HomeMy WebLinkAboutA9161 - JOHN FRIEDMAN ALICE KIM ARCHITECTS101-INFRI.01 MCCOWANA
CERTIFICATE OF LIABILITY INSURANCE
DATE 8 (MM1DDzam
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 pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
PRODUCER License ff OE67768
cO ncT Erica Wilson
uc°Nli , E,d); (858 754-0063 50233
)
FAX
(AIC, No): 619 574-6288
IDA Insurance Services
3636 Nobel Drive
Suite 410
E-MaIL . Erica.Wilson@ioausa.com
San Diego, CA 92122
INSURERS AFFORDING COVERAGE NAIC0
INSURERA:RLI Insurance Company
13056
INSURED
INSURERB:Hudson Insurance Company
25054
INSURER C:
John Friedman Alice Kimm Architects, Inc.
INSURER 0:
1461 E 4th Street
Los Angeles, CA 90033
INSURER E
NSURER F:
Cr1VFRAr;FS CFRTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OF INSURANCE
ADDLNSO
SUER
JNM
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE FX] OCCUR
X
X
PSBOO10799
8/18/2024
811812025
DAMAGETORENTED
1,000,00g
X
MEDEXP(Any onePerson)
$ 10,000
Cent Liab/Sev Int
PERSONAL BADV INJURY
$ 1,000,000
GENL AGGREGATE LIMIT APPLIES PER:
POLICY �X of LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMPIOPAGG
$ 2,000,000
iDed
$ 0
OTHER:
A
LIABILITY
COMBINED SINGLE UMIT
$ 1,000,000
BODILY INJURY Per Person)$
ANY AUTO
X
X
PSA0003522
811812024
8/18/2025
BODILY INJURY Per accident
PUTOMOBILE
OWNED SCHEDULED
AUTOS ONLY AUUpTNNO.pSS
nDAMAGENo
EEpp
AUTOS ONLY ANaMW NLPeGaic�id
Go. Owned
AutosA
UMBRELLA LAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
X
EXCESS LAB
CLAIMS -MADE
PSE0005298
8/18/2024
8118/2025
AGGREGATE
$ 5,000,000
OED I X I RETENTION$ 0
A
WORKERS COMPENSATION
AND EMPLOYERS'LIABILRY
ANY PROPMETORIPARTNERIEJIECIITNE YIN
%FFICERRAEMgER EXCLUDED]
(Mandatory In NH)
NIA
X
PSWOODS832
8118/2024
8/18/2025
X PER OTH-
EL EACH ACCIDENT
1,000,000
8
E.L. DISEASE - EA EMPLOYE
1,000,000
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
1 ggg ggg
B
Professional Liab.
PR80619119451
8/18/2024
8118/2025
Per Claim
2,000,000
B
Ded. $25K Per Claim
PRE0619119451
111112024
111112125
Aggregate
4,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ((ACORD tat, AddiUorial Remarks Schedule, may be aeached 1 more space Is required)
Re: Project: Palm Springs Navigation Center, Cfty Project No. 22-05
The City of Palm Springs, Its officials, employees, and agents are additional Insured with respect to General Liability and Auto Liability per the attached
endorsements as required by written contract. Insurance Is Primary and Non -Contributory. Waiver of Subrogation applies to General Liability, Auto Liability,
and Workers' Compensatlon.
30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of Premium In accordance with the policy provisions.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Palm Springs
Attn3200 Venda Teed, Engineering Division
3200 E. Tahquitz Canyon
AUTHORED REP,R/EESSE/NTTATNE
�,�,Y/Yi' I
ACORD 25 (2016103) @ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Policy Number: PSB0010799
Named Insured: John Friedman Alice Kimm Architects, Inc.
RLI Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
RLIPack° FOR DESIGN PROFESSIONALS
BLANKET ADDITIONAL INSURED ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COVERAGE FORM - SECTION II — LIABILITY
1. C. WHO IS AN INSURED is amended to include as
an additional insured any person or organization that
you agree in a contract or agreement requiring
insurance to include as an additional insured on this
policy, but only with respect to liability for "bodily
injury', "property damage" or "personal and
advertising injury" caused in whole or in part by you
or those acting on your behalf:
a. In the performance of your ongoing operations;
b. In connection with premises owned by or rented
to you; or
c. In connection with "your work" and included
within the "product -completed operations
hazard".
2. The insurance provided to the additional insured by
this endorsement is limited as follows:
a. This insurance does not apply on any basis to
any person or organization for which coverage
as an additional insured specifically is added by
another endorsement to this policy.
b. This insurance does not apply to the rendering
of or failure to render any "professional
services".
c. This endorsement does not increase any of the
limits of insurance stated in D. Liability And
Medical Expenses Limits of Insurance.
3. The following is added to SECTION III H.2. Other
Insurance — COMMON POLICY CONDITIONS
(BUT APPLICABLE ONLY TO SECTION II —
LIABILITY)
However, if you specifically agree in a contract or
agreement that the insurance provided to an
additional insured under this policy must apply on a
primary basis, or a primary and non-contributory
basis, this insurance is primary to other insurance
that is available to such additional insured which
covers such additional insured as a named insured,
and we will not share with that other insurance,
provided that:
a. The "bodily injury" or "property damage" for
which coverage is sought occurs after you have
entered into that contract or agreement; or
b. The "personal and advertising injury" for which
coverage is sought arises out of an offense
committed after you have entered into that
contract or agreement.
4. The following is added to SECTION III K. 2.
Transfer of Rights of Recovery Against Others to
Us — COMMON POLICY CONDITIONS (BUT
APPLICABLE TO ONLY TO SECTION 11 —
LIABILITY)
We waive any rights of recovery we may have
against any person or organization because of
payments we make for "bodily injury", "property
damage" or "personal and advertising injury" arising
out of "your work" performed by you, or on your
behalf, under a contract or agreement with that
person or organization. We waive these rights only
where you have agreed to do so as part of a
contract or agreement with such person or
organization entered into by you before the "bodily
injury" or "property damage" occurs, or the "personal
and advertising injury" offense is committed.
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.
PPB 304 06 10 Page 1 of 1
Policy Number: PSB0010799
RLI Insurance Company
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
M.
N.
O.
P.
Q.
R.
S.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
RLIPack® FOR DESIGN PROFESSIONALS
LIABILITY ENHANCEMENT
SCHEDULE OF COVERAGES ADDRESSED BY THIS ENDORSEMENT
First Aid And Good Samaritan Services
Supplementary Payments
Reasonable Force — Bodily Injury Or Property Damage
Non -Owned Watercraft
Canoes Or Rowboats
Damage To Premises Rented To You
Aircraft Chartered With Crew
Electronic Data Liability
Who Is An Insured — Newly Acquired Or Formed Organizations
Who Is An Insured — Unnamed Partnership Or Joint Venture
Additional Insured — Owner, Manager Or Lessor Of Premises Or Leased Equipment
Additional Insured — State Or Political Subdivisions — Permits Related To Premises Or Operations
General Aggregate Limit — Per Project Or Per Location
Knowledge And Notice Of Occurrence Or Offense
Amended Bodily Injury Definition
Amended Insured Contract Definition — Construction Or Demolition Operations Within 50' Of Railroad
Amended Personal And Advertising Injury Definition — Electronic Material
Unintentional Omission
Waiver Of Transfer Of Rights Of Recovery Against Others To Us
PPB 316 11 13 Page 1 of 7
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COVERAGE FORM — SECTION II — LIABILITY AND SECTION III AS IT PERTAINS TO LIABILITY
ONLY
A. First Aid And Good Samaritan Services
1. The following is added to Section II A.I.
Business Liability Coverages
We will pay those sums that the insured
becomes legally obligated to pay as damages
because of "bodily injury' arising out of either the
rendering of or failure to render, "First Aid" or
"Good Samaritan Services" to any person. For
the purposes of this coverage grant, "First Aid"
or "Good Samaritan Services" will be deemed to
meet the definition of "occurrence". For the
purposes of determining the applicable limits of
insurance, any act or omission together with all
related acts or omissions in the rendering of
"First Aid" or "Good Samaritan Services" to any
one person will be deemed one 'occurrence".
a. "First Aid" means initial care for medical
attention immediately following a "bodily
injury".
b. "Good Samaritan Services" means medical
attention provided in an emergency and for
which no remuneration is demanded or
received.
2. The insurance provided by this provision shall
be excess over any valid and collectible other
insurance available to any insured whether
primary, excess, contingent or any other basis,
except for insurance purchased specifically by
you to apply in excess of the limits of Insurance
shown in the declarations for Business Liability.
B. Supplementary Payments
Section II A.1.f. Coverage Extension —
Supplementary Payments Paragraphs 1.(b) and
1.(d) are deleted and replaced with the following:
(b) Up to $2,500 for the cost of bail bonds required
because of accidents or traffic violations arising
out of any vehicle to which Business Liability
Coverage for "bodily injury' applies. We do not
have to furnish these bonds.
(d) All reasonable expenses incurred by the insured
at our request to assist in the investigation or
defense of the claim or "suit", including actual
loss of earnings up to $500 a day because of
time off work.
C. Reasonable Force — Bodily Injury Or Property
Damage
Section II B.1.a. Exclusions, Expected Or
Intended Injury, is deleted and replaced by the
following:
a. Expected or Intended Injury
"Bodily Injury" or "property damage" ex-
pected 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.
D. Non -Owned Watercraft
1. Section II B.1.g. Exclusions, Aircraft, Auto Or
Watercraft Subparagraph (2) is deleted and
replaced by the following:
(2) A watercraft you do not own that is:
(a) Up to seventy-five (75) feet long; and
(b) Not being used to carry persons or
property for a charge;
2. Only as respects to the insurance provided by
this provision C. Who Is An Insured is
amended to include as an insured any person
who, with your express consent uses the
watercraft.
3. The insurance provided by this provision shall
be excess over any valid and collectible other
insurance available to the insured, whether
primary, excess, contingent or on any other
basis, except for the insurance purchased
specifically by you to apply in excess of the
Limits of Insurance shown in the declarations for
this Coverage Part.
E. Canoes Or Rowboats
The following is added to the exceptions contained
in Section II B.1.g. Exclusions, Aircraft, Auto Or
Watercraft:
(6) Any non -motorized canoe or rowboat owned by
the insured. Only as respects to the insurance
provided by this provision C. Who Is An
Insured is amended to include as an insured
any person who, with your express consent,
uses any such canoe or rowboat.
F. Damage to Premises Rented to You
1. The last paragraph of Section II B.1. Ex-
clusions — Applicable To Business Liability
Coverage is deleted and replaced by the
following:
Exclusions c., d., e., f., g., h., i., k., 1., m., n. and
o. in SECTION II — LIABILITY do not apply to
damage by water, fire, explosion, lightning, or
smoke resulting from fire to premises while
PPB 316 11 13 Page 2 of 7
rented to you, or temporarily occupied by you
with permission by the owner. A separate
Damage To Premises Rented To You Limit of
Insurance applies to this coverage as described
in paragraph D. Liability And Medical
Expenses Limits of Insurance in SECTION II —
LIABILITY.
2. Section II F.9.a. Liability And Medical
Expenses Definitions, 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 water, fire,
explosion, lightning, or smoke resulting from
fire to premises while rented to you or
temporarily occupied by you with permission
of the owner is not an "insured contract";
3. This provision does not apply if coverage for
Damage To Premises Rented To You is ex-
cluded by another endorsement to this policy.
G. Aircraft Chartered With Crew
1. The following is added to the exceptions
contained in Section II B.1.g. Exclusions,
Aircraft, Auto or Watercraft:
(6) Any non -owned aircraft chartered to you
with a crew including a pilot.
2. The insurance provided by this provision shall
be excess over any valid and collectible other
insurance available to the insured whether
primary, excess, contingent or on any other
basis, except for insurance purchased specif-
ically by you to apply in excess of the Limits of
Insurance shown in Declarations.
H. Electronic Data Liability
1. Section If B.1.q. Exclusions is deleted and
replaced by the following:
q. Electronic Data
Damages arising out of the loss of, loss of
use of, damage to, corruption of, inability to
access, disclosure of, display of, theft or
misappropriation of or inability to manipulate
"electronic data". However this exclusion
does not apply to "Property Damage".
2. The following definition is added to Section II F.
Liability And Medical Expenses Definitions:
"Electronic data" means information, facts or
programs stored as or on, created or used on, or
transmitted to or from computer software
(including systems and applications 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 the purposes of the coverage provided by
this endorsement, Section II F. Liability And
Medical Expenses Definitions, Paragraph 17.
is deleted and replaced by the following:
17. "Property damage" means:
a. Physical injury to tangible property,
including all resulting loss of use of that
property. All such loss of use shall be
deemed to occur at the time of the
physical injury that caused it;
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 in-
ability to manipulate "electronic 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.
d. Property damage does not mean dis-
closure of, display of, or theft or mis-
appropriation of electronic data however
caused.
For the purposes of this insurance,
"electronic data" is not tangible property.
1. Who Is An Insured — Newly Acquired Or Formed
Organizations
The following is added to Section II C. Who Is An
Insured:
Any organization you newly acquire or form, other
than a partnership, joint venture or limited liability
company, over which you maintain ownership or
majority interest, will qualify as a Named Insured if
there is no other similar insurance available to that
organization. However:
1. Coverage under this provision is afforded only
until the one hundred eightieth (180`h) day after
you acquire or form the organization or the end
of the policy period, whichever is earlier;
2. Coverage does not apply for "bodily injury" or
"property damage" that occurred before you
acquired or formed the organization.
3. Coverage does not apply for "personal and
advertising injury' arising out of an offense
committed before you acquired or formed the
organization.
PPB 316 11 13 Page 3 of 7
4. This provision does not apply to any
organization for which coverage is excluded by
another endorsement to this policy.
J. Who Is An Insured — Unnamed Partnership Or
Joint Venture
1. The last paragraph of Section II C. Who Is An
Insured 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 showy as a Named Insured
in the Declarations. However this limitation does
not apply to your liability with respect to your
conduct of the business of any current or past
partnership or joint venture:
a. That is not shown as a Named Insured in
the Declarations; and
b. In which you are a member or partner but
only if:
(i) Each and every member or partner in
that joint venture or partnership is not a
construction contractor; and
(ii) The joint venture or partnership is not
providing construction contracting
services.
2. This provision does not apply to any person or
organization for which coverage is excluded by
another endorsement to this policy.
3. The insurance provided by this provision shall
be excess over any valid and collectible other
insurance, whether primary, excess, contingent
or on any other basis, which is available
covering your liability with respect to your
conduct of the business of any current or past
partnership or joint venture that is not shown as
a Named Insured in the Declarations and which
is issued to such partnership or joint venture.
K. Additional Insured — Owner, Manager Or Lessor
Of Premises Or Leased Equipment
Section II C. Who Is An Insured is amended to
include as an insured:
1. Any person or organization that you have
agreed in a contract or agreement to include as
an additional insured on this policy, but:
a. Only with respect to liability for "bodily injury"
or "property damage" that occurs, or
"personal and advertising injury" caused by
an offense committed, after you have
entered into that contract or agreement; and
(1) Only if the "bodily injury", "property dam-
age" or "personal and advertising injury'
is caused, in whole or in part, by you or
any person or organization performing
operations on your behalf, and arises
out of the ownership, maintenance or
use of that part of any premises leased
to you under that contract or agreement;
or
(2) The "bodily injury", "property damage" or
"personal and advertising injury" is
caused, in whole or in part, by you or
any person or organization performing
operations on your behalf, and arises
out of the maintenance, operation or use
of equipment leased to you by such
additional insured.
2. The insurance provided to such additional in-
sured under this provision is subject to the
following:
a. The limits of insurance afforded to such
additional insured shall be the limits which
you agreed to provide in the contract or
agreement, or the limits shown in the
Declarations, whichever are less; and
b. The insurance afforded to such additional
insured does not apply:
(1) To any "bodily injury' or "property dam-
age" that occurs, or "personal and
advertising injury' caused by an offense
committed, after you cease to be a
tenant in that premises;
(2) To any structural alterations, construc-
tion or demolition operations performed
by or on behalf of such additional
insured;
(3) To any premises for which coverage is
excluded by another endorsement to
this Coverage Part;
(4) To any "bodily injury' or "property dam-
age" that occurs, or "personal and
advertising injury' caused by an offense
committed, after the equipment lease
expires; or
(5) If the equipment is leased with an
operator.
3. This provision does not apply on any basis to
any person or organization for which coverage
as an additional insured specifically is added by
another endorsement to this policy.
PPB 316 11 13 Page 4 of 7
L. Additional Insured — State Or Political
Subdivisions — Permits Related To Premises Or
Operations
Section II C. Who Is An Insured is amended to
include as an insured:
1. Any state or political subdivision that has issued
a permit in connection with premises owned or
occupied by, or rented or loaned to, you, but
only with respect to "bodily injury', "property
damage", "personal and advertising injury"
arising out of the existence, ownership, use,
maintenance, repair, construction, erection or
removal of advertising signs, awnings, canopies,
cellar entrances, coal holes, driveways, man-
holes, marquees, hoist away openings, sidewalk
vaults, elevators, street banners or decorations
for which that state or political subdivision has
issued such permit.
2. Any state or political subdivision that has issued
a permit, but only with respect to "bodily injury,
"property damage", "personal and advertising
injury" arising out of operations performed by
you or on your behalf for which that state or
political subdivision has issued such permit.
However, no such state or political subdivision is
an insured for:
a. "Bodily injury", "property damage", "personal
and advertising injury' arising out of op-
erations performed for that state or political
subdivision; or
b. "Bodily injury' or "property damage" included
within the "products -completed operations
hazard".
M. General Aggregate Limit — Per Project Or Per
Location
Section II D. Liability And Medical Expenses
Limits of Insurance, Paragraph 4. Aggregate
Limits. is deleted and replaced by the following:
4. Aggregate Limits
The most we will pay for:
a. All "bodily injury" and "property damage" that
is included in the "products -completed
operations hazard" is twice the Liability and
Medical Expenses limit.
b. All:
(1) "Bodily injury' and "property damage"
except damages because of "bodily in-
jury" or "property damage" included in
the "products -completed operations
hazard";
(2) Plus medical expenses;
(3) Plus all "personal and advertising injury'
caused by offenses committed;
is twice the Liability and Medical Expenses
limit.
The aggregate limit for all "bodily injury" and
"property damage", medical expenses and
"personal and advertising injury" other than
"bodily injury" or "property damage" included in
the "products -completed operations hazard"
applies separately to each of your "projects"
away from premises owned by or occupied by
you or to each of your "locations" owned by or
occupied by you.
"Projects" mean an area away from premises
owned by or rented to you at which you are
performing operations pursuant to a contract or
agreement. For the purposes of determining the
applicable aggregate limit of insurance, each
"project" at the same "location" shall be
considered a single "project".
For the purposes of this provision, "location"
means
1. Premises involving the same or connecting
lots;
2. Premises where connection is interrupted
only by a street, roadway, waterway or right-
of-way of a railroad; or
3. Premises where operations are performed in
sections, stages or phases as a continuation
of the same contract or agreement, even if
the premises do not involve connecting lots.
Subject to Paragraph a. or b. above, whichever
applies, the Damage To Premises Rented To
You Limit is the most we will pay for damages
because of "property damage" to any one
premises, while rented to you, or in the case of
fire; explosion; lightning; smoke resulting from
such fire, explosion or lightning; or water while
rented to you or temporarily occupied by you
with permission of the owner.
The Limits of. Insurance of SECTION II —
LIABILITY apply separately to each consecutive
annual period and to any remaining period of
less than twelve (12) months, starting with the
beginning of the policy period shown in the
Declarations, unless the policy period is
extended after issuance for an additional period
of less than twelve (12) months. In that case, the
additional period will be deemed part of the last
preceding period for purposes of determining the
Limits of Insurance.
N. Knowledge And Notice Of Occurrence Or
Offense
The following is added to Section II E. 2. Liability
and Medical Expenses General Conditions,
Duties In The Event of Occurrence, Offense,
Claim Or Suit:
PPB 316 11 13 Page 5 of 7
Notice of an "occurrence" or of an offense which
may result in a claim must be given as soon as
practicable after knowledge of the "occurrence" or
offense has been reported to you, one of your
"executive officers" (if you are a corporation), one of
your partners who is an individual (if you are a
partnership), one of your managers (if you are a
limited liability company), one of your trustees who is
an individual (if you are a trust), or an "employee"
(such as an insurance, loss control or risk manager
or administrator) designated by you to give such
notice.
Knowledge by any other "employee" of an "occur-
rence" or offense does not imply that you also have
such knowledge.
Notice of an "occurrence" or of an offense which
may result in a claim will be deemed to be given as
soon as practicable to us if it is given in good faith as
soon as practicable to your workers' compensation,
accident, or health insurer. This applies only if you
subsequently give notice of the "occurrence" or
offense to us as soon as practicable after you, one
of your "executive officers" (if you are a corporation),
one of your partners who is an individual (if you are
a partnership), one of your managers (if you are a
limited liability company), one of your trustees who is
an individual (if you are a trust), or an "employee"
(such as an insurance, loss control or risk manager
or administrator) designated by you to give such
notice discovers that the "occurrence" or offense
may involve this policy.
O. Amended Bodily Injury Definition
The definition of "bodily injury' in Section II F.3.
Liability And Medical Expenses Definitions is
deleted and replaced by the following:
"Bodily injury" means injury to the body, sickness,
disease, or death. "Bodily injury' also means mental
injury, mental anguish, emotional distress, pain and
suffering, or shock resulting from injury to the body,
sickness, disease or death of.any person.
P. Amended Insured Contract Definition —
Construction Or Demolition Operations Within
50' Of Railroad
The definition of "insured contract" in Section II
F.9.c. Liability And Medical Expenses Defi-
nitions is deleted and replaced by the following:
c. Any easement or license agreement
2. The definition of "insured contract" in Section II
F.9.f.(1) Liability And Medical Expenses
Definitions is deleted.
3. The insurance provided by this provision shall
be excess over any valid and collectible Railroad
Protective Liability insurance available to an
insured , whether primary, excess, contingent or
on any other basis, except for the insurance
purchased specifically by you to apply in excess
of the Limits of Insurance shown in the
declarations for this Coverage Part.
Q. Amended Personal And Advertising Injury
Definition — Electronic Material
The definition of "personal and advertising
injury" in Section II F.14.d. Liability And
Medical Expenses Definitions is deleted and
replaced by the following:
d. Oral, written or electronic publication, in any
manner, of material that slanders or libels a
person or organization or disparages a
person's or organization's goods, products
or services;
2. The definition of "personal and advertising
injury" in Section II F.14.e. Liability And
Medical Expenses Definitions is deleted and
replaced by the following:
e. Oral, written or electronic publication, in any
manner, of material that violates a person's
right of privacy;
3. Section If B.1.p.(2) Exclusions for Personal
And Advertising Injury is deleted and replaced
by the following:
(2) Arising out of oral, written or electronic
publication of material if done by or at the
direction of the insured with knowledge of its
falsity;
4. Section II BA.p.(2) Exclusions for Personal
And Advertising Injury is deleted and replaced
by the following:
(3) Arising out of oral, written or electronic pub-
lication of material whose first publication
took place before the beginning of the policy
period;
R. Unintentional Omission
The following is added to SECTION III — COMMON
POLICY CONDITIONS Paragraph C. Concealment,
Misrepresentation Or Fraud (BUT APPLICABLE
ONLY TO SECTION II — LIABILITY)
However as it pertains to Business Liability Cover-
age only, the unintentional omission of, or uninten-
tional error in, any information provided by you
which we relied upon in issuing this policy shall not
prejudice your rights under this insurance. This pro-
vision does not affect our right to collect additional
premium or to exercise our right of cancellation or
nonrenewal in accordance with applicable insurance
laws or regulations.
PPB 316 11 13 Page 6 of 7
S. Waiver Of Transfer Of Rights Of Recovery
Against Others To Us
SECTION III — COMMON POLICY CONDITIONS
Paragraph K.2. Transfer of Rights of Recovery
Against Others to Us (BUT APPLICABLE ONLY
TO SECTION If — LIABILITY) is deleted and
replaced by the following:
2. Applicable to Business Liability Coverage:
We waive any rights of recovery we may have
against any person or organization because of
payments we make for "bodily injury', "property
damage", "personal injury and advertising injury"
arising out of:
a. Premises owned by you, temporarily occu-
pied by you with permission of the owner, or
leased or rented to you;
b. Ongoing and completed operations per-
formed by you, or on your behalf, under a
contract or agreement with that person or
organization;
c. Your "work": or
d. "Your products".
We waive these rights only where you have
agreed to do so as part of a contract or agree-
ment entered into by you before the "bodily
injury" or "property damage" occurs or the
"personal and advertising injury" offense is
committed.
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.
PPB 316 11 13 Page 7 of 7
Policy Number: PSA0003522 RLI Insurance Company
Named Insured: ,John Friedman Alice Kimm Architects, Inc.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
RLIPack® BUSINESS AUTO ENHANCEMENT
SCHEDULE OF COVERAGES ADDRESSED BY THIS
A. Broad Form Named Insured
B. Employees As Insureds
C. Blanket Additional Insured
D. Blanket Waiver Of Subrogation
E. Employee Hired Autos
F. Fellow Employee Coverage
G. Auto Loan Lease Gap Coverage
H. Glass Repair— Waiver Of Deductible
I. Personal Effects Coverage
J. Hired Auto Physical Damage Coverage
K. Hired Auto Physical Damage — Loss Of Use
L. Hired Car —Worldwide Coverage
M. Temporary Transportation Expenses
N. Amended Bodily Injury Definition — Mental Anguish
O. Airbag Coverage
P. Amended Insured Contract Definition — Railroad Easement
Q. Coverage Extensions —Audio, Visual And Data Electronic Equipment Not Designed Solely For The
Production Of Sound
R. Notice Of And Knowledge Of Occurrence
S. Unintentional Errors Or Omissions
T. Towing Coverage
PPA 300 03 11 Page 1 of 5
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
A. Broad Form Named Insured
The following is added to the SECTION II —
LIABILITY Coverage, Paragraph A.1. Who Is An
Insured Provision:
Any business entity newly acquired or formed by you
during the policy period, provided you own fifty
percent (50%) or more of the business entity and the
business entity is not separately insured for
Business Auto Coverage. Coverage is extended up
to a maximum of one hundred eighty (180) days
following the acquisition or formation of the business
entity.
This provision does not apply to any person or
organization for which coverage is excluded by
endorsement.
B. Employees As Insureds
The following is added to the SECTION II —
LIABILITY COVERAGE, Paragraph A.1. Who Is An
Insured Provision:
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.
C. Blanket Additional Insured
The following is added to the SECTION 11 —
LIABILITY COVERAGE, Paragraph A.1. Who Is An
Insured Provision:
Any person or organization that you are required to
include as an additional insured on this coverage
form in a contract or agreement that is executed by
you before the "bodily injury' or "property damage"
occurs is an "insured" for liability coverage, but only
for damages to which this insurance applies and
only to the extent that person or organization
qualifies as an "insured" under the Who Is An
Insured provision contained in SECTION II —
LIABILITY COVERAGE.
The insurance provided to the additional insured will
be on a primary and non-contributory basis to the
additional insured's own business auto coverage if
you are required to do so in a contract or agreement
that is executed by you before the "bodily injury" or
"property damage" occurs.
D. Blanket Waiver Of Subrogation
The following is added to the SECTION IV —
BUSINESS AUTO CONDITIONS, A. Loss
Conditions, 5. Transfer Of Rights Of Recovery
Against Others To Us:
We waive any right of recovery we may have against
any person or organization to the extent required of
you by a contract executed prior to any "accident" or
"loss", provided that the "accident" or "loss" arises
out of the operations contemplated by such contract.
The waiver applies only to the person or
organization designated in such contract.
E. Employee Hired Autos
1. The following is added to the SECTION II —
LIABILITY COVERAGE, Paragraph A.1. Who
Is An Insured Provision:
An "employee" of yours is an "insured" while
operating 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.
2. Changes In General Conditions:
Paragraph 5.b. of the Other Insurance
Condition in the BUSINESS AUTO
CONDITIONS is deleted and replaced with 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".
F. Fellow Employee Coverage
SECTION 11 — LIABILITY COVERAGE, Exclusion
B.S. does not apply if you have workers
compensation insurance in -force covering all of your
employees.
G. Auto Loan Lease Gap Coverage
SECTION III — PHYSICAL DAMAGE COVERAGE,
C. Limit Of Insurance, is amended by the addition
of the following:
In the event of a total "loss" to a covered "auto"
shown in the Schedule of Declarations, we will pay
any unpaid amount due on the lease or loan for a
covered "auto". less:
PPA 300 03 11 Page 2 of 5
1. The amount paid under the PHYSICAL
DAMAGE COVERAGE section of the policy;
and
2. Any:
a. Overdue leasefloan 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.
H. Glass Repair — Waiver Of Deductible
SECTION III — PHYSICAL DAMAGE COVERAGE,
D. Deductible is amended by adding the following:
No deductible for a covered "auto" will apply to glass
damage if the glass is repaired rather than replaced.
I. Personal Effects Coverage
The following is added to SECTION III — PHYSICAL
DAMAGE COVERAGE, A. Coverage, 4. Coverage
Extensions:
c. Personal Effects Coverage
In the event of a total theft loss of your covered
"auto we will pay up to $400 for "loss" to wearing
apparel and other personal effects which are:
(1) Owned by an "insured"; and
(2) In or on your covered "auto";
No deductible applies to Personal Effects
Coverage.
J. Hired Auto Physical Damage Coverage
The following is added to SECTION III — PHYSICAL
DAMAGE COVERAGE, A. Coverage, 4. Coverage
Extensions:
d. Hired Auto Physical Damage Coverage
If hired "autos" are covered "autos" for Liability
Coverage and this policy also provides Physical
Damage Coverage for an owned "auto", then the
Physical Damage Coverage is extended to
"autos" that you hire, rent or borrow subject to
the following:
(1) The most we will pay for "loss" in any one
'accident' to a hired, rented or borrowed
"auto" is the lesser of:
(a) $60,000
(b) The actual cash value of the damaged
or stolen property as of the time of the
"loss"; or
(c) The cost of repairing or replacing the
damaged or stolen property with other
property of like kind and quality.
(2) An adjustment for depreciation and physical
condition will be made in the event of a total
"loss".
(3) If a repair or replacement results in better
than like kind or quality, we will not pay for
the betterment.
(4) A deductible equal to the highest Physical
Damage deductible applicable to any owned
auto will apply.
(5) This Coverage Extension will not apply to:
(a) Any "auto" that is hired, rented or
borrowed with a driver, or
(b) Any "auto" that is hired, rented or
borrowed from your "employee"
K. Hired Auto Physical Damage — Loss Of Use
The following is added to SECTION II — LIABILITY
COVERAGE, A.2. Coverage Extensions:
e. We will pay sums which you legally must pay to
the lessor of a covered "auto" which you have
leased without a driver for thirty (30) days or less
for the lessor's loss of use of the covered "auto",
provided:
(1) This insurance provides comprehensive,
specified causes of loss or collision covered
on the covered "auto";
(2) The loss of use results from the covered
"auto" being damaged in an "accident" while
you are leasing it.
We will pay up to a maximum limit of $1,500 for
this covered extension.
L. Hired Car— Worldwide Coverage
The following is added to SECTION II — LIABILITY
COVERAGE, A.2. Coverage Extensions:
f. Hired Car —Worldwide Coverage
(1) We will pay all sums an "insured" legally
must pay as damages because of "bodily
injury" or "property damage" to which this
insurance applies, caused by an "accident"
which occurs outside of the United States of
America, the territories and possessions of
the United States of America, Puerto Rico
and Canada resulting from the maintenance,
or use of any covered "auto" of the private
passenger type you lease, hire, rent or
borrow without a driver for thirty (30) days or
less.
PPA 300 03 11 Page 3 of 5
(2) With respect to any claim made or "suit"
instituted outside the United States of
America, the territories and possessions of
the United States of America, Puerto Rico,
and Canada:
(a) You shall undertake the investigation,
settlement and defense of such claims
and "suits" and keep us advised of all
proceedings and actions.
(b) You will not make any settlement
without our consent.
(c) We will reimburse you:
(i) For the amount of damages be-
cause of liability imposed upon you
by law on account of "bodily" injury"
or "property damage" to which this
insurance applies, and
(11) For all reasonable expenses incur-
red with our consent in connection
with the investigation, settlement or
defense of such claims or "suits".
Reimbursement for expenses will be
part of the Limit of Insurance for
liability coverage shown in the Busi-
ness Auto Coverage Declarations,
and not in addition to such limits.
(3) The limit of Insurance for Liability Coverage
shown in the Business Auto Coverage
Declarations is the most we will reimburse
you for the sum of all damages imposed on
you, as set forth in paragraph 2.c. above,
and all expenses incurred by you arising out
of any single "accident" or "loss".
(4) You must maintain the greater of the
following primary auto liability insurance
limits:
(a) Compulsory admitted insurance with
limits required to be in force to satisfy
the legal requirements of the jurisdiction
where the accident occurs; or
(b) Insurance limits required by law and
issued by a government entity or by an
insurer licensed or permitted by law to
do business in the jurisdiction where the
"accident" occurs; or
(c) Auto liability insurance limits of at least
$300,000 combined single limit or
$100,000 per person/$300,000 per acci-
dent Bodily Injury, $100,000 Property
Damage.
If you fail to comply with the above, this
insurance is not invalidated. However, in
the event of a "loss", we will pay only to the
extent that we would have been liable had
you so complied.
(5) The insurance provided by this coverage
extension is excess over any other
collectible insurance available to you
whether on a primary, excess contingent or
any other basis.
M. Temporary Transportation Expenses
SECTION ill — PHYSICAL DAMAGE COVERAGE,
A.4. Coverage Extensions, subparagraph a.
Transportation Expenses is deleted and replaced
by the following:
a. Transportation Expenses
(1) We will pay up to a maximum of $1,500 for
temporary transportation expense incurred
by you because of Physical Damage to a
coverage "auto".
(2) We will pay only for those covered "autos"
for which you carry Comprehensive,
Collision or Specified Case of Loss
Coverage. ,
(3) We will pay only for those expenses incurred
by you during the period of time that begins
twenty-four (24) hours after the covered
"loss" and ends at the time when the
covered "auto" can be reasonable repaired
or replaced.
(4) This coverage does not apply while there
are spare or reserve "autos" available to you
for your operations.
N. Amended Bodily Injury Definition — Mental
Anguish
The following is added to SECTION V —
DEFINITIONS, Definition C.:
"Bodily injury" also includes mental anguish, but only
when the mental anguish arises from other bodily
injury, sickness or disease.
O. Airbag Coverage
The following is added to SECTION III — PHYSICAL
DAMAGE COVERAGE B. Exclusions 3.a.:
However, this exclusion will not apply to accidental
discharge of an airbag due to mechanical or
electrical breakdown.
P. Amended Insured Contract Definition — Railroad
Easement
SECTION V — DEFINITIONS paragraph H. "Insured
contact" is modified as follows:
1. Paragraph H.3. is replaced by the following:
3. Any easement or license agreement.
2. Paragraph H.6.a. is deleted.
PPA 300 03 11 Page 4 of 5
Q. Coverage Extensions — Audio, Visual And Data
Electronic Equipment Not Designed Solely For
The Production Of Sound
SECTION III — PHYSICAL DAMAGE COVERAGE
B. Exclusions, exception paragraph a. to exclusion
4.c. and 4.d. is deleted and replaced with the
following:
a. Equipment and accessories used with such
equipment, except for tapes, records, discs or
other electronic media device, provided such
equipment is permanently installed in the
covered "auto" at the time of the "loss" or is
removable from the housing unit which 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 "autos" electrical system, in or
upon the covered "autos"; or
R. Notice Of An Knowledge Of Occurrence
SECTION IV — BUSINESS AUTO CONDITIONS,
A.2. Duties In The Event Of Accident, Claim Suit
Or Loss, subparagraph a. is deleted and replaced
with the following:
a. In the event of "accident", claim, "suit" or "loss",
you must give us or our authorized
representative prompt notice of the "accident" or
"loss" including:
(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 person and
witnesses.
Your duty to give us or our authorized
representative prompt notice of the "accident" or
"loss" applies only when the "accident" or "loss"
is known to:
(1) You, if you are an individual;
(2) A partner if you are a partnership; or
(3) An executive officer or insurance manager, if
you are a corporation.
S. Unintentional Errors Or Omissions
SECTION IV — BUSINESS AUTO CONDITIONS, B.
General Conditions; 2. Concealment Misrepre-
sentation Or Fraud is amended by adding the
following:
The unintentional omission of, or unintentional error
in, any information given by you shall not prejudice
your rights under this insurance. However this pro-
vision does not affect our right to collect additional
premium or exercise our right of cancellation or
nonrenewal.
T. Towing Coverage
SECTION III — PHYSICAL DAMAGE COVERAGE,
A.2. Towing, is deleted and replaced by the
following:
2. We will pay up to $750 for towing and labor
costs incurred each time a covered "auto" is
disabled due to a covered cause of loss.
However:
a. All labor must be performed at the place of
disablement; and
b. If the covered auto is a 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.
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.
PPA 300 03 11 Page 5 of 5
WORKERS,'i COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06
(Ed. 04-94)
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. (This agreement applies only to the extent that you perform work under a written contract
that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the
Schedule.
The additional premium for this endorsement shall be _2_%of the California workers' compensation premium otherwise due on such
remuneration. _
Person or Organization
All persons or organizations that are party to a contract that
Requires you to obtain this agreement, provided you executed
The contract before the loss.
Schedule
Job Description
Jobs performed for any person or organization that you have
Agreed with in a written contract to provide this agreement.
This endorsement changes the policy to which it is attached and is effective an the date issued unless otherwise stated.
(The information below is required onlywhen this endorsement Is issued subsequent to preparation of the policy.)
Endorsement Effective 8/18/2024 Policy No.P5W0005832 Endorsement No.
Insured John Friedman Alice Kimm Architets, Inc. Insurance Company RLI Insurance Company
Countersigned By