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HomeMy WebLinkAboutCity of Diamond BarSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 5/18/2023 Alliant Insurance Services,Inc. 32 Old Slip 29th Fl New York NY 10005 Shasta Grant Shasta.Grant@alliant.com Everest National Insurance Com 10120 SLPTACE-01 Sentry Insurance Company 24988Town&Country Event Rentals,LLC 7725 Airport Business Pkwy Van Nuys ,CA 91406 Sentry Casualty Company 28460 474275572 A X 1,000,000 X 1,000,000 10,000 1,000,000 2,000,000 X Y SI8ML02781-221 12/16/2022 12/16/2023 2,000,000 B 1,000,000 X X X Y A0207205-001 12/16/2022 12/16/2023 A X X 5,000,000SI8EX02215-221 12/16/2022 12/16/2023 5,000,000 C XYA0207205-002 12/16/2022 12/16/2023 1,000,000 1,000,000 1,000,000 City of Diamond Bar,its officers,employees,agents,and volunteers are included as Additional Insured with regards to the General Liability and Auto Liability policies as required by written contract subject to the policy terms and conditions.Coverage is Primary and Non-Contributory as required by written contract subject to the policy terms and conditions.Waiver of Subrogation applies with regards to the Workers'Compensation policy as required by written contract subject to the policy terms and conditions.30 days'notice of cancellation applies in accordance with the terms and conditions of the policy. City of Diamond Bar 21810 Copley Drive Diamond Bar,CA 91765-4178 COMMERCIAL AUTO CA 70 55 06 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED SPECIAL BROAD FORM AUTO ENDORSEMENT This endorsement modifies the insurance provided under the following: BUSINESS AUTO COVERAGE FORM 1.Broadened Who Is An Insured Under Section II - Covered Autos Liability Coverage, the following is added to Coverage A.1. Who Is An Insured: d.Employees As Insureds Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or personal affairs. e.Newly Acquired Organizations Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: 1.Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period; whichever is earlier; and 2.Coverage does not apply to "bodily injury", "property damage" or "covered pollution cost or expense" that occurred before you acquired or formed the organization. f.For any covered “auto”: Who Is An Insured is amended to include as an insured any organization or subsidiary thereof which is a legally incorporated entity of which you own a financial interest of more than 50 percent of the voting stock on the effective date of this endorsement. This provision applies only if there is no similar insurance available to the entity described above. 2.Broadened Supplementary Payments Coverage Extension 2.a. Supplementary Payments under Section II - Covered Autos Liability Coverages is amended as follows: A.Paragraph 2.a.(2) is amended to pay up to $3000 for cost of bail bonds; and B.Paragraph 2.a.(4) is amended to pay for loss of earnings up to $500 a day because of time off from work. 3.Fellow Employee Bodily Injury Extension The Fellow Employee exclusion contained in Section II - Covered Autos Liability Coverage does not apply. 4.Accidental Airbag Discharge The following is added to Exclusion B.3.a. under Section III - Physical Damage: This exclusion does not apply to the accidental discharge of an airbag in a covered auto for a loss that Physical Damage Coverage is shown in the Declarations. 5.Physical Damage Coverage Extensions The following replaces the Coverage Extensions under Section III - Physical Damage: A.Transportation Expenses We will pay up to $50 per day to a maximum of $1000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay up to $75 per day to a maximum of $1500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the truck or van type with a Gross Vehicle Weight of less than 10,000 pounds used as a private passenger vehicle. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2CA 70 55 06 18 12/16/2022A0207205 Sentry Insurance Company 00001 0000000000 22350 0 N1 da12782d-091f-478b-a838-7a0f2ee63605da12782d-091f-478b-a838-7a0f2ee63605 B.Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or agreement. We will pay for loss of use expense if caused by: (1)Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2)Specified Causes Of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for any covered "auto"; or (3)Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is $50 per day, to a maximum of $1000. 6.Personal Effects The following is added to A. Coverage under Section III - Physical Damage Coverage: A.We will extend Physical Damage Coverage on a covered "auto" to include personal property owned by you, a relative or an "employee" that is in the covered "auto" at the time of "loss". The "loss" must be caused by damage for which coverage is shown in the Declarations. There must be evidence of forced entry for loss caused by theft. B.The exclusion referring to tapes, records, discs or other similar audio, visual or data electronic devices designated for use with audio, visual or data electronic equipment does not apply. C.The most we will pay for any one "loss" under this coverage extension is $500. No Physical Damage Coverage deductible applies to this coverage extension. D.Coverage provided by this Personal Effects extension is excess over any other collectible insurance. E.The coverage extension does not apply to the following property: (1)Any device designed or used to detect speed-measuring equipment such as radar or laser detectors and any jamming apparatus intended to elude or disrupt speed-measurement equipment; (2)Any electronic equipment that reproduces, receives or transmits audio, visual or data signals; (3)Tools; (4)Jewelry, precious metals and loose gems; (5)Money and securities; or (6)Property specifically insured or covered under the Business Personal Property Coverage of this policy. 7.Glass Deductible Under Section III - Physical Damage, the following is added to A.3. Glass Breakage - Hitting A Bird Or Animal - Falling Objects Or Missiles Coverage: The Comprehensive Coverage deductible shown in the Declarations does not apply to glass breakage if such glass is repaired rather than replaced. 8.Broad Knowledge Of Accident, Claim, Suit Or Loss Under Section IV - Business Auto Conditions, the following is added to Loss Conditions A.2. Duties In The Event Of Accident, Claim, Suit Or Loss: Knowledge of an "accident", claim, "suit" or "loss" by an agent or "employee" of an insured or receipt of any demand, notice, summons or other legal paper in connection with a claim or "suit" by any agent or "employee" of any insured shall not in itself constitute knowledge of the named insured or receipt of the named insured, unless a partner, member, manager, executive officer or director shall have such knowledge or shall have received such demand, notice, summons or legal paper. 9.Unintentional Failure To Disclose Hazards Under Section IV - Business Auto Conditions, the following is added to General Conditions B.2. Concealment, Misrepresentation Or Fraud: If in your representations to us you unintentionally failed to disclose all hazards and exposures subject to this insurance, we shall not deny all coverage under this policy because of such oversight. 10.Mental Anguish A.The definition of "bodily injury" under Section V - Definitions is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including "mental anguish" or death resulting from any of these at any time. B.The following definition is added to Section V - Definitions: "Mental anguish" means extreme pain or distress inflicted upon an individual's emotional and intellectual condition with regard to the individual's response to the environment. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 70 55 06 18Page 2 of 2 12/16/2022A0207205 Sentry Insurance Company INSURED COPY POLICY NUMBER: COMMERCIAL GENERAL LIABILITY ECG 20 591 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ECG 20 591 05 09 Copyright, Everest Reinsurance Company 2009 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 2 ADDITIONAL INSURED --- VENDORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) (Vendor) Your Products Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II ---- Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) (referred to below as vendor) shown in the Schedule, but only with respect to "bodily injury" or "property damage" arising out of "your products" shown in the Schedule which are distributed or sold in the regular course of the ven- dor’s business. B. The insurance afforded to an additional insured shall only include the insurance required by the terms of the written agreement and shall not be broader than the coverage provided within the terms of the Coverage Part. C. The Limits of Insurance afforded to an additional insured shall be the lesser of the following: 1. The Limits of Insurance required by the written agreement between the parties; or 2. The Limits of Insurance provided by this Cov- erage Part. D. The insurance afforded to the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by rea- son of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agree- ment; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, test- ing, or the substitution of parts under instruc- tions from the manufacturer, and then repack- aged in the original container; SI8ML02781221 ANY ENTITY TO WHICH THERE IS A ANY PRODUCT WRITTEN CONTRACT INSURED COPY Page 2 of 2 Copyright, Everest Reinsurance Company 2009 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. ECG 20 591 05 09 e. Any failure to make such inspections, adjust- ments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in con- nection with the distribution or sale of the prod- ucts; f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor’s premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Sub- paragraphs d. or f.; or (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. E. This insurance does not apply to any insured person or organization, from whom you have ac- quired such products, or any ingredient, part or container, entering into, accompanying or contain- ing such products. COMMERCIAL GENERAL LIABILITY ECG 20 597 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ECG 20 597 05 09 Copyright, Everest Reinsurance Company 2009 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 1  ADDITIONAL INSURED – LESSOR OF LEASED EQUIPMENT – AUTOMATIC STATUS WHEN REQUIRED IN LEASE 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 from whom you lease equipment 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 insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" but only to the extent caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. B.The insurance afforded to an additional insured shall only include the insurance required by the terms of the written agreement and shall not be broader than the coverage provided within the terms of the Coverage Part. C.The Limits of Insurance afforded to an additional insured shall be the lesser of the following: 1.The Limits of Insurance required by the written agreement between the parties; or 2.The Limits of Insurance provided by this Coverage Part. D.With respect to the insurance afforded to an additional insured, the following exclusions apply: This insurance does not apply to: 1."Bodily injury", "property damage" or "personal and advertising injury" arising out of any act or omission of an additional insured or any of its employees. 2.Any "occurrence" which takes place after the equipment lease expires. INSURED COPY COMMERCIAL GENERAL LIABILITY ECG 20 599 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ECG 20 599 05 09 Copyright, Everest Reinsurance Company 2009 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 1 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS –AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN CONTRACT OR AGREEMENT WITH YOU – INCLUDING COMPLETED OPERATIONS 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, but only when you and such person or organization have agreed in writing in a contract or agreement prior to the commencement of such operations 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" but only to the extent 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 work" for an additional insured. B.The insurance afforded to an additional insured shall only include the insurance required by the terms of the written agreement and shall not be broader than the coverage provided within the terms of the Coverage Part. C.The Limits of Insurance afforded to an additional insured shall be the lesser of the following: 1.The Limits of Insurance required by the written agreement between the parties; or 2.The Limits of Insurance provided by this Coverage Part. D.With respect to the insurance afforded to an additional insured, the following additional exclusions apply: This insurance does not apply to: 1."Bodily injury", "property damage" or "personal and advertising injury" arising out of any act or omission of an additional insured or any of its employees. 2."Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any 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. 3."Bodily injury", "property damage" or "personal and advertising injury" arising out of any construction projects that are part of a consolidated (wrap-up) insurance program. This exclusion also applies to any: (a)Work or operations performed; or (b)Materials, parts or equipment furnished; in connection with such wrap-up construction projects, regardless of whether they are performed or furnished at the location of the wrap-up construction project or anywhere else. INSURED COPY COMMERCIAL GENERAL LIABILITY ECG 20 600 05 09 THIS ENDORSEMENT CHANGES THE COVERAGE PART. PLEASE READ IT CAREFULLY. ECG 20 600 05 09 Copyright, Everest Reinsurance Company 2009 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 1  ADDITIONAL INSURED – AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN 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 with whom you have a written agreement that such person or organization be added as an additional insured on your Coverage Part. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" but only to the extent 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 operations for an additional insured. B.The insurance afforded to an additional insured shall only include the insurance required by the terms of the written agreement and shall not be broader than the coverage provided within the terms of the Coverage Part. C.The Limits of Insurance afforded to an additional insured shall be the lesser of the following: 1.The Limits of Insurance required by the written agreement between the parties; or 2.The Limits of Insurance provided by this Coverage Part. D.With respect to the insurance afforded to an additional insured, this insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of any act or omission of an additional insured or any of its employees. INSURED COPY POLICY NUMBER: SI8ML02781221 COMMERCIAL GENERAL LIABILITY ECG 20 601 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ECG 20 601 05 09 Copyright, Everest Reinsurance Company 2009 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 1  ADDITIONAL INSURED – MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization (Additional Insured): ANY PERSON OR LEGAL ENTITY IN WHICH YOU HAVE A WRITTEN CONTRACT, AGREEMENT, OR PERMIT WHICH REQUIRES THAT YOU NAME THE CONTRACTING PARTY AS AN ADDITIONAL INSURED. Designation of Premises (Part Leased to You): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II – Who Is An Insured is amended to include as an additional insured the person or organization shown in the Schedule but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: B.The insurance afforded to an additional insured shall only include the insurance required by the terms of the written agreement and shall not be broader than the coverage provided within the terms of the Coverage Part. C.The Limits of Insurance afforded to an additional insured shall be the lesser of the following: 1.The Limits of Insurance required by the written agreement between the parties; or 2.The Limits of Insurance provided by this Coverage Part. D.With respect to the insurance afforded to an additional insured, the following additional exclusions apply: This insurance does not apply to: 1.Any "occurrence" which takes place after you cease to be a tenant in that premises. 2.Structural alterations, new construction or demolition operations performed by or on behalf of the person or organization shown in the Schedule. INSURED COPY INSURED COPY POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 12 04 13 Insurance Services Office, Inc., 2012 Page 1 of 1 ADDITIONAL INSURED --- STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION --- PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II ---- Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products-completed operations hazard". 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: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. SI8ML02781221 ANY ENTITY TO WHICH THERE IS A WRITTEN CONTRACT COMMERCIAL GENERAL LIABILITY ECG 24 520 04 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ECG 24 520 04 02 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1  AMENDMENT – OTHER INSURANCE (PRIMARY NONCONTRIBUTORY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraph a. Primary Insurance of 4. Other Insurance of SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: a. Primary Insurance This insurance is primary except when b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in c. below, except that we will not seek contribution from any party with whom you have agreed in a written contract or agreement that this insurance will be primary and noncontributory, if the written contract or agreement was made prior to the subject “occurrence” or offense. INSURED COPY (Ed. 4-84) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the California workers’ compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description 2 Any person or organization for whom the Named Insured has agreed by written contract executed prior to loss. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Countersigned by © 1998 by the Workers’ Compensation Insurance Rating Bureau of California. All rights reserved. WC 04 03 06 (Ed. 4-84) From the WCIRB’s California Workers' Compensation Insurance Forms Manual ©2001. Page 1 of 1 12/16/2022A0207205002 Sentry Casualty Company 00001 0000000000 22350 0 N1 dd6f3114-1a66-44fa-bfc2-0d0275bc3f7bdd6f3114-1a66-44fa-bfc2-0d0275bc3f7b Endorsement Effective Policy No. A0207205-002 Endorsement No. Insured Insurance Company