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HomeMy WebLinkAboutG. Bortolotto & Company 08.26.24''"`' CERTIFICATE OF LIABILITY DATE INSURANCE 08/26/,MM/2D,YYYY) 2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: Tf the certificate holder Is an ADDITIONAL INSURED, the P0IICy(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 - - - FEDERATED MUTUAL INSURANCE COMPANY AND ITS AFFILIATES INCLUDING PRIMARY SOURCE INSURANCE AGENCY 121 E. PARK SQUARE OWATONNA, MN 55060 UUNIAW Pa. CLIENT CONTACT CENTER (A/C, No, Ext); 888-333-4949 (Aro, No): 507-446-4664 E•MAa ADDREss: CLIENTCONTACTCENTER@FEDINS,COM INSURERS AFFORDING COVERAGE NAIC# - - INSURER A:FEDERATED MUTUAL LINSURED NSURANCE COMPANY 13935 �fflpl�RVNESTCHESTER SURPLUS LINES INSURANCE 10172 G. BO G. BORTOLOTTO &COMPANY INSURER C: 582 BRAGATO RD SAN CARLOS, CA 94070-6227 INSURER D: - INSURER E: INSURER F: _ COVERAGES. CERTIFICATE NUMBER: 63 REVISION NUMBER: 0 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, ILTR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP INSR WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS•MADE OCCUR ( EACH OCCURRENCE $1,000,000 ppAMAOE TO ENTED PREMISES 1Ee occurrence $100,000 A OEN1 X Y N1903446 08!13/2024 -- 08/13/2025 MED EXP (Any one person) EXCLUDED AGGREGATE LIMIT APPLIES PER: POLICY IECT ❑ LOC OTHER: PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE :1270-00,000 PRODUCTS & COMP16P ACC $2,000,000 AUTOMOBILE LIABILITY AUTO COMBINED SINGLE LIMIT (Ea accldent)$1,000,000 BODILY INJURY (Per Person) AOWNED JANY AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS OWNLYAUT GS ONELYY Y N 1903446 08/13/2024 08/13/2025 BODILY INJURY (Per Accident) OPERTY DAMAGE Rr Accident X UMBRELLA LIAB X OCCUR A EXCESS LIAB CLAIMS-MADE N N 1903447 08/13/2024 08/13/2025 EACH OCCURRENCE $8,000,000 D—ITT IREIENTION AGGREGATE $B4OOD,000 PER STATUTE I THER WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/ EXECUTIVE E.I. EACH ACCIDENT OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N/A E.L DISEASE -EA EMPLOYEE If yes, describe under- DESCRIPTION OF OPERATIONS below - E.L DISEASE -POLICY LIMIT ONTRACTORS POLLUTION LIABILITY Y Y G71661726 003 08/23/2024 08/2312025 EACH LIMIT $2,000,000 B AGGREGATE $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may SEE ATTACHED PAGE he attached If more space Is required) CERTIFICATE HOLDER CANCELLATION TOWN OF LOS ALTOS HILLS 63 0 26379 W FREMONT RD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED LOS ALTOS HILLS, CA 94022-2624 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD "..w� AGENCY CUSTOMER ID: ACGIIRO� LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 AGENCY NAMED INSURED G. BORTOLOTTO & COMPANY FEDERATED MUTUAL INSURANCE COMPANY AND ITS AFFILIATES 562 BRAGATO RD INCLUDING PRIMARY SOURCE INSURANCE AGENCY SAN CARLOS, CA 94070-6227 POLICY NUMBER SEE CERTIFICATE # 63.0 NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE # 63.0 CARRIER SEE CERTIFICATE # 63.0 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE G BORTOLOTTO JOB #21-872 RE: 2021 PAVEMENT REHABILITATION AND DRAINAGE IMPROVEMENT PROJECT ADDITIONAL INSURED INCLUDES: TOWN OF LOS ALTOS HILLS, ITS OFFICERS, OFFICIALS, EMPLOYEES AND VOLUNTEERS THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED ENDORSEMENT FOR CONTRACTORS POLLUTION LIABILITY. THE CONTRACTORS POLLUTION LIABILITY COVERAGE CONTAINS A WAIVER OF SUBROGATION IN FAVOR OF THE CERTIFICATE HOLDER SUBJECT TO THE CONDITIONS OF THE WAIVER OF SUBROGATION. INSURANCE PROVIDED BY THE CONTRACTORS POLLUTION LIABILITY IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE. MOLD COVERAGE IS INCLUDED UNDER CONTRACTORS POLLUTION LIABILITY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. INSURANCE PROVIDED BY THE GENERAL ISINSURANCE PROVIDED BY THE BUSINESSLAUTO LLIABILLITYAGE IS PRIMARYARY ANDAND NONCONTRIBUTORYORY OVERVER OTHERHINSURANCE. GENERAL LIABILITY COVERAGE CONTAINS CG 25 03 DESIGNATED CONSTRUCTION GENERAL AGGREGATE LIMIT ENDORSEMENT APPLICABLE TO EACH CONSTRUCTION PROJECT AS REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT. COMMERCIAL UMBRELLA FOLLOWS FORM ACCORDING TO THE TERMS, CONDITIONS, AND ENDORSEMENTS FOUND IN THE COMMERCIAL UMBRELLA POLICY. EFOR VENTETHATSTHEHISSUING COMPANYMENT OF CANCELSPTHEIUM, 30 DAYS POLICY BEFOREOTHEEWILL BE EXPIRATIONRDATEEOFTTHEHIFICATE HOLDER IN THE POLICY. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WAILER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Named Insured G Bortolotto & Company Endorsement Number Policy Symbol Polley Number Policy Period Effective bate of Endorsement CPW 671661726 003 6123/2024 To 8/23/2025. 8123/2024 Issued By (Name of insurance Company) Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided tinder the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As required by written contract, prior to a loss to which this insurance applies (if no entry appears above, information required to complete this endorsement will be shown in the Declaration as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in. the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included In the products -completed operations hazard. This waiver applies only to the parson .or organization shown in the Schedule above. All other terns and conditions remain the same, ENV -3743 (03-05) includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 'I leschese A i:usop.111y MOLD SUBLIMIT ENDORSEMENT — CONTRACTORS POLLUTION LIABILITY Named Insured G. RG-rtolotto & Company Endorsement Number Policy Symbol Policy Number Policy Period Effective Date of Endorsement CFS G71661726/$/2024 To 8/23/202-5 8/23/2024 ooh Issued By (Name of Insurance Company) Westchester Surplus Lines insurance Comparty THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance pro%rided mider the follolving: CONTRACTORS POLLUTION LIABILITY COVERAGE PART I. Subsection U. of the DEFINITIONS section of this Coverage Fart is hereby deleted in its entirety and replaced with tire fallowing: U, Pollution condition means the discharge, dispersal, release, escape, migration, or seepage of any solid, liquid, gaseous or thermal material, matter, irritant or contaminant, including smoke, soot, vapors, fttnres, acids, alkalis, chemicals, hazardous substances, hazardous :materials, low- level radiological. waste, mixed waste or waste materials, including medical, infectious, or pathological wastes, on, in, into, or upon land and structures thereupon, the atmosphere, surface water or groundwater, provided such conditions are not naturally present in the environment in the concentrations or amounts discovered. Pollution condition also includes: i. Electromagnetic fields, mold and bacteria, including legionella pneurn.ophila, provided that any such: a. Conditions are not naturally occurring in the environment in the amounts and concentrations discovered; and 1). Bacteria. i) is nottlie:result of communication or transmission. through human -to -human, human to animal or animal to animal contact, or contact with any of their respective bodily fluids or discharges; ii) is required to be reported to any Federal, state, commonwealth, municipal or other local government agency or body with regulatory jurisdiction over the job site; and iii) becomes pathogenic as a direct result of ,your work. a. The discharge, dispersal, release or escape of silt: or sedi.menlation. Pollution. condition does not include any such material, matter, irritant or contaminant that is or was, contains or contained, includes or included, or involves or involved, in whole or in part, any virus, except for any virus that is exclusively contained within medical, infectious or pathological wastes that have been previously characterized and prepared for disposal pursuant to governing regulations. EIQV-;3213 (04-20) Page i of 2 (299447.4) ester II. With respect to coverage afforded for pollutioli cotiditimis involving miold or bacteria, including legionelto pnezzill.ophila, pursuant to Item 2),above, above, the foiloiAring Sublimits of Insurance and Deductibleapply: Limits of Insurance: $2,000,000 Each Pollution Condition $2,000,000 Mold .Aggregate .Linn t (serves to reduce the General Aggregate Limit shown on the Declarations page) Deductible: $10,000 Each Pollution Condition 'rile Sublimits of 131SUrance a.nd Deductible identified above are subject to the terms and conditions of the LII MS OF INSURANCE section of the Coverage "fart modified by this endorsement. These Sublimits of Insurance shall. be subject to, a:nd payateats made purIquant to these Sublimits of Insurance shall erode, the. Limits of insurance identified on the Declarations to this Policy. Al other terms acid conditions remain the same, u iorsze epresen a zve EVN7-3213 (04-20) Page 2 of 2 (299447.4) Iflatchester `:Fi:i:+ia ;`rrsrsf>:ttr: ADDITIONA[. INSURED ENDORSEMENT — ONGOING WORT{ OR OPERATIONS Named Insured G Bortolotto fit Company _ Endorsement Number Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW 671661726 003 8/23/2024 To 8/23/2025 8/23/2024 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the tn,liey munber.'nc�• rerneiinder of the informaticas i� to he eanspictr.r. only whr:n this endms,enrast is icwrerl sntsegnen[ to the preporntion of the polirc. THIN ENDORSEMENT CHANGES THE POLIC `X. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOVY-ING: CONTRACTORS POLLU'T'ION LIABILITY COVERAGE PART SCHEDULE: Name of Persons) or Organization(s): As required by written contract, prior to a loss to which this insurance applies (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II - WHO IS .AN INSURED is amended to inctude as an additional insured the persons or organizations shown in the Schedule, but only with respect to liability for injury or damage, to which this insurance applies, caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insureds. However: i. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is recluired by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: Exclusions This insurance does not apply to injury or damage occurring after: a. All work or operations, including materials, parts or egni.prrient fu.rriislred. in cons►ection.N t i such work or operations, on the project (other than service, maintenance or repairs) to be performed by you or on your behalf at the site of the covered operations has been completed; or ENV -;32,o (12/78j Includes copyrighted material of Insurance Semites Office, Inc. with its permission Page 7 of z (221012..7) Hvhtchesfer b. That portion Of yo -or worth out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for the additional insured as a part of the same project, C. With respect: to the insurance afforded to these additional insureds, the following is added to SECTION III - LIMITS OF INSURANCE: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance; a. Required by the contract or agreement; or 2. Available tinder the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorseirfent shall not increase the applicable Limits of: insurance shown in the :Declarations. All other terrus and conditions of this policy .remain unchanged. EI\ V- I2,yo (12/18) Includes copyrighted material of Insurance Services Office, Inc. with its permission Plage 2 of 2 (221012.1) ADDITIONAL INSURED ENDORSEMENT — PRODUCTS -COMPLETED OPERATIONS HAZARD Named Insured Endorsement Number G Bortolotto & Complany Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW I 671661726 003 8/23/2024 To 8/23/2025 8/23/2024 Issued By (Name of Insurance Gompany) Westchester Surplus lines Insurance Company Insert the policy number. The remainder of the information is to be rompieted only when this endorsement is issued subsequent to the prel ua.Non of the pohi y. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLI'. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: CONTRACTORS POLLUTION LIABILT['Y CO�rERAC=E PART SCHEDULE Name of Person or Organization As required by written contract, prior to a loss to which this insurance applies (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endarse:ment.) A. SECTION II — WHO IS AN INSUREiD is amended to include as an additional insured the. person(s) or organization(s) shown in the Schedule, but only with respect to liability for injury or damage, to -which this insurance applies, caused by or resulting from yotir work performed for that additional insured and. included in the products -completed operation hazard, and only to the extent that such injury or damage is caused, in whole or in part, by your negligence or the negligence of those acting on your behalf. ti owever: i. The insurance afforded to such additional insured only applies to the extent permitted by law; and z, If coverage :pro-vided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured AdIl not be broader than that which you are :required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to SEC'T'ION III - LIMITS OF INSURANCE: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: i. Required by the contract or agreement; or 2. .Virailable under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. ENTV-32si. (12/18) Includes copyrighted material of Insurance Senlces Offiou. Inc. vd [b.. its permission Page r of i (2'1012.2) PRIMARY AND NONCOl\FIRIBUTORY — OTHER INSURANCE CONDITION Named Insured G Bortolotto & Company Endorsement Number Policy Symbol Policy Number Pal icy Period Effective Date of Endorsement CPW G71661726 003 3/23/2024 To 8/23/2025 8/23/2024 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company 3 nsrrl the. policy' number: Tho remainder of Ihe. informn Zinn is to lir corns leted only when this endursr:ment is elitiued subsequent Lu )lir prepnratiun of the, poliev. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEll ENT MODIFIES INSURANCE PROVIDED UNDERTHEFOLLOAXING: CONTRAACTOWS POLLUTION LIABILITY COVERAGE PART The following is added to the Other Insur3nee. Condition and supersedes any provision to the. contrary-, P'rimaaty and Noncontribixtox-y Insurance: This police is primary to, and wiIl.not seek contribution from, any other insurance available to an additional insured tinder this policy-, provided that: a. The additional insured. is a named. insured tinder such other insurance; and b. The nanned insured has agreed in a KTitten contract or agreement that this insurance would: (i) act as primary insurance; and. (2) would not seek contribution frorn any other insurance available to the additional insured. All other terms and conditions of this policy remain unchanged, r v� -3"�d ria -i8) Rachides copyribhtcd in ltcriltl rrf. rttsurauce.Scry cr,; Office., Inc with its perani.Won Page i of COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance - Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under Your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". © Insurance Services Office, Inc., 2016 Page 1 of 1 CA 04 4911 16 Policy Number: 1903446 Transaction Effective Date: 08/13/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART With respect. to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. WHO IS AN INSURED for "bodily injury" and "property damage" liability is amended to include: Any person or organization other than.a joint venture, for which you have agreed by written contract to procure bodily injury or property damage "auto" liability insurance arising out of operation of a covered "auto" with your permission. However, this additional insurance does not apply to: (1) The owner or anyone else from whom you hire or borrow a covered "auto". This exception does not apply if the covered "auto" is a "trailer" connected to a covered "auto" you own. (2) Your "employee if the covered "auto" is owned by that "employee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours. (4) Anyone other than your "employees", partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees", while moving property to or from a covered "auto". (5) A partner (if you are a partnership), or a member (if you are a limited liability company) for a covered "auto" owned by him or her or a member of his or her household. B. The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms, conditions, and exclusions of the Coverage Part to which this endorsement is attached. In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any insured, or to procure insurance. C. The limits of insurance applicable to such insurance shall be the lesser of the limits required by the agreement between the parties, or the limits provided by this policy. D. Additional exclusions. The insurance afforded to any person or organization as an insured under this endorsement does not apply: 1. To "loss" which occurs prior to the date of your contract with such person or organization; 2. To "loss" arising out of the sole negligence of any person or organization that would not be an insured except for this endorsement. 3. To "loss" for any leased or rented "auto" when the lessor or his or her agent takes possession of the leased or rented "auto" or the policy period ends, whichever occurs first. Includes copyrighted material of Insurance Services Office, Inc. with its permission. CA -F-127 (03-03) Policy Number: 1903446 Transaction Effective Date: 08/13/2024 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract Condition and supersedes any provision to the or agreement that this insurance would be contrary:.primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and © Insurance Services Office, Inc., 2018 Page 1 of 1 CG 20 01 12 19 Policy Number: 1903446 Transaction Effective Date: 08/13/2024 COMMERCIAL GENERAL LIABILITY CG 20 33 12 19 THIS ENDORSEMENT CHANGES. THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. CG 20 33 12 19 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out 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 drawings 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, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. © Insurance Services Office, Inc., 2018 Policy Number: 1903446 Page 1 of 2 Transaction Effective Date: 08/13/2024 2. 'Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 33 12 19 Policy Number: 1903446 Transaction Effective Date: 08/13/2024 443-843-8 63 #B W N D H BS BR001-OA - 0055 #XWXW0021 XXXXXXX5# TOWN OF LOS ALTOS HILLS 26379 W Fremont Rd Los Altos Hills, CA 94022-2624