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HomeMy WebLinkAboutMills Concrete 202425 GL, Stop Gap Auto, Excess & 2526 ID Work Comp Master Certificate - Mills Concrete LLC (1).pdfANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 4/1/2025 License # 6024 (307) 732-5950 23280 Mills Concrete LLC & Mills Concrete Division 2, LLC PO Box 6407 Jackson, WY 83002 36129 A 1,000,000 X X ENP0612123 12/27/2024 12/27/2025 500,000 10,000 1,000,000 3,000,000 3,000,000 WY Stop Gap 1,000,000 1,000,000A EBA0612123 12/27/2024 12/27/2025 2,000,000A ENP0612123 12/27/2024 12/27/2025 2,000,000 0 B 635603 4/1/2025 4/1/2026 1,000,000 1,000,000 1,000,000 GENERAL LIABILITY INCLUDES: Form GC2503 0509 –Per Project Aggregate – Automatic when required by written contract Form GA233 0920 - Contractors’ Commercial General Liability Broadened Endorsement: Additional Insured Specified Relationships/Primary & Noncontributory/Waiver of Subrogation – Automatic when required by written contract Form GA472 0520 – Contractors Additional Insured (Completed Operations)/Primary & Noncontributory/Waiver of Subrogation – Automatic when required by written contract Form GA250 WY 0522 – WY Stop Gap Endorsement Mills Concrete LLC 4821 Thunderbird Loop Suite 102 Rexburg, ID 83440 MILLCON-14 TJOHNSON1 HUB International Mountain States Limited 1315 S Highway 89 Suite 103 Jackson, WY 83001 Darci Keller darci.keller@hubinternational.com Cincinnati Indemnity Company Idaho State Insurance Fund X X X X X X CG 25 03 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 2 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.For all sums whichtheinsured becomes legal- ly obligated to pay as damages caused by "oc- currences"under Section I -Coverage A,and for all medical expenses caused by acci dents under Section I -Coverage C,which can be at- tributed only to ongoing operations at a single designated construction projectshown in the Schedule above: 1.A separate Designated Construction Pro- ject General Aggregate Limit applies to each designated construction project,and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2.The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A,except damages because of "bodily injury"or "property damage"in- cluded inthe"products-completed opera- tions hazard",andfor medical expenses under Coverage C regardless of the num- ber of: a.Insureds; b.Claims made or "suits" brought; or c.Persons or organizations making claims or bringing "suits". 3.Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Des- ignated Construction Project General Ag- gregate Limit for that designated con- struction project.Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4.The limits shown in the Declarations for Each Occurrence,Damage To Premises Rented To You and Medical Expense continuetoapply.However,instead of be- ing subject to the General Aggregate Limit shown in the Declarations,such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B.For all sums whichtheinsured becomes legal- ly obligated to pay as damages caused by "oc- currences"under Section I -Coverage A,and for all medical expenses caused by acci dents under Section I -Coverage C,which cannot be attributed only to ongoing operations at a si n- gle designated construction projectshown in the Schedule above: 1.Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reducethe amount available under the General Ag- gregate Limit or the Products-completed Operations Aggregate Limit,whichever is applicable; and 2.Such payments shall not reduce any Des- ignated Construction Project General Ag- gregate Limit. C.W hen coverage for liability arising out of the "products-completed operations hazard"is provided,any payments for damages because ENP 061 21 23 EACH OF THE NAMED INSURED’S CONSTRUCTION PROJECTS CG 25 03 05 09 ©Insurance Services Office, Inc., 2008 Page 2 of 2 of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-completed Operations Aggregate Limit,and not reduce the General Aggregate Limit nor the Designated Construc- tion Project General Aggregate Limit. D.If the applicable designated construction pro- ject has been abandoned,delayed,or aban- doned andthen restarted,or if the authorized contracting parties deviate from plans,blue- prints,designs, specifications or timetables, the project will still be deemed to be the same construction project. E.The provisions of Section III -Limits OfInsur- ance not otherwisemodified by this endorse- ment shall continue to apply as stipulated. Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 1 of 17 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. CONTRAC TORS'COMMERCIAL GENERALLIABILITY BROAD ENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A.Endorsement -Table of Contents: Coverage:Begins on Page: 1.Employee Benefit Liability Coverage.......................................................................................2 2.Unintentional Failure To Disclose Hazards .............................................................................8 3.Damage To Premises Rented To You ......................................................................................8 4.Supplementary Payments ......................................................................................................10 5.Medical Payments ...................................................................................................................10 6.180 Day Coverage For Newly Formed Or Acquired Organizations ...................................10 7.Waiver Of Subrogation ...........................................................................................................10 8.Au tomatic Additional Insured -Specified Relationships:..................................................10 (a)Managers Or Lessors Of Premises (b)Lessor Of Leased Equipment (c)Vendors (d)State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises (e)Mortgagee,Assignee Or Receiver 9.Property Damage To Borrowed Equipment .........................................................................13 10.EmployeesAsInsureds -Specified Health Care Services And Good Samaritan Services ...................................................................................................................................14 11 .Broadened Notice Of Occurrence .........................................................................................14 12 .Nonowned Aircraft ..................................................................................................................14 13 .Bodily Injury Redefined ..........................................................................................................15 14 .Expected Or Intended Injury Redefined ...............................................................................15 15 .Former Employees As Insureds ............................................................................................15 16.Voluntary Property Damage Coverage and Care,Custody Or Control Liability Coverage ..................................................................................................................................15 17.Broadened Contractual Liability -Work Within 50'Of Railroad Property.........................17 18.Alienated Premises .................................................................................................................17 B.Limits Of Insurance: The Commercial General Liability Limits of Insuranceapply to the insurance provided by this endorse- ment, except as provided below: 1.Employee Benefit Liability Coverage Each Employee Limit:$1,000,000 Aggregate Limit:$3,000,000 Deductible Amount:$1,000 3.Damage To Premises Rented To You The lesser of: a.The Each Occurrence Limit shown in the Declarations; or b.$500,000 unless otherwise stated $ 4.Supplementary Payments a.Bail Bonds:$2,500 b.Loss Of Earnings:$500 Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 2 of 17 5.Medical Payments Medical Expense Limit:$10,000 9.Property DamageTo Borrowed Equipment Each Occurrence Limit:$10,000 Deductible Amount:$250 16.Voluntary Property Damage Coverage (Coverage D)and Care,Custody Or Control Liability Coverage Limits Of Insurance Voluntary Property Damage Coverage: $1,000 Each Occurrence $5,000 Aggregate Care, Custody Or Control Liability Coverage: $5,000 Each Occurrence unless otherwise stated $ Deductible Amount (Each Occurrence) Voluntary Property Damage Coverage:$250 Care, Custody Or Control Liability Coverage:$250 unless otherwise stated $ COVERAGE PREMIUM BASIS (a)Area (b)Payroll (c)Gross Sales (d)Units (e)Other RATE (For Limits in Excess of $5,000) ADVAN CE PREMIUM (For Limits in Excess of $5,000) Care, Custody Or Control Liability $ TOTAL ANNU AL PREMIUM $ C.Coverages 1.Employee Benefit Liability Coverage a.Thefollowing is added to Section I - Coverages: EMPLOYEE BENEFIT LIABILITY COVERAGE (1)Insuring Agreement (a)We will pay those sums that the insured becomes legally obligated to pay as damag- es caused by any act,error or omission of the insured, or of any other person for whose acts the insured is legally liable,to whichthis insuranceapplies.W e will have the right and duty to defendtheinsured against any "suit"seeking those damages.However,we will have no duty to defend against any "suit"seeking damages to which this in- surance does not apply.We may,at our discretion,in- vestigate any report of an act,error or omission and settle any claim or "suit"that may result.But: 1)The amount we will pay for damages is limited as described in C.Cov- erages,1.Employee Benefit Liability Cover- age,c.Limits Of Insur- ance of this endorse- ment; and 2)Our right andduty to defend ends when we have used up the appli- cable limit of insurance in the payment of judg- ments or settlements. No other obligation or liabil- ity to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Pay- ments. (b)This insurance appliesto damages only if the act,er- ror or omission is negligently committed in the "admin- istration"of your "employee benefit program"; and 1)Occurs duringthepolicy period; or Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 3 of 17 2)Occurred prior to the "first effective date"of this endorsement pro- vided: a)You did not have knowledge of a claim or "suit"on or beforethe"first ef- fective date"of this endorsement. You will be deemed to have knowledge of a claim or "suit" when any insured listed under C. Coverages,1. Employee Benefit Liabilit y Coverage, b.Who Is An In- sured,(1)of this endorsement or any "employee" authorized byyou to give or receive noticeofaclaim or "suit": i)Reports all,or any part,of the act,error or omission to us or any other insurer; ii)Receives a writtenor ver- bal demand or claim for dam- ages because of the act,er- ror or omis- sion; and b)There is no other applicable insur- ance. (2)Exclusions This insurance does not apply to: (a)Bodily Injury,Property Damage Or Personal And Advertising Injury "Bodily injury", "property damage"or "personal and advertising injury". (b)Dishonest,Fraudulent, Criminal Or Malicious Act Damages arising out of any intentional,dishonest, fraudulent,criminal or mali- cious act,error or omission, committed by any insured, including the willful or reck- less violationof any statute. (c)FailureTo Perform A Con- tract Damages arising out of fail- ure of performanceofcon- tract by any insurer. (d)Insufficiency Of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the "employee benefit program". (e)Inadequacy Of Perfor- mance Of Invest- ment/Advice Given With Respect To Participation Any claim based upon: 1)Failure of any invest- ment to perform; 2)Errorsinproviding in- formation on past per- formance of investment vehicles;or 3)Advice given to any person with respectto that person's decision to participate or notto par- ticipate in any plan in- cluded inthe"employee benefit program". (f)Workers'Compensation And Similar Laws Anyclaim arising out of your failure to comply with the mandatory provisions of any workers'compensation,un- employment compensation insurance,socialsecurity or disability benefits law or any similar law. (g)ERISA Damages for which any in- sured is liable because ofli- abilityimposed on a fiduci- ary by the Employee Re- tirement Income Security Act of 1974,as now or hereafter amended,or by any similar federal, state or local laws. Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 4 of 17 (h)Available Benefits Any claim for benefits to the extent thatsuch benefits are available,with reasonable effort and cooperationofthe insured,from the applicable funds accrued or other col- lecti ble insurance. (i)Taxes, Fines Or Penalties Taxes,fines or penalties, i n- cluding those imposed un- der the Internal Revenue Code or any similar state or local law. (j)Employment-Related Prac- tices Any liability arising out of any: 1)Refusal to employ; 2)Termination of employ- ment; 3)Coercion,demotion, evaluation,reassign- ment,discipline,defa- mation,harassment, humiliation,discrimina- tion or other employ- ment-related practices, acts or omissions;or 4)Consequentialliability as a result of 1),2)or 3) above. This exclusion applies whether the insured may be held liable as an employer or in any other capacity and to any obligationtoshare damages with or repay someone else who must pay damages because of the in- jury. (3)Supplementary Payments Section I -Supplementary Pay- ments -Coverages A and B also apply tothis Coverage,however 1.b.and 2.of the Supplementary Payments provision do not apply. b.Who IsAn Insured As respects Employee Benefit Liabil- ity Coverage,Section II -Who IsAn Insured is replaced by the following: (1)If you are designated in the Dec- larations as: (a)An individual, youand your spouse are insureds,but on- ly with respect tothecon- duct of a business of which you are the sole owner. (b)A partnership or joint ven- ture,you are an insured. Your members,your part- ners,and their spouses are also insureds but only with respect to the conduct of your business. (c)A limited liability company, you are an insured.Your members are also insureds, but only with respectto the conduct of your business. Your managers are in- sureds,but only with respect to their dutiesasyour man- agers. (d)An organization other than a partnership,joint venture or limited liability company,you are an insured .Your "execu- tive officers"and directors are insureds,but only with respect to their duties as your officers or directors. Your stockholders are also insureds,but only with re- specttotheir liability as stockholders. (e)A trust,you are an insured. Your trustees are also in- sureds,but only with respect to their duties as trustees. (2)Each of the following is also an insured: (a)Eachofyour "employees" who is or was authorized to administer your "employee benefit program"; (b)Any persons,organizations or "employees"having prop- er temporary authorization to administer your "employ- ee benefit program"if you die,but only until your legal representative is appointed; or (c)Your lega l representative if you die,but only with re- spect to duties as such.That representative will have all your rights and duties under this Coverage Part. Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 5 of 17 (3)Any organization you newly ac- quire or form,other than a part- nership,jointventure or limited liability company,and over which you maintain ownership or major- ity interest,will qualifyasa Named Insured if no other similar insuranceapplies tothatorgani- zation.However,coverage under this provision: (a)Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and (b)Does not apply to anyact, error or omission that was committed before you ac- quired or formed the organi- zation. c. Limits Of Insurance As respects Employee Benefit Liabil- ity Coverage,Section III -Limits Of Insurance is replaced by the follow- ing: (1)The Limits of Insurance shown in Section B.Limits Of Insurance, 1.Employee Benefit Liability Coverage of this endorsement and the rules below fix the most we will pay regardless of the number of: (a)Insureds; (b)Claims made or "suits" brought; (c)Persons or organizations making claims or bringing "suits"; (d)Acts, errors or omissions;or (e)Benefits included in your "employee benefit program". (2)The Aggregate Limit shown in Section B.Limits Of Insurance, 1.Employee Benefit Liability Coverage of this endorsement is the most we will pay for all dam- ages because of acts,errors or omissions negligently committed in the "administration"of your "employee benefit program". (3)Subjectto the limit described in (2)above,the Each Employee Limit shown in Section B.Limits Of Insurance,1.Employee Bene- fit Liability Coverage of this en- dorsement is the most we will pay for all damages sustained by any one "employee",incl uding damages sustained by such "employee's"dependents and beneficiaries, as a result of: (a)An act, error or omission; or (b)A series of related acts,er- rors or omissions,regard- less of the amount oftime that lapses between such acts, errors or omissions; negligently committed in the "administration"of your "employ- ee benefit program". However,the amount paid under this endorsement shall not ex- ceed,and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the "employee benefit program." (4)Deductible Amount (a)Our obligation to pay dam- ages on behalf of the in- sured applies only to the amount of damages in ex- cess of the Deductible Amount shown in Section B. Limits Of Insurance,1.Em- ployee Benefit Liability Cov- erage of this endorsement as applicable to Each Em- ployee.The limits of insur- ance shall not be reduced by the amount of this de- ducti ble. (b)The Deductible Amount shown in Section B.Limits Of Insurance,1.Employee Benefit Liability Coverage of this endorsement applies to all damages sustained by any one "employee",includ- ing such "employee's"de- pendents and beneficiaries, becauseofall acts,errors or omissions to which this in- surance applies. (c)The terms of this insurance, includingthose with respect to: 1)Our right andduty to defendtheinsured against any "suits" seeking those damag- es; and Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 6 of 17 2)Your duties,and the du- ties of any other in- volved insured,inthe event of an act,error or omission,or claim; apply irrespectiveof the ap- plication of the Deductible Amount. (d)We may pay any part or all of the Deductible Amount to effect settlement of any claim or "suit"and,uponno- tification of the action taken, you shall promptly reim- burse us for such part of the Deductible Amount as we have paid. d.Additional Conditions As respects Employee Benefit Liabil- ity Coverage,Section IV -Commer- cial General Liability Conditions is amended as follows: (1)Item 2.DutiesIn The Event Of Occurrence,Offense,Claim Or Suit is replaced by the following: 2.Duties In The Event Of An Act,Error,Omission, Claim Or Suit a.You mustsee to it that we are notified as soon as practicable of an act, error or omission which may result in a claim. To the extent possible, notice should include: (1)Wha t the act,error or omission was and when it oc- curred; and (2)The names and addresses of any- one whomaysuf- fer damages as a result of the act, error or omission. b.If a claim is made or "suit"is brought against any insured,you must: (1)Immediately record the specifics of the claim or "suit"and the date received; and (2)Notifyusas soon as practicable. You mustsee to it that we receive written no- tice of the claim or "suit" as soon as practicable. c.You and any other in- volved insured must: (1)Immediately send us copies of any demands,notices, summonses or le- gal papers re- ceived in connec- tion with the claim or "suit"; (2)Authorize us to ob- tain records and other information; (3)Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4)Assist us,upon our request, in the en- forcement of any right against any person or organi- zation which may be liable tothein- sured becauseof an act,error or omission to which this insurance may also apply. d.No insured will,except at that insured's own cost,voluntarily make a payment,assume any obligation,or incur any expense without our consent. (2)Item 4.Other Insurance is re- placed by the following: 4.Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this Employee Benefit Liability Coverage,our obli- gations are limited as fol- lows: a.Primary Insurance This insurance is prima- ry except when c.below applies.If this insurance Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 7 of 17 is primary,our obliga- tions are not affected unless any of theother insurance is also prima- ry.Then,we willshare with all that other insur- anceby the method de- scribed in Paragraph b. below. b.Method Of Sharing If all of the other insur- ance permits con tribu- tion by equalshares, we will follow this meth- od also.Under this ap- proach each insurer contributes equal amounts until it has paid its applicable limit of insurance or noneof the loss remains, whichever comes first. If any of the other in- surance does not permit contribution by equal shares,we will contrib- ute by limits.Under this method,each insurer's share is based on the ratioofits applicable limit of insurance to the total applicable limits of insuranceof all insur- ers. c.No Coverage This insurance shall not cover any loss for which the insured is entitledto recovery under any other insurance in force previous totheeffective date ofthis Employee Benefit Liability Cover- age. e. Additional Definitions As respects Employee Benefit Liabil- ity Coverage,Section V -Definitions is amended as follows: (1)The following definitions are added: 1."Administration"means: a.Providing information to "employees", i ncluding their dependents and beneficiaries,with re- spect to eligibility for or scope of"employee benefit programs"; b.Interpretingthe"em- ployeebenefit pro- grams"; c.Handling records in connection with the "employee benefit pro- grams"; or d.Effecting,continuing or terminating any "em- ployee's"participation in any benefit included in the "employee benefit program". However,"administration" does not include: a.Handling payroll deduc- tions; or b.The failure to effect or maintain any insurance or adequate limits of coverage ofinsurance, including but not limited to unemployment insur- ance,social security benefits,workers'com- pensation and disability benefits. 2."Cafeteria plans"means plans authorizedby applica- ble law to allow "employees" to elect t o pay for certain benefits with pre-tax dollars. 3."Employeebenefit pro- grams"means aprogram providing some or all ofthe following benefits to "em- ployees",whether provided through a "cafeteria plan"or otherwise: a.Group life insurance; group accident or health insurance;dental,vision and hearing plans;and flexible spending ac- counts;provided that no one other than an "em- ployee"may subscribe to such benefits and such benefits are made generally available to those "employees"who satisfy the plan's eligibil- ity requirements; Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 8 of 17 b.Profit sharing plans, employee savings plans,employee stock ownership plans,pen- sion plans and stock subscription plans,pro- vided that no one other than an "employee" may subscribe to such benefits and such bene- fits are made generally available to all "employ- ees"who are eligible under the plan for such benefits; c.Unemployment insur- ance,social security benefits,workers'com- pensation and disability benefits;and d.Vacation plans, i nclud- ing buy and sell pro- grams;leave of ab- sence programs,includ- ing military,maternity, family,and civil leave; tuition assistanceplans; transportation and health club subsidies. 4."First effective date"means the date upon which cover- age was first effected in a series of uninterrupted re- newals of insurance cover- age. (2)The following definitions are de- leted in their entirety and re- placed by the following: 5."Employee"means a person actively employed,formerly employed,on leave of ab- sence or disabled,or retired. "Employee"includes a "leased worker". "Employee" does not include a "tempo- rary worker". 18."Suit"means a civil proceed- ing in which money damag- es because of an act,error or omissiontowhichthis in- surance applies are alleged. "Suit"includes: a.An arbitration proceed- ing in which such dam- ages are claimed and to whichtheinsured must submit or does submit with our consent; b.Any other alternative dispute resolutionpro- ceeding in which such damages are cl aimed and to whichthein- sured submits with our consent; or c.An appeal of a civil pro- ceeding. 2.Unintentional Failure To Disclose Haz- ards Section IV -Commercial General Liabil- ity Conditions,6.Representations is amended by the additionof the following: Based on our dependence upon your rep- resentations as to existing hazards,if un- intentionally you should fail to disclose all such hazards at the inception date of your policy,we will not rejectcoverage under this Coverage Part based solely on such failure. 3.Damage To Premises Rented To You a.The last paragraph of 2.Exclusions under Section I -Coverage A -Bod- ily InjuryAnd Property Damage Li- ability is replaced by the following: Exclusions c.through n.do not apply to damage by fire,explosion,light- ning, smoke or soot to premises while rented to you or temporarily occupied by you with permission of the owner, for which the amount we will pay is limited to the Damage To Premises Rented To You Limit as described in Section III -Limits Of Insurance. b.The insurance providedunder Sec- tion I -Coverage A -BodilyInjury And Property Damage Liability applies to "property damage"arising out of wa- ter damage to premises that are both rented to and occupied by you. As respects W ater Damage Legal Li- ability,as provided in Paragraph 3.b. above: The exclusions under Section I - Coverage A -Bodily Injury And Prop- erty Damage Liability,2.Exclusions, other than i.War and the Nuclear Energy Liability Exclusi on (Broad Form),are deleted and the following are added: This insurance does not apply to: (a)"Property damage": Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 9 of 17 (i)Assumed in any contract or agreement; or (ii)Caused by or resulting from any of the following: 1)Wear and tear; 2)Rust or other corrosi on,de- cay,deterioration,hidden or latent defect or any quality in property that causes it to damage or destroy itself; 3)Smog; 4)Mechanical breakdown,in- cluding rupture or bursting caused by centrifugal force; 5)Settling,cracking,shrinking or expansion; 6)Nesting or infestation,or discharge or releaseof waste products or secre- tions,by insects,birds,ro- dents or other animals; or 7)Presence,growth,prolifera- tion,spread or any activity of fungus,including mold or mildew,and any mycotoxins, spores, scents or byproducts produced or released by fungi. (b)"Property damage"caused di- rectly or indirectly by any of the following: (i)Earthquake,volcanic erup- tion,landslide or any other earth movement; (ii)Water that backs up or over- flows or is otherwise dis- charged from a sewer, drain, sump, sump pump or related equipment; (iii)Water under the ground sur- face pressing on,or flowing or seeping through: 1)Foundations,walls, floors or paved surfac- es; 2)Basements,whether paved or not; or 3)Doors,windows or other openings. (c)"Property damage"causedby or resulting from water that leaks or flows from plumbing,heating,air conditioning,fire protection sys- tems,or other equipment, caused by or resulting from freezing, unless: (i)You did your best to main- tain heat in the building or structure; or (ii)You drained the equipment and shut off the water supply if the heat was not main- tained. (d)"Property damage"to: (i)Plumbing,heating,air condi- tioning,fire protection sys- tems,or other equipment or appliances; or (ii)The interior of any building or structure,or to personal property in the building or structure,caused by or re- sulting from rain,snow,sleet or ice,whether drivenby wind or not. c. Limit Of Insurance With respect to the insuranceafford- ed in Paragraphs 3.a.and 3.b.above, the Damage To Premises Rented To You Limit as shown in the Declara- tions is amended as follows: (1)Paragraph 6.of Section III -Lim- its 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 -Bodily Injury And Property Damage Liability for damages be- causeof"property damage" to any one premises: a.While rentedto you,or temporarilyoccupied by you with permission of the owner; b.In the case of damage by fire,explosion,light- ning,smoke or soot, while rented to you;or c.In the case of damage by water,while rented to and occupied byyou. (2)The most we will pay is limited as described in Section B.Limits Of Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 10 of 17 Insurance,3.Damage To Prem- ises Rented To You of this en- dorsement. 4.Supplementary Payments Under Section I -Supplementary Pay- ments -Coverages A and B: a.Paragraph 1.b.is replaced by the fol- lowing: Up to the limit shown in Section B. Limits Of Insurance,4.a.Bail Bonds of this endorsement for cost of bail bonds requiredbecause of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage ap- plies.We do not have to furnish these bonds. b.Paragraph 1.d.is replaced by the fol- lowing: All reasonable expenses incurred by the insured at our requestto assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to the limit shown in Sec- tion B.Limits OfInsurance,4.b.Loss Of Earnings ofthis endorsement per day becauseof time off from work. 5.Medical Payments TheMedical Expense Limit of Any One Person as shown in the Declarations is amended to the limit shown in Section B. Limits Of Insurance,5.Medical Payments of this endorsement. 6.180 Day Coverage For Newly Formed Or Acquired Organizations Section II -Who IsAn Insured is amended as follows: Subparagraph a.of Paragraph 3.is re- placed by the following: a.Coverage under this provision is af- forded only until the180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; 7.Waiver Of Subrogation Section IV -Commercial General Liabil- ity Conditions,8.Transfer Of Rights Of Recovery Against Others To Us is amended by the additionof the following: We waive any right of recovery against any additionalinsured under this en- dorsement,becauseof any payment we makeunder this endorsement, to whom the insured has waived its right of recov- ery in a written contract,written agree- ment,written permit or written authoriza- tion.Such waiver by us applies only to the extent that the insured has waived its right of recovery againstsuch additional insured prior to loss. 8.Au tomatic Additional Insured -Speci- fied Relationships a.The following is added to Section II - Who IsAn Insured: (1)Any person(s)or organization(s) described in Paragraph 8.a.(2)of this endorsement (hereinafter re- ferred to as additionalinsured) whom you are required to add as an additional insured under this Coverage Part by reason of a written contract,written agree- ment,written permit or written authorization. (2)Only the following persons or or- ganizations are additional in- sureds under this endorsement, and insurance coverage provided to such additional insureds is lim- ited as provided herein: (a)Managers Or Lessors Of Premises Themanager or lessor of a premises leased to you you are required per Paragraph 8.a.(1)of this endorsement to provide insurance,but on- ly with respect to liability for "bodily injury","property damage"or "personal and advertising injury"caused,in whole or in part,by you or those actingon your behalf in connection with the own- ership,maintenance or use of that part of the premises leased to you,subject to the following additional exclu- sions: This insurance does not ap- ply to: (i)Any "occurrence"which takes place after you ceasetobeatenant in that premises; (ii)Structural alterations, new construction or demolition operations performed by or on be- Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 11 of 17 half of such additional insured. (b)Lessor Of Leased Equip- ment Any person(s)or organiza- tion(s)from whom you lease equipment you are required per Paragraph 8.a.(1)of this endorsement to provide in- surance.Suchperson(s)or organization(s)are insureds only with respect to liability for "bodily injury", "property damage"or "personal and advertising injury"caused,in whole or in part,by your maintenance,operation or useofequipment leased to you by such person(s)or or- ganization(s).A person's or organization's status as an additionalinsured under this endorsement ends when their contract or agreement with you for such leased equipment ends.However, this insurance does not ap- ply to any "occurrence" which takes place after the equipment lease expires. (c)Vendors Any person or organization (referred to below as ven- dor)you are required per Paragraph 8.a.(1)of this en- dorsement to provide insur- ance,but only with respect to liability for "bodily injury" or "property damage"arising out of"your products"which are distributed or sold in the regular course of the ven- dor's business, subjectto the following additional ex- clusions: (i)The insuranceafforded the vendor does not apply to: 1)"Bodily injury"or "property damage" for which the ven- do r is obligated to pay damages by reasonofthe as- sumption ofliability 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 agree ment; 2)Any express war- ranty unauthorized by you; 3)Any physical or chemical change in the product made intentionally by the vendor; 4)Repackaging,ex- cept when un- packed solely for the purpose ofin- spection,demon- stration,testing,or the substitution of parts under in- structions from the manufacturer,and then repackaged in the originalcon- tainer; 5)Any failure to make such inspections, adjustments,tests or servicing as the vendor has agreed to makeor normal- ly undertakesto make in the usual course of busi- ness,in connection with the distribution or saleofthe products; 6)Demonstration,in- stallation,servicing or repair opera- tions,except such operations per- formed at the ven- dor's premises in connection with the sale of the product; 7)Products which,af- ter distribution or sale byyou,have been labeled or re- labeled or used as a container,part or ingredient of any other thing or sub- stance by or for the vendor; or Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 12 of 17 8)"Bodily injury"or "property damage" arisingout of the sole negligence of the vendor for its own acts or omis- sions or thoseof its employees or anyoneelse acting on its behalf.How- ever,this exclusion does not apply to: a)The excep- tions contained in Paragraphs (c)(i)4)or 6)of this endorse- ment;or b)Such inspec- tions,adjust- ments,tests or servicing as the vendor has agreed to make or nor- mally under- takes to make in the usual courseof business,in connection with the distri- bution or sale of the prod- ucts. (ii)This insurance does not apply to any insured person or organization: 1)From whom you haveacquired such products,or any ingredient,part or container,enter- ing into,accompa- nying or containing such products; or 2)When liability in- cluded within the "products- completed opera- tions hazard"has been excluded un- der this Coverage Part with respect to such products. (d)State Or Governmental Ag ency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises Any state or governmental agency or subdivision or po- litical subdivision you are required per Paragraph 8.a.(1)of this endorsement to provide insurance, subject to the following additional provi sion: This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or politicalsub- division has issuedapermit or authorization in connec- tion with premises you own, rent or control and to which this insurance applies: (i)The existence,mainte- nance,repair,construc- tion,erection or removal of advertising signs, awnings, canopies, cel- lar entrances,coal holes,driveways,man- holes,marquees,hoist away openings,side- walk vaults,street ban- ners or decorations and similar exposures; (ii)The construction,erec- tion or removal of eleva- tors;or (iii)The ownership,mainte- nance or use of any el- evators covered bythis insurance. (e)Mortgagee,Assignee Or Receiver Any person or organization you are required per Para- graph 8.a.(1)of this en- dorsement to provide insur- ance,but only with respect to their liabilityasmortga- gee,assignee or receiver and arising out of the own- ership,maintenance or use of the premises byyou. However,this insurance does not apply to structural alterations,new construction and demolitionoperations performed by or for that per- son or organization. Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 13 of 17 (3)The insurance affordedto addi- tional insureds described in Par- agraph 8.a.(1)of this endorse- ment: (a)Only applies to the extent permitted by law; (b)Will not be broader than that which you are required by the written contract,written agreement,written permit or written authorization to pro- vide for such additional in- sured; and (c)Does not apply to any per- son,organization,vendor, state,governmental agency or subdivision or political subdivision,specifically named as an additionalin- sured under any other provi- sion of,or endorsement addedto,this Coverage Part,provided such other provision or endorsement covers the injury or damage for which this insurance ap- plies. b.With respect to the insurance afford- ed to the additional insureds de- scribed in Paragraph 8.a.(1)of this endorsement,the following is added to Section III -Limits Of Insurance: The most we will pay on behalf of the additionalinsured is the amount of in- surance: (1)Required by the written contract, written agreement,written permit or writtenauthorization described in Paragraph 8.a.(1)of this en- dorsement.For the purpose of determining the required amount of insurance only,we will include the minimum amount of any Um- brella liability or Excess Liability coverage required for that addi- tional insured inthatwritten con- tract,written agreement,written permit or written authorization;or (2)Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. c.Section IV -Commercial General Liability Conditions is amended to include the following: Au tomaticAdditional Insured Pro- vision This insuranceapplies only if the "bodily injury"or "property damage" occurs,or the "personal and advertis- ing injury"offense is committed: (1)During the policy period; and (2)Subsequent to your execution of the written contract or written agreement,or the issuanceofa writtenpermit or written authori- zation,described in Paragraph 8.a.(1). d.Section IV -Commercial General Liability Conditions is amended as follows: Condition 4.Other Insurance is amended to include: PrimaryAnd Noncontributory In- surance This insurance is primary to and will not seek contribution from any other insuranceavailable to an additional insured per Paragraph 8.a.(1)of this endorsement provided that: (1)Theadditional insured is a Named Insured under suchother insurance; and (2)You have agreed in writing in a contract,agreement,permit or authorization described in 8.a.(2) of this endorsement thatthis in- surance would be primary and would not seekcontribution from any other insurance availableto the additional insured. 9.Property DamageTo Borrowed Equip- ment a.The following is added to Exclusion 2.j.Damage To Property under Sec- tion I -Coverage A -BodilyInjury And Property Damage Liability: Paragraphs (3)and (4)of this exclu- sion do not apply to tools or equip- ment loaned to you,provided they are not being used to perform operations at the time of loss. b.With respect to the insurance provid- ed by this sectionof theendorse- ment,the following addition al provi- sions apply: (1)The Limits of Insurance shown in the Declarations are replaced by the limits shown in Section B. Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 14 of 17 Limits OfInsurance,9.Property Damage To Borrowed Equip- ment of this endorsement with respect to coverage provided by this endorsement.These limits are inclusive of and not in addi- tion to the limits being replaced. The Limits of Insurance shown in Section B.Limits Of Insurance, 9.Property Damage To Bor- rowed Equipment of this en- dorsementfixthe most we will pay in any one "occurrence"re- gardless of the number of: (a)Insureds; (b)Claims made or "suits" brought; or (c)Persons or organizations making claims or bringing "suits". (2)Deductible Clause (a)Our obligation to pay dam- ages on your behalf applies only to the amount of dam- ages for each "occurrence" which are in excess of the Deductible Amount shown in Section B.Limits OfInsur- ance,9.Property Damage To Borrowed Equipment of this endorsement.The limits of insurance will not be re- duced by the application of such deductible amount. (b)Section IV -Commercial General Liability Conditions, 2.Duties In The Event Of Occurrence,Offense,Claim Or Suit,applies to each claim or "suit"irrespective of the amount. (c)We may pay any part or all of the deductible amount to effect settlement of any claim or "suit"and,uponno- tification of the action taken, you shall promptly reim- burse us for such part of the deductible amount as has been paid byus. 10.EmployeesAsInsureds -Specified Health Care Services And Good Samar- itan Services Paragraph 2.a.(1)(d)under Section II - Who Is An Insured does not apply to: 1)Your "employees"who provide pro- fessional health care services on your behalf as a duly licensed nurse, emergency medicaltechnician or paramedic in the jurisdiction where an "occurrence"or offensetowhichthis insurance applies takes place; or 2)Your "employees"or "volunteer work- ers",other than an employed or vol- unteer doctor,providing first aid or good samaritan services during their work hours for you will be deemed to be acting within the scope of their employment by you or performing du- ties related to the conduct of your business. 11 .Broadened Notice Of Occurrence Paragraph a.of Condition 2. Duties In The Event Of Occurrence,Offense, Claim Or Suit under Section IV -Com- mercial General Liability Conditions is replaced by the following: a.You must see to it that we are notified as soon as practicable of an "occur- rence"or an offense which may result in a claim.To the extent possible,no- tice should include: (1)How,when and where the "oc- currence"or offense took place; (2)The names and addresses of any injured persons and wit- nesses;and (3)The nature and location of any injury or damage arising out of the "occurrence"or offense. This requirement applies only when the "occurrence"or offense is known to any insured listed under Paragraph 1.of Section II -Who Is An Insured or any"employee"authorized byyouto give or receive noticeofan "occur- rence"or offense. 12 .Nonowned Aircraft The following is addedto Exclusion 2.g. Aircraft,Auto Or Watercraft under Sec- tion I -Coverage A -Bodily InjuryAnd Property Damage Liability: This exclusion does not apply to an air- craft you do not own, provided that: a.The pilot in command holds a current effective certificate,issued by a duly constituted authority of the United States of America or Canada,desig- natingthat person as a commercial or airline transport pilot; Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 15 of 17 b.The aircraft is rented withatrained, paidcrew; and c.The aircraft does not transport per- sons or cargo for a charge. 13 .Bodily Injury Redefined Section V -Definitions,3."Bodily injury" is replaced by the following: 3."Bodily injury"means bodily harm or injury,sickness,disease,disability, humiliation,shock,fright,mental an- guish or mental injury,including car e, loss of services or death resulting from any of these at any time. 14 .Expected Or Intended Injury Redefined The lastsentence of Exclusion 2.a.Ex- pected Or Intended Injury under Sec- tion I -CoverageA-Bodily InjuryAnd Property Damage Liability is replaced by the following: This exclusion does not apply to "bodily injury"or "property damage"resulting from the use of reasonable force to protect per- sons or property. 15 .Former Employees As Insureds The following is addedtoParagraph 2. under Section II -Who IsAnInsured: 2.Eachofthefollowing is also an in- sured: Any of your former "employees",di- rectors,managers,members,part- ners or "executiveofficers",including but not limited to retired,disabled or those on leave of absence,but only for acts withinthescope of their em- ployment by you or for duties related to the conduct of your business. 16.Voluntary Property Damage Coverage a.Section I -Coverages is amended to include the following: COVERAGE D -VOLUNTARY PROPERTY DAMAGE COVERAGE (1)Insuring Agreement (a)We will pay the cost to re- pair or replace "property damage"to property of oth- ers arising out of operations incidentalto your business when: 1)Damage is caused by you;or 2)Damage occurs while in your possession. At your written request,we will make this payment re- gardless of whether you are at faultfor the "property damage". If you,at our request,re- place,or make any repairs to,damaged property of others,the amount we will pay under Voluntary Proper- ty Damage Coverage will be determined by your actual cost to replace or repair the damaged property,exclud- ing any profit or overhead. Any payment we make un- der Voluntary Property Damage Coverage shall not be interpreted as an admis- sion of liability byyou or by us. It shall be your duty,not our duty,to defend any cl aim or "suit"to which this insurance applies. No other obligation or liabil- ity to pay sums or perform acts or services iscovered. (b)This insurance applies to "property damage"only if: 1)The "property damage" takes place in the "cov- erage territory"; and 2)The "property damage" occurs during the policy period. (2)Exclusions This insurance does not apply to "property damage"that would be excluded by Coverage A -Bodily Injury And Property Damage Lia- bility,2.Exclusions,except for j. Damage To Property,Para- graphs (3),(4),(5)and (6),k. Damage To Your Product,and l. Damage To Your Work. (3)Definitions For purposes of Voluntary Prop- erty Damage Coverage only,the following definitions under Sec- tion V -Definitions are replaced by the following: Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 16 of 17 13."Occurrence"means an in- cident,including continuous or repeated exposureto substantially the same gen- eral harmful conditions that result in "property damage". 17."Property damage"means physical injury to tangible property.Electronic data is not tangible property,and "property damage"does not include disappearance,ab- straction or theft. Asused in this definition, electronic data means in- formation,facts or pro- grams,stored as or on,cre- ated or used on,transmitted to or from computer soft- ware,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. b.Care,Custody Or Control Liability Coverage For purposes ofthe coverage provid- ed by Care,Custody Or Control Lia- bility Coverage in this endorsement only: (1)Section I -Coverage A -Bodily Injury And Property Damage Lia- bility,2.Exclusions,j.Damage To Property,Paragraphs (3),(4) and (5)do not apply to "property damage"to the property of oth- ers described therein. (2)It shall be your duty, not our duty, to defendany claim or "suit"to whichthis insurance applies. No other obligation or liability to pay sums or perform acts or ser- vices is covered. This Paragraph (2)supersedes any provision in the Coverage Part to the contrary. (3)"Property damage"for which Care,Custody Or Control Liabil- ity Coverage providescoverage shall be deemed to be caused by an "occurrence"butshall not serve to limit or restrict the ap- plicability of any exclusionfor "property damage"under this Coverage Part. c.Limits Of Insurance And Deducti- bles For purposes ofthe coverage provid- ed by Voluntary Property Damage Coverage and Care, Custody Or Con- trol Liability Coverage,Section III - Limits Of Insurance is amended to include the following: (1)The Limits of Insurance shown in the Declarations are replaced by the limits shown in Section B. Limits OfInsurance,16.Volun- tary Property Damage Coverage and Care,Custody Or Control Liability Coverage in this en- dorsement.These limits are in- clusive of,and not in addition to, the limits being replaced.The Limits of Insurance shown in the Schedule fix the most we will pay regardless of the number of: (a)Insureds; (b)Claims made or "suits" brought;or (c)Persons or organizations making claims or bringing "suits". (2) (a) Subject to (3)below,the Voluntary Property Damage Coverage Each Occurrence Limit OfInsurance is the most we will pay for the sum of damages under Voluntary Property Damage Coverage; (b)The Care,Custody Or Con- trol Liability Coverage Each Occurrence Limit Of Insur- ance is the most we will pay for the sum of damages un- der Care,Custody Or Con- trol Liability Coverage; because of all "property damage" arisingout of any one "occur- rence". (3)The Voluntary Property Damage Coverage,Aggregate Limit Of Insurance is the most we will pay for the sum of all damages under Voluntary Property Damage Coverage.This limit applies sep- aratelyto each "coverage term". (4)Deductible Clause Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission.Page 17 of 17 (a)Our obligation to pay dam- ages on your behalf applies only to the amount of dam- ages for each "occurrence" which are in excess of the Deductible Amount shown in Section B.Limits Of Insur- ance,16.Voluntary Property Damage Coverage and Care,Custody Or Control Liability Coverage.The lim- its of insurance will not be reduced by the application of such Deductible Amount. (b)Section IV -Commercial General Liability Conditions, 2.Duties In The Event Of Occurrence,Offense,Claim Or Suit,applies to each claim or "suit"irrespective of the amount. (c)We may pay any part or all of the Deductible Amount to effect settlement of any claim or "suit"and,uponno- tification of the action taken, you shall promptly reim- burse us for such part of the Deductible Amount as has been paid byus. 17.Broadened Contractual Liability -Work Within 50'Of Railroad Property Section V -Definitions,9."Insured con- tract"is amended as follows: a.Paragraph c.is replaced by the fol- lowing: c.Any easement or license agree- ment; b.Paragraph f.(1)is deleted in its entire- ty. 18.Alienated Premises Exclusion 2.j.Damage To Property,Para- graph (2)under Section I -Coverage A - Bodily Injury And Property Damage Liabil- ity does not apply if the premises are "your work". Includes copyrighted material of Insurance Services GA 250 WY 05 22 Office,Inc.,with its permission.Page 1 of 5 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. STOP GAP-EMPLOYERS LIABILITY COVERAGE ENDORSEMENT -WYOMING This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Limits of Insurance Bodily Injury by Accident $Each Accident Bodily Injury by Disease$Aggregate Limit Bodily Injury by Disease$Each Employee Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.The following is added to Section I -Cover- ages: Stop Gap -Employers Liability Coverage 1.Insuring Agreement a.W e will pay those sums that the insured becomes legally obligated by Wyoming Law to pay as damages becauseof "bodily injury by accident" or "bodily injury by disease"to your "employee"to which this insurance applies.We will have the right and duty to defend the insured against any "suit"seeking those damag- es.However,we will have no duty to de- fend the insured against any "suit"seek- ing damages to whichthis insurance does not apply.W e may,at our discre- tion,investigate any accident and settle any claim or "suit" that may result. But: (1)The amount we will pay for damages is limited as described in Section III - Limits Of Insurance;and (2)Our right and duty to defend ends when wehave used up the applicable limit of insurance in the payment of judgments or settlements under this coverage. Thetender of the limits of insurance before judgment or settlement does not relieve us of our duty to defend. No other obligation or liability to pay sums or perform acts or services is cov- ered un less explicitly provided for under Supplementary Payments. b.This insurance applies to "bodily injury by accident" or "bodily injury by disease"on- ly if: (1)The: (a)"Bodily injury by accident"or "bodily injury by disease"takes place in the "coverage territory"; (b)"Bodily injury by accident"or "bodily injury by disease"arises out of and in the courseofthe in- jured "employee's" employment by you; and (c)"Employee",at the time of the in- jury,was covered under a work- ers'compensation policy and sub- ject toa"workers'compensation law"of Wyoming; and (2)The: (a)"Bodily injury by accident"is caused by an accident that occurs during the policy period; or 1,000,000 1,000,000 1,000,000 Includes copyrighted material of Insurance Services GA 250 WY 05 22 Office,Inc.,with its permission.Page 2 of 5 (b)"Bodily injury by disease"is caused by or aggravated by conditions of employment by you and the injured "employee's" last day of last exposure to the con- ditions causing or aggravating such "bodily injury by disease" occurs during the policy period. c.The damages we will pay,where recov- ery is permitted by law,include damag- es: (1)For: (a)W hich you are liable to a third par- ty by reason of a claim or "suit" against you by thatthird partyto recover the damages claimed againstsuchthird party as a result of injury t o your "employee"; (b)Care and loss of services; and (c)Consequential "bodily injury by accident"or "bodily injury by dis- ease"toaspouse,child,parent, brother or sister of the injured "employee"; provided that these damages are the direct consequenceof"bodily injury by accident"or "bodily injury by dis- ease"that arises out of and in the courseof the injured "employee's" employment byyou; and (2)Because of "bodily injury by accident" or "bodily injury by disease"to your "employee"that arises out of and in the course of employment,claimed against you in a capacity other than as employer. d.Damages include prejudgment interest awarded against the insured. 2.Exclusions This insurance does not apply to: a.Intentional Injury "Bodily injury by accident"or "bodily inju- ry by disease"intentionally caused or aggravated by you,or "bodily injury by acci dent"or "bodily injury by disease"re- sulting from an act which is determined to have been committed byyou if it was reasonable to believethat an injury is substantially certain to occur. b.Fines Or Penalties Any assessment,penalty or fine levied by any regulatory inspection agency or au thority. c.Statutory Obligations Any obligation of the insured under a workers'compensation,disability bene- fits or unemployment compensation law or any similar law. d.Contractual Liability Liability assumed by you under anycon- tract or agreement. e.Violation Of Law "Bodily injury by accident"or "bodily inju- ry by disease"suffered or caused by any employee while employed in violation of law with your actual knowledge or the ac- tualknowledge of any of your "executive officers". f.Termination, Coercion Or Discrimination Damages arising out of coercion,criti- cism,demotion,evaluation,reassign- ment,discipline,defamation,harass- ment,humiliation,discrimination against or termination of any "employee",or aris- ing out of other employment or personnel decisions concerning the insured. g.FailureTo Comply With "Workers' Compensation Law" "Bodily injury by accident"or "bodily inju- ry by disease"to an "employee"when you are: (1)Deprivedofcommon law defenses; or (2)Otherwise subject to penalty; because ofyour failure to secure your ob ligations or other failuretocomply with any "workers'compensation law". h.Violation Of Age Laws Or Employment Of Minors "Bodily injury by accident"or "bodily inju- ry by disease"suffered or caused by any person: (1)Knowingly employed by you in viola- tion of any law as to age; or (2)Under the age of 14 years, regardless of any such law. i.Federal Laws Any premium,assessment,penalty,fine, benefit,liability or other obligation im- posed by or granted pursuant to: (1)The Federal Employer's Liability Act (45 USC Section 51-60); Includes copyrighted material of Insurance Services GA 250 WY 05 22 Office,Inc.,with its permission.Page 3 of 5 (2)The Non-appropriated Fund Instru- mentalities Act (5 USC Sections 8171-8173); (3)The Longshore and Harbor W orkers' Compensation Act (33 USC Sections 910-950); (4)The Outer Continental Shelf Lands Act (43 USC Section 1331-1356); (5)The Defense Base Act (42 USC Sec- tions 1651-1654); (6)The Federal Coal Mine Health and Safety Act of 1969 (30 USC Sections 901-942); (7)The Migrant and Seasonal Agricultur- al W orker Protection Act (29 USC Sections 1801-1872); (8)Any other workers'compensation, unemployment compensation or dis- ability laws or any similar law; or (9)Any subsequent amendments to the laws listed above. j.Punitive Damages Multiple,exemplary or punitive damages. k.Crew Members "Bodily injury by accident"or "bodily inju- ry by disease"to a master or member of the crew of anyvessel or any member of the flying crew of an aircraft. B.The Supplementary Payments provisions ap- ply to Stop Gap -EmployersLiability Cover- age as well as to Coverages A and B. C.For the purposes of this endorsement,Section II -Who Is An Insured is replaced by the fol- lowing: Section II -Who Is An Insured If you are designated in the Declarations as: 1.An individual,you and your spouse are in- sureds,but only with respect to the conduct of a business of which you are the sole owner. 2.A partnership or jointventure,you are an insured.Your members,your partners,and their spouses are also insureds,but only with respect to the conduct of your business. 3.A limited liability company,you are an in- sured.Your members are also insureds,but only with respect to the conduct of your business.Your managers are insureds,but only with respecttotheir duties as your managers. 4.An organization other thanapartnership, j oint venture or limited liability company,you are an insured. Your "executive officers"and directors are insureds,but only with respect to their duties as your officers or directors. Your stockholders are also insureds,but on- ly with respect to their liability as stockhold- ers. No person or organization is an insured with re- spect to the conduct of any current or past part- nership,joint venture or limited liabilitycompany that is notshown as a Named Insured in the Declarations. D.For the purposes of this endorsement,Section III -Limits Of Insurance is replaced by the fol- lowing: Section III -Limits Of Insurance 1.The Limits OfInsurance shown in the Schedule of this endorsement and the rules below fix the most we will pay regardless of the number of: a.Insureds; b.Claims made or "suits" brought; or c.Persons or organizations making claims or bringing "suits". 2.The "Bodily Injury By Accident"-Each Acci- dent Limit shown in the Schedule of this en- dorsement is the most we will pay for all damages covered by this insurance be- causeof"bodily injury by accident"to one or more "employees"in any one accident. 3.The "Bodily Injury By Disease"-Aggregate Limit shown in the Schedule of this en- dorsement is the most we will payfor all damages covered bythis insurance and arising out of "bodily injury by disease",re- gardless of the number of"employees"who sustain "bodily injury by disease". 4.Subject to Paragraph D.3.of this endorse- ment,the "Bodily Injury By Disease"-Each "Employee"Limit shown in the Schedule of this endorsement is the most we will pay for all damages because of"bodily injury by disease" to any one "employee". The Limits of Insuranceof this Coverage Part apply separately to each “coverage term”. Includes copyrighted material of Insurance Services GA 250 WY 05 22 Office,Inc.,with its permission.Page 4 of 5 E.For the purposes of this endorsement,Condi- tion 2.Duties In The Event Of Occurrence, Claim Or Suit under Section IV -Conditions is replaced by the following: 2.Duties In The Event Of Injury, Claim Or Suit a.You must see to it that we or our agent is notified as soon as practicable of a "bodily injury by accident" or "bodily injury by disease"whichmay result inaclaim. To the extent possible,notice should in- clude: (1)How,when and where the "bodily injury by accident"or "bodily injury by disease" took place; (2)The names and addresses of any injured persons and witnesses; and (3)The nature and location of any injury. b.If a claim is made or "suit"is brought against any insured, you must: (1)Immediately record the specifics of the claim or "suit"andthedate re- ceived;and (2)Notify us assoon as practicable. You mustsee to it that we receive written noticeofthe claim or "suit"as soon as practicable. c.You and any other involved insured must: (1)Immediately send uscopies of any demands,notices, summonses or le- gal papers received in connection with the injury,claim,proceeding or "suit"; (2)Authorize us to obtain records and other information; (3)Cooperate with us and assist us,as we may request,in the investigation or settlement of the claim or defense against the "suit"; (4)Assist us,upon our request,in the enforcement of any right against any person or organization which may be liable to the insured because of injury to whichthis insurance may also ap- ply; and (5)Do nothing after an injury occurs that would interfere with our right to re- cover from others. d.No insured will,except at that insured's own cost,voluntarily make apayment, assume any obligation,or incur any ex- pense,other than for first aid, without our consent. F.For the purposes of this endorsement,Para- graphs 4.and 18.of the Definitions section are replaced by the following: 4."Coverage territory" means: a.The United States of America (including its territories and possessions),Puerto Rico and Canada; b.International waters or airspace,but only if the injury or damage occurs in the course of travel or transportation be- tween any places included in a.above; or c.All other parts of the world if the injury or damage arises out of the activities of a person whose home is in the territory de scribed in a.above,but who is away for a short time on your business; provided the insured's responsibility to pay damages is determined in the United States (including its territories and possessions), Puerto Rico or Canada,in a suit on the mer- its accordingtothesubstantive law in such territory,or in a settlement we agree to. 18."Suit"means a civil proceeding in which damages because of "bodily injury by acci- dent"or "bodily injury by disease"to which this insurance applies are alleged."Suit"in- cludes: a.An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or b.Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured sub- mits with our consent. c.An appeal of a civil proceeding. G.The following are addedtothe Definitions sec- tion: 1."W orkers'Compensation Law"means the Workers'Compensation Law and any Oc- cupational DiseaseLaw of W yoming.This does not include provisions of any law providing non-occupational disability bene- fits. Includes copyrighted material of Insurance Services GA 250 WY 05 22 Office,Inc.,with its permission.Page 5 of 5 2."Bodily injury by accident"means bodily inju- ry,sickness or disease sustained by a per- son,including death,resulting from an acci- dent.A disease is not"bodily injury by acci- dent"unless it results directly from "bodily injury by accident". 3."Bodily injury by disease"means adisease sustained by a person,including death. "Bodily injury by disease"does not include a disease that results directly from an acci- dent. 4."Coverage term"means the following indi- vidual increment,or if amulti-year policy pe- riod,increments,of time,which comprise the policy period of this Coverage Part: a.The year commencing on the Effective Date of this Coverage Part at 12:01 AM standard time at your mailing address shown in the Declarations,and if a multi- year policy period,each consecutive an- nual periodthereafter,or portionthereof if any period is for a period oflessthan 12 months,constitute individual "cover- age terms".The last "coverage term" ends at 12:00 AM standard timeatyour mailing address shown in the Declara- tions on the earlier of: (1)The day the policy period shown in the Declarations ends; or (2)The day the policy to whichthis Coverage Part is attached is termi- nated or cancelled. b.However,if after the issuance of this Coverage Part,any "coverage term"is extended for an additional period of less than 12 months, t hat additional period of time will be deemed to be part of the last preceding "coverage term". H.For the purposes of this endorsement,the defi- nition of "bodily injury" does not apply. Includes copyrighted material of Insurance GA 472 05 20 Services Office, Inc., with its permission.Page 1 of 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ADDITIONAL INSURED-AU TOMATIC STATUS AND AUTOMATIC WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRAC T,AGREEMENT, PERMIT OR AU THORIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A.Ad ditional Insured -Owners,Lessees Or Contractors -Automatic StatusFor Other Parties When Required In Written Contract Or Agreement With You 1.Section II -Who Is An Insured is amended to include as an additionalin- sured any person or organization you haveagreed in writing in a contract or agreement to add as an additional in- sured onthis Coverage Part.Suchper- son(s)or organization(s)is an additional insured only with respect to liability for: a."Bodily injury", "property damage"or "personal and advertising injury" caused,in whole or in part,by the performance of your ongoing opera- tions by you or on your behalf,under that written contract or written agreement.Ongoing operations does not apply to "bodily injury"or "proper- ty 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 additionalinsured(s)at the loca- tion of the coveredoperations has been completed; or (2)That portion of"your work"out of which the injury or damage aris- es has been put to its intended use by any person or organiza- tion other than another contrac- tor or subcontractor engaged in performing operations for a prin- cipal as a part of the same pro- ject; and b."Bodily injury"or "property damage" caused,inwhole or in part,by "your work"performed under that written contract or written agreement and in- cluded in the "products-completed operations hazard", but only if: (1)The Coverage Part to which this endorsement is attached pro- vides coverage for "bodily injury" or "property damage"included within the "products-completed operations hazard"; and (2)The written contract or written agreement requires youtopro- vide additional insured coverage included within the "products- completed operations hazard " for that person or organization. If the written contract or written agreement requires you to provide additional insured coverage included within the "products-completed oper- ations hazard"for a specified length of time for that person or organiza- tion,the "bodily injury"or "property damage"must occur prior to the ex- piration of that period of time in order for this insurance to apply. If the written contract or written agreement requires you to provide additional insured coverage for a person or organization per only ISO additional insured endorsement form number CG 20 10,withoutspecifying an edition date,and without specifi- cally requiring additionalinsured coverage included within the “prod- ucts-completed operations hazard”, this Paragraph b.does not apply to that person or organization. 2.If the written contract or written agree- ment described in Paragraph 1.above specifically requires you toprovide addi- tionalinsured coverage to that person or organization: a.Arising out of your ongoing opera- tions or arising out of "your work"; or Includes copyrighted material of Insurance GA 472 05 20 Services Office, Inc., with its permission.Page 2 of 3 b.By way of an edition of an ISO addi- tional insured endorsementthat in- cludes arising out of your ongoing operations or arising out of "your work"; thenthephrase caused,in whole or in part,b y in Paragraph A.1.a.and/or Para- graph A.1.b.above,whichever applies,is replaced by the phrase arising out of. 3.With respect to the insurance afforded to the additionalinsureds described in Para- graph A.1.,the following additional exclu- sion applies: This insurancedoes not apply to "bodily injury", "property damage"or "personal and advertising injury"arisingout of the rendering of,or the failure to render,any professional architectural,engineering or surveying services, including: a.The preparing,approving or failing to prepare or approve,maps,shop drawings,opinions,reports,surveys, field orders,change orders or draw- ings and specifications; or b.Supervisory,inspection,architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision,hir- ing,employment,training or monitoring of others by that insured,if the "occurrence" which caused the "bodily injury"or "prop- erty damage",or the offense which caused the "personal and advertising inju- ry",involved the rendering of,or the fail- ure to render,any professional architec- tural,engineering or surveying services. 4.This Paragraph A.does not apply to addi- tional insureds described in Paragraph B. B.Ad ditional Insured -State Or Governmental Ag ency Or Subdivision Or Political Subdi- vision -Au tomatic Status When Required In Written Permits Or Authorizations 1.Section II -Who Is An Insured is amended to include as an additionalin- sured anystate or governmental agency or subdivision or politicalsubdivision you haveagreed in writing in a permit or au- thorizationtoadd as an additional insured on this Coverage Part.Such state or gov- ernmental agency or subdivision or politi- calsubdivision is an additional insured only with respect to operations performed by youor on your behalf for whichthe state or governmental agency or subdivi- sion or politicalsubdivi sion has issued,in writing, a permit or authorization. 2.With respect to the insuranceafforded to the additionalinsureds described in Para- graph B.1.,the following additional excl u- sions apply: This insurance does not apply to: a."Bodily injury", "property damage"or "personal and advertising injury"aris- ing out of operations performed for the federal government,state or mu- nicipality; or b."Bodily injury"or "property damage" included within the "products- completed operations hazard." C.The insurance afforded to additionalinsureds described in Paragraphs A.and B.: 1.Only applies to the extent permitted by law;and 2.Will not be broader thanthat which you are required by the written contract,writ- ten agreement,written permit or written authorization to provide for such addition- al insured; and 3.Does not apply to any person,organiza- tion,state,governmental agency or sub- division or politicalsubdivision specifically named as an additional insured for the same project in the schedule of an en- dorsement added to this Coverage Part. D.With respect to the insuranceafforded tothe additional insureds described in Paragraphs A.and B.,the following is added to Section III -Limits Of Insurance: Themost we will pay on behalf of the addi- tional insured is the amount of insurance: 1.Required by the written contract,written agreement,written permit or writtenau- thorization described in Paragraphs A. and B.For the purposeof determining the required amount of insurance only, we will include the minimum amount of any Um- brella Liability or Excess Liabilitycover- age required for that additional insured in that written contract,written agreement, written permit or written authorization; or 2.Available under the applicable limits of in- surance; whichever is less. This endorsement shall not increasetheappli- cable limits of insurance. E.Section IV -Commercial General Liability Conditions is amended to add the following: Au tomatic Additional Insured Provision Includes copyrighted material of Insurance GA 472 05 20 Services Office, Inc., with its permission.Page 3 of 3 This insuranceapplies only if the "bodily inju- ry"or "property damage"occurs,or the "per- sonal and advertising injury"offense is com- mitted: 1.During the policy period; and 2.Subsequent to your execution of the writ- ten contract or written agreement,or the issuance of a written permit or written au- thorization,described in Paragraphs A. and B. F.Except when G.below applies,the following is addedtoSection IV -Commercial General Liability Conditions,Other Insurance,and supersedes any provision to the contrary: When Other Additional Insured Coverage Ap plies On An Excess Basis This insurance is primary to other insurance available to the additionalinsured described in Paragraphs A.and B.except: 1.As otherwise provided in Section IV - Commercial General Liability Condi- tions,Other Insurance,b.Excess In- surance; or 2.For any other valid and collectible insur- ance available to the additional insured as an additional insured on another insur- ancepolicy that is written on an excess basis.In such case,this insurance is also excess. G.Thefollowing is addedtoSection IV -Com- mercial General Liability Conditions,Other Insurance,and supersedes any provi sion to the contrary: Primary Insurance When Required By Writ- ten Contract,Agreement,Permit Or Au - thorization Except when wrap-up insurance applies to the claim or "suit"on behalf of the additionalin- sured,this insurance is primary to any other insuranceavailabletothe additionalinsured described in Paragraphs A.and B.provided that: 1.The additional insured is a Named In- sured under such other insurance; and 2.You have agreed in writing in a contract, agreement,permit or authorization de- scribed in Paragraph A.or B.thatthis in- surance would be primaryto any other in- surance available totheadditionalin- sured. As used in this endorsement,wrap-up insur- ance means a centralized insurance program under whichone party has secured either in- surance or self-insurance covering some or all of the contractors or subcontractors perform- ing work on one or more specific project(s). PrimaryAnd Noncontributory Insurance When Required By Written Contract, Ag reement, Permit Or Authorization Except when wrap-up insurance applies to the claim or "suit"on behalf of the additionalin- sured,this insurance is primary to and will not seek contribution from any other insurance available to the additionalinsured described in Paragraphs A.and B.provided that: 1.The additional insured is a Named In- sured under such other insurance; and 2.You have agreed in writing in a contract, agreement,permit or authorization de- scribed in Paragraph A.or B.thatthis in- surance would be primary and would not seek contribution from any other insur- ance availableto the additional insured. As used in this endorsement,wrap-up insur- ance means a centralized insurance program under whichone party has secured either in- surance or self-insurance covering some or all of the contractors or subcontractors perform- ing work on one or more specific project(s). H.Section IV -Commercial General Liability Conditions,Transfer Of Rights Of Recov- ery Against OthersTo Us is amended by the addition of the following: Waiver of Subrogation We waiveany right of recovery against any additionalinsured under this endorsement, becauseofany payment we makeunder this endorsement,to whom the insured has waived its right of recovery inawritten con- tract,written agreement,writtenpermit or writ- ten authorization.Such waiver byusapplies only totheextent that the insured has waived its right of recovery againstsuch additionalin- sured prior to loss.