the use of covered "autos" in
other insurance whether primary, excess, operations for or affecting a railroad:
contingent or any other basis for which the
Additional Insured has been added as 1. SECTION V – DEFINITIONS, H. "Insured
additional insured on other policies. contract", 3. is deleted and replaced by the
following:
3. The most we will pay on behalf of the
Additional Insured is the amount of insurance 3. An easement or license agreement;
required in writing in a contract or agreement; 2. SECTION V – DEFINITIONS, H. "Insured
or available under the applicable Limits of contract", a. is deleted.
Insurance shown in the Declarations; D. Covered Autos Coverage Extension
whichever is less.
If SECTION 1 COVERED AUTOS is provided as
C. Automatic Waiver of Transfer of Rights of
Symbol 1 Any "Auto" then any "auto" includes
Recovery Against Others To Us mobile equipment subject to compulsory or
Paragraph A.5. Transfer Of Rights Of Recovery financial responsibility or other motor vehicle
Against Others To Us of SECTION IV – insurance law only.
BUSINESS AUTO CONDITIONS is changed with Covered mobile equipment includes only those
the addition of the following: "autos" that are land vehicles and that would
The Transfer of Rights Of Recovery Against qualify under the definition of "mobile equipment"
Others To Us Condition does not apply to any under this policy if they were not subject to a
person(s) or organization(s) for whom you are compulsory or financial responsibility law or other
required to waive subrogation with respect to the motor vehicle insurance law where they are
coverage provided under this Coverage Form, but licensed or principally garaged.
only to the extent that subrogation is waived: E. Drive Other Car – Automatic Coverage for
1. Under a written contract or written agreement Executive Officers
with such person(s) or organization(s); and 1. Changes in SECTION II – COVERED AUTOS
2. Prior to the "accident" or the "loss". LIABILITY COVERAGE
a. If Covered Auto Liability, Auto Medical
SECTION 2 – LIABILITY EXTENSIONS AND Payments, Comprehensive, Specified
ADDITIONAL COVERAGES Causes of Loss, Collision, or Uninsured and
Underinsured Motorist is shown in the
A. Bodily Injury Coverage Extension – Mental Declarations for any private passenger
Anguish auto, then the same type of coverage is
SECTION V – DEFINITIONS, C. "Bodily Injury" provided for Drive Other Car – Automatic
is deleted and replaced by the following: Coverage for Executive Officer.
"Bodily injury" means bodily injury, sickness or b. Any "auto" you don’t own, hire, or borrow is
disease sustained by a person, including mental a covered "auto" while being used by any
anguish and death sustained by the same person "executive officer" or by his or her spouse
that results from such bodily injury, sickness, or while a resident of the same household
disease. "Bodily injury" does not include mental except:
anguish or death that does not result from bodily (1) Any "auto" owned by that "executive
injury, sickness, or disease. officer" or by any member of his or her
B. Certain Trailers And Temporary Substitute household.
Autos Coverage Extension (2) Any "auto" used by that "executive
SECTION I – COVERED AUTOS, Paragraph C.1. officer" or his or her spouse while
is changed by the following: working in a business of selling,
servicing, repairing, or parking "autos".
Gross Vehicle Weight Rating of 3,000 pounds is
deleted and replaced with Gross Vehicle Weight
Rating of 5,000 pounds.
Page 2 of 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 19348 08 22
2. Changes in Auto Medical Payments and In addition to the Limit of Insurance, we will pay
Uninsured and Underinsured Motorists reasonable “travel expenses” incurred by a family
Coverages member or associate of an “insured” or passenger
The following is added to Paragraph A.1. Who who is injured in an “accident” involving a covered
Is An Insured: “auto”, subject to the following conditions:
Any "executive officer" and his or her "family 1. Regardless of the number of traveling family
member" are "insureds" while "occupying" or members or associates, injured “insureds” or
while a pedestrian when being struck by any passengers, claims made or vehicles involved
"auto" you don’t own except: in the “accident”, the most we will pay for all
“travel expenses” resulting from any one
Any "auto" owned by an "executive officer" or “accident” is the limit displayed on the
by any "family member". Coverage Schedule.
3. Changes in SECTION III – PHYSICAL 2. Travel must be to visit the injured party at the
DAMAGE COVERAGE medical or rehabilitation facility or in the event
Any private passenger type "auto" you don’t of death, to the location necessary to handle
own, hire, or borrow is a covered "auto" while the immediate affairs of the deceased.
in the care, custody, or control of any 3. The limit shown on the Coverage Schedule is
"executive officer" or his or her spouse while a the most we will pay for the combined total
resident of the same household except: expenses of room accommodations, meals,
a. Any "auto" owned by that "executive officer" and parking for each family member or
or by any member of his or her household. associate is the per day limit shown on the
b. Any "auto" used by that "executive officer" Coverage Schedule.
while working in a business of selling, 4. Subject to the maximum limit shown on the
servicing, repairing, or parking "autos". Coverage Schedule, we will reimburse ground
4. Additional Definitions transportation using a personal vehicle at the
As used for Drive Other Car – Automatic current rate (rate during your time of travel) set
Coverage for Executive Officers the by the Federal government.
following definitions are added.
5. All “travel expenses” must be supported by
a. "Executive officer" means any person written receipts submitted to us no later than
holding any of the officer positions created one year from the date of the “accident”.
by your organization’s governing document.
b. "Family member" means a person related to “Travel expenses” mean only the following
the "executive officer" by blood, marriage or expenses: reasonable ground, rail or economy
adoption who is a resident of the "executive class air transportation; room accommodations;
officer’s" household, including a ward or meals and parking expenses.
foster child.
F. Expected or Intended Injury Coverage H. Fellow Employee Coverage Extension
Extension SECTION II – COVERED AUTOS LIABILITY
SECTION II – COVERED AUTOS LIABILITY COVERAGE, B. Exclusions Paragraph 5. Fellow
COVERAGE, B.1. Exclusion is deleted and Employee is deleted.
replaced with the following: I. Pollution Liability Additional Coverage
1. Expected Or Intended Injury 1. SECTION II – COVERED AUTOS LIABILITY
"Bodily injury" or "property damage" expected COVERAGE, B. Exclusions are changed as
or intended from the standpoint of the follows:
"insured". But this exclusion does not apply to a. Paragraph 11.a. Pollution Exclusion
"bodily injury" or "property damage" resulting applies only to liability assumed under a
from the use of reasonable force to protect contract or agreement.
persons or property.
b. With respect to the coverage afforded by
G. Family Emergency Travel Coverages Paragraph 1.a. above, Exclusion B.6.
The following is added to Paragraph A.2. Care, Custody Or Control does not apply.
Coverage Extensions of Section II – COVERED
AUTO LIABILITY COVERAGE
19348 08 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 13
2. Changes in SECTION V – DEFINITIONS for 3. The Aggregate Limit shown in the
the purposes of this coverage, Paragraph D. of Coverage Schedule is the most we will
the Definitions Section is replaced by the pay for the sum of all damages and
following: "covered pollution cost or expense"
D. "Covered pollution cost or expense" means involving the insurance provided by
any cost or expense arising out of: this endorsement. The Aggregate Limit
applies separately to each consecutive
1. Any request, demand, order or statutory annual period and to any remaining
or regulatory requirement that any period of less than 12 months, starting
"insured" or others test for, monitor, with the beginning of the Policy Period
clean up, remove, contain, treat, shown in the Declarations, unless the
detoxify or neutralize, or in any way Policy Period is extended after the
respond to, or assess the effects of issuance for an additional period of
"pollutants"; or less than 12 months. In that case, the
2. Any claim or "suit" by or on behalf of a additional period will be deemed part of
governmental authority for damages the last preceding period for purposes of
because of testing for, monitoring, determining the Aggregate Limit.
cleaning up, removing, containing, 4. This additional coverage does not apply
treating, detoxifying, or neutralizing, or to "autos" garaged in Vermont if
in any way responding to or assessing Vermont Changes form 19352 is
the effects of "pollutants". attached to policy.
"Covered pollution cost or expense" does J. Supplemental Payments
not include any cost or expense arising out
of the actual, alleged or threatened SECTION II – LIABILITY COVERAGE, A.
discharge, dispersal, seepage, migration, Coverage, 2. Coverage Extensions, a.
release or escape of "pollutants": Supplementary Payments is changed by:
a. Before the "pollutants" or any property in 1. Replacing the $2,000 Limits of Insurance for
which the "pollutants" are contained are bail bonds with the limits shown in the
moved from the place where they are Coverage Schedule and;
accepted by the "insured" for movement 2. Replacing the $250 Limits of Insurance for
into or onto the covered "auto"; or reasonable expenses with the limits shown in
b. After the "pollutants" or any property in the Coverage Schedule.
which the "pollutants" are contained are
moved from the covered "auto" to the SECTION 3 – PHYSICAL DAMAGE EXTENSIONS
place where they are finally delivered, AND ADDITIONAL COVERAGES
disposed of, or abandoned by the
"insured". Physical Damage Extensions and Additional
Coverages are only available for "autos" with
Paragraphs a. and b. above do not apply Comprehensive, Specified Causes of Loss, and
to "accidents" that occur away from Collision physical damage coverages. SECTION III –
premises owned by or rented to an PHYSICAL DAMAGE COVERAGE is changed as
"insured" with respect to "pollutants" not follows:
in or upon a covered "auto" if:
A. Airbag Coverage
(1) The "pollutants" or any property
in which the "pollutants" are B. Exclusions, 3.a. is changed by adding the
contained are upset, overturned, following:
or damaged as a result of the The mechanical and electrical breakdown portion
maintenance or use of a covered of this exclusion does not apply to the accidental
"auto"; and discharge of an airbag.
(2) The discharge, dispersal, seep- This coverage for airbags is excess over any other
age, migration, release or escape collectible insurance or warranty.
of the "pollutants" is caused B. Audio, Visual and Data Electronic Equipment
directly by such upset, overturn
or damage. Limits of Insurance Paragraph b. is changed by
deleting the $1,000 limit and replacing it with the
limit shown in the Coverage Schedule.
Page 4 of 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 19348 08 22
C. Auto Replacement Option c. Extended Business Income
SECTION III – PHYSICAL DAMAGE If the necessary "suspension" of your
COVERAGE A.4 Coverage Extension is "operations" produces a "business income"
changed to include the following: loss payable under this endorsement, we
1. In the event of a total “loss” to a combustion will pay for the actual loss of "business
engine “auto” for which Comprehensive, income" you incur during the period that:
Specified Causes of Loss, or Collision (1) Begins on the date "business property"
coverage are provided, the Physical Damage is actually repaired or replaced and
Coverages are changed by the following: "operations" are resumed; and
a. If a combustion engine covered “auto” is (2) Ends on the earlier of:
replaced with a “hybrid auto” or an (a) The date you could restore your
“electric auto”, we will pay an additional "operations", with reasonable speed,
10% of the damaged or stolen auto’s to the level which would generate the
actual cash value or replacement cost up "business income" amount that
to the per auto limit shown in the would have existed if no direct and
Coverage Schedule., whichever is less; accidental loss or damage had
b. The damaged or stolen auto must be occurred; or
replaced and a copy of a bill of sale or (b) 60 consecutive days after the date
lease agreement must be received by us determined in Paragraph c.(1). How-
within 60 calendar days of the date of ever, Extended Business Income
“loss”; and Additional Coverage does not apply
c. If more than one auto is damaged or to loss of "business income" incurred
stolen in any one “loss”, the most we will as a result of unfavorable business
pay under this Coverage for any one conditions caused by the impact of
“loss” is shown as the per accident limit the Covered Cause of Loss in the
on the Coverage Schedule. area where "business property" is
D. Business Interruption Additional Coverage normally used. Loss of "business
income" must be caused by direct
1. Coverages and accidental loss or damage to
a. Business Income "business property" caused by or
We will pay for the actual loss of "business resulting from a Covered Cause of
Loss.
income" you sustain due to the necessary
"suspension" of your "operations" during d. Temporary Substitute And Newly
the "period of restoration". The "sus- Acquired Property
pension" must be caused by direct and The coverage applicable to "business
accidental loss or damage to "business property" under this endorsement is
property". The direct and accidental loss or extended to apply to:
damage must be caused by or result from a
Covered Cause of Loss and must occur (1) Property that is used as a temporary
while such "business property" is located substitute for "business property", but
within the coverage territory. only while such "business property" is
out of service due to breakdown, repair,
b. Extra Expense servicing, destruction, or direct and
We will pay the actual and necessary "extra accidental loss or damage;
expense" you incur during the "period of (2) Newly acquired property, other than
restoration" due to direct and accidental temporary substitute property described
loss or damage to "business property". The in Paragraph d.(1), but only if it serves
direct and accidental loss or damage must as a replacement for "business
be caused by or result from a Covered property".
Cause of Loss and must occur while such
"business property" is located within the
coverage territory.
19348 08 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 13
2. Covered Causes Of Loss (c) Insurrection, rebellion, revolution,
With respects to Business Interruption usurped power, or action taken by
coverage, the following Covered Causes of governmental authority in hindering
Loss apply: or defending against any of these.
a. Comprehensive, meaning any cause of b. When direct and accidental loss or damage
direct and accidental loss or damage to "business property" is caused by or
except: results from "business property" being used
in any professional or organized racing or
(1) "Business property's" collision with demolition contest or stunting activity, or
another object; or while practicing for such contest or activity.
(2) "Business property's" overturn. We also do not provide coverage under this
Comprehensive also includes direct and endorsement while that "business property"
is being prepared for such contest or
accidental loss or damage caused by falling
objects, missiles or hitting a bird or animal. activity.
b. Specified Causes of Loss, meaning direct c. When direct and accidental loss or damage
and accidental loss or damage caused by: is due and confined to:
(1) Fire, lightning or explosion; (1) Wear and tear, freezing, mechanical or
(2) Theft; electrical breakdown.
(3) Windstorm, hail or earthquake; (2) Blowouts, punctures, or other road
damage to tires.
(4) Flood;
d. For any increase of "business income" loss
(5) Mischief or vandalism; or caused by or resulting from the suspension,
(6) The sinking, burning, collision or lapse or cancellation of any license, lease,
derailment of any conveyance or contract. But if the suspension, lapse or
transporting “business property cancellation is directly caused by the
c. Collision, meaning direct and accidental "suspension" of "operations", we will cover
loss or damage caused by: such loss that affects your "business
income" during the "period of restoration".
(1) "Business property's" collision with
another object; or e. For any "extra expense" caused by or
resulting from the suspension, lapse or
(2) "Business property's" overturn.
cancellation of any license, lease, or
3. Exclusions contract beyond the "period of restoration".
We do not provide Business Interruption f. For any other consequential loss.
Coverage under this endorsement: 4. Limits of Insurance
a. When direct and accidental loss or damage a. The most we will pay in any one occurrence
is caused by or results from any of the for the total of all covered "business
following, regardless of any other cause or
income" loss and "extra expense" is the
event that contributes concurrently or in any limit provided in the Coverage Schedule,
sequence to the direct and accidental loss regardless of the number of premiums paid
or damage:
or claims made.
(1) Nuclear Hazard b. Payments made under Extended Business
The explosion of any weapon employing Income or Temporary Substitute And Newly
atomic fission or fusion; or Nuclear Acquired Property will not increase the
reaction or radiation, or radioactive applicable Limits of Insurance.
contamination, however caused.
(2) War Or Military Action
(a) War, including undeclared or civil
war;
(b) Warlike action by a military force,
including action in hindering or
defending against an actual or
expected attack, by any government,
sovereign or other authority using
military personnel or other agents; or
Page 6 of 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 19348 08 22
5. Changes In Conditions (5) As often as may be reasonably required,
With respect to the coverage provided by this permit us to inspect "business property"
endorsement, the following conditions are and examine and make copies of your
added and replace any provisions to the books and records.
contrary: (6) Agree to examinations under oath at our
a. Appraisal request and give us a signed statement
of your answers.
If we and you disagree on the amount of
Net Income and operating expense or the (7) Send us a signed, sworn proof of loss
amount of loss, either may make written containing the information we request to
demand for an appraisal. In this event, each investigate the claim. You must do this
party will select a competent and impartial within 60 days after our request. We will
appraiser. The two appraisers will select an supply you with the necessary forms.
umpire. If they cannot agree, either may (8) Cooperate with us in the investigation or
request that selection be made by a settlement of the claim.
judge of a court having jurisdiction. The (9) If you intend to continue your business,
appraisers will state separately the amount you must resume all or part of your
of Net Income and operating expense or "operations" as quickly as possible.
amount of loss. If they fail to agree, they will
submit their differences to the umpire. A c. Other Insurance
decision agreed to by any two will be (1) You may have other insurance subject
binding. to the same plan, terms, conditions, and
Each party will: provisions as the insurance provided
under this endorsement. If you do, we
(1) Pay its chosen appraiser; and will pay our share of the covered
(2) Bear the other expenses of the "business income" loss or "extra
appraisal and umpire equally. expense". Our share is the proportion
that the applicable Limits of Insurance
If there is an appraisal, we will still retain under this endorsement bears to the
our right to deny the claim. Limits of Insurance of all insurance
covering on the same basis.
b. Duties In The Event Of Loss
(2) If there is other insurance covering the
If there is direct and accidental loss or same "business income" loss or "extra
damage to "business property", you must expense", other than that described in
do the following: Paragraph 6.a. above, we will pay only
for the amount of covered "business
(1) Give us or our authorized representative income" loss or "extra expense" in
prompt notice of such loss or damage. excess of the amount due from that
Include a description of the "business other insurance, whether you can collect
property" involved. on it or not. But we will not pay more
(2) As soon as possible, give us or our than the applicable Limits of Insurance.
authorized representative a description d. Loss Determination
of how, when and where such loss or
damage occurred. (1) The amount of "business income" loss
will be determined based on:
(3) Promptly notify the police if "business
property" or any of its equipment is (a) The Net Income of your "operations"
stolen. before the direct and accidental loss
or damage occurred;
(4) Take all reasonable steps to protect
"business property" from further damage
and keep a record of your expenses
necessary to protect "business proper-
ty", for consideration in the settlement of
the claim. Also, if feasible, set such
property aside and in the best possible
order for examination.
19348 08 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 13
(b) The likely Net Income of your (2) We will reduce the amount of your "extra
"operations" if no direct and expense" loss to the extent you can
accidental loss or damage had return "operations" to normal and
occurred, but not including any Net discontinue such "extra expense".
Income that would likely have been (3) If you do not resume "operations", or do
earned as a result of an increase in not resume "operations" as quickly as
the volume of your "operations" due possible, we will pay based on the
to favorable business conditions length of time it would have taken to
caused by the impact of the Covered resume "operations" as quickly as
Cause of Loss on customers or on possible.
other businesses;
f. Loss Payment
(c) The operating expenses, including
payroll expenses, necessary to We will pay for covered "business income"
resume "operations" with the same loss or "extra expense" within 30 days after
quality of service that existed just we receive the sworn documentation
before the direct and accidental loss addressed in Paragraph b.(7) if you have
or damage; and complied with all of the terms of this
Coverage Part and:
(d) Other relevant sources of infor-
mation, including: (1) We have reached agreement with you
on the amount of such loss; or
(i) Your financial records and
accounting procedures; (2) An appraisal award has been made.
(ii) Bills, invoices, and other 6. Additional Definitions
vouchers; and As used for Business Interruption Coverage
(iii) Titles, liens, or contracts. the following definitions are added:
(2) The amount of "extra expense" will be a. "Business income" means the:
determined based on: (1) Net Income (Net Profit or Loss before
(a) All expenses that exceed the normal income taxes) that would have been
operating expenses that would have earned or incurred; and
been incurred by "operations" during (2) Continuing normal operating expenses
the "period of restoration" if no direct incurred, including payroll.
and accidental loss or damage had b. "Business property" means any property
occurred. We will deduct from the necessary for your mobile business that is
total of such expenses: in or on a covered "auto" regardless if it is
(i) The salvage value that permanently installed, including:
remains of any property bought for (1) Electronic equipment;
temporary use during the "period of
restoration", once "operations" are (2) Supplies, furnishings, and equipment
resumed; and not permanently attached to covered
"auto".
(ii) Any "extra expense" that is
paid for by other insurance, except c. "Extra expense" means necessary expens-
for insurance that is written subject to es (other than the expense to repair or
the same plan, terms, conditions, replace property) that you would not have
and provisions as the coverage incurred if there had been no direct and
provided by this endorsement; and accidental loss or damage to "business
property". "Extra expense" includes ex-
(iii) Necessary expenses that
penses which are incurred:
reduce the "business income" loss
that otherwise would have been (1) To avoid or minimize the "suspension"
incurred. of "operations" and to continue "opera-
tions";
e. Resumption Of Operations
(2) To minimize the "suspension" if you
(1) We will reduce the amount of your
cannot continue "operations"; or
"business income" loss, other than
"extra expense", to the extent you can (3) For temporary use of other property.
resume "operations", in whole or in part, d. "Operations" means your off premises or
by using any property. mobile business activities that are
dependent on "business property".
Page 8 of 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 19348 08 22
e. "Period of restoration" means the period of The deductible does not apply to "loss" caused by
time that: collision to such covered "auto" while it is:
(1) Begins 72 hours after the time of direct 1. In the charge of an "insured";
and accidental loss or damage for 2. Legally parked; and
Business Income Coverage, or
immediately after the time of direct and 3. Unoccupied.
accidental loss or damage for Extra The total amount of the damage to the covered
Expense Coverage; caused by or "auto" must exceed the deductible shown in the
resulting from a Covered Cause of Loss Declarations or Change Endorsement.
to "business property"; and This provision does not apply to any "loss" if the
(2) Ends on the earlier of: covered "auto" is in the charge of any person or
(a) The date when "business property" organization engaged in the automobile business.
should be repaired or replaced with G. Deductible Waived – Glass
reasonable speed and similar quality; SECTION III – PHYSICAL DAMAGE COVER-
or
AGE, Paragraph D. Deductible is changed by
(b) The date when "operations" are adding the following:
resumed. No deductible applies to glass damage.
"Period of restoration" does not include any H. Fire Department Service Charge
increased period required due to the
enforcement of or compliance with any When the fire department is called to save or
ordinance or law that: Regulates the use or protect a covered "auto" its equipment, contents,
repair of any property, or requires updated or occupants from a covered "accident", we will
emissions controls or safety features which pay the amount stated in the Coverage Schedule
were not part of "business property" prior to for your liability for fire department service
the direct and accidental loss or damage; or charges:
requires anyone to test for, monitor, clean 1. Assumed by contract or agreement prior to
up, remove, contain, treat, detoxify or loss; or
neutralize, or in any way respond to, or
2. Required by local ordinance.
assess the effects of "pollutants". The
expiration date of this Policy will not cut No deductible applies to this additional coverage.
short the "period of restoration". I. Fire Extinguisher Recharge
f. "Suspension" means the slowdown or We will pay the actual cost of recharging or
cessation of your "operations". replacing, whichever is less, fire extinguishers kept
E. Deductible Waived – Multiple Policies With Us in your covered "auto" that are intentionally
SECTION III – PHYSICAL DAMAGE COVER- discharged in an attempt to extinguish a fire.
AGE, Paragraph D.2. is deleted and replaced with J. Hired Auto Loss Of Use
the following: Changes in SECTION III – PHYSICAL DAMAGE
2. Regardless of the number of covered "autos" COVERAGE, Coverage Extension for Loss Of
damaged or stolen, the maximum deductible Use Expenses in Paragraph A.4.b. is deleted and
applicable for all "loss", in any one event replaced by the following:
caused by: For Hired Auto Physical Damage we will pay
a. Theft or mischief or vandalism; or expenses for which an "insured" becomes legally
b. All perils, responsible to pay for loss of use of a vehicle
rented or hired without a driver under a written
will be the highest deductible applicable to rental contract or agreement. We will pay for the
those covered "autos". loss of use expenses if caused by:
If the application of the highest deductible is (1) Other than collision only if the Declarations
less favorable or more restrictive to the insured indicates that Comprehensive Coverage is
than the separate deductibles as applied in the provided for any covered "auto";
standard form, the standard deductibles will
(2) Specified Causes Of Loss only if the
apply.
Declarations indicates that Specified Causes
F. Deductible Waived – Collision Of Parked Auto Of Loss Coverage is provided for any covered
SECTION III – PHYSICAL DAMAGE COVER- "auto" or
AGE, Paragraph D. Deductible is changed by
adding the following:
19348 08 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 9 of 13
(3) Collision only if the Declarations indicates that M. Loan/Lease Gap Coverage
Collision Coverage is provided for any covered SECTION III – PHYSICAL DAMAGE COVERAGE
"auto". C. Limits of Insurance is changed by the addition
However, the most we will pay under this of the following:
coverage is the amount shown in the Coverage In the event of a total "loss" to a covered "auto", of
Schedule. the private passenger or light truck type with an
K. Hired Auto Physical Damage – Employee As original loan or lease:
Lessor 1. We will pay any unpaid amount due on the
Changes in General Conditions lease or loan for a covered "auto" less:
Section IV – Business Auto Conditions, 5. a. The amount paid under the Policy’s
Other Insurance, b. is deleted and replaced by Physical Damage Coverage; and
the following; b. Any:
b. For Hired Auto Physical Damage Coverage the (1) Overdue lease or loan payments at the
following are deemed to be covered "autos" time of the "loss";
you own:
(2) Financial penalties imposed under the
(1) Any covered "auto" you lease, hire, rent or lease due to high mileage, excessive
borrow; and use or abnormal wear and tear;
(2) Any covered "auto" hired or rented by your (3) Security deposits, not returned by the
"employee" under a contract in that lessor;
"employee’s" name with your permission,
while performing duties related to the (4) Costs for extended warranties, Credit
conduct of your business. Life Insurance, Health, Accident or
Disability Insurance purchased with the
However, any "auto" that is leased, hired, loan or lease; and
rented, or borrowed with a driver is not a
covered "auto". (5) Carry-over balances from previous
loans or leases.
L. Hired Auto Physical Damage Including Trailers
2. The Other Insurance Condition is changed
If hired "autos" are covered "autos" for Liability for this coverage to add the following:
Coverage, then Comprehensive, Specified Causes
of Loss, and Collision Physical Damage coverages The insurance provided by this Loan/Lease
are provided under SECTION III – PHYSICAL Gap Coverage is excess over any other
DAMAGE COVERAGE for any "auto" you own, collectible insurance including but not limited to
then Physical Damage coverage provided is any coverage provided by or purchased from
extended to "autos" you hire and certain "trailers" the lessor or any financial institution.
with a registered Gross Vehicle Weight of 5,000 N. Lock Replacement Including Emergency Lock
pounds or less designed primarily for travel on Out
public roads, subject to the following: We will reimburse you up to the limit displayed on
1. The most we will pay for "loss" to certain hired the Coverage Schedule for reasonable expense
"trailer" or hired "auto" is the limit displayed on incurred for the services of a locksmith to enter
the Coverage Schedule, or Actual Cash Value your covered "auto" subject to these provisions:
or Cost of Repair, whichever is smallest. 1. Your door key, electronic key or key entry pad
2. The deductible will be equal to the largest has been lost, stolen, or locked in your covered
deductible applicable to any owned "auto" for "auto" and you are unable to enter such "auto",
that coverage or $1,000, whichever is less. or
Deductible does not apply to loss by fire or 2. Your keyless entry device battery dies, and you
lightning.
are unable to enter such "auto" as a result, or
3. Hired Auto Physical Damage coverage is 3. Your key, electronic key or key entry pad has
excess over any other collectible insurance. been lost or stolen and you have changed the
4. Subject to the limit, deductible, and excess lock to prevent an unauthorized entry.
provisions we will provide coverage equal to Original copies of receipts for services from a
the broadest coverage applicable to any
locksmith must be provided before reimbursement
covered "auto" you own under this policy. is payable.
Page 10 of 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 19348 08 22
O. Personal Property Coverages a. Comprehensive, Specified Causes of Loss,
Personal Effects and Collision coverages are provided for
Personal Property Of Others that "auto" at the time of "loss";
Personal Property Used In Your Business b. The total "loss" occurs within the number of
months shown on the Coverage Schedule
Under SECTION III – PHYSICAL DAMAGE
after you become the original owner of that
COVERAGE – Coverage Extensions, Paragraph "auto" and
A.4. the following is added:
c. The mileage shown on the odometer of that
1. We will extend the Comprehensive, Specified
"auto" at the time of the "loss" is less than
Causes of Loss, and Collision coverages that the number of miles shown on the
apply to a covered "auto" to "loss" of personal Coverage Schedule.
property contained in or on a covered "auto".
This coverage extension is subject to the 2. The following is added to Paragraph C. Limits
following: of Insurance:
a. Covered property is personal property a. The most we will pay will be the amount to
owned by you, personal property owned by replace a covered "auto" of the private
others, and personal property used in your passenger type for the same make, model,
business. trim level, and equipment or an equivalent.
b. Comprehensive and Specified Causes of If a new vehicle with the same make,
Loss coverages are extended only for "loss" model, trim level and equipment or an
because of fire, lightning, theft or attempted equivalent is not available, our limit of
theft, if there are visible signs of someone liability will be the amount to replace the
breaking into the covered "auto". However, covered "auto" with a new vehicle that is:
visible signs of someone breaking into the (1) Similar in class, body type, size, and
covered "auto" are not a requirement when equipment; and
the entire vehicle is stolen.
(2) Similar in price to the price you paid for
2. This coverage extension does not apply to: the covered "auto" that is being replaced
a. Property that is covered by Audio, Visual but not to exceed an amount equal to
and Electronic Data Equipment provided in 110% of the Manufacturer’s Suggested
SECTION 3 – PHYSICAL DAMAGE Retail Price (MSRP) of the covered
EXTENSIONS AND ADDITIONAL COV- "auto" being replaced.
ERAGES Paragraph B. or any other b. No one will be entitled to receive duplicate
communication or electronic data devices; payments for the same elements of "loss"
b. Money or jewelry; and under this endorsement and SECTION III –
PHYSICAL DAMAGE COVERAGE.
c. Property specifically insured.
Q. Replacement Costs – Trucks Up To 20,000
3. The most we will pay for "loss" in any one
GVW
"accident" is the least of:
Under SECTION III – PHYSICAL DAMAGE
a. The actual cash value of the damaged or
COVERAGE, Paragraph A. Coverage the
stolen property as of the time of the "loss". following is added:
b. The cost of repairing or replacing the 1. In the event of a total "loss" to a covered "auto"
damaged or stolen property with other you own of the truck type with a Gross Vehicle
property of like kind and quality; or
Weight less than 20,000 pounds, we will pay to
c. The limit displayed on the Coverage replace such covered "auto", minus any
Schedule. applicable deductible shown in the
P. Replacement Cost – Private Passenger Autos Declarations, if:
Under SECTION III – PHYSICAL DAMAGE a. Comprehensive, Specified Causes of Loss,
COVERAGE, Paragraph A. Coverage the and Collision coverages are provided for
following is added: that "auto" at the time of "loss";
1. In the event of a total "loss" to a covered "auto" b. The total "loss" occurs within number of
you own of the private passenger type we will months shown on the Coverage Schedule
pay to replace such covered "auto", minus any after you become the original owner of that
applicable deductible shown in the "auto" and
Declarations, if:
19348 08 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 11 of 13
c. The mileage shown on the odometer of that S. Towing And Labor
"auto" at the time of the "loss" is less than SECTION III – PHYSICAL DAMAGE
the number of miles shown on the COVERAGE, Paragraph A.2. is deleted and
Coverage Schedule. replaced by the following:
2. The following is added to Paragraph C. Limits 1. We will pay for towing and labor cost incurred
of Insurance: subject to the following:
a. The most we will pay will be the amount to a. Up to the limit shown on the Coverage
replace a covered "auto" of the truck type Schedule each time a covered "auto" of the
with a Gross Vehicle Weight of less than private passenger type is disabled; or
20,000 pounds for the same make, model,
trim level, and equipment or an equivalent. b. Up to the limit shown on the Coverage
Schedule each time a covered "auto" other
If a new truck with the same make, model, than private passenger type is disabled.
trim level and equipment or an equivalent is
not available, our limit of liability will be the 2. The labor must be performed at the place of
amount to replace the covered "auto" with a disablement.
new vehicle that is: 3. This coverage extension is in addition to any
(1) Similar in class, body type, size, and limit shown on the Declarations for Towing and
equipment; and Labor.
(2) Similar in price to the price you paid for T. Vehicle Sign and Wrap Coverage
the covered "auto" that is being replaced SECTION III – PHYSICAL DAMAGE COVERAGE
but not to the exceed the limit displayed Paragraph 4. is changed to add the following:
on the Coverage Schedule, whichever is 1. We will pay with respect to a covered "auto" for
less.
"loss" to automobile customization which
b. No one will be entitled to receive duplicate includes special carpeting and insulation,
payments for the same elements of "loss" height - extended roofs and custom murals,
under this endorsement and SECTION III – paintings, vinyl wraps or other details or
PHYSICAL DAMAGE COVERAGE. graphics.
R. Transportation Expense Extension 2. Our limit of liability for "loss" to automobile
SECTION III – PHYSICAL DAMAGE COV- customizations in any one "accident" shall be
ERAGE, Paragraph A.4.a. Transportation the least of:
Expenses is deleted and replaced with the a. The actual cash value of the stolen or
following: damaged property;
1. We will pay for transportation expense incurred b. The amount necessary to repair or replace
by you because of a "loss" of a covered "auto" the property; or
of the private passenger, or light truck type. We c. Up to the limit shown on the Coverage
will pay only for those covered "autos" for
Schedule.
which you carry Comprehensive, Specified
Causes of Loss, and Collision coverages. This Coverage Extension does not apply to
electronic equipment.
2. We will pay for transportation expenses
incurred during the period beginning 24 hours
after the covered "loss" and ending, regardless SECTION 4 – CHANGES IN CONDITIONS
of the Policy’s expiration, when the covered
"auto" is returned to use or we pay for its A. Changed Duties In The Event Of Accident,
"loss". Occurrence, Claim Or Suit
3. If the temporary transportation expenses you The requirement in SECTION IV – BUSINESS
incur arise from your rental of an "auto" of the AUTO LOSS CONDITIONS Paragraph A.2.a. –
private passenger or light truck type, the most DUTIES IN THE EVENT OF ACCIDENT, CLAIM,
we will pay is the amount it costs to rent an SUIT OR LOSS – of SECTION IV – BUSINESS
"auto" of the private passenger or light truck AUTO CONDITIONS that you must notify us of an
type which is of like kind and quality as the "accident" applies only when the "accident" is
covered "auto" subject to the maximum limit on known to:
the Coverage Schedule. 1. You, if you are an individual;
4. A per day limit and deductible do not apply to 2. A partner, if you are a partnership; or
this coverage.
Page 12 of 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 19348 08 22
3. An executive officer or insurance manager, if
you are a corporation.
B. Liberalization
If we revise this endorsement to provide more
coverage without additional premium charge, your
policy will automatically provide the additional
coverage as of the day the revision is effective in
your state.
C. Unintentional Failure To Disclose Hazards /
Concealment Misrepresentation Or Fraud
SECTION IV – BUSINESS AUTO CONDITIONS,
Paragraph B.2. is changed to add the following:
However, if you should unintentionally mispresent
or conceal information to us at any time, we will
not deny coverage under this policy based on this
unintentional error or omission.
This provision does not affect our right to cancel or
non-renew your coverage or collect additional
premium for any added exposures.
19348 08 22 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 13 of 13
This page has been left blank intentionally.
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PAXTPAT-01 MIRANDAM
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 2/21/2025
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).
CONTACT
PRODUCER NAME:
Hill and Stone Insurance Agency, Inc. PHONE FAX
(A/C, No, Ext): (847) 295-3030 (A/C, No): (847) 295-0099
900 North Shore Drive Ste. 225 E-MAIL
Lake Bluff, IL 60044 ADDRESS: customerservice@hillandstone.com
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : Allmerica Financial Benefit 41840
INSURED INSURER B : The Hartford 13161
Paxton/Patterson, LLC INSURER C : Lloyd's of London 15792
4141 W. 126th Street INSURER D :
Alsip, IL 60803
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 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 EACH OCCURRENCE $
1,000,000
CLAIMS-MADE X OCCUR Z2CJ674025 3/24/2024 3/24/2025 DAMAGE TO RENTED
PREMISES (Ea occurrence) $
1,000,000
MED EXP (Any one person) $
5,000
PERSONAL & ADV INJURY $
1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
2,000,000
POLICY PRO-
JECT LOC PRODUCTS - COMP/OP AGG $
2,000,000
OTHER: $
A AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accident) $
1,000,000
X ANY AUTO AWCJ674018 3/24/2024 3/24/2025 BODILY INJURY (Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident) $
PROPERTY DAMAGE
X HIRED
AUTOS ONLY X NON-OWNED
AUTOS ONLY (Per accident) $
$
A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $
10,000,000
EXCESS LIAB CLAIMS-MADE Z2CJ674025 3/24/2024 3/24/2025 AGGREGATE $
10,000,000
DED RETENTION $ $
B WORKERS COMPENSATION X PER
STATUTE
OTH-
ER
AND EMPLOYERS' LIABILITY
Y/N 83WECAR7KP9 3/24/2024 3/24/2025 1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
1,000,000
If yes, describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
C Tech E&O L9491CYLA240 3/24/2024 3/24/2025 E&O Aggregate 1,000,000
C Cyber Liability L9491CYLA240 3/24/2024 3/24/2025 Cyber Liab Aggregate 3,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EVIDENCE OF INSURANCE ONLY
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
DeKalb Co School System ACCORDANCE WITH THE POLICY PROVISIONS.
1701 Mountain Industrial Blvd
Stone Mountain, GA 30083
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 02/05/2025
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 Adrienne Colvard
NAME:
Chastain & Associates Ins PHONE (706) 543-2575 FAX (706) 543-4847
(A/C, No, Ext): (A/C, No):
P.O. Box 1908 E-MAIL adrienne@chastain-assoc.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
Athens GA 30603 INSURER A : State Auto Mutual 25135
INSURED INSURER B : Western Surety Co 13188
Nisewonger Audio Visual Center, Inc. INSURER C : Evanston Insurance Co 35378
1125 Cripple Creek Drive INSURER D :
INSURER E :
Lawrenceville GA 30043 INSURER F :
COVERAGES CERTIFICATE NUMBER: CL2461243655 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
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED 500,000
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $
MED EXP (Any one person) $ 10,000
A Y Y 10177569CP 06/13/2024 06/13/2025 PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
PRO- 2,000,000
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: Employee Benefits $ 1,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
A OWNED SCHEDULED Y Y 10177641CA 06/13/2024 06/13/2025 BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
Uninsured motorist $ 1,000,000
combined single limit
UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000
A EXCESS LIAB CLAIMS-MADE Y Y 10177642CU 06/13/2024 06/13/2025 AGGREGATE $ 1,000,000
DED RETENTION $ 10000 $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
A OFFICER/MEMBER EXCLUDED? Y N/A Y 10177574WC 06/13/2024 06/13/2025
(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
Empl. Dishonesty Limit 10,000
Employee Dishonesty 3/28/2024-2025
B/C Excess Liability 6/13/2024-2025 15122654 / EZXS3161248 Excess Liab Occur Limit 4,000,000
Excess Liab Agg Limit 4,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
ITB 25-519 General Liability Extension Endorsement 8-E-3548 Ed. 7-2011-Additional Insured -Owners, Lessees or Contractors-Completed Operations CG
20 37 04 13 Primary and Non-Contributory-Other Insurance Condition CG 20 01 04 13 Commercial Automobile Extension Endorsement 8-E-2419- ED.
04-2017 Waiver of our Right to Recover from Others Endorsement WC 00 03 13
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
DeKalb County School District ACCORDANCE WITH THE POLICY PROVISIONS.
1701 Mountain Insdustrial Blvd
AUTHORIZED REPRESENTATIVE
Stone Mountain GA 30083-1027
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 02/05/2025
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 Adrienne Colvard
NAME:
Chastain & Associates Ins PHONE (706) 543-2575 FAX (706) 543-4847
(A/C, No, Ext): (A/C, No):
P.O. Box 1908 E-MAIL adrienne@chastain-assoc.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
Athens GA 30603 INSURER A : Convex Insurance UK Limited 071499
INSURED INSURER B :
Nisewonger Audio Visual Center, Inc. INSURER C :
1125 Cripple Creek Drive INSURER D :
INSURER E :
Lawrenceville GA 30043 INSURER F :
COVERAGES CERTIFICATE NUMBER: CL24121945465 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
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
DAMAGE TO RENTED
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
PRO-
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
Errors & Omissions
A Professional Liability $5,000 Ded AE00291-00 12/18/2024 12/18/2025 Each Claim $3,000,000
General Aggregate $3,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
ITB 25-519
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
DeKalb County School District ACCORDANCE WITH THE POLICY PROVISIONS.
1701 Mountain Insdustrial Blvd
AUTHORIZED REPRESENTATIVE
Stone Mountain GA 30083-1027
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 11/25/2024
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).
CONTACT
PRODUCER
NAME: Kelly McEvoy
Marsh & McLennan Agency PHONE FAX
17335 Golf Parkway (A/C, No, Ext): 262-796-8824 (A/C, No):
E-MAIL
Suite 450 ADDRESS: kelly.mcevoy@marshmma.com
Brookfield WI 53045 INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : Liberty Mutual Fire Insurance Company 23035
INSURED INSURER B : First Liberty Insurance Corporation 42404
NASCO Education LLC DBA NASCO
INSURER C : Liberty Insurance Corporation 42404
901 Janesville Avenue
Fort Atkinson WI 53538 INSURER D : Employers Insurance Company of Wausau 21458
INSURER E : Palomar Excess and Surplus Ins Co 16754
INSURER F :
COVERAGES CERTIFICATE NUMBER: 1522739724 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
B X COMMERCIAL GENERAL LIABILITY TB6Z91471982 6/30/2024 6/30/2025 EACH OCCURRENCE $ 2,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 2,000,000
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 $ 1,000,000
AUTOMOBILE LIABILITY AS2Z91471982 6/30/2024 6/30/2025 (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) $
$
C X UMBRELLA LIAB X OCCUR TH7Z91471982054 6/30/2024 6/30/2025 EACH OCCURRENCE $ 10,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000
X RETENTION $ $
DED 0
PER OTH-
D WORKERS COMPENSATION WCCZ91471982 6/30/2024 6/30/2025 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
E Cyber Liability PLMCBSHL2UE3SQ003 6/30/2024 6/30/2025 Limit $5,000,000
Retention $25,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Dekalb County School District and indemnitees are included as additional insured on General Liability and Umbrella Liability on a Primary Non-Contributory
basis when required by written contract. A waiver of subrogation applies in favor of the additional insureds on General Liability, Auto Liability, Umbrella Liability,
and Workers Compensation when required by written contract. A 30 day notice of cancellation applies in favor of the Certificate Holder where allowed by law.
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 AUTHORIZED REPRESENTATIVE
Stone Mountain GA 30083
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Page 1 of 1
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 02/21/2025
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 WTW Certificate Center
NAME:
Willis Towers Watson Northeast, Inc. PHONE FAX
c/o 26 Century Blvd (A/C, No, Ext): 1-877-945-7378 (A/C, No): 1-888-467-2378
E-MAIL
P.O. Box 305191 ADDRESS: certificates@wtwco.com
Nashville, TN 372305191 USA INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : ACE American Insurance Company 22667
INSURED INSURER B : Hartford Casualty Insurance Company 29424
LEGO Brand Retail, Inc. dba LEGO Education US
100 Print Shop Road INSURER C : Twin City Fire Insurance Company 29459
Enfield, CT 06082 INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: W37839456 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
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3,000,000
DAMAGE TO RENTED
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ 1,000,000
A MED EXP (Any one person) $ 10,000
OGL G46674005 04/01/2024 04/01/2025 PERSONAL & ADV INJURY $ 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
PRO- 3,000,000
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 3,000,000
(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
B OWNED SCHEDULED 10 UEN DL2706 04/01/2024 04/01/2025 BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
C ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? No N/A 10 WB AZ7P0T 04/01/2024 04/01/2025
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
B Auto Liability 10 UEN DL2906 04/01/2024 04/01/2025 (Any Auto) - CSL $3,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
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
AUTHORIZED REPRESENTATIVE
Attn: Vendor Services Department - Procurement
1701 Mountain Industrial Boulevard
Stone Mountain, GA 30083
© 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
SR ID: 27323472 BATCH: 3843266
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 09/27/2024
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 Melinda Lankford
NAME:
STARR-MATHEWS AGENCY PHONE (706) 629-4441 FAX (706) 629-3631
(A/C, No, Ext): (A/C, No):
108 North Court St. E-MAIL mlankford@starrmathews.com
ADDRESS:
P. O. Box 188 INSURER(S) AFFORDING COVERAGE NAIC #
Calhoun GA 30703-0188 INSURER A : Westfield Insurance Co 24112
INSURED INSURER B : Hartford Insurance Co. 00914
Learning Labs, Inc. INSURER C :
PO Box 1419 INSURER D :
INSURER E :
Calhoun GA 30703 INSURER F :
COVERAGES CERTIFICATE NUMBER: 2024-25 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
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED 500,000
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $
MED EXP (Any one person) $ 5,000
A CWP003964J 10/01/2024 10/01/2025 PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
PRO- 2,000,000
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: Employment Practices $ 250,000
Liability Coverage
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY
(Ea accident)
$ 1,000,000
ANY AUTO BODILY INJURY (Per person) $
A OWNED SCHEDULED CWP003964J 10/01/2024 10/01/2025 BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
Medical payments $ 5,000
UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000
A EXCESS LIAB CLAIMS-MADE CWP003964J 10/01/2024 10/01/2025 AGGREGATE $ 2,000,000
DED RETENTION $ 0 $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
B OFFICER/MEMBER EXCLUDED? N/A 20WBCAA8DRY 10/01/2024 10/01/2025
(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
Coverage Limit 250,000
Employee Theft
A CWP003964J 10/01/2024 10/01/2025 Deductible 500
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Commercial General Liability Expanded Endorsement, CG 71 35 11 12; Waiver of Transfer of Rights of Recovery Against Others to Us, CG 24 04A 05 09;
Additional Insured Vendors CG 20 15 24 13; Business Auto Expanded Endorsement, CA 70 78 10 13; Commercial Liability Umbrella Coverage Form CU 00
01 04 13; CG 20 01 04 13 Primary and Non Contributory - Other Insurance Condition
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Dekalb County School District ACCORDANCE WITH THE POLICY PROVISIONS.
1701 Mountain Industrial Blvd
AUTHORIZED REPRESENTATIVE
Stone Mountain GA 30083
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY EXPANDED
ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SCHEDULE
The coverage provided by this endorsement is summarized below and is intended to provide a general
coverage description only. For the details affecting each coverage, please refer to the terms and condi-
tions in this endorsement.
A.
.
Expected or Intended Injury
Reasonable force
.
B. Non-owned Watercraft
Increased to 60 feet
C. Non-owned Aircraft
D. Property Damage - Elevators
.
E. Damage To Premises Rented To You
Limit increased to $500,000
.
F. Personal and Advertising Injury
Exclusions
G. Medical Payments - Volunteer Workers
H. Voluntary Property Damage
I. Care, Custody and Control
..
J. Supplementary Payments
Bail Bonds - $2500
Loss of Earnings - $1000
..
K. Who Is An Insured broadened:
Limited Liability Partnership
..
Joint Ventures / Partnership / Limited Liability Company
Health Care Professionals (Incidental Medical Malpractice)
.
Newly Formed or Acquired Entities (up to 365 days)
Individual Owners of Buildings
L. Knowledge and Notice Of Occurrence
M. Unintentional Failure To Disclose Hazards
N. Liberalization
..
O. Definitions
Bodily Injury redefined
.Expanded Personal and Advertising Injury definition
Unintentional Damage or Destruction added
In addition to the policy amendments contained in A through O listed above, the endorsements listed
below will automatically be attached to your policy to complete the coverage provided by the Commercial
..
General Liability Endorsement:
Additional Insured - Co-Owners of Insured Premises - CG 20 27
..Additional Insured - Concessionaire - CG 20 03
Additional Insured - Controlling Interest - CG 20 05
..
Additional Insured - Grantor of Franchise - CG 20 29
Additional Insured - Lessor of Leased Equipment - CG 20 34
..
Additional Insured - Managers or Lessors of Premises - CG 20 11
Additional Insured - Mortgagee, Assignee or Receiver - CG 20 18
.
Additional Insured - Owners or Other Interests From Whom Land Has Been Leased - CG 20 24
Additional Insured - State or Governmental Agency or Subdivision or Political Subdivision -
..
Permits or Authorizations - CG 20 12
Additional Insured - Vendors - CG 20 15
Waiver of Transfer of Rights of Recovery - CG 24 04
CG 71 35 11 12
Page 1 of 5
A. EXPECTED OR INTENDED INJURY Exclusions c. through n. do not apply to
damage by fire or explosion to premises
Under SECTION I - COVERAGES, COVERAGE while rented to you or temporarily occu-
A BODILY INJURY AND PROPERTY DAMAGE pied by you with permission of the
LIABILITY, Item 2. Exclusions a. is replaced owner. A separate limit of insurance
with the following: applies to this coverage as described in
a. Expected Or Intended Injury Section III - LIMITS OF INSURANCE.
"Bodily injury" or "property damage" ex- F. PERSONAL AND ADVERTISING INJURY
pected or intended from the standpoint Under SECTION I - COVERAGES, COVERAGE
of the insured. This exclusion does not B PERSONAL AND ADVERTISING INJURY LI-
apply to "bodily injury" or "property ABILITY, the following are added to Item 2.
damage" resulting from the use of rea- Exclusions:
sonable force for the purpose of protect-
ing persons or property. q. Discrimination Relating To Room, Dwell-
ing or Premises
B. NON-OWNED WATERCRAFT
Caused by discrimination directly or in-
Under SECTION I - COVERAGES, COVERAGE directly related to the sale, rental, lease
A BODILY INJURY AND PROPERTY DAMAGE or sub-lease or prospective sale, rental,
LIABILITY, Item 2. Exclusions g. (2) (a) is re- lease or sub-lease of any room, dwelling
placed with the following: or premises by or at the direction of any
insured.
(a) Less than 60 feet long; and
r. Fines or Penalties
C. NON-OWNED AIRCRAFT
Fines or penalties levied or imposed by
Under SECTION I - COVERAGES, COVERAGE a governmental entity because of dis-
A BODILY INJURY AND PROPERTY DAMAGE crimination.
LIABILITY, Item 2. Exclusions, g. Aircraft,
Auto or Watercraft, the following is added: G. MEDICAL PAYMENTS - VOLUNTEER WORK-
ERS
(6) An aircraft you do not own, provided
that: Under SECTION I - COVERAGES, COVERAGE
C MEDICAL PAYMENTS, item 2. Exclusions
(a) The pilot in command holds a b. Hired Person is replaced with the following:
currently effective certificate is-
sued by the duly constituted au- b. Hired Person
thority of the United States of To a person hired to do work for or on
America or Canada, designating behalf of any insured or tenant of any in-
that person as a commercial or sured; however this exclusion does not
airline transport pilot; apply to "volunteer workers" while en-
gaged in maintenance or repair of your
(b) It is rented with a trained, paid premises.
crew; and
Under SECTION I - COVERAGES, the following are
(c) It does not transport persons or added:
cargo for a charge.
H. VOLUNTARY PROPERTY DAMAGE
D. PROPERTY DAMAGE - ELEVATORS
With respect to Exclusions of SECTION I - 1. Insuring Agreement
COVERAGES, COVERAGE A. BODILY IN- We will pay, at your request, for "prop-
JURY AND PROPERTY DAMAGE LIABILITY, erty damage" to property of others
item 2. Exclusions, paragraphs (3), (4) and (6) caused by you, or while in your pos-
of Exclusion j. Damage to Property and Ex- session arising out of your business op-
clusion k. Damage To Your Product do not erations.
apply to the use of elevators. The insurance
afforded by this provision is excess over any 2. Exclusions
valid and collectible property insurance (in- Coverage for Voluntary Property Damage
cluding any deductible) available to the in- does not apply to:
sured, and the Other Insurance Condition is
changed accordingly. a. "Loss" of property at premises
owned, rented, leased, operated or
E. DAMAGE TO PREMISES RENTED TO YOU used by you.
Under SECTION I - COVERAGES, COVERAGE b. "Loss" of property while in transit;
A BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Item 2. Exclusions, the last para- c. "Loss" of property owned by, rented
graph of item 2. Exclusions is replaced with to, leased to, borrowed by or used
the following: by you;
CG 71 35 11 12
Page 2 of 5
d. The cost of repairing or replacing:
unless the "property damage" is
(1) "Your work" defectively or in- caused directly by you after de-
correctly done by you; livery of "your product" or com-
pletion of "your work" and
(2) "Your product" manufactured, resulting from a subsequent
sold or supplied by you; or undertaking.
unless the "property damage" is d. "Property damage" to property
caused directly by you after delivery caused by or arising out of the
of "your product" or completion of "products-completed operations
"your work" and resulting from a hazard".
subsequent undertaking.
3. Deductible
e. "Loss" of property caused by or
arising out of the "products- We will not pay for "property damage" in
completed operations hazard." any one "occurrence" until the amount
of "property damage" exceeds $250. We
3. Deductible will then pay the amount of "property
damage" in excess of $250, up to the ap-
We will not pay for "loss" in any one plicable limit of insurance.
"occurrence" until the amount of "loss"
exceeds $250. We will then pay the 4. Actual Cost
amount of "loss" in excess of $250, up to
the applicable limit of insurance. In the event of covered "property dam-
age", you shall, if requested by us, re-
4. Actual Cost place the property or furnish the labor
and materials necessary for repairs
In the event of covered "loss", you shall,
thereto at your actual cost, excluding
if requested by us, replace the damaged
profit or overhead charges.
property or furnish the labor and materi-
als necessary for repairs thereto at your The most we will pay under Care, Custody or
actual cost, excluding profit or overhead Control for "property damage" is $1,000 for
charges. each "occurrence". The most we will pay for
the sum of all damages because of "property
The most we will pay under Voluntary Prop-
damage" under this coverage is $5,000.
erty Damage for "loss" arising out of any one
"occurrence" is $250. The most we will pay J. SUPPLEMENTARY PAYMENTS
for the sum of all "losses" under this cover-
age is $1,000. Under SECTION I - SUPPLEMENTARY PAY-
MENTS COVERAGES A AND B, item 1.b. is
I. CARE, CUSTODY OR CONTROL replaced with the following:
1. Insuring Agreement b. Up to $2,500 for cost of bail bonds re-
quired because of accidents or traffic law
We will pay those sums the insured be-
violations arising out of the use of any
comes legally obligated to pay as dam-
vehicle to which the "Bodily Injury" Li-
ages because of "property damage" to
ability Coverage applies. We do not have
property of others while in your care,
to furnish these bonds.
custody or control or property as to
which you are exercising physical control Under SECTION I - SUPPLEMENTARY PAYMENTS
if the "property damage" arises out of COVERAGES A AND B, item 1.d. is replaced with
your business operations. the following:
2. Exclusions d. All reasonable expenses incurred by the
Coverage for Care, Custody or Control insured at our request to assist us in the
does not apply to: investigation or defense of the claim or
"suit", including actual loss of earnings
a. "Property damage" to property at up to $1,000 a day because of time off
any premises owned, rented, leased, from work.
operated or used by you;
K. WHO IS AN INSURED BROADENED
b. "Property damage" to property while
Under SECTION II - WHO IS AN INSURED
in transit;
Item 1.b. is replaced with the following:
c. The cost of repairing or replacing;
b. A partnership (including a limited liability
(1) "Your work" defectively or in- partnership) or joint venture, you are an
correctly done by you; or insured. Your members, your partners,
and their spouses are also insureds, but
(2) "Your product" manufactured, only with respect to the conduct of your
sold or supplied by you; business.
CG 71 35 11 12
Page 3 of 5
Under SECTION II - WHO IS AN INSURED the
This does not apply to nurses,
following is added to item 1:
emergency medical technicians
f. Joint Ventures / Partnership / Limited Li- or paramedics employed by you
ability Company Coverage to provide health care services,
but only if you are not in the
You are an insured when you had an in- business or occupation of pro-
terest in a joint venture, partnership or viding such professional ser-
limited liability company which is termi- vices.
nated or ended prior to or during this
policy period but only to the extent of (2) "Property damage" to property:
your interest in such joint venture, part-
nership or limited liability company. This (a) Owned, occupied or used by,
coverage does not apply:
(b) Rented to, in the care, custody
(1) Prior to the termination date of any or control of, or over which
joint venture, partnership or limited physical control is being exer-
liability company; or cised for any purpose by you,
any of your "employees" or vol-
(2) If there is other valid and collectible unteer workers, any partner or
insurance purchased specifically to member (if you are a partner-
insure the partnership, joint venture ship or joint venture), or any
or legal liability company.
member (if you are a limited li-
Under SECTION II - WHO IS AN INSURED, item ability company).
2.a. is replaced with the following:
Under SECTION II - WHO IS AN INSURED, item
a. Your "employees" or volunteer workers, 3.a. is replaced with the following:
other than either your "executive offi-
cers" (if you are an organization other a. Coverage under this provision is af-
than a partnership, joint venture or lim- forded only until the end of the policy
ited liability company) or your managers period or the next anniversary of this
(if you are a limited liability company), policy's effective date after you ac-
but only for acts within the scope of their quire or form the organization,
employment by you or while performing whichever is earlier.
duties related to the conduct of your
business. However, none of these "em- Under SECTION II - WHO IS AN INSURED, the
ployees" or volunteer workers are an in- following is added:
sured for:
4. For COVERAGE A and COVERAGE B
(1) "Bodily injury" or "personal and ad- only, the owner of any building leased to
vertising injury": you, but only if the building owner is a
shareholder in your corporation or a
(a) To you, to your partners or partner in your partnership insured in
members (if you are a partner- this policy, and only with respect to li-
ship or joint venture), to your ability arising out of the ownership,
members (if you are limited li- maintenance or use of that part of the
ability company), or to a co-
premises leased to you. However, this
"employee" or co-volunteer
worker while that is either in the insurance does not apply:
course of his or her employment a. To any "occurrence" or offense
or performing duties related to
which takes place after you cease to
the conduct of your business;
be a tenant in the premises; or
(b) To the spouse, child, parent,
brother or sister of that co- b. To structural alterations, new con-
"employee" or co-volunteer struction or demolition operations
worker as a consequence of performed by or on behalf of the
paragraph (1)(a) above; building owner.
(c) For which there is any obligation Under SECTION II - WHO IS AN INSURED the last
to share damages with or repay paragraph of this section is replaced with the fol-
someone else who must pay lowing:
damages because of the injury
described in paragraphs (1)(a) Except as provided in 3. above, no person or
or (b) above; or organization is an insured with respect to the
conduct of any current or past partnership,
(d) Arising out of his or her provid- joint venture or limited liability company that
ing or failing to provide profes- is not shown as a named insured in the Dec-
sional health care services. larations.
CG 71 35 11 12
Page 4 of 5
L. KNOWLEDGE AND NOTICE OF OCCURRENCE all hazards or prior "occurrences" is not
intentional.
Under SECTION IV - COMMERCIAL GENERAL
LIABILITY CONDITIONS, 2. Duties in the N. LIBERALIZATION
Event of Occurrence, Offense, Claim Or Suit,
the following is added: Under SECTION I - COVERAGES, SECTION II
- WHO IS AN INSURED, SECTION III - LIMITS
e. The requirement in Condition 2.a. applies OF INSURANCE, SECTION IV - COMMERCIAL
only when the "occurrence" or offense is GENERAL LIABILITY CONDITIONS AND SEC-
known to: TION V - DEFINITIONS, the following is
added:
(1) You, if you are an individual; Liberalization
(2) A partner, if you are a partnership; If we adopt any revision that would broaden
the coverage under this endorsement without
(3) An "executive officer" or insurance additional premium within 45 days prior to or
manager, if you are a corporation; during the policy period, the broadened cov-
or erage will immediately apply to this endorse-
ment.
(4) A manager, if you are a limited li-
ability company. O. DEFINITIONS
f. The requirement in Condition 2. b. will Under SECTION V - DEFINITIONS, item 3. is
not be breached unless the breach oc- deleted and replaced with the following:
curs after such claim or "suit" is known 3. "Bodily injury" means bodily injury, disa-
to: bility, sickness, or disease sustained by
(1) You, if you are an individual; a person, including death resulting from
any of these at any time. "Bodily injury"
(2) A partner, if you are a partnership; includes mental anguish or other mental
injury resulting from "bodily injury".
(3) An "executive officer" or insurance
manager, if you are a corporation; Under SECTION V - DEFINITIONS, item 14.
or the following is added to the definition of
"Personal and advertising injury":
(4) A manager, if you are a limited li- h. Discrimination or humiliation that results
ability company. in injury to the feelings or reputation of
g. Your rights under this Coverage Part will a natural person but only if such dis-
not be prejudiced if you fail to give us crimination or humiliation is:
notice of an "occurrence," offense, claim, (1) not done intentionally by or at the
or "suit" and that failure is solely due to direction of:
your reasonable belief that the "bodily
injury" or "property damage" is not cov- (a) The insured; or
ered under this Coverage Part. However,
(b) Any "executive officer," director,
you shall give written notice of this "oc-
stockholder, partner, member
currence," offense, claim, or "suit" to us
or manager (if you are a limited
as soon as you are aware this insurance
liability company) of the insured;
may apply to such "occurrence", offense,
and
claim, or "suit".
(2) Not directly or indirectly related to
M. UNINTENTIONAL FAILURE TO DISCLOSE the employment, prospective em-
HAZARDS ployment, past employment or ter-
Under SECTION IV - COMMERCIAL GENERAL mination of employment of any
LIABILITY CONDITIONS, 6. Representations, person or persons by any insured.
the following is added:
Under SECTION V - DEFINITIONS, the follow-
d. Your failure to disclose all hazards or ing definition is added:
prior "occurrences" existing as of the in- 23. "Loss" means unintentional damage or
ception date of this policy shall not prej- destruction but does not include disap-
udice the coverage afforded by this pearance, theft, or loss of use.
policy, provided such failure to disclose
CG 71 35 11 12
Page 5 of 5
POLICY NUMBER: CWP 003964J COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - VENDORS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or
Organization(s) (Vendor) Your Products
Automatic status when required by written Your products related to your operations.
contract, agreement or permit.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II - Who Is An Insured is amended c. Any physical or chemical change
to include as an additional insured any in the product made intentionally
person(s) or organization(s) (referred to by the vendor;
throughout this endorsement as vendor)
shown in the Schedule, but only with re- d. Repackaging, except when un-
spect to "bodily injury" or "property dam- packed solely for the purpose of
age" arising out of "your products" shown inspection, demonstration, test-
in the Schedule which are distributed or ing, or the substitution of parts
sold in the regular course of the vendor's under instructions from the man-
business. ufacturer, and then repackaged in
the original container;
However:
e. Any failure to make such in-
1. The insurance afforded to such ven- spections, adjustments, tests or
dor only applies to the extent permit- servicing as the vendor has
ted by law; and agreed to make or normally
undertakes to make in the usual
2. If coverage provided to the vendor is
course of business, in connection
required by a contract or agreement,
with the distribution or sale of the
the insurance afforded to such vendor
products;
will not be broader than that which
you are required by the contract or f. Demonstration, installation, ser-
agreement to provide for such vendor. vicing or repair operations, ex-
cept such operations performed
B. With respect to the insurance afforded to
at the vendor's premises in con-
these vendors, the following additional
nection with the sale of the prod-
exclusions apply:
uct;
1. The insurance afforded the vendor
g. Products which, after distribution
does not apply to:
or sale by you, have been labeled
a. "Bodily injury" or "property dam- or relabeled or used as a con-
age" for which the vendor is obli- tainer, part or ingredient of any
gated to pay damages by reason other thing or substance by or for
of the assumption of liability in a the vendor; or
contract or agreement. This ex-
clusion does not apply to liability h. "Bodily injury" or "property dam-
for damages that the vendor age" arising out of the sole
would have in the absence of the negligence of the vendor for its
contract or agreement; own acts or omissions or those
of its employees or anyone else
b. Any express warranty unauthor- acting on its behalf. However,
ized by you; this exclusion does not apply to:
¢ Insurance Services Office, Inc., 2012 CG 20 15 04 13
Page 1 of 2
(1) The exceptions contained in C. With respect to the insurance afforded to
Subparagraphs d. or f.; or these vendors, the following is added to
Section III - Limits Of Insurance:
(2) Such inspections, adjust- If coverage provided to the vendor is re-
ments, tests or servicing as quired by a contract or agreement, the
the vendor has agreed to most we will pay on behalf of the vendor
make or normally undertakes is the amount of insurance:
to make in the usual course
of business, in connection 1. Required by the contract or agree-
with the distribution or sale ment; or
of the products. 2. Available under the applicable Limits
of Insurance shown in the Declara-
2. This insurance does not apply to any tions;
insured person or organization, from
whom you have acquired such pro- whichever is less.
ducts, or any ingredient, part or con- This endorsement shall not increase the
tainer, entering into, accompanying applicable Limits of Insurance shown in
or containing such products. the Declarations.
CG 20 15 04 13
Page 2 of 2
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COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO EXPANDED ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SCHEDULE
The coverage provided by this endorsement is summarized below and is intended to provide a general
coverage description only. For the details affecting each coverage, please refer to the terms and condi-
tions in this endorsement.
A.
..WhoAdditional
Is An Insured broadened:
Insured by Contract, Agreement or Permit
. Newly Acquired Organizations
Legally Incorporated Subsidiaries
.. Bail Bonds - $5000
B. Supplementary Payments
Loss of Earnings - $500
C. Fellow Employee Exclusion Amendment
.. Transportation
D. Coverage Extensions
Expenses
Personal Effects (Excess Basis)
.. Expenses paid for returning a stolen covered auto
E. Additional Coverages
Fire Department Service Charge
F. Airbag Coverage - Accidental Discharge
G. Glass Repair - Waiver of Deductible
H. Knowledge and Notice of an Accident, Claim or Suit
I. Unintentional Failure To Disclose Hazards
J. Worldwide Coverage
K.
.
Definitions
Bodily Injury Redefined
In addition to the policy amendments contained in A. through K. listed above, the endorsements listed
below will automatically be attached to your policy to complete the coverage provided by the Business
Auto Expanded Endorsement:
.. Audio, Visual and Data Electronic Equipment Coverage Added Limits - CA 99 60
. Auto Loan/Lease Gap Coverage - CA 20 71
Drive Other Car Coverage - Broadened Coverage For Named Individuals - (Executive
.. Officers/Spouses) - CA 99 10
Employee Hired Autos - CA 20 54
.. Employees As Insureds - CA 99 33
Hired Auto Physical Damage (Refer to Auto Declarations page)
. Rental Reimbursement Coverage - CA 99 23
Waiver of Transfer of Rights of Recovery (Waiver of Subrogation) - CA 04 44
A. WHO IS AN INSURED BROADENED policy but for its termination or the
exhaustion of its limit of insurance.
SECTION II - COVERED AUTOS LIABILITY
COVERAGE, item A. Coverage, 1. Who Is An Coverage under this provision is af-
Insured is amended to include the following forded only for the first 180 days af-
additional paragraphs: ter you acquire or form the
organization or until the end of the
d. Any legally incorporated subsidiary policy period, whichever comes first.
of yours in which you own more than
50% of the voting stock on the ef- e. Any organization you newly acquire
fective date of this endorsement. or form, other than a partnership or
However, "insured" does not include joint venture, and over which you
any subsidiary that is an "insured" maintain ownership or a majority in-
under any other liability policy or terest. However, coverage under
would be an "insured" under such a this provision:
CA 70 78 10 13
Page 1 of 3
(1) Does not apply if the organiza- a. Transportation Expenses
tion you acquire or form is an
"insured" under another auto li- We will pay up to $100 per day to a
ability policy or would be "in- maximum of $1,800 for transporta-
sured" under such a policy but tion expense incurred by you be-
for its termination or the ex- cause of the total theft of a covered
haustion of its limits of insur- "auto" of the private passenger type.
ance; We will pay only for those covered
"autos" for which you carry either
(2) Does not apply to "bodily injury" Comprehensive or Specified Causes
or "property damage" that oc- of Loss Coverage. We will pay for
curred before you acquired or transportation expenses incurred
formed the organization; and during the period beginning 48 hours
after the theft and ending, regardless
(3) Is afforded only for the first 180 of the policy's expiration, when the
days after you acquire or form covered "auto" is returned to use or
the organization or until the end we pay for its "loss".
of the policy period, whichever
The following is added to Item 4. Cover-
comes first.
age Extensions:
f. Any person or organization with c. Personal Effects
whom you agreed in writing in a
contract, agreement or permit, to We will pay up to $500 for the "loss"
provide insurance such as is af- of your personal effects that are
forded under this policy. contained in a covered "auto" due to
the total theft of the covered "auto."
This provision only applies if the We will pay only for those personal
written contract or agreement has effects that are contained in covered
been executed or permit has been "autos" for which you carry either
issued, prior to the "bodily injury" or Comprehensive or Specified Causes
"property damage". Of Loss Coverage.
B. SUPPLEMENTAL PAYMENTS Our payment for "loss" of or damage
to personal effects will apply only on
SECTION II - COVERED AUTOS LIABILITY an excess basis over other collect-
COVERAGE, item A. Coverage, 2. Coverage ible insurance.
Extensions, a. Supplementary Payments, sub-
paragraphs (2) and (4) are deleted and re- E. ADDITIONAL COVERAGES
placed with the following:
SECTION III - PHYSICAL DAMAGE COVER-
(2) Up to $5,000 for cost of bail AGE, A. Coverage, is amended to include the
bonds (including bonds for re- following additional coverage items:
lated traffic law violations) re-
5. We will pay the expense of returning a
quired because of an "accident"
stolen covered "auto" to you.
we cover. We do not have to
furnish these bonds. 6. Fire Department Service Charge
(4) All reasonable expenses in- When a fire department is called to save
curred by the "insured" at our or protect a covered "auto", its equip-
request, including actual loss of ment, its contents or occupants from a
earnings up to $500 per day be- Covered Cause Of Loss, we will pay up
cause of time off from work. to $1,000 for your liability for Fire De-
partment Service Charges:
C. FELLOW EMPLOYEE EXCLUSION AMEND-
MENT (a) Assumed by contract or agreement
prior to loss; or
SECTION II - COVERED AUTOS LIABILITY
COVERAGE, item B. Exclusions, 5. Fellow (b) Required by local ordinance.
Employee does not apply if the "bodily injury"
results from the use of a covered "auto" you No deductible applies to this additional
own or hire. coverage.
D. COVERAGE EXTENSIONS F. AIRBAG COVERAGE - ACCIDENTAL DIS-
CHARGE
SECTION III - PHYSICAL DAMAGE COVER-
AGE, Item A. Coverage, 4. Coverage Exten- SECTION III - PHYSICAL DAMAGE COVER-
sions, a. Transportation Expenses is replaced AGE, Item B. Exclusions, subparagraph 3.a.
with the following: is deleted and replaced with the following:
CA 70 78 10 13
Page 2 of 3
a. Wear and tear, freezing, mechanical I. UNINTENTIONAL FAILURE TO DISCLOSE
or electrical breakdown. Mechanical HAZARDS
breakdown does not apply to the ac- Under SECTION IV - BUSINESS AUTO CON-
cidental discharge of an airbag. DITIONS, B. General Conditions, 2.
Concealment, Misrepresentation Or Fraud is
G. GLASS REPAIR - WAIVER OF DEDUCTIBLE
amended to include the following additional
SECTION III - PHYSICAL DAMAGE COVER- paragraph:
AGE, item D. Deductible the following para-
If you unintentionally fail to disclose any
graph is added:
hazards existing at the inception date of
No deductible shall apply to glass dam- your policy, we will not deny coverage
age if the glass is repaired rather than under this Coverage Part because of
replaced. such failure.
J. WORLDWIDE COVERAGE
H. KNOWLEDGE AND NOTICE OF AN ACCI-
DENT, CLAIM OR SUIT Under SECTION IV - BUSINESS AUTO CON-
DITIONS, B. General Conditions, 7. Policy
SECTION IV - BUSINESS AUTO CONDITIONS, Period, Coverage Territory, subparagraph (5)
Item A. Loss Conditions is amended as fol- is deleted and replaced with the following:
lows:
(5) Anywhere in the world, if:
Subparagraph a. under Item 2. Duties In
The Event Of Accident, Claim, Suit Or (a) A covered "auto" of the private
Loss, is amended to include the following passenger type is leased, hired,
paragraphs: rented or borrowed without a
driver for a period of 45 days or
This requirement applies when the less; and
"accident," claim, "suit" or "loss" is (b) The "insured's" responsibility to
first known to: pay damages is determined in
a "suit" on the merits, in the
(1) You, if you are an individual; United States of America, the
territories and possessions of
(2) A partner, if you are a partner-
the United States of America,
ship; or
Puerto Rico or Canada or in a
(3) An executive officer or insur- settlement we agree to.
ance manager, if you are a cor- (c) If, for such "autos" a "suit" is
poration. brought outside the territory de-
scribed in 7.(1) through 7.(4)
Subparagraph b.(2) under 2. Duties In above, we will reimburse the
The Event Of Accident, Claim, Suit Or insured for defense expenses
Loss is amended as follows: incurred with our written con-
sent, but we will make no pay-
(2) Immediately send us copies of
ment, nor will we reimburse the
any request, demand, order, insured for damages.
notice, summons or legal paper
received concerning the claim K. DEFINITIONS
or "suit."
Under SECTION V - DEFINITIONS, Item C. is
Your employees may know of replaced by the following:
documents received concerning
C. "Bodily injury" means bodily injury, sick-
a claim or "suit". This will not
ness or disease sustained by a person,
mean that you have such know-
including mental anguish, mental injury
ledge, unless receipt of such or death resulting from any of these.
documents is known to you, any "Bodily injury" includes mental anguish
of your executive officers or or other mental injury resulting from
partners or your insurance "bodily injury".
manager.
CA 70 78 10 13
Page 3 of 3
COMMERCIAL LIABILITY UMBRELLA
COMMERCIAL LIABILITY UMBRELLA
COVERAGE FORM
Various provisions in this policy restrict coverage. No other obligation or liability to pay
Read the entire policy carefully to determine sums or perform acts or services is cov-
rights, duties and what is and is not covered. ered unless explicitly provided for under
Supplementary Payments - Coverages A
Throughout this policy the words "you" and "your"
refer to the Named Insured shown in the Declara- and B.
tions, and any other person or organization quali- b. This insurance applies to "bodily injury"
fying as a Named Insured under this policy. The or "property damage" that is subject to
words "we", "us" and "our" refer to the company
an applicable "retained limit". If any
providing this insurance.
other limit, such as a sublimit, is speci-
The word "insured" means any person or organ- fied in the "underlying insurance", this
ization qualifying as such under Section II - Who insurance does not apply to "bodily in-
Is An Insured. jury" or "property damage" arising out of
that exposure unless that limit is speci-
Other words and phrases that appear in quotation
fied in the Declarations under the
marks have special meaning. Refer to Section V
- Definitions. Schedule of "underlying insurance".
SECTION I - COVERAGES c. This insurance applies to "bodily injury"
and "property damage" only if:
COVERAGE A - BODILY INJURY AND PROPERTY
DAMAGE LIABILITY (1) The "bodily injury" or "property
damage" is caused by an "occur-
1. Insuring Agreement rence" that takes place in the "cov-
a. We will pay on behalf of the insured the erage territory";
"ultimate net loss" in excess of the "re-
(2) The "bodily injury" or "property
tained limit" because of "bodily injury"
damage" occurs during the policy
or "property damage" to which this in-
period; and
surance applies. We will have the right
and duty to defend the insured against (3) Prior to the policy period, no insured
any "suit" seeking damages for such listed under Paragraph 1.a. of Sec-
"bodily injury" or "property damage" tion II - Who Is An Insured and no
when the "underlying insurance" does
"employee" authorized by you to
not provide coverage or the limits of
give or receive notice of an "occur-
"underlying insurance" have been ex-
rence" or claim, knew that the "bod-
hausted. When we have no duty to de-
fend, we will have the right to defend, or ily injury" or "property damage" had
to participate in the defense of, the in- occurred, in whole or in part. If such
sured against any other "suit" seeking a listed insured or authorized "em-
damages to which this insurance may ployee" knew, prior to the policy pe-
apply. However, we will have no duty to riod, that the "bodily injury" or
defend the insured against any "suit" "property damage" occurred, then
seeking damages for "bodily injury" or any continuation, change or
"property damage" to which this insur- resumption of such "bodily injury" or
ance does not apply. At our discretion, "property damage" during or after
we may investigate any "occurrence" the policy period will be deemed to
that may involve this insurance and set- have been known prior to the policy
tle any resultant claim or "suit" for which period.
we have the duty to defend. But: d. "Bodily injury" or "property damage"
(1) The amount we will pay for the "ulti- which occurs during the policy period
mate net loss" is limited as de- and was not, prior to the policy period,
scribed in Section III - Limits Of known to have occurred by any insured
Insurance; and listed under Paragraph 1.a. of Section II
- Who Is An Insured or any "employee"
(2) Our right and duty to defend ends authorized by you to give or receive no-
when we have used up the applica- tice of an "occurrence" or claim, includes
ble limit of insurance in the payment any continuation, change or resumption
of judgments or settlements under of that "bodily injury" or "property dam-
Coverages A or B. age" after the end of the policy period.
¢ Insurance Services Office, Inc., 2012 CU 00 01 04 13
Page 1 of 19
e. "Bodily injury" or "property damage" will an insured are deemed to be dam-
be deemed to have been known to have ages because of "bodily injury" or
occurred at the earliest time when any "property damage", provided:
insured listed under Paragraph 1.a. of
Section II - Who Is An Insured or any (a) Liability to such party for, or for
"employee" authorized by you to give or the cost of, that party's defense
receive notice of an "occurrence" or has also been assumed in the
claim: same "insured contract"; and
(1) Reports all, or any part, of the "bod- (b) Such attorneys' fees and liti-
ily injury" or "property damage" to gation expenses are for defense
us or any other insurer; of that party against a civil or
alternative dispute resolution
(2) Receives a written or verbal demand proceeding in which damages to
or claim for damages because of the which this insurance applies are
"bodily injury" or "property damage"; alleged.
or
c. Liquor Liability
(3) Becomes aware by any other means "Bodily injury" or "property damage" for
that "bodily injury" or "property which any insured may be held liable by
damage" has occurred or has begun reason of:
to occur.
(1) Causing or contributing to the
f. Damages because of "bodily injury" in- intoxication of any person;
clude damages claimed by any person
by organization for care, loss of services (2) The furnishing of alcoholic
or death resulting at any time from the beverages to a person under the le-
"bodily injury". gal drinking age or under the influ-
ence of alcohol; or
2. Exclusions
(3) Any statute, ordinance or regulation
This insurance does not apply to:
relating to the sale, gift, distribution
a. Expected or Intended Injury or use of alcoholic beverages.
"Bodily injury" or "property damage" ex- This exclusion applies even if the claims
pected or intended from the standpoint against any insured allege negligence or
of the insured. This exclusion does not other wrongdoing in:
apply to "bodily injury" resulting from the
use of reasonable force to protect per- (a) The supervision, hiring, employ-
sons or property. ment, training or monitoring of oth-
ers by that insured; or
b. Contractual Liability
(b) Providing or failing to provide trans-
"Bodily injury" or "property damage" for portation with respect to any person
which the insured is obligated to pay that may be under the influence of
damages by reason of the assumption of alcohol;
liability in a contract or agreement. This
exclusion does not apply to liability for if the "occurrence" which caused the
damages: "bodily injury" or "property damage" in-
volved that which is described in Para-
(1) That the insured would have in the graph (1), (2) or (3) above.
absence of the contract or agree-
ment; or However, this exclusion applies only if
you are in the business of manufacturing,
(2) Assumed in a contract or agreement distributing, selling, serving or furnishing
that is an "insured contract", pro- alcoholic beverages. For the purposes of
vided the "bodily injury" or "property this exclusion, permitting a person to
damage" occurs subsequent to the bring alcoholic beverages on your prem-
execution of the contract or agree- ises, for consumption on your premises,
ment. Solely for the purposes of li- whether or not a fee is charged or a li-
ability assumed in an "insured cense is required for such activity, is not
contract", reasonable attorneys' fees by itself considered the business of sell-
and necessary litigation expenses ing, serving or furnishing alcoholic
incurred by or for a party other than beverages.
CU 00 01 04 13
Page 2 of 19
This exclusion does not apply to the ex- This exclusion does not apply to liability
tent that valid "underlying insurance" for assumed by the insured under an "in-
the liquor liability risks described above sured contract".
exists or would have existed but for the
exhaustion of underlying limits for "bodily With respect to injury arising out of a
injury" and "property damage". To the "covered auto", this exclusion does not
extent this exclusion does not apply, the apply to "bodily injury" to domestic "em-
insurance provided under this Coverage ployees" not entitled to workers' com-
Part for the liquor liability risks described pensation benefits. For the purposes of
above will follow the same provisions, this insurance, a domestic "employee" is
exclusions and limitations that are con- a person engaged in household or do-
tained in the applicable "underlying in- mestic work performed principally in
surance", unless otherwise directed by connection with a residence premises.
this insurance. This exclusion does not apply to the ex-
tent that valid "underlying insurance" for
d. Workers' Compensation And Similar the employer's liability risks described
Laws above exists or would have existed but
Any obligation of the insured under a for the exhaustion of underlying limits for
workers' compensation, disability bene- "bodily injury". To the extent this exclu-
fits or unemployment compensation law sion does not apply, the insurance pro-
or any similar law. vided under this Coverage Part for the
employer's liability risks described
e. ERISA above will follow the same provisions,
exclusions and limitations that are con-
Any obligation of the insured under the tained in the applicable "underlying in-
Employees' Retirement Income Security surance", unless otherwise directed by
Act of 1974 (ERISA), and any amend- this insurance.
ments thereto or any similar federal,
state or local statute. h. Employment-related Practices
f. Auto Coverages "Bodily injury" to:
(1) "Bodily injury" or "property damage" (1) A person arising out of any:
arising out of the ownership, main-
tenance or use of any "auto" which (a) Refusal to employ that person;
is not a "covered auto"; or
(b) Termination of that person's
(2) Any loss, cost or expense payable employment; or
under or resulting from any first-
party physical damage coverage; (c) Employment-related practices,
no-fault law, personal injury pro- policies, acts or omissions, such
tection or auto medical payments as coercion, demotion, evalu-
coverage; or uninsured or ation, reassignment, discipline,
underinsured motorist law. defamation, harrassment, hu-
miliation, discrimination or ma-
g. Employer's Liability licious prosecution directed at
that person; or
"Bodily injury" to:
(2) The spouse, child, parent, brother or
(1) An "employee" of the insured arising sister of that person as a conse-
out of and in the course of: quence of "bodily injury" to that per-
son at whom any of the
(a) Employment by the insured; or
employment-related practices de-
(b) Performing duties related to the scribed in Paragraph (a), (b), or (c)
conduct of the insured's busi- above is directed.
ness; or
This exclusion applies whether the
(2) The spouse, child, parent, brother or injury-causing event described in Para-
sister of that "employee" as a con- graph (a), (b) or (c) above occurs before
sequence of Paragraph (1) above. employment, during employment or after
employment of that person.
This exclusion applies whether the in- This exclusion applies whether the in-
sured may be liable as an employer or in sured may be liable as an employer or in
any other capacity, and to any obligation any other capacity, and to any obligation
to share damages with or repay some-
to share damages with or repay some-
one else who must pay damages be-
one else who must pay damages be-
cause of the injury.
cause of the injury.
CU 00 01 04 13
Page 3 of 19
i. Pollution above exists or would have existed
but for the exhaustion of underlying
(1) "Bodily injury" or "property damage" limits for "bodily injury" or "property
which would not have occurred in damage". To the extent this exclu-
whole or part but for the actual, al- sion does not apply, the insurance
leged or threatened discharge, dis- provided under this Coverage Part
persal, seepage, migration, release for the aircraft or watercraft risks
or escape of "pollutants" at any time; described above will follow the same
or provisions, exclusions and limita-
tions that are contained in the
(2) "Pollution cost or expense". "underlying insurance", unless oth-
erwise directed by this insurance; or
This exclusion does not apply if valid
"underlying insurance" for the pollution (5) Aircraft that is:
liability risks described above exists or
would have existed but for the ex- (a) Chartered by, loaned to, or
haustion of underlying limits for "bodily hired by you with a paid crew;
injury" and "property damage". To the and
extent this exclusion does not apply, the
insurance provided under this Coverage (b) Not owned by any insured.
Part for the pollution risks described
above will follow the same provisions, k. Racing Activities
exclusions and limitations that are con- "Bodily injury" or "property damage"
tained in the applicable "underlying in- arising out of the use of "mobile equip-
surance", unless otherwise directed by ment" or "autos" in, or while in practice
this insurance. for, or while being prepared for, any pre-
arranged professional or organized rac-
j. Aircraft Or Watercraft ing, speed, demolition, or stunting
"Bodily injury" or "property damage" activity or contest.
arising out of the ownership, mainte-
l. War
nance, use or entrustment to others of
any aircraft or watercraft owned or oper- "Bodily injury" or "property damage",
ated by or rented or loaned to any in- however caused, arising, directly or indi-
sured. Use includes operation and rectly, out of:
"loading or unloading".
(1) War, including undeclared or civil
This exclusion applies even if the claims war;
against any insured allege negligence or
other wrongdoing in the supervision, hir- (2) Warlike action by a military force,
ing, employment, training or monitoring including action in hindering or de-
of others by that insured, if the "occur- fending against an actual or ex-
rence" which caused the "bodily injury" pected attack, by any government,
or "property damage" involved the own- sovereign or other authority using
ership, maintenance, use or entrustment military personnel or other agents;
to others of any aircraft or watercraft that or
is owned or operated by or rented or
loaned to any insured. (3) Insurrection, rebellion, revolution,
usurped power, or action taken by
This exclusion does not apply to: governmental authority in hindering
or defending against any of these.
(1) A watercraft while ashore on prem-
ises you own or rent; m. Damage To Property
(2) A watercraft you do not own that is: "Property damage" to:
(a) Less than 50 feet long; and (1) Property:
(b) Not being used to carry persons (a) You own, rent, or occupy, in-
or property for a charge; cluding any costs or expenses
incurred by you, or any other
(3) Liability assumed under any "in- person, organization or entity,
sured contract" for the ownership, for repair, replacement, en-
maintenance or use of aircraft or hancement, restoration or
watercraft; maintenance of such property
for any reason, including pre-
(4) The extent that valid "underlying in- vention of injury to a person or
surance" for the aircraft or damage to another's property;
watercraft liability risks described or
CU 00 01 04 13
Page 4 of 19
(b) Owned or transported by the in- (1) A defect, deficiency, inadequacy or
sured and arising out of the dangerous condition in "your prod-
ownership, maintenance or use uct" or "your work"; or
of a "covered auto".
(2) A delay or failure by you or anyone
(2) Premises you sell, give away or acting on your behalf to perform a
abandon, if the "property damage" contract or agreement in accordance
arises out of any part of those with its terms.
premises;
This exclusion does not apply to the loss
(3) Property loaned to you; of use of other property arising out of
sudden and accidental physical injury to
(4) Personal property in the care, cus- "your product" or "your work" after it has
tody or control of the insured; been put to its intended use.
(5) That particular part of real property q. Recall Of Products, Work Or Impaired
on which you or any contractors or Property
subcontractors working directly or Damages claimed for any loss, cost or
indirectly on your behalf are per- expense incurred by you or others for the
forming operations, if the "property loss of use, withdrawal, recall, in-
damage" arises out of those oper- spection, repair, replacement, adjust-
ations; or ment, removal or disposal of:
(6) That particular part of any property (1) "Your product";
that must be restored, repaired or
replaced because "your work" was (2) "Your work"; or
incorrectly performed on it.
(3) "Impaired property";
Paragraph (2) of this exclusion does
not apply if the premises are "your if such product, work, or property is
work" and were never occupied, withdrawn or recalled from the market
rented or held for rental by you. or from use by any person or organiza-
tion because of a known or suspected
Paragraphs (1)(b), (3), (4), (5) and (6)
defect, deficiency, inadequacy or dan-
of this exclusion do not apply to li-
gerous condition in it.
ability assumed under a sidetrack
agreement. r. Personal And Advertising Injury
Paragraphs (3) and (4) of this exclu- "Bodily injury" arising out of "personal
sion do not apply to liability as- and advertising injury".
sumed under a written Trailer
Interchange agreement. s. Professional Services
Paragraph (6) of this exclusion does "Bodily injury" or "property damage" due
not apply to "property damage" in- to rendering of or failure to render any
cluded in the "products-completed professional service. This includes but
operations hazard". is not limited to:
n. Damage To Your Product (1) Legal, accounting or advertising
services;
"Property damage" to "your product"
arising out of it or any part of it. (2) Preparing, approving, or failing to
prepare or approve maps, shop
o. Damage To Your Work drawings, opinions, reports, surveys,
"Property damage" to "your work" arising field orders, change orders or
out of it or any part of it and included in drawings or specifications;
the "products-completed operations haz-
(3) Inspection, supervision, quality con-
ard".
trol, architectural or engineering ac-
This exclusion does not apply if the tivities done by or for you on a
damaged work or the work out of which project on which you serve as con-
the damage arises was performed on struction manager;
your behalf by a sub-contractor.
(4) Engineering services, including re-
p. Damage To Impaired Property Or Prop- lated supervisory or inspection ser-
erty Not Physically Injured vices;
"Property damage" to "impaired prop- (5) Medical, surgical, dental, X-ray or
erty" or property that has not been phys- nursing services treatment, advice
ically injured, arising out of: or instruction;
CU 00 01 04 13
Page 5 of 19
(6) Any health or therapeutic service surance provided under this Coverage
treatment, advice or instruction; Part will follow the same provisions, ex-
clusions and limitations that are con-
(7) Any service, treatment, advice or in- tained in the applicable "underlying
struction for the purpose of appear- insurance", unless otherwise directed by
ance or skin enhancement, hair this insurance.
removal or replacement or personal
grooming or therapy; u. Recording And Distribution Of Material
Or Information In Violation Of Law
(8) Any service, treatment, advice or in-
struction relating to physical fitness, "Bodily injury" or "property damage"
including service, treatment, advice arising directly or indirectly out of any
or instruction in connection with diet, action or omission that violates or is al-
cardio-vascular fitness, bodybuilding leged to violate:
or physical training programs;
(1) The Telephone Consumer Protection
(9) Optometry or optical or hearing aid Act (TCPA), including any amend-
services including the prescribing, ment of or addition to such law;
preparation, fitting, demonstration
(2) The CAN-SPAM Act of 2003, includ-
or distribution of ophthalmic lenses
ing any amendment of or addition to
and similar products or hearing aid
such law;
devices;
(3) The Fair Credit Reporting Act
(10) Body piercing services;
(FCRA), and any amendment of or
(11) Services in the practice of pharmacy; addition to such law, including the
Fair and Accurate Credit Trans-
(12) Law enforcement or firefighting ser- actions Act (FACTA); or
vices; and
(4) Any federal, state or local statute,
(13) Handling, embalming, disposal, ordinance or regulation, other than
burial, cremation or disinterment of the TCPA, CAN-SPAM Act of 2003 or
dead bodies. FCRA and their amendments and
additions, that addresses, prohibits,
This exclusion applies even if the claims or limits the printing, dissemination,
against any insured allege negligence or disposal, collecting, recording,
other wrongdoing in the supervision, hir- sending, transmitting, communicat-
ing, employment, training or monitoring ing or distribution of material or in-
of others by that insured, if the "occur- formation.
rence" which caused the "bodily injury"
or "property damage", involved the ren- COVERAGE B - PERSONAL AND ADVERTISING
dering of or failure to render any profes- INJURY LIABILITY
sional service.
1. Insuring Agreement
t. Electronic Data
a. We will pay on behalf of the insured the
Damage arising out of the loss of, loss "ultimate net loss" in excess of the "re-
of use of, damage to, corruption of, ina- tained limit" because of "personal and
bility to access or inability to manipulate advertising injury" to which this insur-
electronic data. ance applies. We will have the right and
However, this exclusion does not apply duty to defend the insured against any
to liability for damages because of "bod- "suit" seeking damages for such "per-
sonal and advertising injury" when the
ily injury".
"underlying insurance" does not provide
As used in this exclusion, electronic data coverage or the limits of "underlying in-
means information, facts or programs surance" have been exhausted. When
stored as or on, created or used on, or we have no duty to defend, we will have
transmitted to or from computer soft- the right to defend, or to participate in the
ware, including systems and applications defense of, the insured against any other
software, hard or floppy disks, CD-ROMs, "suit" seeking damages to which this in-
tapes, drives, cells, data processing de- surance may apply. However, we will
vices or any other media which are used have no duty to defend the insured
with electronically controlled equipment. against any "suit" seeking damages for
"personal and advertising injury" to
This exclusion does not apply if valid which this insurance does not apply. At
"underlying insurance" for the electronic our discretion, we may investigate any
data risks described above exists or offense that may involve this insurance
would have existed but for the ex- and settle any resultant claim or "suit"
haustion of underlying limits for "bodily for which we have the duty to defend.
injury" and "property damage". The in- But:
CU 00 01 04 13
Page 6 of 19
(1) The amount we will pay for the "ulti- (5) Contractual Liability
mate net loss" is limited as de-
scribed in Section III - Limits Of For which the insured has assumed
Insurance; and liability in a contract or agreement.
This exclusion does not apply to:
(2) Our right and duty to defend end
when we have used up the applica- (a) Liability for damages that the
ble limit of insurance in the payment insured would have in the ab-
of judgments or settlements under sence of the contract or agree-
Coverages A or B. ment.
No other obligation or liability to pay (b) Liability for false arrest, de-
sums or perform acts or services is cov- tention or imprisonment as-
ered unless explicitly provided for under sumed in a contract or
Supplementary Payments - Coverages A agreement.
and B.
(6) Breach Of Contract
b. This insurance applies to "personal and
advertising injury" that is subject to an Arising out of a breach of contract,
applicable "retained limit". If any other except an implied contract to use
limit, such as a sublimit, is specified in another's advertising idea in your
the "underlying insurance", this insur- "advertisement".
ance does not apply to "personal and
advertising injury" arising out of that ex- (7) Quality Or Performance Of Goods --
posure unless that limit is specified in the Failure To Conform To Statements
Declarations under the Schedule of Arising out of the failure of goods,
"underlying insurance". products or services to conform with
any statement of quality or perform-
c. This insurance applies to "personal and
advertising injury" caused by an offense ance made in your "advertisement".
arising out of your business but only if (8) Wrong Description Of Prices
the offense was committed in the "cov-
erage territory" during the policy period. Arising out of the wrong description
of the price of goods, products or
2. Exclusions services stated in your "advertise-
This insurance does not apply to: ment".
a. "Personal and advertising injury": (9) Infringement Of Copyright, Patent,
Trademark Or Trade Secret
(1) Knowing Violation Of Rights Of An-
other Arising out of the infringement of
copyright, patent, trademark, trade
Caused by or at the direction of the secret or other intellectual property
insured with the knowledge that the rights. Under this exclusion, such
act would violate the rights of an- other intellectual property rights do
other and would inflict "personal and
not include the use of another's ad-
advertising injury".
vertising idea in your "advertise-
(2) Material Published With Knowledge ment".
Of Falsity However, this exclusion does not
Arising out of oral or written publi- apply to infringement, in your "ad-
cation, in any manner, of material, if vertisement", of copyright, trade
done by or at the direction of the in- dress or slogan.
sured with knowledge of its falsity.
(10) Insureds In Media And Internet Type
(3) Material Published Prior To Policy Businesses
Period
Committed by an insured whose
Arising out of oral or written publi- business is:
cation, in any manner, of material
whose first publication took place (a) Advertising, broadcasting, pub-
before the beginning of the policy lishing or telecasting;
period.
(b) Designing or determining con-
(4) Criminal Acts
tent of web sites for others; or
Arising out of a criminal act commit-
ted by or at the direction of the in- (c) An Internet search, access,
sured. content or service provider.
CU 00 01 04 13
Page 7 of 19
However, this exclusion does not described in Paragraph (i), (ii)
apply to Paragraphs 14.a., b. and c. or (iii) above is directed.
of "personal and advertising injury"
under the Definitions section. This exclusion applies whether the
injury-causing event described in
For the purposes of this exclusion, Paragraph (i), (ii) or (iii) above oc-
the placing of frames, borders or curs before employment, during em-
links, or advertising, for you or oth- ployment or after employment of that
ers anywhere on the Internet, is not person.
by itself, considered the business of
advertising, broadcasting, publishing This exclusion applies whether the
insured may be liable as an em-
or telecasting.
ployer or in any other capacity, and
(11) Electronic Chatrooms Or Bulletin to any obligation to share damages
Boards with or repay someone else who
must pay damages because of the
Arising out of an electronic chatroom injury.
or bulletin board the insured hosts,
owns, or over which the insured ex- (15) Professional Services
ercises control. Arising out of the rendering of or
failure to render any professional
(12) Unauthorized Use Of Another's
service. This includes but is not
Name Or Product
limited to:
Arising out of the unauthorized use
of another's name or product in your (a) Legal, accounting or advertising
e-mail address, domain name or services;
metatag, or any other similar tactics
(b) Preparing, approving, or failing
to mislead another's potential cus-
to prepare or approve maps,
tomers. shop drawings, opinions, re-
(13) Pollution ports, surveys, field orders,
change orders or drawings or
Arising out of the actual, alleged or specifications;
threatened discharge, dispersal,
seepage, migration, release or es- (c) Inspection, supervision, quality
cape of "pollutants" at any time. control, architectural or engi-
neering activities done, by or for
(14) Employment-related Practices you on a project on which you
serve as construction manager;
To:
(d) Engineering services, including
(a) A person arising out of any: related supervisory or in-
spection services;
(i) Refusal to employ that per-
son; (e) Medical, surgical, dental, X-ray
or nursing services treatment,
(ii) Termination of that per- advice or instruction;
son's employment; or
(f) Any health or therapeutic ser-
(iii) Employment-related prac- vice treatment, advice or in-
tices, policies, acts or struction;
omissions, such as
coercion, demotion, evalu- (g) Any service, treatment, advice
ation, reassignment, disci- or instruction for the purpose of
pline, defamation, appearance or skin enhance-
harrassment, humiliation, ment, hair removal or replace-
discrimination or malicious ment or personal grooming or
prosecution directed at that therapy;
person; or
(h) Any service, treatment, advice
(b) The spouse, child, parent, or instruction relating to phys-
brother or sister of that person ical fitness, including service,
as a consequence of "personal treatment, advice or instruction
and advertising injury" to that in connection with diet, cardio-
person at whom any of the vascular fitness, bodybuilding
employment-related practices or physical training programs;
CU 00 01 04 13
Page 8 of 19
(i) Optometry or optical or hearing (c) The Fair Credit Reporting Act
aid services including the pre- (FCRA), and any amendment of
scribing, preparation, fitting, or addition to such law, includ-
demonstration or distribution of ing the Fair and Accurate Credit
ophthalmic lenses and similar Transactions Act (FACTA); or
products or hearing aid devices;
(d) Any federal, state or local stat-
(j) Body piercing services; ute, ordinance or regulation,
other than the TCPA,
(k) Services in the practice of phar- CAN-SPAM Act of 2003 or FCRA
macy; and their amendments and ad-
ditions, that addresses, prohib-
(l) Law enforcement or firefighting its, or limits the printing,
services; and dissemination, disposal, collect-
ing, recording, sending, trans-
(m) Handling, embalming, disposal,
mitting, communicating or
burial, cremation or
distribution of material or infor-
disinterment of dead bodies.
mation.
This exclusion applies even if the
b. "Pollution cost or expense".
claims against any insured allege
negligence or other wrongdoing in SUPPLEMENTARY PAYMENTS - COVERAGES A
the supervision, hiring, employment, AND B
training or monitoring of others by
that insured, if the offense which 1. We will pay, with respect to any claim we in-
caused the "personal and advertis- vestigate or settle, or any "suit" against an
ing injury", involved the rendering of insured we defend, when the duty to defend
or failure to render any professional exists:
service.
a. All expenses we incur.
(16) War
b. Up to $2000 for cost of bail bonds (in-
However caused, arising, directly or cluding bonds for related traffic law vio-
indirectly, out of: lations) required because of an
"occurrence" we cover. We do not have
(a) War, including undeclared or to furnish these bonds.
civil war;
c. The cost of bonds to release attach-
(b) Warlike action by a military ments, but only for bond amounts within
force, including action in the applicable limit of insurance. We do
hindering or defending against not have to furnish these bonds.
an actual or expected attack, by
any government, sovereign or d. All reasonable expenses incurred by the
other authority using military insured at our request to assist us in the
personnel or other agents; or investigation or defense of the claim or
"suit", including actual loss of earnings
(c) Insurrection, rebellion, revo- up to $250 a day because of time off from
lution, usurped power, or action work.
taken by governmental authority
in hindering or defending e. All court costs taxed against the insured
against any of these. in the "suit". However, these payments
do not include attorneys' fees or attor-
(17) Recording And Distribution Of Mate- neys' expenses taxed against the in-
rial Or Information In Violation Of sured.
Law
f. Prejudgment interest awarded against
Arising directly or indirectly out of the insured on that part of the judgment
any action or omission that violates we pay. If we make an offer to pay the
or is alleged to violate: applicable limit of insurance, we will not
pay any prejudgment interest based on
(a) The Telephone Consumer Pro- that period of time after the offer.
tection Act (TCPA), including
any amendment of or addition to g. All interest on the full amount of any
such law; judgment that accrues after entry of the
judgment and before we have paid, of-
(b) The CAN-SPAM Act of 2003, in- fered to pay, or deposited in court the
cluding any amendment of or part of the judgment that is within the
addition to such law; applicable limit of insurance.
CU 00 01 04 13
Page 9 of 19
These payments will not reduce the limits of (a) Obtain records and other infor-
insurance. mation related to the "suit"; and
2. When we have the right but not the duty to (b) Conduct and control the defense
defend the insured and elect to participate in of the indemnitee in such "suit".
the defense, we will pay our own expenses
but will not contribute to the expenses of the So long as the above conditions are met,
insured or the "underlying insurer". attorneys' fees incurred by us in the de-
fense of that indemnitee, necessary liti-
3. If we defend an insured against a "suit" and gation expenses incurred by us and
an indemnitee of the insured is also named necessary litigation expenses incurred
as a party to the "suit", we will defend that by the indemnitee at our request will be
indemnitee if all of the following conditions paid as Supplementary Payments.
are met: Notwithstanding the provisions of Para-
graph 2.b.(2) of Section I - Coverage A -
a. The "suit" against the indemnitee seeks Bodily Injury And Property Damage Li-
damages for which the insured has as- ability, such payments will not be
sumed the liability of the indemnitee in a deemed to be damages for "bodily in-
contract or agreement that is an "insured jury" and "property damage" and will not
contract"; reduce the limits of insurance.
b. This insurance applies to such liability Our obligation to defend an insured's
assumed by the insured; indemnitee and to pay for attorneys' fees
and necessary litigation expenses as
c. The obligation to defend, or the cost of Supplementary Payments ends when we
the defense of, that indemnitee, has also have used up the applicable limit of in-
been assumed by the insured in the surance in the payment of judgments or
same "insured contract"; settlements or the conditions set forth
above, or the terms of the agreement
d. The allegations in the "suit" and the in- described in Paragraph f. above, are no
formation we know about the "occur- longer met.
rence" are such that no conflict appears
to exist between the interests of the in- SECTION II - WHO IS AN INSURED
sured and the interests of the
indemnitee; 1. Except for liability arising out of the owner-
ship, maintenance or use of "covered autos":
e. The indemnitee and the insured ask us
to conduct and control the defense of that a. If you are designated in the Declarations
indemnitee against such "suit" and agree as:
that we can assign the same counsel to
defend the insured and the indemnitee; (1) An individual, you and your spouse
and are insureds, but only with respect
to the conduct of a business of which
f. The indemnitee: you are the sole owner.
(1) Agrees in writing to: (2) A partnership or joint venture, you
are an insured. Your members, your
(a) Cooperate with us in the inves- partners, and their spouses are also
tigation, settlement or defense insureds, but only with respect to the
of the "suit"; conduct of your business.
(b) Immediately send us copies if (3) A limited liability company, you are
any demands, notices, an insured. Your members are also
summonses or legal papers re- insureds, but only with respect to the
ceived in connection with the conduct of your business. Your
"suit"; managers are insureds, but only
with respect to their duties as your
(c) Notify any other insurer whose managers.
coverage is available to the
indemnitee; and (4) An organization other than a part-
nership, joint venture or limited li-
(d) Cooperate with us with respect ability company, you are an insured.
to coordinating other applicable Your "executive officers" and direc-
insurance available to the tors are insureds, but only with re-
indemnitee; and spect to their duties as your officers
or directors. Your stockholders are
(2) Provides us with written authori- also insureds, but only with respect
zation to: to their liability as stockholders.
CU 00 01 04 13
Page 10 of 19
(5) A trust, you are an insured. Your being exercised for any
trustees are also insureds, but only purpose by;
with respect to their duties as trus-
tees. you, any of your "employees",
"volunteer workers", any part-
b. Each of the following is also an insured: ner or member (if you are a
partnership or joint venture), or
(1) Your "volunteer workers" only while any member (if you are a limited
performing duties related to the liability company).
conduct of your business, or your
"employees", other than either your (2) Any person (other than your "em-
"executive officers" (if you are an ployee" or "volunteer worker"), or
organization other than a partner- any organization while acting as
ship, joint venture or limited liability your real estate manager.
company) or your managers (if you (3) Any person or organization having
are a limited liability company), but proper temporary custody of your
only for acts within the scope of their property if you die, but only:
employment by you or while per-
forming duties related to the conduct (a) With respect to liability arising
of your business. However, none of out of the maintenance or use
these "employees" or "volunteer of that property; and
workers" are insureds for:
(b) Until your legal representative
(a) "Bodily injury" or "personal and has been appointed.
advertising injury":
(4) Your legal representative if you die,
(i) To you, to your partners or but only with respect to duties as
members (if you are a part- such. That representative will have
nership or joint venture), to all your rights and duties under this
your members (if you are a Coverage Part.
limited liability company),
to a co-"employee" in the c. Any organization you newly acquire or
course of his or her em- form, other than a partnership, joint ven-
ture or limited liability company, and
ployment or performing du-
over which you maintain ownership or
ties related to the conduct
majority interest, will qualify as a Named
of your business or to your Insured if there is no other similar insur-
other "volunteer workers" ance available to that organization.
while performing duties re- However:
lated to the conduct of your
business; (1) Coverage under this provision is af-
forded only until the 90th day after
(ii) To the spouse, child, par- you acquire or form the organization
ent, brother or sister of that or the end of the policy period,
co-"employee" or "volun- whichever is earlier;
teer worker" as a conse-
quence of Paragraph (a)(i) (2) Coverage A does not apply to "bod-
above; or ily injury" or "property damage" that
occurred before you acquired or
(iii) For which there is any obli- formed the organization; and
gation to share damages
(3) Coverage B does not apply to "per-
with or repay someone else
sonal and advertising injury" arising
who must pay damages be-
out of an offense committed before
cause of the injury de- you acquired or formed the organ-
scribed in Paragraph (a)(i) ization.
or (ii) above.
2. Only with respect to liability arising out of the
(b) "Property damage" to property: ownership, maintenance or use of "covered
autos":
(i) Owned, occupied or used
by; a. You are an insured.
(ii) Rented to, in the care, cus- b. Anyone else while using with your per-
tody or control of, or over mission a "covered auto" you own, hire
which physical control is or borrow is also an insured except:
CU 00 01 04 13
Page 11 of 19
(1) The owner or anyone else from
Additional insured coverage provided by this
whom you hire or borrow a "covered
insurance will not be broader than coverage
auto". This exception does not apply
provided by the "underlying insurance".
if the "covered auto" is a trailer or
semitrailer connected to a "covered No person or organization is an insured with re-
auto" you own. spect to the conduct of any current or past part-
(2) Your "employee" if the "covered nership, joint venture or limited liability company
auto" is owned by that "employee" that is not shown as a Named Insured in the Dec-
or a member of his or her house- larations.
hold. SECTION III - LIMITS OF INSURANCE
(3) Someone using a "covered auto" 1. The Limits of Insurance shown in the Decla-
while he or she is working in a busi- rations and the rules below fix the most we
ness of selling, servicing, repairing, will pay regardless of the number of:
parking or storing "autos" unless
that business is yours. a. Insureds;
(4) Anyone other than your "employ- b. Claims made, "suits" brought, or number
ees", partners (if you are a partner- of vehicles involved; or
ship), members (if you are a limited
liability company), or a lessee or c. Persons or organizations making claims
borrower or any of their "employ- or bringing "suits".
ees", while moving property to or
from a "covered auto". 2. The Aggregate Limit is the most we will pay
for the sum of all "ultimate net loss" under:
(5) A partner (if you are a partnership),
or a member (if you are a limited li- a. Coverage A, except "ultimate net loss"
ability company) for a "covered because of "bodily injury" or "property
auto" owned by him or her or a damage" arising out of the ownership,
member of his or her household. maintenance or use of a "covered auto";
and
(6) "Employees" with respect to "bodily
injury" to: b. Coverage B.
(a) Any fellow "employee" of the 3. Subject to Paragraph 2. above, the Each Oc-
insured arising out of and in the currence Limit is the most we will pay for the
course of the fellow "employ- sum of all "ultimate net loss" because of all
ee's" employment or while per- "bodily injury" and "property damage" under
forming duties related to the Coverage A arising out of any one "occur-
conduct of your business; or rence".
(b) The spouse, child, parent, 4. Subject to Paragraph 2. above, the Personal
brother or sister of that fellow And Advertising Injury Limit is the most we
"employee" as a consequence will pay under Coverage B for the sum of all
of Paragraph (a) above. "ultimate net loss" because of all "personal
and advertising injury" sustained by any one
c. Anyone liable for the conduct of an in-
person or organization.
sured described above is also an in-
sured, but only to the extent of that 5. If there is "underlying insurance" with a policy
liability. period that is nonconcurrent with the policy
period of this Commercial Liability Umbrella
3. Any additional insured under any policy of
Coverage Part, the "retained limit(s)" will only
"underlying insurance" will automatically be
be reduced or exhausted by payments for:
an insured under this insurance.
Subject to Section III - Limits Of Insurance, if a. "Bodily injury" or "property damage"
coverage provided to the additional insured which occurs during the policy period of
is required by a contract or agreement, the this Coverage Part; or
most we will pay on behalf of the additional
insured is the amount of insurance: b. "Personal and advertising injury" for of-
fenses that are committed during the
a. Required by the contract or agreement, policy period of this Coverage Part.
less any amounts payable by any
"underlying insurance"; or However, if any "underlying insurance" is
written on a claims-made basis, the "retained
b. Available under the applicable Limits of limit(s)" will only be reduced or exhausted by
Insurance shown in the Declarations; claims for that insurance that are made dur-
ing the policy period, or any Extended Re-
whichever is less. porting Period, of this Coverage Part.
CU 00 01 04 13
Page 12 of 19
The Aggregate Limit, as described in Paragraph (1) Immediately record the specifics of
2. above, applies separately to each consecutive the claim or "suit" and the date re-
annual period and to any remaining period of less ceived; and
than 12 months, starting with the beginning of the
policy period shown in the Declarations, unless (2) Notify us as soon as practicable.
the policy period is extended after issuance for an You must see to it that we receive written
additional period of less than 12 months. In that notice of the claim or "suit" as soon as
case, the additional period will be deemed part practicable.
of the last preceding period for purposes of de-
termining the Limits of Insurance. c. You and any other involved insured must:
SECTION IV - CONDITIONS (1) Immediately send us copies of any
demands, notices, summonses or
1. Appeals legal papers received in connection
with the claim or "suit";
If the "underlying insurer" or insured elects
not to appeal a judgment in excess of the (2) Authorize us to obtain records and
"retained limit", we may do so at our own other information;
expense. We will also pay for taxable court
costs, pre- and postjudgment interest and (3) Cooperate with us in the investi-
gation or settlement of the claim or
disbursements associated with such appeal.
defense against the "suit"; and
In no event will this provision increase our li-
ability beyond the applicable Limits of Insur- (4) Assist us, upon our request, in the
ance described in Section III - Limits Of enforcement of any right against any
Insurance. person or organization which may
be liable to the insured because of
2. Bankruptcy injury or damage to which this in-
surance may also apply.
a. Bankruptcy Of Insured
Bankruptcy or insolvency of the insured d. No insured will, except at that insured's
or of the insured's estate will not relieve own cost, voluntarily make a payment,
us of our obligations under this Coverage assume any obligation, or incur any ex-
Part. pense, other than for first aid, without or
consent.
b. Bankruptcy Of Underlying Insurer
4. Legal Action Against Us
Bankruptcy or insolvency of the "under-
No person or organization has a right under
lying insurer" will not relieve us of our
this Coverage Part:
obligations under this Coverage Part.
a. To join us as a party or otherwise bring
However, this insurance will not replace the us into a "suit" asking for damages from
"underlying insurance" in the event of bank- an insured; or
ruptcy or insolvency of the "underlying
insurer". This insurance will apply as if the b. To sue us on this Coverage Part unless
"underlying insurance" were in full effect. all of its terms have been full complied
with.
3. Duties In The Event Of Occurrence, Offense,
Claim Or Suit A person or organization may sue us to re-
cover on an agreed settlement or on a final
a. You must see to it that we are notified as judgment against an insured; but we will not
soon as practicable of an "occurrence" be liable for damages that are not payable
or an offense, regardless of the amount, under the terms of this Coverage Part or that
which may result in a claim. To the ex- are in excess of the applicable limit of insur-
tent possible, notice should include: ance. An agreed settlement means a settle-
ment and release of liability signed by us, the
(1) How, when and where the "occur- insured and the claimant or the claimant's
rence" or offense took place; legal representative.
(2) The names and addresses of any in- 5. Other Insurance
jured persons and witnesses; and
a. This insurance is excess over, and shall
(3) The nature and location of any injury not contribute with any of the other in-
or damage arising out of the "occur- surance, whether primary, excess, con-
rence" or offense. tingent or on any other basis. This
condition will not apply to insurance
b. If a claim is made or "suit" is brought specifically written as excess over this
against any insured, you must: Coverage Part.
CU 00 01 04 13
Page 13 of 19
When this insurance is excess, we will in this Coverage Part to the first Named In-
have no duty under Coverages A or B to sured, this insurance applies:
defend the insured against any "suit" if
any other insurer has a duty to defend a. As if each Named Insured were the only
the insured against that "suit". If no Named Insured; and
other insurer defends, we will undertake
to do so, but we will be entitled to the b. Separately to each insured against whom
insured's rights against all those other claim is made or "suit" is brought.
insurers.
9. Transfer Of Rights Of Recovery Against Oth-
b. When this insurance is excess over other ers To Us
insurance, we will pay only our share of If the insured has rights to recover all or part
the "ultimate net loss" that exceeds the of any payment we have made under this
sum of: Coverage Part, those rights are transferred to
(1) The total amount that all such other us. The insured must do nothing after loss to
insurance would pay for the loss in impair them. At our request, the insured will
the absence of the insurance pro- bring "suit" or transfer those rights to us and
vided under this Coverage Part; and help us enforce them.
(2) The total of all deductible and self- 10. When We Do Not Renew
insured amounts under all that other If we decide not to renew this Coverage Part,
insurance. we will mail or deliver to the first Named In-
6. Premium Audit sured shown in the Declarations written no-
tice of the nonrenewal not less than 30 days
a. We will compute all premiums for this before the expiration date.
Coverage Part in accordance with our If notice is mailed, proof of mailing will be
rules and rates. sufficient proof of notice.
b. Premium shown in this Coverage Part as 11. Loss Payable
advance premium is a deposit premium
only. At the close of each audit period Liability under this Coverage Part does not
we will compute the earned premium for apply to a given claim unless and until:
that period and send notice to the first
Named Insured. The due date for audit a. The insured or insured's "underlying
and retrospective premiums is the date insurer" has become obligated to pay the
shown as the due date on the bill. If the "retained limit"; and
sum of the advance and audit premiums
paid for the policy period is greater than b. The obligation of the insured to pay the
the earned premium, we will return the "ultimate net loss" in excess of the "re-
excess to the first Named Insured. tained limit" has been determined by a
final settlement or judgment or written
c. The first Named Insured must keep re- agreement among the insured, claimant
cords of the information we need for and us.
premium computation, and send us
copies at such times as we may request. 12. Transfer Of Defense
When the underlying limits of insurance have
7. Representations Of Fraud been used up in the payment of judgments
By accepting this policy, you agree: or settlements, the duty to defend will be
transferred to us. We will cooperate in the
a. The statements in the Declarations are transfer of control to us of any outstanding
accurate and complete; claims or "suits" seeking damages to which
this insurance applies which would have
b. Those statements are based upon re- been covered by the "underlying insurance"
presentations you made to us; had the applicable limit not been used up.
c. We have issued this policy in reliance 13. Maintenance Of/Changes To Underlying In-
upon your representations; and surance
d. This policy is void in any case of fraud Any "underlying insurance" must be main-
by you as it relates to this policy or any tained in full effect without reduction of cov-
claim under this policy. erage or limits except for the reduction of the
aggregate limit in accordance with the pro-
8. Separation Of Insureds
visions of such "underlying insurance" that
Except with respect to the Limits of Insurance, results from payment of claims, settlement or
and any rights or duties specifically assigned judgments to which this insurance applies.
CU 00 01 04 13
Page 14 of 19
Such exhaustion or reduction is not a failure d. The insured must fully maintain any cov-
to maintain "underlying insurance". Failure to erage required by law, regulation or
maintain "underlying insurance" will not in- other governmental authority during the
validate insurance provided under this Cov- policy period, except for reduction of the
erage Part, but insurance provided under this aggregate limits due to payments of
Coverage Part will apply as if the "underlying claims, judgments or settlements.
insurance" were in full effect.
Failure to maintain such coverage re-
If there is an increase in the scope of cover- quired by law, regulation or other gov-
age of any "underlying insurance" during the ernmental authority will not invalidate
term of this policy, our liability will be no this insurance. However, this insurance
more than it would have been if there had will apply as if the required coverage by
been no such increase. law, regulation or other governmental
authority was in full effect.
You must notify us in writing, as soon as
practicable, if any "underlying insurance" is SECTION V - DEFINITIONS
cancelled, not renewed, replaced or other-
wise terminated, or if the limits or scope of 1. "Advertisement" means a notice that is
coverage of any "underlying insurance" is broadcast or published to the general public
changed. or specific market segments about your
goods, products or services for the purpose
14. Expanded Coverage Territory of attracting customers or supporters. For the
purposes of this definition:
a. If a "suit" is brought in a part of the
"coverage territory" that is outside the a. Notices that are published include mate-
United States of America (including its rial placed on the Internet or on similar
territories and possessions), Puerto Rico electronic means of communication; and
or Canada, and we are prevented by law,
or otherwise, from defending the insured, b. Regarding web sites, only that part of a
the insured will initiate a defense of the web site that is about your goods, pro-
"suit". We will reimburse the insured, ducts or services for the purposes of at-
under Supplementary Payments, for any tracting customers or supporters is
reasonable and necessary expenses in- considered an advertisement.
curred for the defense of a "suit" seeking
damages to which this insurance applies, 2. "Auto" means:
that we would have paid had we been
able to exercise our right and duty to a. A land motor vehicle, "trailer" or semi-
defend. trailer designed for travel on public
roads, including any attached machinery
If the insured becomes legally obligated or equipment; or
to pay sums because of damages to
which this insurance applies in a part of b. Any other land vehicle that is subject to
the "coverage territory" that is outside a compulsory or financial responsibility
the United States of America (including law or other motor vehicle insurance law
its territories and possessions), Puerto where it is licensed or principally ga-
Rico or Canada, and we are prevented raged.
by law, or otherwise, from paying such
However, "auto" does not include "mo-
sums on the insured's behalf, we will re-
bile equipment".
imburse the insured for such sums.
3. "Bodily injury" means bodily injury, disability,
b. All payments or reimbursements we
sickness or disease sustained by a person,
make for damages because of judgments
including death resulting from any of these
or settlements will be made in U.S. cur- at any time. "Bodily injury" includes mental
rency at the prevailing exchange rate at anguish or other mental injury resulting from
the time the insured became legally ob- "bodily injury".
ligated to pay such sums. All payments
or reimbursements we make for ex- 4. "Coverage territory" means anywhere in the
penses under Supplementary Payments world with the exception of any country or ju-
will be made in U.S. currency at the pre- risdiction which is subject to trade or other
vailing exchange rate at the time the ex- economic sanction or embargo by the United
penses were incurred. States of America.
c. Any disputes between you and us as to 5. "Covered auto" means only those "autos" to
whether there is coverage under this which "underlying insurance" applies.
policy must be filed in the courts of the
United States of America (including its 6. "Employee" includes a "leased worker".
territories and possessions), Canada or "Employee" does not include a "temporary
Puerto Rico. worker".
CU 00 01 04 13
Page 15 of 19
7. "Executive officer" means a person holding the absence of any contract or agree-
any of the officer positions created by your ment.
charter, constitution, bylaws or any other
similar governing document. Paragraphs f. and g. do not include that part
of any contract or agreement:
8. "Impaired property" means tangible property,
other than "your product" or "your work", that (1) That indemnifies a railroad for "bodily
cannot be used or is less useful because: injury" or "property damage" arising out
of construction or demolition operations,
a. It incorporates "your product" or "your within 50 feet of any railroad property
work" that is known or thought to be de- and affecting any railroad bridge or
fective, deficient, inadequate or danger- trestle, tracks, roadbeds, tunnel, under-
ous; or pass or crossing;
b. You have failed to fulfill the terms of a (2) That pertains to the loan, lease or rental
contract or agreement; of an "auto" to you or any of your "em-
ployees", if the "auto" is loaned, leased
if such property can be restored to use by the or rented with a driver; or
repair, replacement, adjustment or removal
of "your product" or "your work", or your ful- (3) That holds a person or organization en-
filling the terms of the contract or agreement. gaged in the business of transporting
property by "auto" for hire harmless for
9. "Insured contract" means: your use of a "covered auto" over a route
or territory that person or organization is
a. A contract for a lease of premises. authorized to serve by public authority.
However, that portion of the contract for
a lease of premises that indemnifies any 10. "Leased worker" means a person leased to
person or organization for damage by you by a labor leasing firm under an agree-
fire to premises while rented to you or ment between you and the labor leasing firm,
temporarily occupied by you with per- to perform duties related to the conduct of
mission of the owner is not an "insured your business. "Leased worker" does not in-
contract"; clude a "temporary worker".
b. A sidetrack agreement; 11. "Loading or unloading" means the handling
of property:
c. Any easement or license agreement, ex-
cept in connection with construction or a. After it is moved from the place where it
demolition operations on or within 50 feet is accepted for movement into or onto an
of a railroad; aircraft, watercraft or "auto";
d. An obligation, as required by ordinance, b. While it is in or on an aircraft, watercraft
to indemnify a municipality, except in or "auto"; or
connection with work for a municipality;
c. While it is being moved from an aircraft,
e. An elevator maintenance agreement; watercraft or "auto" to the place where it
is finally delivered;
f. That part of any contract or agreement
entered into, as part of your business, but "loading or unloading" does not include
pertaining to the rental or lease, by you the movement of property by means of a me-
or any of your "employees", of any chanical device, other than a hand truck, that
"auto." However, such contract or is not attached to the aircraft, watercraft or
agreement shall not be considered an "auto".
"insured contract" to the extent that it
obligates you or any of your "employees" 12. "Mobile equipment" means any of the follow-
to pay for "property damage" to any ing types of land vehicles, including any at-
"auto" rented or leased by you or any of tached machinery or equipment:
your "employees".
a. Bulldozers, farm machinery, forklifts and
g. That part of any other contract or agree- other vehicles designed for use princi-
ment pertaining to your business (in- pally off public roads;
cluding an indemnification of a b. Vehicles maintained for use solely on or
municipality in connection with work next to premises you own or rent;
performed for a municipality) under
which you assume the tort liability of an- c. Vehicles that travel on crawler treads;
other party to pay for "bodily injury" or
"property damage" to a third person or d. Vehicles, whether self-propelled or not,
organization. Tort liability means a li- maintained primarily to provide mobility
ability that would be imposed by law in to permanently mounted:
CU 00 01 04 13
Page 16 of 19
(1) Power cranes, shovels, loaders, arising out of one or more of the following
diggers or drills; or offenses:
(2) Road construction or resurfacing a. False arrest, detention or imprisonment;
equipment such as graders,
scrapers or rollers; b. Malicious prosecution;
e. Vehicles not described in Paragraph a., c. The wrongful eviction from, wrongful
entry into, or invasion of the right of pri-
b., c. or d. above that are not self-
vate occupancy of a room, dwelling or
propelled and are maintained primarily premises that a person occupies, com-
to provide mobility to permanently at- mitted by or on behalf of its owner, land-
tached equipment of the following types: lord or lessor;
(1) Air compressors, pumps and gener- d. Oral or written publication, in any man-
ators, including spraying, welding, ner, of material that slanders or libels a
building cleaning, geophysical ex- person or organization or disparages a
ploration, lighting and well servicing person's or organization's goods, pro-
equipment; or ducts or services;
(2) Cherry pickers and similar devices e. Oral or written publication, in any man-
used to raise or lower workers; ner, of material that violates a person's
right of privacy;
f. Vehicles not described in Paragraph a.,
b., c. or d. above maintained primarily for f. The use of another's advertising idea in
purposes other than the transportation your "advertisement"; or
of persons or cargo.
g. Infringing upon another's copyright, trade
However, self-propelled vehicles with the dress or slogan in your "advertisement".
following types of permanently attached
equipment are not "mobile equipment" 15. "Pollutants" means any solid, liquid, gaseous
but will be considered "autos": or thermal irritant or contaminant, including
smoke, vapor, soot, fumes, acids, alkalis,
(1) Equipment designed primarily for: chemicals and waste. Waste includes mate-
rials to be recycled, reconditioned or re-
(a) Snow removal; claimed.
(b) Road maintenance, but not con- 16. "Pollution cost or expense" means any loss,
struction or resurfacing; or cost or expense arising out of any:
(c) Street cleaning; a. Request, demand, order or statutory or
regulatory requirement that any insured
(2) Cherry pickers and similar devices or others test for, monitor, clean up, re-
mounted on automobile or truck move, contain, treat, detoxify or neutral-
chassis and used to raise or lower ize, or in any way respond to, or assess
workers; and the effects of "pollutants"; or
(3) Air compressors, pumps and gener- b. Claim or suit by or on behalf of a gov-
ators, including spraying, welding, ernmental authority for damages be-
building cleaning, geophysical ex- cause of testing for, monitoring, cleaning
ploration, lighting and well servicing up, removing, containing, treating,
equipment. detoxifying or neutralizing, or in any way
responding to, or assessing the effects
However, "mobile equipment" does not of, "pollutants".
include land vehicles that are subject to
17. "Products-completed operations hazard":
a compulsory or financial responsibility
law or other motor vehicle insurance law a. Includes all "bodily injury" and "property
where it is licensed or principally ga- damage" occurring away from premises
raged. Land vehicles subject to a com- you own or rent and arising out of "your
pulsory or financial responsibility law or product" or "your work" except:
other motor vehicle insurance law are
considered "autos". (1) Products that are still in your phys-
ical possession; or
13. "Occurrence" means an accident, including
continuous or repeated exposure to substan- (2) Work that has not yet been com-
tially the same general harmful conditions. pleted or abandoned. However,
"your work" will be deemed com-
14. "Personal and advertising injury" means in- pleted at the earliest of the following
jury, including consequential "bodily injury", times:
CU 00 01 04 13
Page 17 of 19
(a) When all of the work called for data processing devices or any other media
in your contract has been com- which are used with electronically controlled
pleted. equipment.
(b) When all of the work to be done 19. "Retained limit" means the available limits of
at the job site has been com- "underlying insurance" scheduled in the Dec-
pleted if your contract calls for larations or the "self-insured retention",
work at more than one job site. whichever applies.
(c) When that part of the work done 20. "Self-insured retention" means the dollar
at a job site has been put to its amount listed in the Declarations that will be
intended use by any person or paid by the insured before this insurance be-
organization other than another comes applicable only with respect to "oc-
contractor or subcontractor currences" or offenses not covered by the
working on the same project. "underlying insurance". The "self-insured re-
tention" does not apply to "occurrences" or
Work that may need service, main- offenses which would have been covered by
tenance, correction, repair or re- "underlying insurance" but for the exhaustion
placement, but which is otherwise of applicable limits.
complete, will be treated as com-
pleted. 21. "Suit" means a civil proceeding in which
damages because of "bodily injury", "prop-
b. Does not include "bodily injury" or erty damage" or "personal and advertising
"property damage" arising out of: injury" to which this insurance applies are
alleged. "Suit" includes:
(1) The transportation of property, un-
less the injury or damage arises out a. An arbitration proceeding in which such
of a condition in or on a vehicle not damages are claimed and to which the
owned or operated by you, and that insured must submit or does submit with
condition was created by the "load- our consent; or
ing or unloading" of that vehicle by
any insured; or b. Any other alternative dispute resolution
proceeding in which such damages are
(2) The existence of tools, uninstalled claimed and to which the insured sub-
equipment or abandoned or unused mits with our consent or the "underlying
materials. insurer's" consent.
18. "Property damage" means: 22. "Temporary worker" means a person who is
furnished to you to substitute for a permanent
a. Physical injury to tangible property, in- "employee" on leave or to meet seasonal or
cluding all resulting loss of use of that short-term workload conditions.
property. All such loss of use shall be
deemed to occur at the time of the phys- 23. "Ultimate net loss" means the total sum, after
ical injury that caused it; or reduction for recoveries or salvages collect-
ible, that the insured becomes legally obli-
b. Loss of use of tangible property that is gated to pay as damages by reason of
not physically injured. All such loss of settlement or judgments or any arbitration or
use shall be deemed to occur at the time other alternate dispute method entered into
of the "occurrence" that caused it. with our consent or the "underlying insurer's"
With respect to the ownership, maintenance consent.
or use of "covered autos", property damage 24. "Underlying insurance" means any policies
also includes "pollution cost or expense", but of insurance listed in the Declarations under
only to the extent that coverage exists under
the Schedule of "underlying insurance".
the "underlying insurance" or would have ex-
isted but for the exhaustion of the underlying 25. "Underlying insurer" means any insurer who
limits. provides any policy of insurance listed in the
For the purposes of this insurance, with re- Schedule of "underlying insurance".
spect to other than the ownership mainte-
nance or use of "covered autos", electronic 26. "Volunteer worker" means a person who is
data is not tangible property. not your "employee", and who donates his or
her work and acts at the direction of and
As used in this definition, electronic data within the scope of duties determined by you,
means information, facts or programs stored and is not paid a fee, salary or other com-
as or on, created or used on, or transmitted pensation by you or anyone else for their
to or from computer software (including sys- work performed for you.
tems and applications software), hard or
floppy disks, CD-ROMs, tapes, drives, cells, 27. "Your product":
CU 00 01 04 13
Page 18 of 19
a. Means: (2) The providing of or failure to provide
warnings or instructions.
(1) Any goods or products, other than
real property, manufactured, sold, c. Does not include vending machines or
handled, distributed or disposed of other property rented to or located for
by: the use of others but not sold.
(a) You; 28. "Your work":
(b) Others trading under your a. Means:
name; or
(1) Work or operations performed by
(c) A person or organization whose you or on your behalf; and
business or assets you have
acquired; and (2) Materials, parts or equipment fur-
nished in connection with such work
(2) Containers (other than vehicles), or operations.
materials, parts or equipment fur-
nished in connection with such b. Includes:
goods or products.
(1) Warranties or representations made
b. Includes: at any time with respect to the fit-
ness, quality, durability, perform-
(1) Warranties or representations made ance or use of "your work"; and
at any time with respect to the fit-
ness, quality, durability, perform- (2) The providing of or failure to provide
ance or use of "your product"; and warnings or instructions.
CU 00 01 04 13
Page 19 of 19
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 7/2/2024
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).
CONTACT
PRODUCER
NAME: Arelis Nunez
Alliant Insurance Services, Inc. PHONE FAX
32 Old Slip Fl 17 (A/C, No, Ext): 212-504-1894 (A/C, No): 212-504-5989
E-MAIL
New York NY 10005 ADDRESS: Arelis.Nunez@alliant.com
INSURER(S) AFFORDING COVERAGE NAIC #
License#: BR-800584 INSURER A : Liberty Mutual Insurance Company 1112
INSURED SYSTINC-01
INSURER B :
Global Equipment Company, Inc
c/o Global Industrial Company, f/k/a Systemax Inc. INSURER C :
11 Harbor Park Drive INSURER D :
Port Washington NY 11050 INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 1113640809 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 Y Y TB2-651-291604-014 7/1/2024 7/1/2025 EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 1,000,000
MED EXP (Any one person) $ 25,000
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X POLICY PRO-
JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000
OTHER: $
A Y Y COMBINED SINGLE LIMIT $ 1,000,000
AUTOMOBILE LIABILITY AS2-651-291604-024 7/1/2024 7/1/2025 (Ea accident)
ANY AUTO BODILY INJURY (Per person) $
OWNED
AUTOS ONLY
X SCHEDULED
AUTOS
BODILY INJURY (Per accident) $
NON-OWNED
X HIRED
AUTOS ONLY
X AUTOS ONLY
PROPERTY DAMAGE
(Per accident) $
$
A X UMBRELLA LIAB X OCCUR Y Y TH7-651-291604-044 7/1/2024 7/1/2025 EACH OCCURRENCE $ 5,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000
X RETENTION $ $
DED 10,000
PER OTH-
A WORKERS COMPENSATION Y WA7-65D-291604-094 7/1/2024 7/1/2025 X STATUTE ER
A AND EMPLOYERS' LIABILITY Y/N WC7-651-291604-104 7/1/2024 7/1/2025
ANYPROPRIETOR/PARTNER/EXECUTIVE 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
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
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.
Global Equipment Company,
Incc/o Global Industrial
Company, f/k/a Systemax Inc. AUTHORIZED REPRESENTATIVE
11 Harbor Park DrivePort
Washington NY 11050
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 11/25/2025 2/19/2025
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).
CONTACT
PRODUCERLockton Companies, LLC NAME:
DBA Lockton Insurance Brokers, LLC in CA PHONE FAX
(A/C, No, Ext): (A/C, No):
CA license #0F15767 E-MAIL
ADDRESS:
2100 Ross Ave., Ste. 1400
INSURER(S) AFFORDING COVERAGE NAIC #
Dallas TX 75201
(214) 720-5563 INSURER A : The Hanover Insurance Company 22292
INSURED
Flinn Scientific Inc. INSURER B : Allmerica Financial Benefit Insurance Co 41840
1551584 770 North Raddant Road INSURER C : Employers Compensation Insurance Company 11512
Batavia IL 60510-4208 INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 21431217 REVISION NUMBER: XXXXXXX
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 Y Y ZHY-H091903-06 11/25/2024 11/25/2025 EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADEX OCCUR PREMISES (Ea occurrence) $ 1,000,000
X Employee Benefits: MED EXP (Any one person) $ 10,000
X $1,000,000 PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
PRO-
X POLICY JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000
OTHER: $
COMBINED SINGLE LIMIT
B AUTOMOBILE LIABILITY Y Y AWD-H091937-06 11/25/2024 11/25/2025 (Ea accident) $
1,000,000
ANY AUTO BODILY INJURY (Per person) $
X XXXXXXX
OWNED SCHEDULED BODILY INJURY (Per accident) $ XXXXXXX
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX
AUTOS ONLY AUTOS ONLY (Per accident)
$ 1,000,000
UIM
A UMBRELLA LIAB N N UHY-H091922-06 11/25/2024 11/25/2025 $ 10,000,000
X X OCCUR EACH OCCURRENCE
EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000
DED RETENTION $ $ XXXXXXX
C
WORKERS COMPENSATION Y EIG 5372237-02 11/25/2024 11/25/2025 X PER
STATUTE
OTH-
ER
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
N/A
E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N
(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
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION See Attachments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
21431217 ACCORDANCE WITH THE POLICY PROVISIONS.
DeKalb County School District
1701 Mountain Industrial BLVD AUTHORIZED REPRESENTATIVE
Stone Mountain GA 30083
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
CONTINUATION DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS (Use only if more space is required)
All policies include a blanket notice of cancellation to certificate holders endorsement, providing for 30 days' advance notice
if the policy is cancelled by the company other than for nonpayment of premium, 10 days' notice if the policy is cancelled for
nonpayment of premium. Notice is sent to certificate holders with mailing addresses on file with the agent or the company.
The endorsement does not provide for notice of cancellation if the named insured requests cancellation.
All policies (except Workers' Compensation/EL) contain a special endorsement with “primary and noncontributory” wording.
The Umbrella Liability policy includes the General Liability, Automobile Liability and Employer's Liability policies in the
underlying schedule.
The General Liability and Auto Liability policies include a blanket automatic additional insured [provision] that con
fers additional insured status to the certificate holder only if there is a written contract between the named insured an
d the certificate holder that requires the named insured to name the certificate
holder as an additional insured. In the absence of such a contractual obligation on the part of the named insured, the
certificate holder is not an additional insured under the policy.
The General Liability and Auto Liability policies include a blanket automatic waiver of subrogation
endorsement [provision] that provides this feature only when there is a written contract between the
named insured and the certificate holder that requires it. In the absence of such a contractual obligation on the part
of the named insured, the waiver of subrogation feature does not apply.
ACORD 25 (2016/03) Certificate Holder ID: 21431217
LDD J905264 00 1602412
Attachment Code: D662886 Certificate ID: 21431217
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY BROADENING ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SUMMARY OF COVERAGES
1. Additional Insured by Contract, Agreement or Permit Included
2. Additional Insured — Primary and Non-Contributory Included
3. Blanket Waiver of Subrogation Included
4. Bodily Injury Redefined Included
5. Broad Form Property Damage — Borrowed Equipment, Customers Goods & Use of Elevators Included
6. Knowledge of Occurrence Included
7. Liberalization Clause Included
8. Medical Payments — Extended Reporting Period Included
9. Newly Acquired or Formed Organizations - Covered until end of policy period Included
10. Non-owned Watercraft 51 ft.
11. Supplementary Payments Increased Limits
- Bail Bonds $2,500
- Loss of Earnings $1000
12. Unintentional Failure to Disclose Hazards Included
13. Unintentional Failure to Notify Included
This endorsement amends coverages provided under the Commercial General Liability Coverage Part through new
coverages, higher limits and broader coverage grants.
1. Additional Insured by Contract, Agreement or Permit (1) "Your work" for the additional insured(s)
The following is added to SECTION II — WHO IS AN designated in the contract, agreement or
INSURED: permit;
(2) Premises you own, rent, lease or occupy; or
Additional Insured by Contract, Agreement or Permit
(3) Your maintenance, operation or use of
a. Any person or organization with whom you agreed in
a written contract, written agreement or permit that equipment leased to you.
such person or organization to add an additional b. The insurance afforded to such additional insured
insured on your policy is an additional insured only described above:
with respect to liability for "bodily injury", "property (1) Only applies to the extent permitted by law; and
damage", or "personal and advertising injury"
caused, in whole or in part, by your acts or (2) Will not be broader than the insurance which
omissions, or the acts or omissions of those acting you are required by the contract, agreement or
on your behalf, but only with respect to: permit to provide for such additional insured.
421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 4
Attachment Code: D658487 Master ID: 1551584, Certificate ID: 21431217
(1) Applies on a primary basis if that is required advertising injury” involved the rendering of
by the written contract, written agreement or failure to render any professional
or permit. services by or for you.
(2) Will not be broader than coverage provided d. With respect to the insurance afforded to these
to any other insured. additional insureds, the following is added to
(3) Does not apply if the “bodily injury”, SECTION III – LIMITS OF INSURANCE:
“property damage” or “personal and The most we will pay on behalf of the additional
advertising injury” is otherwise excluded insured for a covered claim is the lesser of the
from coverage under this Coverage Part, amount of insurance:
including any endorsements thereto.
1. Required by the contract, agreement or
c. This provision does not apply: permit described in Paragraph a.; or
(1) Unless the written contract or written 2. Available under the applicable Limits of
agreement was executed or permit was Insurance shown in the Declarations.
issued prior to the "bodily injury”, “property
damage", or "personal injury and This endorsement shall not increase the
advertising injury". applicable Limits of Insurance shown in the
Declarations.
(2) To any person or organization included as
an insured by another endorsement issued 2. Additional Insured – Primary and Non-
by us and made part of this Coverage Part. Contributory
(3) To any lessor of equipment: The following is added to SECTION IV –
(a) After the equipment lease expires; or COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 4. Other insurance:
(b) If the “bodily injury”, “property
damage”, “personal and advertising Additional Insured – Primary and Non-
injury” arises out of sole negligence of Contributory
the lessor If you agree in a written contract, written agreement
(4) To any: or permit that the insurance provided to any person
or organization included as an Additional Insured
(a) Owners or other interests from. whom under SECTION II – WHO IS AN INSURED, is
land has been leased which takes primary and non-contributory, the following applies:
place after the lease for the land ex-
pires; or If other valid and collectible insurance is available
to the Additional Insured for a loss covered under
(b) Managers or lessors of premises if: Coverages A or B of this Coverage Part, our
(i) The occurrence takes place after obligations are limited as follows:
you cease to be a tenant in that
a. Primary Insurance
premises; or
This insurance is primary to other insurance
(ii) The "bodily injury", "property
that is available to the Additional Insured which
damage", "personal injury" or
covers the
"advertising injury" arises out of
structural alterations, new con- Additional Insured as a Named Insured. We will
struction or demolition operations not seek contribution from any other insurance
performed by or on behalf of the available to the Additional Insured except:
manager or lessor. (1) For the sole negligence of the Additional
(5) To “bodily injury”, “property damage” or Insured;
“personal and advertising injury” arising out (2) When the Additional Insured is an
of the rendering of or the failure to render Additional Insured under another primary
any professional services. liability policy; or
This exclusion applies even if the claims (3) when b. below applies.
against any insured allege negligence or
other wrongdoing in the supervision, hiring, If this insurance is primary, our obligations are
employment, training or monitoring of not affected unless any of the other insurance
others by that insured, if the “occurrence” is also primary. Then, we will share with all that
which caused the “bodily injury” or other insurance by the method described in c.
“property damage” or the offense which below.
caused the “personal and
421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 4
Attachment Code: D658487 Master ID: 1551584, Certificate ID: 21431217
b. Excess Insurance insurer contributes equal amounts until it has
(1) This insurance is excess over any of the paid its applicable limit of insurance or none of
other insurance, whether primary, excess, the loss remains, whichever comes first. If any
contingent or on any other basis: of the other insurance does not permit
contribution by equal shares, we will contribute
(a) That is Fire, Extended Coverage, by limits. Under this method, each insurer's
Builder's Risk, Installation Risk or share is based on the ratio of its applicable limit
similar coverage for "your work"; of insurance to the total applicable limits of
(b) That is Fire insurance for premises insurance of all insurers
rented to the Additional Insured or 3. Blanket Waiver of Subrogation
temporarily occupied by the Additional The following is added to SECTION IV –
Insured with permission of the owner;
COMMERCIAL GENERAL LIABILITY
(c) That is insurance purchased by the CONDITIONS, Paragraph 8. Transfer Of Rights
Additional Insured to cover the Of Recovery Against Others To Us:
Additional Insured’s liability as a tenant
for "property damage" to premises We waive any right of recovery we may have
rented to the Additional Insured or against any person or organization with whom you
temporarily occupied by the Additional have a written contract that requires such waiver
with permission of the owner; or because of payments we make for damage under
this coverage form. The damage must arise out of
(d) If the loss arises out of the your activities under a written contract with that
maintenance or use of aircraft, "autos" person or organization. This waiver applies only to
or watercraft to the extent not subject the extent that subrogation is waived under a
to Exclusion g. of SECTION I – written contract executed prior to the “occurrence”
COVERAGE A – BODILY INURY AND or offense giving rise to such payments.
PROPERTY DAMAGE LIABILITY.
4. Bodily Injury Redefined
(2) When this insurance is excess, we will have
SECTION V – DEFINITIONS, Definition 3. “bodily
no duty under Coverages A or B to defend
injury” is replaced by the following:
the insured against any "suit" if any other
insurer has a duty to defend the insured 3. “Bodily injury” means bodily injury, sickness or
against that "suit". If no other insurer disease sustained by a person including death
defends, we will undertake to do so, but we resulting from any of these at any time. “Bodily
will be entitled to the insured's rights injury” includes mental anguish or other mental
against all those other insurers. injury resulting from “bodily injury”.
(3) When this insurance is excess over other 5. Broad Form Property Damage – Borrowed
Insurance, we will pay only our share of the Equipment, Customers Goods, Use of
amount of the loss, if any, that exceeds the Elevators
sum of: a. SECTION I – COVERAGES, COVERAGE A –
(a) The total amount that all such other BODILIY INJURY AND PROPERTY
insurance would pay for the loss in the DAMAGE LIABILITY, Paragraph 2.
absence of this insurance; and Exclusions subparagraph j. is amended as
(b) The total of all deductible and self follows:
insured amounts under all that other Paragraph (4) does not apply to "property
insurance. damage" to borrowed equipment while at a
We will share the remaining loss, if any, jobsite and not being used to perform
with any other insurance that is not operations.
described in this Excess Insurance Paragraphs (3), (4) and (6) do not apply to
provision and was not bought specifically to "property damage" to "customers goods" while
apply in excess of the Limits of Insurance on your premises nor do they apply to the use
shown in the Declarations of this Coverage of elevators at premises you own, rent, lease or
Part. occupy.
c. Method Of Sharing b. The following is added to SECTION V –
If all of the other insurance permits contribution DEFINTIONS:
by equal shares, we will follow this method also. 24. "Customers goods" means property of your
Under this approach each customer on your premises for the purpose
of being:
421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 4
Attachment Code: D658487 Master ID: 1551584, Certificate ID: 21431217
a. worked on; or 10. Non-Owned Watercraft
b. used in your manufacturing process. SECTION I – COVERAGES, COVERAGE A
. The insurance afforded under this BODILY INJURY AND PROPERTY DAMAGE
provision is excess over any other valid and LIABILITY, Paragraph 2. Exclusions,
collectible property insurance (including subparagraph g.(2) is replaced by the following:
deductible) available to the insured whether g. Aircraft, Auto Or Watercraft
primary, excess, contingent (2) A watercraft you do not own that is:
6. Knowledge of Occurrence (a) Less than 51 feet long; and
The following is added to SECTION IV – (b) Not being used to carry persons or
COMMERCIAL GENERAL LIABILITY property for a charge;
CONDITIONS, Paragraph 2. Duties in the Event
This provision applies to any person who,
of Occurrence, Offense, Claim or Suit:
with your consent, either uses or is
e. Notice of an "occurrence", offense, claim or responsible for the use of a watercraft.
"suit" will be considered knowledge of the
11. Supplementary Payments Increased Limits
insured if reported to an individual named
insured, partner, executive officer or an SECTION I – SUPPLEMENTARY PAYMENTS
"employee" designated by you to give us such COVERAGES A AND B, Paragraphs 1.b. and 1.d.
a notice. are replaced by the following:
7. Liberalization Clause 1.b. Up to $2,500 for cost of bail bonds required
The following is added to SECTION IV – because of accidents or traffic law violations
arising out of the use of any vehicle to which the
COMMERCIAL GENERAL LIABILITY
Bodily Injury Liability Coverage applies. We do
CONDITIONS: not have to furnish these bonds.
Liberalization Clause 1.d. All reasonable expenses incurred by the
If we adopt any revision that would broaden the insured at our request to assist us in the
coverage under this Coverage Form without investigation or defense of the claim or “suit",
additional premium, within 45 days prior to or during including actual loss of earnings up to $1000 a
the policy period, the broadened coverage will day because of time off from work.
immediately apply to this Coverage Part. 12. Unintentional Failure to Disclose Hazards
8. Medical Payments – Extended Reporting Period The following is added to SECTION IV –
a. SECTION I – COVERAGES, COVERAGE C – COMMERCIAL GENERAL LIABILITY
MEDICAL PAYMENTS, Paragraph 1. Insuring CONDITIONS, Paragraph 6. Representations:
Agreement, subparagraph a.(3)(b) is replaced
We will not disclaim coverage under this Coverage
by the following:
Part if you fail to disclose all hazards existing as of
(b) The expenses are incurred and reported to the inception date of the policy provided such failure
us within three years of the date of the is not intentional.
accident; and
13. Unintentional Failure to Notify
b. This coverage does not apply if COVERAGE
The following is added to SECTION IV –
C – MEDICAL PAYMENTS is excluded either
by the provisions of the Coverage Part or by COMMERCIAL GENERAL LIABILITY
endorsement. CONDITIONS, Paragraph 2. Duties in the Event
of Occurrence, Offense, Claim or Suit:
9. Newly Acquired Or Formed Organizations
Your rights afforded under this policy shall not be
SECTION II – WHO IS AN INSURED, Paragraph prejudiced if you fail to give us notice of an
3.a. is replaced by the following: "occurrence", offense, claim or "suit", solely due to
a. Coverage under this provision is afforded until your reasonable and documented belief that the
the end of the policy period. "bodily injury" or "property damage" is not covered
under this policy.
ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED.
421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 4
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 2/24/2025
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).
CONTACT
PRODUCER
NAME: Carrie Fowler, CISR
Marsh & McLennan Agency LLC PHONE FAX
2301 Sugar Bush Road, Suite 600 (A/C, No, Ext): 919-786-5673 (A/C, No): 212-948-9258
E-MAIL
Raleigh NC 27612 ADDRESS: macertrequest@marshmma.com
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : Travelers Cas & Surety Co of America 31194
CAROLBIOLO
INSURED INSURER B : Travelers Prop & Casualty Co of America 25674
Carolina Biological Supply Company
INSURER C : Travelers Casualty Ins Co of America 19046
2700 York Road
Burlington NC 27215 INSURER D : Travelers Indemnity Company 25658
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 627371042 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
B X COMMERCIAL GENERAL LIABILITY 6306X704930 4/1/2024 4/1/2025 EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 1,000,000
MED EXP (Any one person) $ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X POLICY PRO-
JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000
OTHER: $
B COMBINED SINGLE LIMIT $ 1,000,000
AUTOMOBILE LIABILITY 8106X704813 4/1/2024 4/1/2025 (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) $
$
C X UMBRELLA LIAB X OCCUR CUP7X636256 4/1/2024 4/1/2025 EACH OCCURRENCE $ 15,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $ 15,000,000
X RETENTION $ $
DED 0
PER OTH-
D WORKERS COMPENSATION UB6X737961 4/1/2024 4/1/2025 X STATUTE ER
AND EMPLOYERS' LIABILITY Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE 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
A Cyber Liability 107791629 3/1/2024 3/1/2025 $5,000,000 Limit $50,000 Retention
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
BID 25-519
Catalog Discount – Career Technical & Agricultural Materials, Equipment and Supplies
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 Purchasing Dept.
1701 Mountain Industrial Blvd AUTHORIZED REPRESENTATIVE
Stone Mountain GA 30083-1027
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 02/20/2025
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 Peter J Moon
NAME:
The Whitlock Group, Inc. PHONE (678) 906-2008 FAX (855) 906-2012
(A/C, No, Ext): (A/C, No):
2915 Premiere Pkwy Suite 120 E-MAIL pmoon@twgins.net
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
Duluth GA 30097 INSURER A : Allmerica Financial Benefit Insurance Company 41840
INSURED INSURER B : Hanover American Insurance Company 36064
Amitrace Computer Systems, Inc INSURER C : Hanover Insurance Company 22292
8000 Miller Court E INSURER D :
INSURER E :
Norcross GA 30071 INSURER F :
COVERAGES CERTIFICATE NUMBER: CL2432805244 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
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
DAMAGE TO RENTED 1,000,000
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $
MED EXP (Any one person) $ 5,000
A Y Y Z2AJ678950 03/31/2024 03/31/2025 PERSONAL & ADV INJURY $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
PRO- 4,000,000
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: EPLI $ 100,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
A OWNED SCHEDULED Y Y AWAJ678935 03/31/2024 03/31/2025 BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 3,000,000
A EXCESS LIAB CLAIMS-MADE Y Y Z2AJ678950 03/31/2024 03/31/2025 AGGREGATE $ 3,000,000
DED RETENTION $ 0 $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
B OFFICER/MEMBER EXCLUDED? N/A WZAJ678953 03/31/2024 03/31/2025
(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
Each Claim $3,000,000
Tech E&O, Network Security & Privacy
C Liability. Retroactive Date: 3/31/2021 LHAJ679562 03/31/2024 03/31/2025 Aggregate $3,000,000
Retention $10,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
(See attached Comments/Remarks page for coverage details)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
DeKalb County Board of Education ACCORDANCE WITH THE POLICY PROVISIONS.
1701 Mountain Industrial Blvd
AUTHORIZED REPRESENTATIVE
Stone Mountain GA 30083
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 00000848
LOC #:
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY NAMED INSURED
The Whitlock Group, Inc. Amitrace Computer Systems, Inc
POLICY NUMBER
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: Notes
*Blanket Additional Insured status for General Liability is provided to any person or organization in primary and non-contributory basis as required by written
contract with the named insured, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused, in whole or in
part, by the named insured’s acts or omissions in the performance of on going operations and only with respect to liability for bodily injury or property
damage caused, in whole or in part, by the named insured’s worked performed for that additional insured.
*Blanket Additional Insured status for Automobile Liability is provided to any person or organization in primary and non-contributory basis as required by
written contract with the named insured, but only with respect to liability for bodily injury or property damage caused, in whole or in part, by the named
insured’s ownership, maintenance or use of a covered auto.
*Blanket Waiver of Subrogation in favor of the additional insured applies to all coverages as required by a Written Contract with the Named Insured.
*Umbrella/Excess Liability is Follow Form
*Third-party 30-day notice of cancellation/non-renewal will be mailed to the Certificate Holder if required.
*This certificate of insurance is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend,
extend or alter the coverage, terms exclusions and conditions afforded by the policies referenced herein.*
ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD