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HomeMy WebLinkAboutG. Bortolotto & Company 08.26.24 V2'`' CERTIFICATE OF LIABILITY - - -----' KC�.V.. J.ON NUMBER: DATE (MM/2024 Y) INSURANCE 08/26/2024 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 CERTIFICATE ES BELOW. THIS CERTIFICATE TE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR .PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL IN 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-CONIAQT FEDERATED MUTUAL INSURANCE COMPANY AND ITS AFFILIATES INCLUDING PRIMARY SOURCE INSURANCE AGENCY 121 E. PARK SQUARE OWATONNA, MN 55060 NAME! CLIENT CONTACT CENTER (A0, No, Ext): 888-333-4949 F (A/G, No): 507-446-4664 EMAIL A°°REss:CLIENTCONTACTCENTER®FEDINS.COM INSURERS AFFORDING COVERAGE - NAIC H INSURER AIFEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED�N��,r���NESTCHESTER G. BORTOLOTTO & COMPANY SURPLUS LINES INSURANCE 10172 INSURER C: 562 BRAGATO RD SAN CARLOS, CA 94070-6227 INSURER D: EACH OCCURRENCE $1,000,000 INSURER E: - COVERAGES CERTIFICATE NUMRFR' 7111 7 R INSURER FI - u. 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. TTR TYPE OF INSURANCE INBR sWVR POLICY NUMBER ppOLICyy EFF POLICY EXP MM/DD/YYYY MMIDDIY XP LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR - EACH OCCURRENCE $1,000,000 AMAGE TO ENTED PREMISES $100000 Ea occurrenco AMED Y N 1903448 08/13/2024 08/13/2025 EXP (Any one person) EXCLUDED 0EN1 XOTHER: AGGREGATE LIMIT APPLIES PER: POLICY " PRO- ❑ LOC ECT PERSONAL& ADV INJURY - $1,000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS & COMPIOP ACC $2,000,000 AUTOMOBILE LIABILITY - X ANYAUTO COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per Person) A OWNED AUTOS ONLY SCHEDULED HIRED AUTOS OWNLY AUTOS ONLY Y N. 1903446 08/13/2024 08/13/2025 BODILY INJURY (Per Accident) PPerROPERTY DAMAGE ( Accident AEXCESSLIAB �UMBRELLA LIAB XOCCUR CLAIMS -MADE N N _ 1903447 - 08/13/2024 08/13/2025 EACH OCCURRENCE $8,000,000 DED - RE'I-EN]ION AOOREOATE $8,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERI EXECUTIVE PER STATUTE THER El EACH ACCIDENT OFFICERIMEMBER EXCLUDED7 (Mandatory in NH) N/A E.L DISEASE -EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below E.I. DISEASE • POLICY LIMIT ONTRACTORS POLLUTION LIABILITY Y Y G71661726 003 08/23/2024 08/23/2025 EACH LIMIT $2,000,000 B GGREG4TE $2,000,000 - DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES IACORD 701, Additional Remarks Schedule, may be attached If more space Is required) SEE ATTACHED PAGE CERTIFICATE HOLDER �.HriCELLAI I VN TOWN OF LOS ALTOS HILLS 78 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. ACORD 25 (2016103)(?) 1988-2016 ACORD CORPORATION. All rights reserved, The ACORD name and Ingo are registered marks of AC RD AGENCY CUSTOMER ID: C'N LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 AGENCY NAMED INSURED G. RRAGATO O &COMPANY FEDERATED MUTUAL INSURANCE COMPANY AND ITS AFFILIATES 582 ATO RD B INCLUDING PRIMARY SOURCE INSURANCE AGENCY SAN CARLOS, CA 94070-6227 POLICY NUMBER SEE CERTIFICATE # 78.0 NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE # 78.0 CARRIER SEE CERTIFICATE # 78.0 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 26 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE G BORTOLOTTO JOB #19-803 RE: 2019 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 LIABILITY COVERAGE IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE. INSURANCE PROVIDED BY THE BUSINESS AUTO LIABILITY IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE. GENERAL LIABILITY COVERAGE CONTAINS CO 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. FOR REASONS OTHER THAN NON-PAYMENT OF PREMIUM, 30 DAYS NOTICE WILL BE PROVIDED TO THE CERTIFICATE HOLDER IN THE EVENT THAT THE ISSUING COMPANY CANCELS THE POLICY BEFORE THE EXPIRATION DATE OF THE POLICY. ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO U5 Named Insured G Bortolotto & Company Endorsement Number Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW 671661726 003 8123/2024 To 8123/2025 8123/7024 Issued Oy (Name of Insurance Company) Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided under 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 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 person or organization shown in the: Schedule above. All other terms and conditions remain the same. ENV -3143 (03-05) Includes oopydghted material of Insurance Services Office, Inc. with ifs permission Page 1 of'! ,A .,tlii 6.{;ftt�SfS:ti2>.' MOLD SUBLIMIT ENDORSEMENT — CONTRACTORS POLLUTION LIABILITY Named Insured Cs R(ye'tolotto & Company Endorsement Number Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW G71661726 3/23/2024 To 8/23/2025 8/23/2024 moa Issued By (Name of Insurance Company) Westchcstee Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREF'ULL'Y. This endorsement modifies insurance provided under the follo-wing: CONTRACTORS POLLUTION LIABHJTY COVERAGE PART I. ;subsection U. of. the DEFINITIONS section of this Coverage Part is hereby deleted in its entirety and replaced with the following: 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, fumes, 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 stRiCtures 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: g. Electromagnetic fields, mold and bacteria, including legionella pneumophila, provided that any such: a. Conditions are not naturally occurring in the environment in the amounts and concentrations discovered; and 1). Bacteria: i) is notthe result of communication or transmission. through human -to -human, hr roan to animal or annual to animal contact, or contact witli 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. ,,. The discharge, dispersal, release or escape of silt or sedimentation. 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. ENV -,^,213 (04-20) Page 1 of 2 (299447.4) 14A.'st. ester >1:;:iiair., i?ssrrs£s:iaa: II. with:respect to coverage aff(ycdedfor pollutioxi eonditioxzs involving Mold or bacteria, including legionella pneurnophila, parsuant to Item 2), above, above, the following Sublimits of Insurance and Deductible apply Limits of Insurance: $2,000,000 Each Pollution Condition $--,000,000 -Rold Aggregate .Limit (serves to reduce the G nieral Aggregate Unlit shown on the Declarations page) Deductible: $10,000 Each Pollution Condition The Sublimits of 'Insurance and Dedl icti.ble identified above are subject to the terms and conditions of the LI14 US OF INSUI ANCE section of the Coverage Part modified by this .endorsement. These Sublimits of Insurance shall. he subject to, and:payments made pursuant to these Sublimits of Insurance shall erode, the Limits of Insurance identified on the Declarations to this Policy. .Allother terms and conditions remain the same, atliorrz&TR epresen tat.ive (04-20) Parc 2 r,i'2 (--99447.4) AI :(esi.8, tstssls:ttr, ADDITIONAL INSURED ENDORSEMENT — ONGOING vVORIC OR OPERATIONS Named Insured G Bortolotto & Company Endorsement Number Policy Symbol Policy Number Poilcy Period Effective Date of Endorsement CPW I 071661726 003 8/23/2024 To 8/23/2025 8/23/2024 Issued By (Name of Insurance Company) Westchester Surplus Lines insurance Company Insert the, policy number. Thr rernainder of the. information into be temple e, only whin this endorsement is issued subsequent to the preparation oft! Ie policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSE1%1ENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE: Name of Person(s) or Organizationk): 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 - NATHO IS AN INSURED is amended to include as an additional insured the persons or organizations shown in the Schedule, but only vdth 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 far the additional insureds. However: a. The insurance afforded to such additional insured only applies to the extent permitted by lay; and •_. If coverage provided to the additional insured is required 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. R. 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. Al work or operations, including materials, parts such work or operations, on the project (other than service, maintenance or repairs) :to be perforated by you or on your behalf at the site of the covered operations has been completed; or El\ W-3z;,o (12/18) Includes copyrighted material of Insurance SerN ices Office, Inc. with its permission Page 1 of z (221012.1) >b. That portion of yow 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 the additional insured as a part of the same project. C. With respect to the inWrance afforded to theseadditional insureds, the following is added to SEC MON III — I,Imms or, 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. Available tinder the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of €risurance shown in the :Declarations. All other terms and conditions of this policy remain unchanged. Er V-Sz ,o (12/18) Includes cop.ziahted nwerial of Insurance Services office. Inc, with its permission Page 2 of,-, HAestchester ADDI'T'IONAL INSURED ENDORSEMENT — PRODUCTS -COMPLETED OPERATIONS EA7,ARD Named Insured Endorsement Number G Bortolotto & Company Policy Symbol Policy Number Palicy Period Effective Date of Endorsement CPW G7166172C Of}3 8/23/2024 To 8/23/2025 8/23/2024 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Inmrt the policy number. The. remainder of the information is to be rompieted only whin this endorsement. is issued subsequent to the prep arabon of the policy. THIS ENDORSEMENT CHANGESTHE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES IN SLTRANCE PROVIDED UNDER THE FOLLO'AV1 NG - CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Penson or Organization; As required by written contract, prior to a loss to which this insurance applies ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- (If no entty appears above, information required to complete this endarsement will be shown. in the Declarations as applicable to this endorse:tnent.) A. SECTION II — NVHO IS AN INSURED is amended to include as an additional insured the pel:soli(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 yo1w work performed for that additional insured and. included in the Products -completed operations Iaazard, and only to the extent that such injure or damage is caused, in whole or in part, by your negligence or the negligence of those acting on your behalf. Haweve:r: i. The insurance afforded to such additional insured only applies to the extent permitted by law, and �. If coverage :provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured Arill riot be broader than that whichyou 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 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. i. Required by the contract or agreement, or 2. Available under the applicable Linrits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. MI other terms and conditions of this policy remain unchanged. ] ,NV. Gj7. (i2/x8) Includes copyrighted material of Insurance SeMces Office, Inc. with its permission Page 1 of z ('221012.2) 1 .1 S. 4t, tchester i>.,r,:}ffl3fls £.h`tnl5::lkf PRIMARY AND NONCONTRIBUTORY — OTHER INSURANCE CONDITION [N;�imed Endorsement Number CPW ctwouve uare or Endorsers 671651725 00 8/23/2024 To 8/23/2025 8/23/2024 Issued By (Name or Insurance company) Westchester Surplus Lines Insurance Company Insert the poliuy mrmber.'Ibr. remninder of rhe information is w be. completed only ashen thin endorsement is issued sohsequent to the prepmnLion of Ow.policy. THIS ENDORSEMENT CHANGES THE POLIM PLEASE READ IT CAREFULLY. THIS ENDOPUSEMENI' MODIFIES INSURANCE PROVIDED UNDER TREFOLLOAATING: CONT'RACTOR'S POLLUTION LIABILITY COVERAGE PART The following is added to the Otrner Insurance, Condition and supersedes anyprovisiori to the contrary: Primary and Noncontributory Insurance This policy is primary to, and vtrill snot seek contribution from, any other insurance available to an additional insured,. nder this policy, provided that: a. The additional insured, is a named insured finder such other insurance; and b. The hanged iinsured leas agreed in a Kmitten contract or agreemenrt that this insurance would: (1) act as primary insurance; and. (Z) would not seek contribution from any other insurance available to the additional insured, .All other terms and. conditions of this policy remain unchanged. F;,NV-3253 (12-18) t31 (,&36F,62.2) lfICIl1CtC5 CO�iVf.1�i11Cd fn ltCiltit of.11lSLCQ1ICG.�CCY1C'.C: CHfirc, lot. with its prrtniss. n page i of. i. 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 49 11 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 Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek 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 (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 the additional insured. © 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 2033 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. 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 CG 20 33 12 19 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 78 #B W N DH BS BR001-OA - 0062 #XWXW0021 XXXXXXX5# TOWN OF LOS ALTOS HILLS 26379 W Fremont Rd Los Altos Hills, CA 94022-2624