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HomeMy WebLinkAboutA6569 - CSG CONSULTANTS INC.AMENDMENT NO. 4 TO CONSULTING SERVICES AGREEMENT CSG CONSULTANTS, INC. This Amendment No. 4 to the Consulting Services Agreement ("Amendment") is made and entered into this 1st day of July 2018 by and between the City of Palm Springs, California, a California Charter City ("City"), and CSG Consultants, Inc. ("Consultant"). RECITALS A. City and Consultant have entered into a Consulting Services Agreement for the services of fire plan examination and inspection services ("Agreement'). B. City and Consultant are agreeable to modifying certain terms and conditions to the Agreement pursuant to the terms of this Amendment. AGREEMENT In consideration of the promises and covenants contained in this Amendment and other good and valuable consideration, the City and the Consultant agree: SECTION 1. City and Consultant agree that the terms of the agreement shall remain unchanged and in full force and effect, except as specifically provided in this Amendment. SECTION 4. Section 4.4 of the Agreement (titled "Term"), is amended to read: 4.4 Term. Unless earlier terminated in accordance with Section 4.5 of this Agreement, this Agreement shall continue in full force and effect commencing on July 1, 2018 and ending on June 30, 2019 unless extended by mutual written agreement of the parties. In witness whereof, City and Consultant have executed and entered into this Amendment as of the date first written above. CITY OF PALM SPRINGS A California Charter City David H. Ready, City Manager A EST: r thony J. M WAefiw City elerk Consulting Service Agmt. Amend. No. 4 CSG Consultants, Inc. Page 1 of 1 CONSULTANT CSG Cons"ar APPROVAL AS TO FORM: Edward Z. Kotkin, CIO Attorr ey APPROVED BY CITY MANAGER q ev-krd 'kom ('03al1 CITY OF PALM SPRINGS FIRE PREVENTION SERVICES Fee Schedule CSG's fee schedule for proposed work is provided in the table below. CSG will coordinate the pickup and return of all plans to CSG via staff or a licensed courier service. This service is provided at no additional cost. Plan review based on a percentage of plan check fees includes initial plan review and two subsequent reviews. Additional reviews will be charged at the appropriate hourly rate indicated below. FEE SCHEDULE Fire Plan Check— Hourly Expedited Fire Plan Check —Hourly Fire Inspection Overtime $105 / Hour 1.5 x Hourly Rate $105 / Hour 1.5 x Hourly Rate All hourly rates include overhead costs including, but not limited to, salaries, benefits, Workers Compensation Insurance, travel and office expenses. Should the scope of work change or circumstances develop which necessitate special handling, CSG will notify the City prior to proceeding. On each anniversary of the contract start date, CSG will initiate a rate increase based on change in CPI-W for the applicable region. CSG will mail an invoice at the beginning of every month for services rendered during the previous month. CSG CONSULTANTS, INC. CSG CONSULTANTS N111111111001101F April 5, 2018 Janet Vines Administrative Assistant Palm Springs Fire Department 300 North El Cielo Palm Springs, CA 92262 FIRE DEPARMEIT RECEIVED APR 0 9 2018 CITY OF PALM SPRINGS RE: AMENDMENT NO.4 TO CONSULTING SERVICES AGREEMENT Dear Ms. Vines: 550 Pilgrim Drive Foster City, CA 94404 phone 650.522.2500 fax 650.522.2599 www.csgengr.com Enclosed please find two (2) wet signed originals of the Amendment No. 4 to Consulting Services Agreement between the City of Palm Springs and CSG Consultants, Inc. A copy of our current Certificate of Liability Insurance has also been included in this package. Upon the City's final signatures, please return an executed copy to my attention via email at gregm@cseengr.com, or mail a hard copy to our corporate headquarters at: Greg Masztal CSG Consultants, Inc. 550 Pilgrim Drive Foster City, CA 94404 We appreciate this continued opportunity to service the City of Palm Springs. Feel free to contact me by phone at (650) 522-2523 or by email at greRm@csgengr.com should there be questions or concerns. Sincerely, Ap"O?to- Greg Masztal Analyst Enclosures cc: Project Files A� I CERTIFICATE OF LIABILITY INSURANCE DA Elmmloorcywl 5/4/2018 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 endorsemant s . PRODUCER Arthur J. Gallagher & Co. Insurance Brokers of CA, Inc. LIC #0726293 1255 Battery Street, Suite 450 CONTACT NAME: PHONE H. 415-536-8617 FAX 415-536-8627 E-MAIL ADORES INSURERS AFFORDING COVERAGE NAIC# San Francisco CA94111 INSURERA:AmeBcan Fire and Casualty Company 24066 INSURED CSGCONS-01 INsuRERe:Arch Insurance Company 11150 INSURER c:West American Insurance Company 44393 CSG Consultants, Inc., Precision Inspection Company, Inc. 550 Pilgrim Drive INSURERD:Berkshire Hathaway Homestate Insurance 20044 Foster City CA 94404 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 532274944 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 LTR TYPE OF INSURANCE DOLSUBRI INSD VIVO POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM4)D LIMITS C X COMMERCIAL GENERAL LIABILITY Y BKW(18)57695795 1214/2017 12/4/2018 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X❑OCCURe00, PREMISE Eaolnce $500,000 MED EXP(Any one person) $5,000 V PERSONAL &ADV INJURY $1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S2,000,000 POLICY 0 JECT a LOC PRODUCTS - COMPIOPAGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y BAA(18)57695795 17114/2017 12/4/2018 UUMBINEaacrl LU $1,000,000 BODILY INJURY (Par parson) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTO$ HIRED NONAWNED AUTOS ONLY AUTOS ONLY BODILY INJURY(Peracciden0 $ Per account $ $ A X UMBRELLA LIAB X OCCUR USA(18)57695795 12/4/2017 12/4/2018 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 EXCESS UAS CLAIMS -MADE OED IX I RETEWION$O I $ I D WORKERS COMPENSATION AND EMPLOYERS' UABUTY YIN ANY OFFICEME BEREEXCLUDED?ECUTIVE N (Mandatory In Niq /A y CSWC821833 12/4/2017 12141201E / ✓ X STATUTE ERH E.L. EACH ACCIDENT $1,000,000 E.L DISEASE - EA EMPLOYEE $1,000,000 If describes, dese under DESCRIPTIONOF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 B Professional Liability retractile: 1/1/1991 PAAEP0008802 12/4/2017 12/4/2018 Each Claim $5.000,000 Aggregate $5.000.000 Deductible: $50.000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe allachad if more space is required) re: Any and all work performed for the City. The City of Palm Springs, its officials, employees and agents are included as I al insureds on E1111a '�l=N - ntibuto basis on GL and Auto with 30 Day Notice of Cancellation per attached endorsements. Waiver 0 U raga Ion on a per attached enclorsement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Palm Springs THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3200 E. Tahquitz Canyon Way ACCORDANCE WITH THE POLICY PROVISIONS. Palm Springs CA 92262 USA AUTHORIZED REPRESENTATIVE ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE COMMERCIAL GENERAL LIABILITY Policy #: BKW(18)57695795 CG 8810 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON -OWNED AIRCRAFT 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY - ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 3 ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORSIMALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY IN4URY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY - ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply If such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section 1- Coverage A -Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services office. Inc., with its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6. under Section III -Limits, Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND .B 1. Under Supplementary Payments -Coverages A and B, Paragraph i.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work, G. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section 11- Who Is An insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, In the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or ® 2013 Liberty Mutual Insurance CG 88 10 0413 Includes copyrighted material of Insurance Services Office, inc., with its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or C. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquess, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However: 1. The insurance afforded to such additional insured only applies to the extent permitted bylaw; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement Is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition ? Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions. ® 2013 Liberty Mutual Insurance CG 8810 0413 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. C. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even If the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement Is- sued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contractor agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision .applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4.Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services office, Inc., with its permission. Page 5 of 8 b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS ! MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II - Who Is An insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you, Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and © 2013 Liberty Mutual insurance CG 88 10 04 13 InrlutiPc tnnvrinhtpd material of Incamanrp CPruirne nuiro in.- uuith ite normiremn Paso is of R advertising injury" arising out of their willful conduct, which Is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section 11- Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority Interest, will quality as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage 8 does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section 11- Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. 0. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following: 3. "Bodily injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. © 2013 Liberty Mutual Insurance CG 88 10 0413 Includes copyrighted material of Insurance Services Office, inc.. with its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. 0. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED 1N A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we / make for injury or damage arising out of your ongoing operations or "your work" done under a ✓ contract with that person or organization and included in the "products -completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. ® 2013 Liberty Mutual Insurance CG 8810 0413 Includes copyrighted material of Insurance Services Office. Inc., with its permission. Page 8 of 8 Policy #: BKW(18)57695795 COMMERCIAL GENERAL LIABILITY CG 89 70 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF CANCELLATION PROVISIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Any term or provision of the Cancellation Conditions of the policy or any endorsement amending or replac- ing such Conditions is amended by the following: If you have agreed in a written contract or written agreement to provide a person or organization notice of cancellation we agree to the following: Provide 30 days prior written cancellation notice to such person or organization for reasons other than nonpayment of premium, but only if we are provided with a schedule of persons or organizations with whom you have agreed to provide notification more than 30 days before the cancellation is to take effect. For purposes of this endorsement, knowledge of the agent as to the persons or organizations requesting notice of cancellation is insufficient to invoke our duty to provide notice of cancellation unless the identity of the persons or organizations is provided directly to us in accordance with the terms of this endorsement. Failure to provide notice to a person or organization in accordance with the terms of this endorsement shall not extend the effective date of the cancellation or otherwise affect cancellation of the policy as to any insured. O 2013 Liberty Mutual Insurance CG 89 70 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 Policy #BAA(18)57695795 COMMERCIAL AUTO CA 88 10 01 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. COVERAGE INDEX SUBJECT PROVISION NUMBER ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT 3 ACCIDENTAL AIRBAG DEPLOYMENT 12 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 19 AMENDED FELLOW EMPLOYEE EXCLUSION 5 AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 13 BROAD FORM INSURED 1 BODILY INJURY REDEFINED 22 EMPLOYEES AS INSUREDS (including employee hired auto) 2 EXTENDED CANCELLATION CONDITION 23 EXTRA EXPENSE — BROADENED COVERAGE 10 GLASS REPAIR — WAIVER OF DEDUCTIBLE 15 HIRED AUTO PHYSICAL DAMAGE (including employee hired auto and loss of use) 6 HIRED AUTO COVERAGE TERRITORY 20 LOAN / LEASE GAP 14 PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) 16 PERSONAL EFFECTS COVERAGE 11 PHYSICAL DAMAGE —ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8 RENTAL REIMBURSEMENT 9 SUPPLEMENTARY PAYMENTS 4 TOWING AND LABOR 7 TWO OR MORE DEDUCTIBLES 17 UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 18 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 20 SECTION II — LIABILITY COVERAGE is amended as follows: 1. BROAD FORM INSURED SECTION 11 — LIABILITY COVERAGE, paragraph A.I. —WHO IS AN INSURED is amended to include the following as an insured: d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period. However, "insured" does not include any organization that. (1) Is a partnership or joint venture; or (2) Is an insured under any other automobile policy; or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture, of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self -insured retention plan available to that organization; 0 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7 (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow, but only for acts within the scope of their employment by you. Insurance provided by this endorsement is excess over any other insurance available to any "employee". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II - LIABILITY COVERAGE, paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: h. Any person or organization with respect to the operation, maintenance or use of a covered "auto', provided that you and such person or organization have agreed in a written contract, agreement, or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person or organization is an "insured". (1) Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, paragraphs (2) and (4) are replaced by the following. (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including actual loss of earnings up to $500 a day because of time off from work. S. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule, or similar protection, the following provision is added. - SECTION II - LIABILITY, exclusion B.S. FELLOW EMPLOYEE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. SECTION III - PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE, is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto" you own, then the Physical Damage coverages provided are extended to "autos": a. You hire, rent or borrow; or ® 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 7 b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of: (1) $50,000; or (2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. B. The deductible will be equal to the largest deductible applicable to any owned 'auto" for that coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. D. Subject to a maximum of $1,000 per "accident", we will also cover the actual loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss. E. This coverage extension does not apply to: (1) Any "auto" that is hired, rented or borrowed with a driver; or (2) Any "auto" that is hired, rented or borrowed from your "employee". For the purposes of this provision, SECTION V — DEFINITIONS is amended by adding the following: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. 7. TOWING AND LABOR SECTION III — PHYSICAL DAMAGE COVERAGE, paragraph A.2. Towing, is amended by the addition of the following: We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is disabled: a. For private passenger type vehicles, we will pay up to $50 per disablement. b. For "light trucks", we will pay up to S50 per disablement. "Light trucks" are trucks that have a gross vehicle weight (GVW) of 10,000 pounds or less. C. For "medium trucks" , we will pay up to $150 per disablement. "Medium trucks" are trucks that have a gross vehicle weight (GVW) of 10,001 — 20,000 pounds. However, the labor must be performed at the place of disablement. 8. PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a., Coverage Extension of SECTION III — PHYSICAL DAMAGE COVERAGE, is amended to provide a limit of S50 per day and a maximum limit of $1,500 9 2013 Liberty Mutual Insurance CA 88 10 0113 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 9. RENTAL REIMBURSEMENT SECTION III — PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: a. We will pay up to S75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident" or `loss", to an "auto" for which we also pay a "loss' under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those expenses incurred after the first 24 hours following the "accident" or "loss" to the covered "auto." b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than S75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. C. We will also pay up to $500 for reasonable and necessary expenses Incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage does not apply unless you have a business necessity that other "autos" available for your use and operation cannot fill. e. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4. Coverage Extension. f. No deductible applies to this coverage. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11. 10. EXTRA EXPENSE - BROADENED COVERAGE Under SECTION III — PHYSICAL DAMAGE COVERAGE, A. COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000. 11. PERSONAL EFFECTS COVERAGE A. SECTION III — PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen., we will pay, without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance. B. SECTION V — DEFINITIONS is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible property that is wom or carried by an insured." "Personal effects" does not include tools, equipment, jewelry, money or securities. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION III — PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the following: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other coverage or warranty. 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III — PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclusions 4.c. and 4.d. is deleted and replaced with the following: 0 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes coppighted material of Insurance Services Office. Inc., witti its perrni5siurl. Page 4 Of 7 Exclusion 4.c. and 4.d. do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto" and physical damage coverages are provided for the covered "auto"; or If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a S 100 deductible. 14. LOAN / LEASE GAP COVERAGE A. Paragraph C., LIMIT OF INSURANCE of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a "total loss' to a covered "auto" owned by or leased to you in any one "accident" is the greater of the: 1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the "loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the "loss", b. Financial penalties imposed under a lease due to high mileage, excessive use or abnormal wear and tear, C. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, e. Final payment due under a "Balloon Loan", f. The dollar amount of any unrepaired damage which occurred prior to the "total loss' of a covered "auto", g. Security deposits not refunded by a lessor, h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto", I. Any amount representing taxes, J. Loan or lease termination fees; or 2. The actual cash value of the damage or stolen property as of the time of the "loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss". This adjustment is not applicable in Texas. B. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto" that incurred the loss serves as collateral, or lease written on the covered "auto" that incurred the loss. C. SECTION V - DEFINTIONS is changed by adding the following: As used in this endorsement provision, the following definitions apply: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. Q 2013 Liberty Mutual Insurance CA 88 10 01 13 includes copyrighted material of Insurance Services Office. Inc., with Its permission. Page 5 of 7 15. GLASS REPAIR - WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION III — PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: No deductible applies to glass darnage if the glass is repaired rather than replaced. 16. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION III — PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible does not apply to loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is: a. In the charge of an "insured"; b. Legally parked, and C. Unoccupied. The "loss" must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or organization engaged in the automobile business. 17. TWO OR MORE DEDUCTIBLES Under SECTION III PHYSICAL DAMAGE COVERAGE, if two or more company policies or coverage forms apply to the same accident, the following applies to paragraph D. Deductible: a. If the applicable Business Auto deductible is the smaller (or smallest) deductible it will be waived, or b. If the applicable Business Auto deductible is not the smaller (or smallest) deductible it will be reduced by the amount of the smaller (or smallest) deductible; or C. If the loss involves two or more Business Auto coverage forms or policies the smaller (or smallest) deductible will be waived. For the purpose of this endorsement company means any company that is part of the Liberty Mutual Group. SECTION IV — BUSINESS AUTO CONDITIONS is amended as follows: 18. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV- BUSINESS AUTO CONDITIONS, Paragraph 8.2. is amended by adding the following: If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 19. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS SECTION IV -- BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the following: a. In the event of "accident", claim. "suit" or "loss", you must promptly notify us when it is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership, 3. Member, if you are a limited liability company; 4. An executive officer or the "employee" designated by the Named Insured to give such notice. if you are a corporation. 0 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., YAM its permission. Page 6 of 7 To the extent possible, notice to us should include: (1) How, when and where the "accident" or "loss" took place; (2) The "insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 20. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV — BUSINESS AUTO CONDITIONS, paragraph A.S., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has waived those rights before an "accident" or "loss", our rights are waived also. 21. HIRED AUTO COVERAGE TERRITORY SECT ION IV — BUSINESS AU f 0 CONDI T IONS, paragraph B.7., Policy Penod, Coverage Territory, is amended by the addition of the following: f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the insured's responsibility to pay for damages is determined in a "suit", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. SECTION V — DEFINITIONS is amended as follows: 22. BODILY INJURY REDEFINED Under SECTION V — DEFINTIONS, definition C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. COMMMON POLICY CONDITIONS 23. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS, paragraph A.— CANCELLATION condition applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancellation. O 2013 Liberty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 POLICY NUMBER: BAA(18)57695795 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM V With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Effective Date: 12/4/2017 Named Insured: CSG Consultants. Inc.; Precision Inspection-CSG SCHEDULE Name of Person(s) or Organization(s): as required by written contract (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 0 Pallcy ' BAA(18)57695795 COMMERCIAL AUTO CA 88 66 05 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, DESIGNATED INSURED — NONCONTRIBUTING This endorsement modifies insurance provided under the following. BUSINESS AUTO COVERAGE FORM / GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. Schedule Name of Person(s) or Organizatiorl Any entity with respect to a covered "auto" provided that you and such entity have agreed in a written contract, agreement, or permit to add such entity as an "insured". Regarding Designated Contract or Project: NIA Each person or organization shown in the Schedule of this endorsement is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an' insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. The following is added to the Other Insurance Condition: If you have agreed in a written agreement that this policy will be primary and without right of contribution from any insurance in force for an Additional Insured for liability arising out of your operations, and the agreement was executed prior to the "bodily injury" or "property damage", then this insurance will be primary and we will not seek contribution from such insurance. 0 2013 Liberty Mutual Insurance. All rights reserved. CA 88 66 05 13 Includes copyrighted material of Insurance Services Office, Inc.. with its permission. Page 1 of 1 Policy# BAA(18)57695795 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF CANCELLATION PROVISIONS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM GARAGE COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the policy apply unless modified by this endorsement. Any term or provision of the Cancellation Conditions of the policy or any endorsement emending or replacing such Conditions is amended by the following: If you have agreed in a written contract or written agreement to provide a person or organization notice of cancellation we agree to the following: a. Provide a 30 days prior written cancellation notice to such persons or organization for reasons other than nonpayment of premium, but only if we are provided with a schedule of persons or organizations with whom you have agreed to provide notification more than 30 days before the cancellation is to take effect. As a condition of this endorsement, you must notify your agent of any written contract or agreement where you have agreed to provide notce of cancellation, other than nonpayment of premium, to a specific person or organization. Failure to provide to a person or organization in accordance with the terms of this endorsement shall not extend the effective date of the cancellation or otherwise affect cancellation of the policy as to any insured. CA 88 76 03 14 ® 2013 Liberty Mutual Insurance. All rights reserved. Page 1 of 1 Includes mpydghted material of Insurance Services Office, Inc.. with its permission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 04 10B (Ed. 9-14) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) The additional premium for this endorsement shall be 2% of the total manual premium otherwise due on such remuneration. The minimum premium for this endorsement is $350. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.. v SCHEDULE BLANKET WAIVER Person/Organization Blanket Waiver — Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description Waiver Premium All CA Operations 2935.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below Is required only when this endorsement Is issued subsequent to preparation of the policy.) Endorsement Effective 12/1/17 - Policy No. GSWC821833 Endorsement No. Insured CSG Consultants, Inc. Premium $ Insurance company Berkshire Hathaway Homestate Ins Co WC 99 04 10B (Ed. 9-14) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION - CERTIFICATE HOLDERS (SPECIFIED DAYS) The person(s) or organization(s) listed or described in the Schedule below have requested that they receive written notice of cancellation when this policy is cancelled by us. We will mail or deliver to the Person(s) or Organization(s) listed or described in the Schedule a copy of the written notice of cancellation that we sent to you. If possible, such copies of the notice will be mailed at least 30 days, except for cancellation for non-payment of premium which will be mailed 10 days, prior to the effective date of the cancellation, to the address or addresses of certificate holders as provided by your broker or agent. Schedule Person(s) or Organization(s) including mailing address: All certificate holders where written notice of the cancellation of this policy is required by written contract, permit or agreement with the Named Insured and whose names and addresses will be provided by the broker or agent listed in the Declarations Page of this policy for the purposes of complying with such request. This notification of cancellation of the policy is intended as a courtesy only. Our failure to provide such notification to the person(s) or organization(s) shown in the Schedule will not extend any policy cancellation date nor impact or negate any cancellation of the policy. This endorsement does not entitle the person(s) or organization(s) listed or described in the Schedule above to any benefit, rights or protection under this policy. Any provision of this endorsement that is in conflict with a statute or rule is hereby amended to conform to that statute or rule. All other terms and conditions of this policy remain unchanged. Endorsement Number: 7 Policy Number: PAAEP0008802 Named Insured: CSG Consultants, Inc. This endorsement is effective on the inception date of this Policy unless otherwise stated herein: Endorsement Effective Date: December 4, 2016 00 ML0087 0011 10 Page 1 of 1 lk��-�J CSOCONS-01 A`ORO" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDONYYY) 12/7/2022 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. N 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 License IIIOC36861 CONTACT M911S38 Hill NAME: Aillant Insurance Services, Inc. PHONE FAX INC, no, Eael: (Ale, Meg 560 Mission St 6th FI San Francisco, CA 94105 _ noonEss: MeliSsa.HiIIQellient.Com IMSURER(S) AFFORDING COVERAGE _ MAX INSURERA: Fireman's Fund Insurance Company__ _ _ 21873 INSURED INSURERS:AmericanAutomobile Insurance Company 21849 CSG Consultants INSURERC:National Surety Corporation 21881 550 Pilgrim Dr INSURER D:Pacific Insurance Company, Limited 10046_ Foster City, CA 94404 INSURERS: nnveewr_e¢ CERT!eleATE NUMBER: REVISION NUMBER: vTHIS 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 TYPE OF INSURANCE ADOL1SUBR IBM Vivo pOI�Y NUMBER POLICY EFF POLICY EJfP LaaTB A X COMMERCIAL GENERAL LABILITY EACH OCCURRENCE_ ; 1,005'000 CLAIMS -MADE XJ occuR XU$C032778220 1214/2022 12I4/2023 DAMAGE TO RENTED docunarrcal- 100,000PREMISES(Ea 10,000 MED EXP (Any one person __ l 1,000,000 PERSONAL &ADV INJURY GE_Ni AGGREGATE UNIT APPLIES PER: GENERAL AGGREGATE__ it _ 2,000,000 POLICY X—I jLj LIlLOC PRODUCTS -COMPIOPAGG 2.000,000 OTHER: B COMBINED SINGLE LIMLIMITM 1,000,000 AUTOMOBILE LABILITY (Ea accident)_ s _ X ANY AUTO X SCV013084-22-01 1214/2022 12/412023 BODILY INJURY (Per paamt OWNED AUTOS DONLY AUTOS W�pN�W� SCHEDULED BODILY INJURY (Per _ HAUTOs ONLY MPS PROPERTYeoot) AMAGE — A X UMBRELLA LAB X OCCUR EACH OCCURRENCE 51 00,000 EXCESS LAB CLAIMS -MADE USCO2998922'1 121412022 1214/2023 AGGREGATE 5,000,000 DED I X I RETENTIONS 10,000 C WORKERS COMPENSATION X I PER ERH AND EMPLOYERS' LABILITY YIN X CW023953-22-01 12/4/2022 12/412023 1,000,000 ANY PROPRIETORIPARTNEWEXECUmIE r EL EACH ACCIDENT _ S RMEMN&,EXCLUDED? MIA 1,000,000FNFCo In EL DISEASE - EAEMPLOVEE $_ Ilyes describe under DESCRIPTION OF OPERATIONS tallow E.L. DISEASE - POLICY LIMIT E 1,000,000 p Professional Liab. 83 ON U89503-22 1214/2022 1214/2023 Ded: $50,000; Agg: 5,000,000 D'Retro Date: 1/1/1991 53 ON 0489603.22 12/4/2022 12/412023 Occurrence: 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Atldllional Remarks scha ful, may be aeaehad If more apace is required) Re: Any and all work performed for the City. The City of Palm Springs, its officials, employees and agents are included as additional insureds on Primary & Non-Contibutory basis on GL and are included as additional insureds on Auto per attached endorsements. Waiver of Subrogation on WC per attached endomement. Primary & Non -Contributory wording on Auto, 30 Day Notice of Cancellation to Certholder on GL, Auto & Professional can be requested from Carrier upon contract execution per attached endorsements. CERTIFICATE HOLDER i2prFliuFn CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DEC 2 72022 THE EXPIRATION DATE THEREOF, NOTICE WILL 9E DELIVERED IN City of Palm Springs ACCORDANCE WITH THE POLICY PROVISIONS. 3200 E. Tahquitz Canyon Way Palm Springs, CA 92262 City Hall Reception Desk AUTHORIZED REPRESENTATIVE �� 4, ACORD 25 (2016/03) 0 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: USC032778220 Allianz ill MultiCover® -Without Medical Payments - CIS 7193 03 19 Policy Amendment(s) Commercial General Liability Coverage Form Your Commercial General Liability Coverage Form is revised as follows: 1. Broadened Named Insured A. SECTION II -WHO IS AN INSURED, item 3., is deleted and replaced by the following: 3. Any organization that you own at the inception of this policy, or newly acquire or form during the policy period, and over which you maintain during the policy period majority ownership or majority interest, will qualify as a Named Insured if: a. There is no other similar insurance available to that organization; and b. The first Named Insured shown in the Declarations has the responsibility of placing insurance for that organization; and c. That organization is incorporated or organized under the laws of the United States of America. However: (1) Coverage under this provision 3 is afforded only until the next occurring annual anniversary of the beginning of the policy period shown in the Declarations, or the end of the policy period, whichever is earlier: and (2) Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization; and (3) Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. B. SECTION II -WHO IS AN INSURED, the last paragraph, is deleted and replaced by the following: No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture, or limited liability company that is not shown as a Named Insured in the Declarations. However, this does not apply to a limited liability company that meets all of the conditions in Section II - Who Is An Insured, item 3., above. 2. Additional Insured If an Additional Insured endorsement is attached to this policy that specifically names a person or organization as an additional insured, then this Section 2. Additional Insured does not apply to such person or organization. SECTION II - WHO IS AN INSURED, subsection 2.e., is added as follows: e. Any person or organization is included as an additional insured, but only to the extent such person or organization is legally obligated to pay for bodily injury, property damage or personal and advertising injury caused by your acts or omissions. With respect to the insurance afforded to such additional insured, all of the following additional provisions apply: (1) You have agreed in a written insured contract that such person or organization be added as an additional insured under this policy; (2) The bodily injury, property damage or personal and advertising injury for which said person or organization is legally obligated to pay occurs subsequent to the execution of such insured contract; (3) The most we will pay is the lesser of either the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or the limits of insurance required by the insured contract; (4) The insurance afforded to such additional insured only applies to the extent permitted by law, Policy Number: USC032778220 Allianz ili (5) Such person or organization is an additional insured only with respect to: (a) Their ownership, maintenance, or use of that part of the premises, or land, owned by, rented to, or leased to you, except such person or organization is not an insured with respect to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization; (b) Your ongoing operations performed for that insured; (c) Their financial control of you, except such person or organization is not an insured with respect to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization; (d) The maintenance, operation or use by you of equipment leased to you by such person or organization; (a) Operations performed by you or on your behalf and for which a state or political subdivision has issued a permit, provided such operations are not performed for such state or political subdivision, and are not included within the products -completed operations hazard; or (f) Their liability as a grantor of a franchise to you. (6) This insurance does not apply to bodily injury, property damage, personal and advertising injury, occurrence or offense: (a) Which takes place at a particular premises after you cease to be a tenant of that premises; (b) Which takes place after all work, including materials, parts or equipment furnished in connection with such work to be performed by or on behalf of the additional insured at the site of the covered operations, has been completed; (c) Which takes place after that portion of your work out of which the injury or damage arises has been put to its intended use by any other person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project; or (d) Which takes place after the expiration of any equipment lease to which (4)(d) above applies; (7) With respect to architects, engineers or surveyors, coverage does not apply to bodily injury, property damage or personal and advertising injury arising out of the rendering or failure to render any professional services by or for you, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; or (b) Supervisory, inspection, architectural, or engineering services. These exclusions apply even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the occurrence which caused the bodily injury or property damage, or the offense which caused the personal or advertising injury, involved the rendering of or the failure to render any professional services by or for you. 3. Additional Insured -Vendors If an Additional Insured Vendors endorsement is attached to this policy that specifically names a person or organization as an additional insured, then this Section 3. Additional Insured - Vendors does not apply to that person or organization. Unless the products -completed operations hazard is excluded from this policy, SECTION II - WHO IS AN INSURED, item 21. is added as follows: f. Any vendor of yours is included as an additional insured, but only with respect to bodily injury or property damage caused by your products which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: Policy Number:USC032778220 Allianz ili (1) The insurance afforded such vendor does not apply to: (a) Bodily injury or property damage for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (a) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed by the vendor in full compliance with the manufacturer's written instructions at the vendor's premises in connection with the sale of the product; (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) Bodily injury or property damage arising out of the liability of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. (2) This insurance does not apply to any insured person or organization from whom you have acquired such products or any ingredient, part or container, entering into, accompanying or containing such products; (3) The most we will pay is the lesser of either the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or the limits of insurance required by the contract or agreement; and (4) The insurance afforded to such vendor only applies to the extent permitted by law. 4. Additional Insured -Limited Primary and Noncontributory Provision The following is added as a second paragraph to Section IV Conditions, Condition 4. Other Insurance, following paragraph b.(2): However, if you have added any person, organization or vendor of yours as an additional insured to this policy by way of this MultiCover® endorsement and have agreed in a written insured contract that this insurance is primary and non-contributory with other insurance available to that additional insured, this insurance is primary and we will not seek contribution from such additional insured's other insurance, provided that the additional insured is a Named Insured under such other insurance. 5. Waiver of Subrogation SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 8., is deleted and replaced by the following: 8. Transfer of Rights of Recovery Against Others to Us and Blanket Waiver of Subrogation a. If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after the loss to impair those rights. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. b. If required by a written insured contract executed prior to the occurrence or offense, we waive any right of recovery we may have against any person or organization named in such insured contract, because of payments we make for injury or damage arising out of your operations or your work for that person or organization. Policy Number: USC032778220 6. Cancellation -90 Days Allianz ili Common Policy Conditions endorsement IL0017, A. Cancellation, item 2.b. is deleted and replaced by the following: b. 90 days before the effective date of cancellation if we cancel for any other reason. 7. Liberalization SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added as an additional Condition: Liberalization If we adopt a change in our forms or rules which would broaden the coverage provided by any form that is a part of this policy without an extra premium charge, the broader coverage will apply to this policy. This extension is effective upon the approval of such broader coverage in your state. 8. Fire, Explosion, Sprinkler Leakage, or Lightning Legal Liability Coverage A. SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, the last paragraph, is deleted and replaced by the following: Exclusions c. through n. do not apply to damage by fire, explosion, sprinkler leakage, or lightning to premises while: Rented to you; 2. Temporarily occupied by you with the permission of the owner; or 3. Managed by you under a written agreement with the owner. A separate limit of insurance applies to this coverage as described in Section III - LIMITS OF INSURANCE. B. SECTION III -LIMITS OF INSURANCE, item 6., is deleted and replaced by the following: 6. Subject to 5. above, the Damage to Premises Rented To You Limit shown in the Declarations, for property damage to any one premises while rented to you, or in the case of damage by fire, explosion, sprinkler leakage, or lightning while rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner, is the greater of: a. $1,000,000 Any One Premises; or b. The Damage To Premises Rented To You Limit shown in the Declarations. C. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance, b. Excess Insurance, (1)(a), items (i) and (iii), are deleted and replaced by the following: (i) That is Fire, Explosion, Sprinkler Leakage or Lightning insurance for premises while rented to you, temporarily occupied by you with permission of the owner, or managed by you under a written agreement with the owner; (iii) That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner, or D. SECTION V -DEFINITIONS, 9. Insured Contract, item a., is deleted and replaced by the following: (a) A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, explosion, sprinkler leakage, or lightning to premises while rented to you, temporarily occupied by you with permission of the owner, or managed by you under a written agreement with the owner, is not an insured contract; 9. Damage to Invitees' Automobiles from Falling Trees or Tree Limbs - Limited Coverage Policy Number: USC032778220 Allianz ill This coverage applies to direct physical damage to automobiles owned by invitees subject to all of the following: 1. Provided such damage originates from trees on premises owned, managed, leased or rented by an insured; 2. Coverage applies only to invitees of an insured or an insured's tenant; 3. Such damage is directly caused by wind -driven falling trees or tree limbs; 4. The most we will pay for anyone loss is the lowest of: a. the actual cash value of the damaged automobile as of the time of the loss; or b. the cost of repairing the damaged automobile; or c. the cost of replacing the damaged automobile with another automobile of like kind and quality. Regardless of the number of occurrences, losses or claims, this coverage is subject to a limit of $25,000 in any one policy period; 5. This coverage is not subject to the General Liability General Aggregate Limit; and 6. We will make payments under this coverage without regard to fault. 10. Non -Owned or Chartered Watercraft SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, item g. Aircraft, Auto, or Watercraft, item (2), is deleted and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used for public transportation or as a common carrier; 11. Chartered Aircraft SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, g. Aircraft, Auto Or Watercraft, item (6), is added as follows: (6) An aircraft in which you have no ownership interest and that you have chartered with crew. 12. Coverage Territory - Broadened SECTION V - DEFINITIONS, item 4.a., is deleted and replaced by the following: a. The United States of America (including its territories and possessions), Puerto Rico, Canada, Bermuda, the Bahamas, The Cayman Islands and the British Virgin Islands; 13. Personal and Advertising Injury - Contractual Unless personal and advertising injury is excluded from this policy the following applies: SECTION I - COVERAGES, COVERAGE B, 2. Exclusions, item e., is deleted. 14. Fellow Employee Coverage SECTION II - WHO IS AN INSURED, 2.a., item (1) is deleted and replaced by the following: (1) Personal and advertising injury: However, subsections (a), (b), (c) and (d) of item (1) remain unchanged. 15. Bodily Injury Definition - Broadened SECTION V - DEFINITIONS, 3. Bodily Injury is deleted and replaced by the following: Bodily Injury means bodily injury, sickness or disease sustained by a person including death or mental anguish resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. 16. Expected or Intended Injury -Amendment to Exclusion Policy Number: USC032778220 Al l i an z @ SECTION I. Coverage A Bodily Injury and Property Damage Liability, 2. EXCLUSIONS, a. Expected or Intended Injury, is deleted and replaced by the following: a. Expected or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury or property damage resulting from the use of reasonable force to protect persons or property. 17. Unintentional Failure to Disclose Hazards SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 6. Representations, the following is added: d. If you unintentionally fail to disclose any hazards existing at the inception date of this policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. 18. Supplementary Payments - Increased Limits SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B, items 1.b. and 1.d., are deleted and replaced by the following: b. The cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit, including substantiated loss of earnings up to $500 a day because of time off from work. 19. Duties in the Event of an Occurrence, Offense, Claim or Suit - Amended SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 2.a. is deleted and replaced by the following: (1) You must see to it that we or any licensed agent of ours are notified of a General Liability occurrence or offense which may result in a claim as soon as practicable after it becomes known to: (a) You, if you are an individual; (b) Your partner or member, if you are a partnership or joint venture; (c) Your member, if you are a limited liability company; (d) Your executive officer if you are an organization other than a partnership, joint venture or limited liability company; or (e) Your authorized representative or insurance manager. Knowledge of an occurrence or offense by persons other than those listed above does not imply that those listed above also have such knowledge. (2) To the extent possible, notice should include: (a) How, when and where the occurrence or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the occurrence or offense. 20. Non Employment Discrimination Liability Unless personal and advertising injury is excluded from this policy the following applies: A. SECTION V -DEFINITIONS, 14. Personal and advertising injury, item h. is added as follows: h. Discrimination. B. B. SECTION V - DEFINITIONS, item 23. is added as follows: Policy Number: USC032778220 Allianz ili 23. Discrimination means the unlawful treatment of a person or class of persons because of their specific race, color, religion, gender, age, or national origin in comparison to one or more persons who are not members of the specified class. C. SECTION I - COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, 2. Exclusions, the following are added: q. Discrimination directly or indirectly related to the past employment, employment or prospective employment of any person or class of persons by any insured; r. Discrimination directly or indirectly related to the sale, rental, lease or sublease or prospective sale, rental, lease or sublease of any dwelling or permanent lodging by or at the direction of any insured; s. Discrimination, if insurance thereof is prohibited by law; or I. Fines, penalties, specific performance, or injunctions levied or imposed by a governmental entity, governmental code, law, or statute because of discrimination. All other terms and conditions of the policy apply. Policy Number: SC V 013084 22 01 FleetCover® Endorsement — CA 70 18 10 14 Policy Amendment This Endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Broadened Named Insured Section II — Covered Autos Liability Coverage, A. Coverage, 1. Who Is An Insured, the following is added: Any organization you own on the inception of this policy, or newly acquire or form during the policy period, and over which you maintain during the policy period, majority ownership or majority interest will qualify as a Named Insured if: (1) There is no other similar insurance available to that organization; and (2) The first Named Insured shown in the Declarations of this policy has the responsibility of placing insurance for that organization; and (3) The organization is incorporated or organized under the laws of the United States of America. However: (a) Coverage under this provision is afforded only until the next occurring 12 month anniversary of the beginning of the policy period shown in the Declarations, or the end of the policy period, whichever is earlier; and (b) Coverage under this provision does not apply to bodily injury or property damage that results from an accident that occurred before you acquired or formed the organization; and (c) No person or organization is an insured with respect to any current or past partnership, or joint venture that is not shown as a Named Insured in the Declarations; and (d) Coverage under A.(1), (2) and (3) above does not apply to any organization that is covered as an insured under any other automobile liability insurance policy whose limits of insurance have been exhausted or whose insurer has become insolvent. B. Broadened Who Is an Insured 1. Form CAO001 (if attached to this policy), Section II — Covered Autos Liability Coverage, A. Coverage, 1. Who Is An Insured, item b.(2) is deleted, and d. is added as follows: d. Your employee while using his owned auto, or an auto owned by a member of his or her household, in your business or your personal affairs, provided you do not own, hire or borrow that auto. 2. Form CAO020 (if attached to this policy), Section It — Covered Autos Liability Coverage, A. Coveraqe, 1. Who Is An Insured, item b.(2) is deleted, and f. is added as follows: f. Your employee or agent while using his owned private passenger type auto, or a private passenger type auto owned by a member of his or her household, in your business or personal affairs, provided you do not own, hire, or borrow that auto. This form must be attached to Change Endorsement when issued after the policy is written. One of the Allianz Global Risks US Companies as named in the policy. CA701810-14 Page 1 of 10 Copyright @2014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 C. Additional Insured Coverage and Waiver of Subrogation 1. Form CA0001 (if attached to this policy), Section II — Covered Autos Liability Coverage, A. Coverage, 1. Who Is An Insured, the following is added as item e.; and form CA0020 (if attached to this policy), Section 11 — Covered Autos Liability Coverage, A. Coverage, 1. Who Is An Insured; the following is added as item g.: Any person or organization with respect to the operation, maintenance, or use, of a covered auto, provided that you and such person or organization have agreed under an expressed provision in a written insured contract or written agreement, or a written permit issued to you by a governmental or public authority, to add such person, organization, or governmental or public authority to this policy as an insured. However, such person or organization is an insured: (1) Only with respect to the operation, maintenance, or use, of a covered auto; and (2) Only for bodily injury or property damage caused by an accident which takes place after: (a) You executed the insured contract or written agreement; or (b) The permit has been issued to you. 2. Form CA0001 (if attached to this policy), Section IV - Business Auto Conditions, A. Loss Conditions, item 5.; and form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions, A. Loss Conditions, item 6.; the following is added: Waiver of Subrogation If required by a: a. Written insured contract or written agreement executed prior to the accident; or b. Written permit issued to you by a governmental or public authority prior to the accident; we waive any right of recovery we may have against any person or organization named in such contract, agreement or permit, because of payments we make for injury or damage arising out of the ownership, maintenance or use of a covered auto. D. Auto Medical Payments - Increased Limit For each covered auto described in the Declarations or shown in the Schedule as having Auto Medical Payments Coverage, the Medical Payments Limit of Insurance for those autos is revised to the greater of: 1. $5,000; or 2. The limit shown in the Declarations. E. Hired Auto Physical Damage Coverage and Loss of Use Expenses Hired Auto Physical Damage Coverage CA7018 10-14 Page 2 of 10 Copyright ©2014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 If Physical Damage Coverage is provided by this policy on your owned covered autos, the following applies: Any auto that you lease, hire, rent or borrow without a driver, will be covered under this policy for Physical Damage Coverage. However any such auto: 1. Will be covered only for the same Physical Damage Coverage that applies to your owned covered autos; 2. Will be subject to the same applicable deductible shown in the Declarations that applies to your most similar owned covered auto, except any Comprehensive Coverage deductible does not apply to loss caused by fire or lightning; and 3. The most we will pay for any one loss in anyone accident is the lesser of the following: a. Actual cash value of the damaged or stolen property as of the time of the loss as determined by us; or b. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. In addition, we will pay costs and fees associated with such covered loss only for a maximum time period of seven days beginning with the date of loss, subject to a maximum of $500. However: 1. If form CA0001 is attached to this policy, this coverage does not apply to autos you lease, hire, rent or borrow from any of your employees, partners (if you are a partnership), members (if you are a limited liability company) or members of their households; and 2. If form CA0020 is attached to this policy, this coverage does not apply to any private passenger type auto you lease, hire, rent or borrow from any member of your household, any of your employees, partners (if you are a partnership), members (if you are a limited liability company), or agents or members of their households. Hired Auto Loss of Use Expenses Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage, 4. Coverage Extension, b. Loss of Use Expenses; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, 4. Coverage Extension, b. Loss of Use Expenses; is deleted and replaced by the following: b. For Hired Auto Physical Damage, we will pay expenses for which an Insured becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver, under a written rental contract or agreement. We will pay for loss of use expenses if caused by: (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered auto; (2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss is provided for any covered auto; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered auto. CA7018 10-14 Page 3 of 10 Copyright ©2014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of$1,000. F. Coverage Territory - Hired Auto 1. Form CA0001, (if attached to this policy), Section IV - Business Auto Conditions, B. General Conditions, 7. Policy Period, Coverage Territory, b.(5) is deleted and replaced by the following: (5) Anywhere in the world if a covered auto of the private passenger type is leased, hired, rented or borrowed without a driver for a period of 180 days or less, 2. Form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions, B. General Conditions, 7. Policy Period, Coverage Territory, b.(5) is deleted and replaced by the following: (5) Anywhere in the world if a covered auto of the private passenger type is leased, hired, rented or borrowed without a driver for a period of 180 days or less, G. Communication Equipment Coverage Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, C. Limits of Insurance, Paragraph 1.b.; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, C. Limits of Insurance, Paragraph 1.b.; is deleted and replaced by the following: b. All electronic equipment that reproduces , receives or transmits audio, visual or data signals in any one loss is $1,500, if, at the time of loss, such electronic equipment is: H. Tapes, Records, CDs and DVD Coverage The Physical Damage Coverage Section is amended as follows: 1. The exclusion referring to tapes, records, discs, or other similar audio, visual or data electronic devices designed for use with audio, visual or data electronic equipment does not apply. 2. Under Comprehensive Coverage - Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage; and form CA0020 (if attached to this policy), Section IV- Physical Damage Coverage, A. Coverage; the following is added: We will pay for loss to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices: a. Are your property, or that of a family member; and b. Are in a covered auto at the time of a loss. The most we will pay for loss is $250. No deductible applies to this coverage. I. Personal Effects Coverage Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage, 4. Coverage Extensions; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, 4. Coverage Extensions; item c. is added as follows: CA701810-14 Page 4 of 10 Copyright ©2014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 c. Personal Effects Coverage We will pay up to $500 for loss for clothing items or other personal effects that are owned by an insured and are in an Owned auto at the time of a covered loss. Personal Effects do not include audio visual or electronic devices, money, giftcards, securities, jewelry, or tools. This coverage is excess over any other collectible insurance. No deductible applies to this coverage. J. Airbag Coverage 1. Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, B. Exclusions, 3.a.; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, B. Exclusions, 3.a.; the following is added: However, mechanical breakdown does not mean the unintended discharge of an airbag, provided that any loss covered under this provision is excess over any other collectable insurance or warranty designed to cover such unintended discharge. K. Rental Reimbursement Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage, 4. Coverage Extensions; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, 4. Coverage Extensions; item d. is added as follows: d. Rental Reimbursement or Transportation Expenses If loss occurs to a covered auto described or designated in the Declarations or Schedule and covered for Physical Damage Coverage, we will pay for rental expenses for the rental of a similar replacement auto and additional transportation expenses, incurred by you. This payment applies in addition to the otherwise applicable amount of each coverage you have on the covered auto. No deductible applies to this coverage. However: (1) We will pay only for those expenses incurred by you that begin 24 hours after the covered loss. (2) We will cease paying for those expenses, regardless of the policy's expiration date, at the earlier of the following dates: (a) The number of days reasonably required to repair or replace the covered auto. If loss is caused by theft, this number of days is added to the number of days it takes to locate and return the covered auto to you; or (b) 45 days from the date this coverage begins. (3) Our payment is limited to the lesser of the following amounts: (a) Necessary and actual expenses incurred by you; or (b) $1.500. (4) This coverage does not apply while there are spare or reserve autos available to you for CA701e 10-14 Page 5 of 10 Copyright ©2014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 your operations. (5) If loss results from the total theft of a covered private passenger type auto (if CA0020 is attached to this policy), or a covered private passenger auto (if CA0001 is attached to this policy), we will pay under this coverage only that amount of your covered rental expenses or additional transportation expenses which are not already provided for under the Physical Damage Coverage Extensions. L. Extended Towing Coverage 1. Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage, 2. Towing, is deleted and replaced by the following: 2. Extended Towing We will pay up to $750 per disablement for towing and labor costs you incur each time your covered auto is disabled. However: a. All labor must be performed at the place of disablement; and b. If the covered auto is of the private passenger type, no deductible applies; and c. If the covered auto is not of the private passenger type, our obligation to pay will be reduced by a $250 deductible per disablement. d. If the covered auto is not of the private passenger type and the disablement results from a loss covered under Section III - Physical Damage Coverage, A. Coverage, Paragraphs 1, a., b., or c., there is no separate deductible for the Extended Towing Coverage. For purposes of this coverage, disablement means a breakdown of the covered auto including mechanical breakdown, engine failure, or tire blowout, where re- pairs cannot be made roadside and a tow is required to remove the auto from the roadway and to seek additional services and repair. 2. Form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, 2. Towing - Private Passenger Autos, is deleted and replaced by the following: 2. Extended Towing We will pay up to $750 per disablement for towing and labor costs you incur each time your covered auto is disabled. However: a. All labor must be performed at the place of disablement; and b. If the covered auto is of the private passenger type no deductible applies; and c. If the covered auto is not of the private passenger type our obligation to pay will be reduced by a $250 deductible per disablement. d. If the covered auto is not of the private passenger type and the disablement results from a loss covered under Section III - Physical Damage Coverage, A. Coverage, Paragraphs 1, a., b., or c., there is no separate deductible for the Extended Towing Coverage. For purposes of this coverage, disablement means a breakdown of the covered auto CA7018 10-14 - Page 6 of 10 Copyright ©2014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 including mechanical breakdown, engine failure, or tire blowout, where repairs cannot be made roadside and a tow is required to remove the auto from the roadway and to seek additional services and repair. M. Cancellation - 120 Days Notice If we cancel this policy for any reason other than nonpayment of premium, we will mail or deliver to the first Named Insured at the last mailing address known to us, written notice of cancellation at least 120 days prior to the effective date of cancellation. N. Supplementary Payments - Increased Limits Section II - Liability Coverage, 2. Coverage Extensions, a. Supplementary Payments, items (2) and (4) are deleted and replaced by the following: (2) Up to $2,500 for the cost of bail bonds (including bonds for related traffic law violations) required because of an accident we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including substantiated loss of earnings up to $500 a day, because of time off from work. O. Duties in the Event of Accident, Claim, Suit or Loss - Amended Form CA0001 (if attached to this policy) Section IV - Business Auto Conditions, A. Loss Conditions, item 2. a.; and form CA0020 (if attached to this policy) Section V - Motor Carrier Conditions, A. Loss Conditions, item 2. a.; is deleted and replaced by the following: a. In the event of accident, claim, suit or loss, you must promptly notify us or our authorized representative when it becomes known to: (1) You, if you are an individual; (2) Your partner or member, if you are a partnership or joint venture; (3) Your member, if you are a limited liability company; (4) Your executive officer if you are an organization other than a partnership, joint venture or limited liability company; or (5) Your authorized representative or insurance manager. Knowledge of an accident, claim, suit or loss by other persons does not imply that the persons listed above have such knowledge. Notice should include: (1) How, when and where the accident or loss occurred; and (2) The insured's name and address; and (3) To the extent possible, the names and address of any injured persons and witnesses. P. Unintentional Failure to Disclose Hazards Form CA0001 (if attached to this policy), Section IV - Business Auto Conditions, B. General CA701810-14 Page 7 of 10 Copyright 02014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 Conditions, item 2.; and form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions, B. General Conditions, item 2.; the following is added: However, if you unintentionally fail to disclose any hazards existing at the inception date of this policy, we will not deny coverage under this Coverage Form because of such failure. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. Q. Fellow Employee Coverage Section II - Liability Coverage, B. Exclusions, 5. Fellow Employee, the following is added: However, this exclusion does not apply if the bodily injury results from the use of a covered auto you own or hire, and provided that any coverage under this provision only applies in excess over any other collectible insurance. R. Limited Mexico Coverage WARNING AUTO ACCIDENTS IN MEXICO ARE SUBJECT TO THE LAWS OF MEXICO ONLY - NOT THE LAWS OF THE UNITED STATES OF AMERICA. THE REPUBLIC OF MEXICO CONSIDERS ANY AUTO ACCIDENT A CRIMINAL OFFENSE AS WELL AS A CIVIL MATTER. IN SOME CASES THE COVERAGE PROVIDED HERE MAY NOT BE RECOGNIZED BY THE MEXICAN AUTHORITIES AND WE MAY NOT BE ALLOWED TO IMPLEMENT THIS COVERAGE AT ALL IN MEXICO. YOU SHOULD CONSIDER PURCHASING AUTO COVERAGE FROM A LICENSED MEXICAN INSURANCE COMPANY BEFORE DRIVING IN MEXICO. THIS ENDORSEMENT DOES NOT APPLY TO ACCIDENTS OR LOSSES WHICH OCCUR OUTSIDE OF 25 MILES FROM THE BORDER OF THE UNITED STATES OF AMERICA. Form CA0001 (if attached to this policy), Section IV - Business Auto Conditions, B. General Conditions, item 7.; and form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions, B. General Conditions, item 7.; the following is added: The coverage territory is extended to include Mexico, but only: a. For accidents or losses occurring within 25 miles of the United States border; and b. For trips into Mexico of 10 days or less; and c. If the covered auto is principally garaged and principally used in the United States; and d. If the insured is a resident of the United States. If a loss to a covered auto occurs in Mexico, we pay for such loss in the United States. If the covered auto must be repaired in Mexico in order to be driven, we will not pay for more than the actual cash value of such loss as determined by us at the nearest United States point where the repairs can be made. Any insurance provided under this provision will be excess over any other collectible insurance. CA701810-14 Page 8 of 10 Copyright ©2014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 S. Extended Glass Coverage Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage, item 3.a.; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, item 3.a.; is deleted and replaced by the following: a. Glass breakage. If glass must be replaced, the deductible will be $100 or the deductible shown in the Declarations, whichever is less. If glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced. T. Broadened Definition of Bodily Injury Form CA0001 (if attached to this policy), Section V - Definitions, item C.; and Form CA0020 (if attached to this policy), SECTION VI - DEFINITIONS, item C.; is deleted and replaced by the following: C. Bodily Injury means bodily injury, sickness or disease sustained by a person including death or mental anguish resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. U. Customer Lease or Loan Physical Damage Coverage Extension Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, C. Limit Of Insurance; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, C. Limits Of Insurance; item 4. is added as follows: 4. If your covered owned auto is: (1) Shown in the Schedule and designated as covered for Physical Damage Coverage; and (2) Shown in this policy as having a loss payee or additional -insured -lessor; and (3) Incurs a covered total loss; we will pay the greater of: (a) The actual cash value, as determined by us, of the damaged or stolen property as of the time of the total loss; or (b) The outstanding indebtedness under the initial finance agreement for the covered auto and its equipment. As used here, outstanding indebtedness means the amount you owe on the finance agreement at the time of total loss: (i) Less any amounts representing taxes, overdue payments, penalties, interest, or charges resulting from overdue payments, additional mileage, excess wear and tear, or lease termination fees; and (ii) Less any administrative costs or overhead fees assessed by the finance company who has leased the covered auto to you; and (iii) Less security deposits not returned by the lessor; and (iv) Less costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and CA701807-17 Page 9 of 10 Copyright © 2017 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 (v) Less carry-over balances from previous loans or leases. V. Two or More Deductibles 1. Section III - Physical Damage Coverage, D. Deductible, of form CA0001 (if attached to this policy), the following is added: If another Allianz Global Risks US Insurance Company policy or coverage form that is not an automobile policy or coverage form applies to the same accident or loss, the following applies: (1) If the deductible under this Business Auto Coverage Form is the lesser of (or least) deductible, it will be waived. (2) If the deductible under this Business Auto Coverage Form is not the lesser, (or least) deductible, it will be reduced by the amount of the lesser (or least) deductible. 2. Section IV - Physical Damage Coverage, D. Deductible, of form CA0020 (if attached to this policy), the following is added: If another Allianz Global Risks US Insurance Company policy or coverage form that is not an automobile policy or coverage form applies to the same accident or loss, the following applies: (1) If the deductible under this Business Auto Coverage Form is the lesser of (or least) deductible, it will be waived. (2) If the deductible under this Business Auto Coverage Form is not the lesser, (or least) deductible, it will be reduced by the amount of the lesser (or least) deductible. All other terms and conditions of the policy remain unchanged. CA701807-17 Page 10 of 10 Copyright © 2017 Allianz Global Risks US Insurance Company. All rights reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.00% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Blanket Waiver of Subrogation as required by written contract. Associated Job Premium This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 12/0412022 Insured CSG Consultants, Inc. WC 04 03 06 (Ed. 04-84) Policy No. SCW0239532201 Endorsement No. Insurance Company National Surety Premium Corporation Countersigned By CSGCONS-01 CSPANGLER2 A`ORO CERTIFICATE OF LIABILITY INSURANCE �(pG� D11/29/202ATE YYI � v29r2o2a 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 poticy(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 endorsements . PRODUCER License # OC36861 CONTACT NAA1E: Alliant Insurance Services, Inc. PHONWo. 415 946-7500 W 560 Mission St 6th FI t Ems= (— ----- (A/C, San Francisco, CA 94105 AJL ADORES -_ INSURER(S) AFFORDING COVERAGE NAIC• INSURER A: General Casualty Co of WI (QBE) 24414 INSURED INSURER B : North Pointe Insurance Comlpany_ 27740 CSG Consultants INSURER QBE Insurance COrporaUon 39217 550 Pilgrim Dr INSURER D: Praetorian Insurance Comoanv 37257 Foster City, CA 94404 INSURER E : 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 TYPE OF INSURANCE AOOL SUER _ —POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY IEACH OCCURRENCE $ 1,000'000 CLAIMSMADE , occuR CGA1414883 12/4/12023 12J412024 DAMAGE TO RENTED 1,000,000 X PREMISES1Ea occu n $ __ GENL AGGREGATE LIMB APPLIES PER: POLICY-1 (�X I LOC OTHER: AUTOMOBILE LIABILITY X ANY AUTO X 161001088 12/4/2023 12/4/2024 OWNED SCHEDULED AUTOS ONLY AUTNOpSyyNEp AUTOS ONLY RUA ONLY I X UMBRELLALW9 X. OCCUR ExCES3LIAB CLAIMS -MADE 191000608 12/4/2023 121412024 _ nED X RETENTION$ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN X 152000753 12/4/2023 12/412024 ANY PROPRIETORIPARTNER(EXECUnVE KFICER'MEMBER EXCLUDED? n NIA andatory in NH) If yes, describe under i DESCRIPTION OF OPERATIONS below MED, EXP one person) PERSONAL & ADV INJURY GENERALAGGREGATE_ PRODUCTS - COMP/OF AG $ 10,000 $ 1,000,000 $ 2,000,000. COMBINED SINGLE LIMIT (Ea accide ll) — $ BODILY INJURY (Per person) $ 80DILY INJURY (Per accident). $ PROPERTY AMAGE (Per accident $ AGGREGATE Aggregate STAT IUTE E.L. EACH ACC EA DESCRIPTION OF OPERATIONS ( LOCATIONS I VEHICLES tACORO 101, Additional Remarks Schedule, may be attached H more space is required) te: Any and all work performed for the City. The City of Palm Springs, its officials, employees and agents are included as additional insureds on Primary & ion-Contibutory basis on GL and are included as additional insureds on Auto per attached endorsements. Waiver of Subrogation on WC per attached Indorsement. Primary & Non -Contributory wording on Auto, 30 Day Notice of Cancellation to Certholder on GL, Auto & Professional can be requested from :artier upon contract execution per attached endorsements. FE HOLDER CANCELLATION RECEIVED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cit of Palm Springs C((� �y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3200 E. Tahqu tz Canyon Way OEC 11 2023 ACCORDANCE WITH THE POLICY PROVISIONS. Palm Springs, CA 92262 City Hall AUTHORIZED REPRESENTATIVE Reception Desk C�o (Q- ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: CGA1414883 COMMERCIAL GENERAL LIABILITY CG 82 24 0512 PREMIER GENERAL LIABILITY COVERAGE EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. REASONABLE FORCE g. Aircraft, Auto Or Watercraft Paragraph 2.a. Expected or Intended Injury under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I — COVERAGES within the COMMERCIAL GENERAL LIABILITY. COVERAGE FORM is replaced by: a. Expected or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the in- sured. This exclusion does not apply to "bodi- ly injury" or"property damage" resulting from the use of reasonable force to protect any person'or property. B. CONTRACTUAL LIABILITY Paragraph 2.b. Contractual Liability under COVERAGE A. BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY of SECTION I — COVERAGES within the COMMERCIAL GEN- ERAL LIABILITY COVERAGE FORM is replaced by: b. Contractual Liability "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a con- tract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have had in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract', provided the "bodily injury" or "property damage" oc- curs subsequent to the execution of the contract or agreement. (2) A watercraft you do not own that is: (a) less than 75 feet long; and (b) Not being used to carry persons or property for a charge. D. ELECTRONIC DATA LIABILITY 1. Paragraph 2.p. Electronic Data under COV- ERAGEA. BODILY INJURYANDPROPERTY DAMAGE LIABILITY of SECTION I — COV- ERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "elec- tronic data" that does not result from physical injury to tangible property. However, this exclusion does not apply to liability for damages because of "bodily injury". 2. The following definition is added to SEC- TION V — DEFINITIONS: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 3. For purposes of the coverage provided for "Electronic Data", Paragraph 17. in SEC- TION V — DEFINITIONS is replaced by: 17. "Property damage" means: C. NON OWNED WATERCRAFT a. Physical injury to tangible property, Paragraph 2.g.(2) in the Aircraft, Auto Or Wa- including all resulting loss of use of tercraft exclusion under COVERAGE& BODILY that property. All such loss of use INJURY AND PROPERTY DAMAGE LIABILITY shall be deemed to occur at the time of SECTION I — COVERAGES within the COM- of the physical injury that caused it; or MERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: Includes copyrighted material of Insurance Services Office, Inc., CG 82 24 0512 with its permission. Page 1 of 6 Policy Number: CGA1414883 b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it; or c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "elec- tronic data", resulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For purposes of this insurance, "electron- ic.data" is not tangible property. E. DAMAGE TO PREMISES RENTED TO YOU 1. The last paragraph after the listed exclusions under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SEC- TION I — COVERAGES within the COM- MERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: Exclusions c. through n. do not apply to "property damage" by fire; smoke from a "hostile fire"; explosion; lightning; smoke re- sulting from such explosion or lightning; colli- sion by "mobile equipment" or leakage from fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as de- scribed in SECTION III — LIMITS OF IN- SURANCE. 2. Paragraph 6. of SECTION III — LIMITS OF INSURANCE within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: 6. Subject to Paragraph 5. above, the Dam- age To Premises Rented To You Limit is the most we will pay in any one event un- der COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE for damages because of "property damage" from fire; smoke from a "hostile fire"; explosion; lightning; smoke resulting from such ex- plosion or lightning; collision by "mobile equipment" or leakage from fire protection systems to premises while rented to you or temporarily occupied by you with per- mission of the owner. F. MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as de- scribed below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations: Provided that: (a) The accident takes place in the "coverage territory" and during the policy period; (b) The expenses are incurred and reported to us within three years of the date of the accident; and (c) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonable require. G. SUPPLEMENTARY PAYMENTS SUPPLEMENTARY PAYMENTS — COVERAG- ES A AND B of SECTION I COVERAGES within the COMMERCIAL GENERAL LIABILITY COW ERAGE FORM is replaced by: 1. We will pay, with respect to any claim we Investigate or settle, or any "suit" against an insured we defend: a. All expenses we incur. b. Up to $5,000 for cost of bail bonds re- quired because of accidents or traffic law violations arising out of the use of any vehicletowhich the Bodily Injury Liability Coverage applies. We do not have to fur- nish these bonds. c. The cost of bonds to release attach- ments, but only for bond amounts within the applicable limit of insurance. We do have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. e. All costs taxed against the "insured" in any "suit". 1. Paragraph 1.a. under COVERAGE f. Prejudgment interest awarded against the C. MEDICAL PAYMENTS of SECTION 1 — insured on that part of the judgment we COVERAGES within the COMMERCIAL pay. If we make an offer to pay the appli- GENERAL LIABILITY COVERAGE FORM is cable. limit of insurance, we will not pay replaced by: any prejudgment interest based on that period of time after the offer. Includes copyrighted material of Insurance Services:Office, Inc., Page 2 of 6 with its permission. CG 82 24 0512 Policy Number: CGA1414883 g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, of- fered to pay, or deposited in court the part of the judgment that is within the applica- ble limit of insurance. These payments will not reduce the limits of insurance. 2. If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the "suit", we will defend that indem- nitee if all of the following conditions are met: a. The "suit" against the indemnitee seeks damages for which the insured has as- sumed the liability of the indemnitee in a contractor agreement that is an "insured contract'; b. This insurance applies to such liability as- sumed by the insured; c. The obligation to defend, or the cost of the defense of, that indemnitee, has also been assumed by the insured in the same "insured contract"; d. The allegations in the "suit" and the in- formation we know about the "occur- rence" are such that no conflict appears to exist between the interests of the in- sured and the interests of the indemnitee; e. The indemnitee and the insured ask us to conduct and control the defense of that in- demnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee; and f. The indemnitee: (1) Agrees in writing to: (a) Cooperate with us in the investi- gation, settlement or defense of the "suit"; (b) Immediately send us copies of any demands, notices, sum- monses or legal papers received in connection with the "suit"; (c) Notify any other insurer whose coverage is available to the in- demnitee; and (d) Cooperate with us with respect to coordinating other applicable insurance available to the in- demnitee; and (2) Provides us with written authoriza- tion to: (a) Obtain records and other infor- mation related to the "suit": and (b) Conduct and control the defense of the indemnitee in such "suit". Our obligation to defend an insured's in- demnitee and to pay for attorneys' fees and necessary litigation expenses as Supplementary Payments ends when we haw used up the applicable limit of in- surance in the payment ofjudgments or settlements or the conditions set forth above, or the terms of the agreement de- scribed in Paragraph f. above, are no longer met. H. FELLOW EMPLOYEE COVERAGE — SUPERVISOR OR HIGHER Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM does not apply to the following: Yoursupervisory or management "employees" for "bodily injury" only. Damages owed to an injured co -"employee" or "wlunteerworker"will be reduced by any amount paid or available to the injured co -"employee" or "volunteer worker' under any other valid and collectible insurance. I. NEWLY ACQUIRED ORGANIZATIONS Paragraph 3.a. of SECTION II — WHO IS AN INSURED within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: a. Cowrage underthis provision is afforded only until the end of the current policy period. J. BROAD FORM NAMED INSURED The following is added to SECTION II — WHO IS AN INSURED within the COMMERCIAL GEN- ERAL LIABILITY COVERAGE FORM: Throughout this policy the words "you" and "your' refer to any corporation or other business organi- zation, otherthan ajoint venture, in which the first Named Insured has or acquires during the policy period an ownership interest of more than 50% and is subject to the management control -of the first Named Insured or its subsidiaries, and which is domiciled within the United States of America or its territories or possessions. K. AMENDMENT OF AGGREGATE LIMIT OF INSURANCE The General Aggregate Limit Of Insurance refer- enced in Paragraph 2. of SECTION III — LIMITS OF INSURANCE within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM applies separately to: 1. Each of your "locations" owned by or rented to you; and Includes copyrighted material of Insurance Services Office, Inc., CG 82 24 05 12 with its permission. Page 3 of Policy Number. CGA1414883 2. Each of your projects away from premises owned by or rented to you. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. L. KNOWLEDGE OF OCCURRENCE The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: Knowledge of an "occurrence", offense, claim or. "suit" by your agent, servant or "employee" shall not be considered knowledge by you unless you, your insurance manager or any other person you designate has received notice of the 'occur- rence", offense, claim or "suit' from your agent, servant, or "employee." M. OTHER INSURANCE Paragraph 4.b.(1)(a) in the Other Insurance condition of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: 4. Other Insurance b. Excess Insurance (1) This insurance is excess over. (a) any of the other insurance, whether primary, excess, contin- gent or on any other basis: (1) That is Fire, Extended Cov- erage, Builders Risk; Installa- tion Risk or similar coverage for "your work'; (ii) That is insurance covering Fire; smoke from a "hostile fire"; explosion; lightning; smoke resulting from such explosion or lightning; colli- sion by "mobile equipment' or leakage from fire protec- tion systems for premises while rented to you or tempo- rarily occupied by you with permission of the owner, or (III) That is insurance to cover your liability as a tenant for "proper- ty damage" to premises while rented to you or temporarily occupied by you with permis- sion of the owner, or (iv) If the loss arises out of the maintenance or use of aircraft, "autos", or watercraft to the extent not subject to Para- graph 2.g. Aircraft, Auto Or Watercraft under COVER- AGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY of SECTION I — COVERAGES within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM. N. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following is added to -,Paragraph 6. Representations of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: Any unintentional failure to disclose all exposures or hazards existing as of the effective date of the Commercial General Liability Coverage Form or at any time during the policy period will not invali- date or adversely affect the coverage for such exposure or hazard. However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after the exposure or hazard is discovered. O. WAIVER OF SUBROGATION The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMER- CIAL GENERAL LIABILITY COVERAGE FORM: This condition does not apply to any person or organization to which you waived this condition by written contract or agreement, but only to the extent that subrogation is waived prior to the "bodily injury" or "property damage" under a contract with that person or organization. P. LIMITED WORLDWIDE LIABILITY COVERAGE The following is added to SECTION IV — CON- DITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 6 with its permission. CG 82 24 0512 Policy Number: CGA1414883 Expanded Coverage Territory 1. If a "suit" is brought in a part of the "coverage territory" that is outside the United States of America (including its territories and posses- sions), Puerto Rico or Canada, and we are prevented by law, or otherwise, from defend- ing the insured, the insured will initiate a de- fense of the "suit". We will reimburse the in- sured, under Supplementary Payments, for any reasonable and necessary expenses in- curred -for the defense of a "suit" seeking damages to which this insurance applies, that we would have paid had we been able to ex- ercise our right and duty to defend. If the insured becomes legally obligated to pay sums because of damages to which this insurance applies in a part of the "coverage territory" that is outside the United States of America (including its territories and posses- sions), Puerto Rico or Canada, and we are prevented by law, or otherwise, from paying such sums on the insured's behalf, we will re- imburse the insured for such sums. 2. All payments or reimbursements we make for damages because of judgments or settle- ments will be made in U.S. currency at the prevailing exchange rate at the time the in- sured became legally obligated to pay such sums. All payments or reimbursements we make for expenses under Supplementary Payments will be made in U.S. currency at the prevailing exchange rate at the time the expenses were incurred. 3. Any disputes between you and us as to whether there is coverage under this policy must be filed in the courts of the United States of America (including its territories and possessions), Puerto Rico or Canada. 4. The insured must fully maintain any coverage required by law, regulation or other governmen- tal authority during the policy period, except for reduction of the aggregate limits due to pay- ments of claims, judgments or settlements. Failuretomaintain such coverage required by law,' regulation or other governmental authori- ty will not invalidate this insurance. However, this insurance will apply as if the required coverage by law, regulation or other govern- mental authority was in full effect. For purposes of this coverage only, the following is added to Paragraph 4.b.(1)(a) under Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM: If the insured's liability to pay damages is deter- mined in a "suit" brought outside the United States of America (including its territories and possessions), Puerto Rico or Canada; or That is coverage required by law, regulation or other governmental authority in a part of the "coverage territory" that is outside the United States of America (including its territories and possessions), Puerto Rico or Canada. For purposes of this coverage only, Paragraph 4. of SECTION V — DEFINITIONS within the COMMERCIAL GENERAL LIABILITY COVER- AGE FORM is replaced by: 4. "Coverage territory" means anywhere in the world with the exception of any country or j u- risdiction which is subject to trade or other economic sanction or embargo by the United States of America. Q. BODILY INJURY REDEFINITION Paragraph 3. of SECTION V. — DEFINITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish, injury or illness or emotional distress and/or death resulting from any of these at any time. R. INSURED CONTRACT --LEASE OF PREMISES Paragraph 9.a. of SECTION V — DEFINITIONS within the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by: 9. "Insured contract" means: a. a contract for lease of premises. Howev- er, that portion of the contract for a lease of premises that indemnifies any person or organization for "property damage" by fire; smoke from a "hostile fire", explo- sion; lightning; smoke resulting from such explosion or lightning; collision by "mobile equipment" or leakage from fire protection systems to premises while rented to you or temporarily occupied by you with per- mission of the owner is not an "insured contract". S. LIBERALIZATION If we revise this endorsement to provide more coverage without additional premium charge, your policy will automatically, provide the coverage as of the day the revision is effective in your state. Includes copyrighted material of Insurance Services Office, Inc., CG 82 24 0512 with its permission. Page 5 of 6 Policy Number: CGA1414883 T. GOOD SAMARITAN SERVICES 1. Under SECTION II —WHO IS AN INSURED, paragraph 2.d., the following is added: This exclusion does not apply to your em- ployees or volunteer workers, other than an employed or volunteer physician, rendering "Good Samaritan services". 2. The following definition is added to SECTION V — DEFINITIONS: "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. Includes copyrighted material of Insurance Services Office, Inc.; Page 6 of 6 with its permission. CG 82 24 0512 Policy Number: CGA1414883 COMMERCIAL GENERAL LIABILITY CG 8102 08 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CONTRACTORS BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization (called additional insured) whom you are required to add as an additional insured on this policy under a written contract or written agreement; but the written contract or written agreement must be: 1. Currently in effect or becoming effective during the term of this policy; and 2. Executed prior to the "bodily. injury", "property damage" or "personal and advertising injury". B. The insurance provided to the additional insured is limited as follows: 1. That person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf. in the performance of your operations for the additional insured. 2. The Limits of Insurance applicable to the additional insured are those specified in the written contract or written agreement or in the Declarations of this policy, whichever is less. These Limits of Insurance are inclusive of, and nofin addition to, the -Limits of Insurance shown in the Declarations. 3. The coverage provided to the additional insured by this endorsement and paragraph f. of the definition of "insured contract" under DEFINITIONS (SECTION V) do not apply to "bodily injury" or "property damage" arising out of the "products -completed operations hazard" unless required by the written contract or written agreement. 4. The insurance provided to the additional insured does not apply to: "Bodily ' injury", "property damage", or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failure to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and b. Supervisory, inspection, architectural or engineering activities. 5. We have no duty to defend or indemnify an additional insured under this endorsement: a. For any liability due to negligence attributable to any person or entity other than you or those acting on your behalf in the performance of your operations for the additional insured. b. For any loss which occurs prior to our named insured commencing operations at the location of the loss. c. Until we receive written notice of a claim or "suit" from the additional insured as required in the Duties In The Event of Occurrence, Offense Claim or Suit Condition. C. As respects the coverage provided under this endorsement, the COMMERCIAL GENERAL LIABILITY CONDITIONS (SECTION IV) are amended as follows: 1. The following is added to the Duties In The Event of Occurrence, Offense, Claim or Suit Condition: An additional insured under this endorsement will as soon as practicable: Includes copyrighted material of Insurance Services Office Inc., with its permission. CG 8102 08 05 Copyright, Insurance Services Office, Inc. 2002 Page 1 of 2 Policy Number: CGA1414883 (1) Give written notice of an occurrence or an offense to us which may result in a claim or "suit" under this insurance; (2) Agree to trigger or activate any other insurance which the additional insured has, which is primary, for a loss we cover under this Coverage Part by tendering the defense to the insurers of all such other insurance. 2. As respects the coverage provided under this endorsement, Paragraph 4.b. of the Other Insurance Condition is deleted and replaced by the following: 4. Otherinsurance b. Excess Insurance This insurance is excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis unless the written contract or agreement described in A. above specifically requires that this insurance be provided on either a primary basis or a primary and noncontributory basis. Includes copyrighted material of Insurance Services Office Inc., with its permission. Page 2 of 2 Copyright, Insurance Services Office, Inc. 2002 CG 81 02 08 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE ENHANCEMENT Name of Insured: CSG Consultants, Inc. Policy Number: 161001088 Endorsement Number: I Effective Date of Endorsement: 1 12/412023 1 Name of Insurer: I North Pointe Insurance Company This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PRELIMINARY STATEMENT — This endorsement broadens coverage provided under the Coverage Form. However, further limitations and exclusions may apply to these coverages. Read all provisions of this endorsement and the entire policy carefully to determine ali rights, duties, coverages and limitations provided. A. BROADENED WHO IS AN INSURED B. NEWLY ACQUIRED OR FORMED ORGANIZATIONS C. LIABILITY COVERAGE EXTENSIONS SUPPLEMENTARY PAYMENTS D. FELLOW EMPLOYEE COVERAGE E. POLLUTION LIABILITY — BROADENED COVERAGE FOR COVERED AUTOS F. EXTENDED TOWING G. PHYSICAL DAMAGE COVERAGE EXTENSIONS H. RENTAL REIMBURSEMENT I. AIRBAG COVERAGE J. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT K. TAPES, RECORDS AND DISCS COVERAGE L. PHYSICAL DAMAGE DEDUCTIBLE — SINGLE DEDUCTIBLE AND GLASS REPAIR M. PERSONAL EFFECTS COVERAGE N. LOANILEASE PAYOFF COVERAGE O. CUSTOM SIGNS AND DECORATIONS P. HIRED AUTO PHYSICAL DAMAGE Q. EXTENDED EMPLOYEE HIRED AUTO PHYSICAL DAMAGE R. EXTRA EXPENSE — STOLEN AUTOS S. PARKED AUTO COLLISION WAIVER OF DEDUCTIBLE T. DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS U. WAIVER OF SUBROGATION V. CANCELLATION CONDITION W. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS X. POLICY PERIOD, COVERAGE TERRITORY Y. DEFINITION OF BODILY INJURY AMENDED CD © QBE . 2020 Includes copyrighted material of Insurance Services Office, Inc., CA-BA-2003 (12-20) with its permission. Page 1 of 6 PROVISIONS A. BROADENED WHO IS AN INSURED SECTION II — COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured is amended by the addition of the following: Employees As Insureds Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. Employee Hired Auto Any "employee" of yours is an "insured" while using an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. Additional Insured By Written Contract Any person or organization to whom you are required by a written contract or agreement to provide additional insured status is an "insured" under Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under Section II.A.1. Who Is An Insured of this Coverage Form. The written contract or agreement must be in effect during the policy period shown in the Declarations and must have been executed prior to the "bodily injury" or "property damage". B. NEWLY ACQUIRED OR FORMED ORGANIZATIONS Throughout this policy, the words "you" and "your" also refer to any subsidiary organization you newly acquire or form and over which you maintain 50% or more ownership interest, but only if there is no similar insurance available to that organization. However: 1. "Insured" does not include any subsidiary organization where similar insurance is unavailable because the organization has exhausted that policy's limits of insurance or the other carrier has become insolvent. 2. The coverage does not apply to an "accident" which occurred prior to your acquisition or formation of the organization. 3. Unless you notify us to add coverage to your policy, the coverage under this provision is afforded only until: a. The 180th day after you acquire or form the organization, or b. The end of the policy period, whichever is earlier. C. LIABILITY COVERAGE EXTENSIONS SUPPLEMENTARY PAYMENTS SECTION II — COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a. Supplementary Payments, Paragraphs (2) and (4) are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. D. FELLOW EMPLOYEE COVERAGE SECTION II — COVERED AUTOS LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire that is not a bus, motorcycle or van used to transport "employees". This Fellow Employee Coverage is excess over any other collectible insurance. E. POLLUTION LIABILITY — BROADENED COVERAGE FOR COVERED AUTOS 1. SECTION II — COVERED AUTOS LIABILITY COVERAGE, B. Exclusions is amended as follows: 11. Pollution, Paragraph a. applies only to liability assumed under a contract or agreement. b. With respect to the coverage afforded by Paragraph 1.a. above, 6. Care, Custody Or Control does not apply. 2. Changes in Definitions For the purposes of this endorsement, SECTION V — DEFINITIONS, Paragraph D. is replaced by the following: D. "Covered pollution cost or expense" means any cost or expense arising out of: Any request, demand, order or statutory or regulatory requirement that any "insured" or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of "pollutants"; or 0 © Q8E., 2020 Includes copyrighted material of Insurance Services Office, Inc., CA-BA-2003 (12-20) with its permission. Page 2 of 6 2. Any claim or "suit" by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to or assessing the effects of "pollutants". "Covered pollution cost or expense" does not include any cost or expense arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants": a. Before the "pollutants" or any property in which the "pollutants" are contained are moved from the place where they are accepted by the "insured" for movement into or onto the covered "auto"; or b. After the "pollutants" or any property in which the "pollutants" are contained are moved from the covered "auto" to the place where they are finally delivered, disposed of or abandoned by the "insured". Paragraphs a. and b. above do not apply to "accidents" that occur away from premises owned by or rented to an "insured" with respect to "pollutants" not in or upon a covered "auto" if: (1) The "pollutants" or any property in which the "pollutants" are contained are upset, overturned or damaged as a result of the maintenance or use of a covered "auto"; and (2) The discharge, dispersal, seepage, migration, release or escape of the "pollutants" is caused directly by such upset, overturn or damage. This Pollution Liability Coverage is subject to an Annual Aggregate Limit of Liability of $100,000. F. EXTENDED TOWING SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 2. Towing And Labor is replaced by the following: 2. Extended Towing And Labor We will pay for towing and labor costs each time a covered "auto" is disabled. All labor must be performed at the place of disablement. The most we will pay under this Extended Towing coverage is $750 per occurrence. No deductible applies to this coverage. G. PHYSICAL DAMAGE COVERAGE EXTENSIONS SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is amended as follows: a. Transportation Expenses The amount we will pay for temporary transportation expense is increased to $75 per day to a maximum of $3,000. b. Loss of Use Expenses The amount we will pay for loss of use is increased to $75 per day and to a maximum limit of $1,000. H. RENTAL REIMBURSEMENT 1. This coverage applies only to a covered "auto" described or designated in the Schedule or in the Declarations as carrying physical damage coverage. 2. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of coverage you have on each covered "auto". 3. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: a. The number of days reasonably required to repair or replace the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you; or b. 30 days. 4. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses incurred; or b. $75 per day 5. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 6. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for 0- o Q`i 2020 Includes copyrighted material of Insurance Services Office, Inc., CA-BA-2003 (12-20) with its permission. Page 3 of 6 under SECTION III — PHYSICAL DAMAGE COVERAGE in Paragraph A.4. Coverage Extensions. No deductible applies to this coverage. I. AIRBAG COVERAGE SECTION III — PHYSICAL DAMAGE COVERAGE, B. Exclusions, Paragraph 3.a. is amended by the addition of the following: This exclusion does not apply to the unintended discharge of an airbag. J. AUDIO, VISUAL_ AND DATA ELECTRONIC EQUIPMENT SECTION III — PHYSICAL_ DAMAGE COVERAGE is amended as follows: 1. C. Limits Of Insurance, Paragraph 1.b. is amended as follows: The $1,000 limit is increased to $1,500. 2. D. Deductible does not apply to coverage provided in C. Limits Of Insurance, Paragraph 1.b. K. TAPES, RECORDS AND DISCS COVERAGE SECTION III — PHYSICAL DAMAGE COVERAGE, B. Exclusions, Paragraph 4.a. is replaced by the foliowing: a. Tapes, records, discs or other similar audio, visual or data electronic devices designed for use with audio, visual or data electronic equipment except when the tapes, records, discs or other similar audio, visual or data electronic devices: (1) Are your property or that of a family member, and (2) Are in a covered "auto" at the time of "loss". The most we will pay for "loss" under this Tapes, Records and Discs Coverage is $200. No Physical Damage Coverage deductible applies to this coverage. L. PHYSICAL DAMAGE DEDUCTIBLE — SINGLE DEDUCTIBLE AND GLASS REPAIR SECTION III — PHYSICAL DAMAGE COVERAGE, D. Deductible is replaced by the following: D. Deductible For each covered "auto", our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Declarations prior to the application of the Limit of Insurance. Any Comprehensive Coverage deductible shown in the Declarations does not apply to "loss" caused by fire or fightning. When two or more covered "autos" sustain "loss" in the same occurrence, the total of all the "loss" for all the involved covered "autos" will be reduced by a single deductible, which will be the largest of all the deductibles applying to all such covered "autos." No deductible applies to glass damage if the glass is repaired rather than replaced. M. PERSONAL EFFECTS COVERAGE 1. If you purchase Comprehensive Coverage on this policy for a stolen owned "auto", we will pay up to $1,000 for "personal effects" stolen with the "auto". 2. "Personal effects" as used in this extension means tangible property that is worn or carried by the "insured". "Personal effects" does not include tools, jewelry, money, securities, radar or laser detectors, or tapes, records, discs or similar audio, visual or data electronic equipment. No deductible applies to this coverage. The insurance provided by this extension is excess over any other collectible insurance. N. LOAN/LEASE PAYOFF COVERAGE SECTION III — PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: In the event of a total "loss" to a covered "auto" shown in the Declarations, we will pay any unpaid amount due on the lease or loan for a covered "auto", less: 1. The amount paid under the Physical Damage Coverage Section of the policy; and 2. Any: a. Overdue leaselloan payments at the time of the "loss"; b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; c. Security deposits not returned by the lessor; d. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and e. Carry-over balances from previous loans or leases. O. CUSTOM SIGNS AND DECORATIONS In the event of a total "loss" to a vehicle insured for auto physical damage coverage on this policy, in addition to the ACV of the vehicle, we will pay the actual cost to repair or replace signage or custom paint details up to $5,000. OO QBE., 2020 Includes copyrighted material of Insurance Services Office, Inc., CA-BA-2003 (12-20) with its permission. Page 4 of 6 P. HIRED AUTO PHYSICAL DAMAGE If hired "autos" are covered "autos" for Liability Coverage and if Physical Damage Coverage of Comprehensive, Specified Causes of Loss, or Collision are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire of like kind and use subject to the following limit: The most we will pay for any one "loss" is the lesser of the following: 1. $100,000 per "accident"; 2. Actual Cash Value; or 3. The cost of repair. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning. This Hired Auto Physical Damage coverage is excess over any other collectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. Q. EXTENDED EMPLOYEE HIRED AUTO PHYSICAL DAMAGE SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, Paragraph b. is replaced by the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own; (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". R. EXTRA EXPENSE — STOLEN AUTOS SECTION 111 — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions is amended by the addition of the following: Extra Expense — Stolen Autos We will pay the extra expense of returning a stolen covered "auto" to you if: (1) The Declarations indicates that Comprehensive Coverage is provided for the stolen covered "auto"; or (2) The Declarations indicates that Specified Causes of Loss is provided for the stolen covered "auto". However, the most we will pay for any extra expense under this Coverage Extension is $1,000. S. PARKED AUTO COLLISION WAIVER OF DEDUCTIBLE SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph D. Deductible is amended by the addition of the following: The deductible does not apply to "loss" caused by collision to a covered "auto" of the private passenger type or light weight truck with a maximum gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer while it is: 1. In the charge of an "insured"; 2. Legally parked; and 3. Unoccupied. The "loss" must be reported to the police within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or organization in the automobile business. T. DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS SECTION IV — BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit Or Loss, Paragraph a. is replaced by the following: a. In the event of "accident", claim, "suit" or "loss", you, your insurance manager or any other person you designate must give us or our authorized representative prompt notice of such "accident" or "loss". Include: (1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. Knowledge of an "accident", claim, "suit" or "loss" by your agent, servant or "employee" shall not be considered knowledge by you unless you, your insurance manager or any other person you designate has received notice of the "accident", claim, "suit" or "loss" from your agent, servant, or "employee". Q © QBE, 2020 Includes copyrighted material of Insurance Services Office, Inc., CA-BA-2003 (12-20) with its permission. Page 5 of 6 U. WAIVER OF SUBROGATION SECTION IV — BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer Of Rights Of Recovery Against Others To Us is amended as follows: This condition does not apply to any person or organization to which you waived this condition by written contract or agreement, but only to the extent that subrogation is waived prior to the "accident" or "loss" under a contract with that person or organization. V. CANCELLATION CONDITION Subject to any statute or regulation requiring a longer time period, if we cancel for any reason other than nonpayment of premium, we will mail or deliver to the first Named Insured written notice of cancellation at least 90 days prior to the effective date of cancellation. W. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions, 2. Concealment, Misrepresentation Or Fraud is amended by the addition of the following: Any unintentional failure to disclose all exposures or hazards existing as of the effective date of this Coverage Form or at any time during the policy period will not invalidate or adversely affect the coverage for such exposure or hazard. However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery. X. POLICY PERIOD, COVERAGE TERRITORY SECTION 1V — BUSINESS AUTO CONDITIONS, B. General Conditions, 7. Policy Period, Coverage Territory is replaced by: 7. Policy Period, Coverage Territory Under this Coverage Form, we cover "accidents" and "losses" occurring: a. During the policy period shown in the Declarations; and b. Within the coverage territory. The coverage territory is: (1) The United States of America; (2) The territories and possessions of the United States of America; (3) Puerto Rico; (4) Canada; and (5) Anywhere else in the world if a covered "auto" is leased, hired, rented or borrowed for a period of 30 days or less, provided that the "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, the territories and possessions of the United States of America, Puerto Rico or Canada, or in a settlement we agree to. We also cover "loss" to, or "accidents" involving, a covered "auto" while being transported between any of these places. Y. DEFINITION OF BODILY INJURY AMENDED SECTION V — DEFINITIONS, Paragraph C. is replaced the following: C. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish, injury or illness or emotional distress and/or death resulting from any of these at any time. None of the extensions provided under this coverage endorsement apply if coverage is more specifically Identified elsewhere in the policy or endorsements, for which a premium charge is made or a higher limit is identified. Under no circumstances is any limit provided under this extension to be combined with a limit provided elsewhere in the policy or endorsements. All other terms and conditions of this policy remain unchanged. O © QBE-, 2020 Includes copyrighted material of Insurance Services Office, Inc., CA-BA-2003 (12-20) with its permission. Page 6 of 6 Policy Number: 161001088 COMMERCIAL AUTO CA 80 02 0512 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. ADDITIONAL INSURED BY CONTRACT OR AGREEMENT Paragraph A.I. Who Is an Insured of SECTION II — LIABILITY COVERAGE is amended to in- clude the following: Any person or organization to whom you become obligated to include as an additional insured un- der this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with re- spect to liability arising out of your operations or premises owned by or rented to you. However; the insurance provided will not exceed the lesser of: , 1. The coverage and/or limits of this policy, or 2. The coverage and/or limits required by said contract or agreement. Includes copyrighted material of Insurance Services Office, Inc., CA 80 02 0512 with its permission. Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not en- force our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Blanket Waiver of Subrogation as required by written contract. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 12/4/2023 Policy No. 152000753 Insured CSG Consultants, Inc. Endorsement No. Premium $ I Insurance Company Praetorian Insurance Company Countersigned by WC 00 03 13 (Ed. 4-84) Copyright 1983 National Council on Compensation Insurance.