Loading...
HomeMy WebLinkAboutCP1411 16-14 Muckelshoot Indian Tribe Master Meters /CITY OF T T • ALT T� U �1Nancy Backus, Mayor l It J AJWAS H II N GTG111ON 25 West Main Street * Auburn WA 98001-4998 * www.auburnwa.gov * 253-931-3000 July 6, 2016 CERTIFIED MAIL RETURN RECEIPT REQUESTED Scott Fournier A Advanced Septic Services, Inc. 2518 East Valley Highway East Sumner, WA 98390 NOTICE TO PROCEED RE: CP1411, Muckleshoot Indian Tribe Master Meters, Contract#16-14 You are hereby notified to proceed as of July 8, 2016 with the work on the above- referenced project, within the time period specified, in accordance With the provisions of the contract documents, copy enclosed. This project has 60 working days for completion. If you have any questions, please contact the inspector for the project, Dave Roselle at 253-804-5085 or the Contract Administration Specialist, Amanda DeSilver at 253-876- 1980. Sincerely, P2> Ingrid Ga Asst. Director of Engineering/City Engineer Community Development & Public Works Department IG/ad/as Enclosure cc: Dani Daskam, City Clerk Joel Chalmers, Project Engineer Dave Roselle, Project Inspector File 13.11 Project #CP1411 AUBURN * MORE THAN YOU IMAGINED CONTRACT Contract No. 16-14 THIS AGREEMENT AND CONTRACT,` made and entered into, in duplicate, at Auburn,..�J Washington, this (pt*' day of JL1 , 2016, by and between the CITY OF AUBURN, WASHINGTON, a municipal corporation, and A Advanced Septic Services, Inc. 2518 East Valley Highway East, Sumner, WA 98390 hereinafter called the CONTRACTOR. WITNESSETH: That, in consideration of the terms and conditions contained in the Contract Documents entitled "CP1411, Muckleshoot Indian Tribe Master Meters," which are by this reference incorporated herein and made a part of this Contract, the parties hereto covenant and agree as follows: I. The CONTRACTOR shall do all work and furnish all tools, materials and equipment for Project CP1411, Muckleshoot Indian Tribe Master Meters — the construction of installation of two master meter vaults with backflow assembly enclosures at the Muckleshoot Indian Tribe Casino located at 2600 Auburn Way South and disconnection of three existing water mains nearby for a unit bid price of three hundred sixty-two thousand ninety-six dollars and eighty cents ($362,096.80) and Washington State Sales Tax of thirty-four thousand three hundred ninety-nine dollars and twenty cents ($34,399.20) for a total contract value of three hundred ninety-six thousand four hundred ninety-six dollars ($396,496.00) in accordance with and as described in the Contract Documents which are by this reference incorporated herein and made a part hereof, and shall perform any alterations in or additions to the work provided under this Contract and every part thereof. This Contract shall be executed by the Contractor and returned to the City within 7 calendar days after the receipt of the dated notification of award and the Contract time shall commence within 5 working days after execution of the Contract by the City and so designated on the Notice to Proceed. Physical completion shall be within 60 working days of the date on the Notice to Proceed. If said work is not completed within the time specified, the CONTRACTOR agrees to pay liquidated damages to the CITY OF AUBURN, as specified in Section 1-08.9 (Liquidated Damages) of the Standard Specifications. The CONTRACTOR shall provide and bear the expense of all equipment, work and labor of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in this Contract and every part thereof, except'such as are mentioned in the Contract Documents to be furnished by the CITY OF AUBURN. II. The CITY OF AUBURN hereby promises and agrees with the CONTRACTOR to employ, and does employ the CONTRACTOR to provide the materials and to do and cause to be done the above described work and to complete and finish the same according to the Contract Documents and the terms and conditions herein contained and hereby contracts to pay for the same according to said Contract Documents and the aforesaid proposal hereto attached, at the time and in the manner and upon the conditions provided for in this Contract. III. The CONTRACTOR for himself, and for his heirs, executors, administrators, successors, and assigns, does hereby agree to the full performance of all the covenants herein contained upon by part of the CONTRACTOR. IV. It is further provided that no liability shall attach to the CITY OF AUBURN, WASHINGTON by reason of entering into this Contract, except as expressly provided herein. [N WITNESS WHEREOF the parties hereto have caused this Contract to be executed the day and year first hereinabove written. CITY OF AUBURN, WASHINGTON By Nanc s, Mayor Countersigned: this (pmday of , TJ v , 2016 ATTEST: `�u �e �A`LEIJ Danielle E. Daskam,City Clerk APPROVED AS TO FORM: K ' &i d Daniel B. Heid, Attorney A A IV• NCED SEPTIC SERVICES, INC By Ti uttiori. d Official Signature CONTRACT BOND CONTRACT NO. 16-14 BOND NO. SUR40010436 BOND TO CITY OF AUBURN, WASHINGTON KNOW ALL MEN BY THESE PRESENTS: That we, the undersigned, A Advanced Septic Services, Inc, 2518 East Valley Highway East, Sumner, WA 98390, as principal, and IRONSHORE INDEMNITY INC. , a corporation, organized and existing under the laws of the State of MINNESOTA as.a surety corporation, and qualified under the laws of the State of Washington to become surety upon bonds of contractors with municipal corporations, as surety, are jointly and severally held and firmly bound to the City of Auburn, Washington, in the penal sum of three hundred ninety-six thousand four hundred ninety-six dollars (5396,496.00) for the payment of which sum we jointly and severally bind ourselves and our successors, heirs, administrators or personal representatives as the case may be. This obligation is entered into in pursuance of the Statutes of the State of Washington and the Ordinances of the City of Auburn, Washington. Dated at Auburn, Washington, this (Uhl day of TO KS , 2016. Nevertheless, the conditions of the above obligation are such that: WHEREAS, the City of Auburn on the 20th day of June, 2016, let to the above bounden principal a certain Contract. The said Contract being numbered 16-14, and providing for the construction of Project CP1411, Muckleshoot Indian Tribe Master Meters - installation of two master meter vaults with backflow assembly enclosures at the Muckleshoot Indian Tribe Casino located at 2600 Auburn Way South and disconnection of three existing water mains nearby (which Contract is referred to herein and is made a part hereof as though attached hereto), and WHEREAS, the said principal has accepted, or is about to accept, the said Contract, and undertake to perform the work therein provided for in the manner and within the time set forth: NOW, THEREFORE, if the above bounden principal shall faithfully and truly observed and comply with the terms, conditions, and provisions of said Contract in all respects and shall well and truly and fully do and perform all matters and things by them undertaken to be performed under said Contract, upon the terms proposed therein, and any and all duly authorized modifications of said Contract that may hereafter by made, and within the time prescribed therein, and until the same is accepted, and shall pay all laborers, mechanics, subcontractors and material men, and all persons who shall supply principal or subcontractors with provisions and supplies for the carrying on of said work and shall hold said City of Auburn, Washington, harmless from any loss or damage occasioned to any person or property by reason of any carelessness or negligence on the part of said principal or any subcontractor in the performance of said work, and shall in all respects faithfully perform said Contract according to law, and shall indemnify and hold the City of Auburn, Washington, harmless from any damage or expense by reason of failure of performance, as specified in said Contract, and The undersigned principal and the undersigned surety present this contract bond related to the Contract, PROVIDED that this document shall not be enforceable Unless and until the City of Auburn awards and executes the Contract to the undersigned principal. No obligations under this bond, for the performance of the above-referenced contract, shall be enforceable until the City of Auburn has executed the contract to the undersigned principal. The Surety, hereby agrees that modifications and changes may be made in the terms and provisions of the aforesaid Contract without notice to Surety, and any such modifications or changes increasing the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this Contract Bond in a like amount, such increase; however, not to exceed twenty — five percent (25%) of the original amount of this bond without the consent of the Surety. PROVIDED, however, that after the acceptance of this Contract and the expiration of the lien period, and if there are no liens pending, then the penal sum of this bond, shall be reduced to either ten percent (10%) of the value of the improvements to the City or two thousand dollars ($2,000), whichever is greater, to warranty against defects appearing or developing in the material or workmanship provided or performed under this Contract within a period of one (1) year after acceptance. Not withstanding the reduction of this bond, the principal and surety shall hold the City of Auburn harmless from all defects appearing or developing in the material or workmanship provided or performed under this Contract within a period of one (I) year after acceptance, THEN and in that event this obligation shall be void; but otherwise it shall be and remain in full force and effect. It is hereby expressly agreed that if any legal action is necessary to be brought under the conditions of this bond, that the decisions of the Courts of the State of Washington shall be binding. IN WITNESS WHEREOF, the above-bounden partie have -xecut this instrument this 22ND day of JUNE ( 01, By A Advanced Septic Sent s, Inc I'-ONSHORE INDEMN INC. 11 Sure[ Attorney in Fact Mark D.Hanks ,CO •app'••� j� �� FRONTIER BONDING SERVICE, LLC • e 0 R9�'1'st _ ▪el SEAL ta • ; - t 1919 IP= 155 NE 100TH STREET,SUITE 201,SEATTLE,WA 98125 `' 'NEBi�l• ,'', �I * %%%% Resident AgenCslAdd�res &1-0712 Phone Number POWER OF ATTORNEY SUR40010436 Ironshore Indemnity Inc. KNOW ALL MEN BY THESE PRESENTS,that IRONSHORE INDEMNITY INC.,a Minnesota Corporation,with Its principal office in New York,NV does hereby constitute and appoint: MARK D. HANKS Its true and lawful Attorney-In-Fact to make,execute,seal and deliver for, and on Its behalf as surety,a CONTRACT BOND under bond or undertaking number SUR40010436 Issued on behalf of, A ADVANCED SEPTIC SERVICES,INC as principal In the penal sum of 5396,496.00 This authority Is made under and by the authority of a resolution which was passed by the Board of Directors of IRONSHORE INDEMNITY INC. on the 22nd Day of April,2013 as follows: Resolved,that the Director of the Company Is hereby authorized to appoint and empower any representative of the company or other person or persons as Attorney-In-Fact to execute on behalf of the Company any bonds,undertakings,policies,contracts of indemnity or other writings obligatory In nature of a bond not to exceed$396,496.00 dollars,which the Company might execute through Its duly elected officers,and affix the seal of the Company thereto. Any said execution of such documents by an Attorney-in-Fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company.Any Attorney-In-Fact,so appointed,may be removed far good cause and the authority so granted maybe revoked as specified in the Power of Attorney. Resolved, that the signature of the Director and the seal of the Company may be affixed by facsimile on any power of attorney granted,and the signatureof the Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power andany such power or certificate bearing such facsimile signature and seal shall be valid and binding or the Company.Any such power so executed and sealed and certificate so executed and sealed shall,with respect to any bond of undertaking to which it is attached,continue to be valid and binding on the Company. IN WITNESS THEREOF,IRONSHORE INDEMNITY INC.has caused this Instrument to be signed by its Director,and its Corporate Seal to be affixed this t"Day of May,2013. IRONSHORE INDEMNITY INC. ��pPOgy��\ itSEAL tl 19,8 !Axvsc:0 By: � � Daniel L Suh-nrdn Director ACKNOWLEDGEMENT On this 1"Day of May,2013,before me,personally came Daniel L Sussman to me known,who being duly sworn,did depose and say that he is the Director of Ironshore Indemnity,Inc. ,the corporation described in and which executed the above instrument;that he executed said instrument on behalf of the corporation by authority of his office under the By-laws of said corporation. PHER``ty r4jro4n 3 �pCR Amy l 26," �r / NOTARY +N� x--✓, Tsyp•.. PU&.IC . " Christophe Dobbs �9La`'•��•_•�•N f Notary Public 3�nfaunoas`Pa MY COMMISSION BOBER June 21,201d&`` LATE I, the undersigned, Secretary of IRONSHORE INDEMNITY INC.,A Minnesota Company, DO HEREBY CERTIFY that the original Power of Attorney of which the foregoing is a true and correct copy,Is In Full force and effect and has not been revoked and the resolutions as set forth ire now In force. Signed and Sealed at this 22ND Day of JUNE , 2016. 'h. V1.'61 i�1 SEAL ‘1‘. Paul S.Giordano Secretary "WARNING:Any person who knowingly and with Intent to defraud any insurance company or other person,flies and application for Insurance or statement of claim containing any materially false information,or conceals for the purpose of misleading information concerning any fact material thereto,commits a fraudulent Insurance act,which Is a crime and subjects such person to criminal and civil penalties." Page 1 of 2 Consumer tools Agent and Company Lookup Orders Independent Review Decisions IRONSHORE INDEMNITY INC Licensing I Appointments I Complaints I Orders I National Info I Ratings I Tax Filings Back to Search General information Contact information Name: IRONSHORE INDEMNITY INC Registered address Mailing address Corporate family group: IRONSHORE GRP 0 c/o CT Corporation System One State Street Plaza Organization type: PROPERTY Inc 7th & 8th Floor 100 S Fifth St Suite 1075 New York, NY 10004 WAOIC: 873 Minneapolis, MN 55402 NAIC: 23647 Telephone Telephone 917-324-0409 917-324-0409 Status: ACTIVE Admitted date: 06/24/1975 Ownership type: STOCK 2 back to top Types of coverage authorized to sell o. Insarancetypes Casualty Disability Marine Ocean Marine Property_ Surety Vehicle ^• back to top Agents and agencies that represent this company (Appointments) o View agents View agencies ^back to Lop Company complaint history o View complaints 4 back to top Orders issued since 2015 a No orders are found R back to top haps://www.insurance.wa.gov/consumertoolkit/Company/CompanyProfi le.aspx?WAOIC—... 6/28/2016 Page 2 of 2 Disciplinary orders 2008-2014 0 No disciplinary orders are found Looking for other types of orders? Our Pre-2015 orders search allows you to search orders prior to 2015. I'back to top Premium tax filings by tax year p 2015 2014 2013 2012 2011 e back to top National information on insurance companies Want more information about this company?The NAIC's Consumer Information (CIS) page allows you to retrieve national financial and complaint information on insurance companies, plus has Information and tips to help you understand current insurance issues. •back fo pqp Ratings by financial organizations The following organizations rate insurance companies on their financial strength and stability. Some of these companies charge for their services. A.M. Best Weiss Group Ratings Standard and Poor's Corp Moody's Investors Service Fitch IBCA, Duff and Phelps Ratings back to top https://www.i nsurance.wa.gov/consumertoolkit/Company/Company Profile.aspx?WAOI C=... 6/28/2016 A.M. Best's Consumer Insurance Information Center Page 1 of 1 A..Maa@B�ersat''s� �Q�{� p tgnatlRa a tn*uE a Center di Member Center j,ggJQ I Sion lip Need Coverage? How Does Your Insurer Rate? State Insurance Information •pp;11I Fina insurers by state or coverage type !Enter a Company Name 1 I Soled a Slate V 0 Consumer Home I Terms to Know I V1.V1.16/Ta Best's Raeng is Important I Contact Us 0 Life&Retirement Health&Disability Q Car 8 Home O Other Life Events Ironshore Indemnity Inc: a Pnnl This page In menVmr of eenahom inserence o'outl M Bee 13547 NAICa 23647 FEIN .I012,e40 Address' P.O.Box 3407 Phone. 646-8266600 New York,NY 10008 Fax: 646-8266601 UNITED STATES Web: www ironshore com Best's Ratings View Definition ' Need More information? Financial Strength Ralinp'. A AMB_ • ' .� Purchase an insurer report,complete with Outlook: Ne adve rating history,market share and a list of . 9 Credit.Rep'burt . competitive usurers for$9.95 Effective Date: June 24,2016(Affirmed) 4,;z7":".._ View Sample Report Financial Size Category. XIV($1.60 Billion to$2.00 Billion) Licensing: The company is licensed in the District of Columbia,Puerto Rico,AL,AK,AR,CA,CO,CT,DE,FL,GA,HI.ID,IL,IN,IA.KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT, NE,NV,NH,NJ,NM,NY;NC;ND,OH,OK,OR,PA,RI,SC,SD,TN,TX,UT,VT,VA,WA,WV,WI and WY,It also operates on a surplus lines or non-admitted basis in Arizona. ironshore Indemnity Inc.is an accredited reinsurer in all states where it holds a license. Top Line(n)of Business tbeendopen peen v,emumawanem 1. Other Liability(Claims-made)mew Definition I 2. Other Liability(Occurrence)(View Definition) 3 Surety(Mew oeenmooI 4, Accident and Health(View Deenelen) 5. Inland Marine(View Donmlwn i Trip State(s)of Business(bass upon Neel Premiums wrote) 1. Now York 2. California 3. Mlsalaelppt 4. Texas 5 Arizona Visa our NewsRoom for the latest News and Press Releases for this company and its AM Best Group Terms of Use All information provided on the A.M.Best website,including but not limited to text,data,ratings,reports,images,photos,graphics,and charts is owned by or licensed to A.M.Best Company and is protected by United Stales copyright laws and international treaty provisions.A.M.Best and its licensors retain all copyright and other proprietary rights to the website content. Best's Credit Ratings,obtained through any source,may not be reproduced,distributed to Third Parties,or stared in a database or retrieval system in any form for Commercial purposes without the prior written permission of the A M.Best Company.All unauthorized use of Best's Credit Ratings or other published information is strictly prohibited.By logging into Best's Member Center or accessing this site,you accept and agree to be bound by our complete Terms of Use. Customer Service I Product Support I Member Center I centail Info I Careers About A M Best I Site Map I Privacy Policy Security I Terms of Use I Legal 8 Licensing Copynght®2016 A.M.Best Company,Inc.and/or its affiliates ALL RIGHTS RESERVED. http://www3.am best.com/Consumers/CompanyProfile.aspx?BL=36&am bnum=013 847&P... 6/28/2016 CITY OF / * Escrow Agreement For Retainage Declined WASHINGTON A ADVANCED SEPTIC SERVICES, INC, 2518 EAST VALLEY HIGHWAY EAST, SUMNER, WA 98390 (CONTRACTOR) acknowledges that they have been offered the option of setting up an escrow agreement for their retainage on Contract No. 16-14, Project No. CP1411: Muckleshoot Indian Tribe Master Meters. The CONTRACTOR declines to set up an escrow agreement and understands that the City will hold the 5% retainage with no interest until the project is complete, accepted by the City, and all releases and liens have been satisfied. g/e Autho zen Signature °en>) A . Gt nca Print or Type Name • �reS� , e opt Title 1,1231 ►t� Date File: 13.11 (CP1411) AUBURN * MORE THAN YOU IMAGINED NYY ACO CERTIFICATE OF LIABILITY INSURANCE D6/zz/ D 6YI 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 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 CONTACT Marianne Jackson NAME: Leavitt Group Northwest PHONa FaD (253)565-3500 I(A/C,No): (253)565-7209 Mark Hanks _nooRess:marianne-jackson@leavitt.com — 2121 70th Ave West, NB INSURER(S)AFFORDING COVERAGE _ NAICa University Place WA 98466 INSURER A:Ohio Security Insurance Company 24082 INSURED INSURER e:Ohio Casualty Insurance Company 024074 A Advanced Septic Services, Inc. ; AJ LLC INSURER C:Admiral Insurance Company 24856 Gunia Group LLC INSURER D: 2518 E Valley Hwy E INSURER E Sumner WA 98390-9510 INSURER F: COVERAGES CERTIFICATE NUMBER:2016-2017 REVISION NUMBER: THIS'IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ( ICY EXP I LTR TYPE OF INSURANCE IF IAN pLI WODI POLICY NUMBER I(MM,00IYYCMY YY)F I(MMILOD/YYYY) LIMITS X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DA CLAIMS.MADE X OCCUR PRE1MGESRENTED ET(ER NTED a)_ $ 1,000,000 DA AG X BKS 17 54727936 4/13/2016 4/13/2017 MED EXP JAnyone person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. GENERAL AGGREGATE $ 2,000,000 PRO POLICY X JECT LOC PRODUCTS--COMP/OP AGG $ 2,000,000 OTHER Stopgap $ 1,000,000 I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea pcndenq A X ANY AUTO BODILY INJURY(Per person) S • ALL OWNED SCHEDULED -- AUTOS AUTOS X BAS54727936 4/13/2016 4/13/2017 BODILY INJURY(Per accident) S NEO PROPERTY DAMAGE HIRED AUTOS AUTOSUTOS __(Per=orient) $ _ I MoaRBI eaymenls 1$ 5,000 X UMBRELLA LIAB — OCCUR EACH_OCCURRENCE _ $ 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 I DED I X ( RETENTIONS 10,000 US054727936 4/13/2016 4/13/2017 $ WORKERS COMPENSATION PER 0TH AND EMPLOYERS'LIABILITY YIN I STATUTE_(X ER LS ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT I $ 1,000,000 OFFICER/MEMBER EXCLUDED/ N NIA A (Mandatory In NH) BKS 17 54727936 4/13/2016 4/13/2017 E .DISEASE-EAEMPLOYE _$ 1,000,000 Byes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT IS 1,000,000 C Professional Liability E0000026037-02 2/5/2016 4/13/2017 Earn Claim $1,000,000 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks schedule,may be attached II more specs Is required) RE: Muckleshoot Indian Tribe Master Meters contract #16-14 Endorsements CGB810 04/13 & CA8810 01/10 attached See comments/remarks. . . CERTIFICATE HOLDER CANCELLATION (253) 931-3053 12539313053@efaxsend.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Auburn THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 25 W Main ACCORDANCE WITH THE POLICY PROVISIONS. Auburn, WA 98001 • AUTHORIZED REPRESENTATIVE / Mark Hanks/MAJACK ILC_t b L- „44*--• ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) • Additional Named Insureds Other Named Insureds AJ LLC Limited Liability Company, Additional Named Insured Gunia Group LLC Limited Liability Company, Additional Named Insured OFAPPINF(02/2007) COPYRIGHT 2007,AMS SERVICES INC COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON-OWNED AIRCRAFT 2 NON-OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY-ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU(Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS-COVERAGES A AND B 3 ADDITIONAL INSUREDS-BY CONTRACT,AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY-ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS-EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED-INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED-FELLOW EMPLOYEE EXTENSION-MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE,OFFENSE,CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US- 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office.Inc.,with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON-OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g.Aircraft,Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada,designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However,the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this polity), contingent or on any other basis,that would also apply to the loss covered under this provision. B. NON-OWNED WATERCRAFT Under Paragraph 2.Exclusions of Section I-Coverage A-Bodily Injury And Property Damage Liability, Subparagraph (2)of exclusion g.Aircraft,Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long;and (b) Not being used to carry persons or property fora charge. C. PROPERTY DAMAGE LIABILITY-ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision,elevators do not include vehicle lifts.Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance,Paragraph b.Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary,excess,contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU(Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2.Exclusions of Section I-Coverage A-Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1),(3) and (4)of this exclusion do not apply to "property damage" (other than damage by fire,lightning,explosion,smoke,or leakage from an automatic fire protection system)to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7'or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. O 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 2 of 8 b. The last paragraph of subsection 2.Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III-Limits Of Insurance. 2. Paragraph 6.tinder Section III-Limits 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 for damages because of"property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage)- Paragraph 9.a.of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I -Coverage C - Medical Payments, Subparagraph (b)of Paragraph a.is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS-COVERAGES A AND B 1. Under Supplementary Payments-Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to$500 a day because of time off from work. G. ADDITIONAL INSUREDS-BY CONTRACT,AGREEMENT OR PERMIT 1. Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf,in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or © 2013 Liberty Mutual Insurance • CG 88 10 04 13 Includes copyrighted material of Insurance Services office,Inc.,with its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or c. The maintenance,operation or use by you of equipment rented or leased to you by such person or • organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction,erection,or removal of elevators; or (c) The ownership,maintenance,or use of any elevators covered by this insurance. However: 1. 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 required by a contract or agreement, the insur- ance 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. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (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 performedby or on behalf of the additional insured(s)at the location of the covered operations has been completed; or (2) 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. With respect to Paragraph Lb. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV -Commercial General Liability Condi- tions. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc..with its permission. Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I•Coverage A-Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports,surveys,field orders,change orders or drawings and specifications; or (2) 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 "occur- rence" 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. d. "Bodily injury" or"property 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 additional insured(s)at the location of the covered operations has been completed; or (2) 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. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. 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 i_nsurance: a. Required by the contract or agreement; or b. 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. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV- COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a.Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. O 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 5 of 8 b. The following is added to Paragraph b.Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement,or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS-EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2.Duties In The Event Of Occurrence,Offense,Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED-INCIDENTAL MEDICAL ERRORS/MALPRACTICE WHO IS AN INSURED-FELLOW EMPLOYEE EXTENSION-MANAGEMENT EMPLOYEES Paragraph 2.a.(1)of Section II-Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you,to your partners or members(if you are a partnership or joint venture),to your members(if you are a limited liability company), to a co-"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; F (b) To the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as a consequence of Paragraph(1)(a)above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs(1)(a)or(b)above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a)and(b)above do not apply to "bodily injury" or"personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office.Inc.,with its permission. Page 6 of 8 advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3.of Section II-Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form 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: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership,joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV-Commercial General Liability Conditions,the following is added to Condition 6.Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior"occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE.OFFENSE.CLAIM OR SUIT Under Section IV-Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence,Offense.Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II-Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge,your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V-Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. 8 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV -Commercial General Liability Conditions, the following is added to Condition 8.Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization 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" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. 111 I © 2013 Liberty Mutual Insurance Includes copy CG 88 10 04 13 righted material of Insurance Services Office.Inc.,with its permission. Page 8 of 8 COMMERCIAL AUTO CA 88 10 01 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. • COVERAGE INDEX SUBJECT PROVISION NUMBER ADDITIONAL INSURED BY CONTRACT,AGREEMENT OR PERMIT 3 ACCIDENTAL AIRBAG DEPLOYMENT 12 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 18 AMENDED FELLOW EMPLOYEE EXCLUSION 5 AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 13 BROAD FORM INSURED 1 BODILY INJURY REDEFINED 21 EMPLOYEES AS INSUREDS (including employee hired auto) 2 EXTENDED CANCELLATION CONDITION 22 EXTRA EXPENSE - BROADENED COVERAGE 10 GLASS REPAIR - WAIVER OF DEDUCTIBLE 15 HIRED AUTO PHYSICAL DAMAGE(including employee hired auto) 6 HIRED AUTO COVERAGE TERRITORY 20 LOAN / LEASE GAP 14 PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) 16 PERSONAL EFFECTS COVERAGE 11 PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8 RENTAL REIMBURSEMENT 9 SUPPLEMENTARY PAYMENTS 4 TOWING AND LABOR 7 UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 17 rNAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TOUS 14 SECTION II-LIABILITY COVERAGE is amended as follows: 1. BROAD FORM INSURED SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period. However, "insured" does not include any organization that: (1) Is a partnership or joint venture; or (2) Is an insured under any other automobile policy; or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture,of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self-insured retention plan available to that organization; ®2010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 1 of 7 (2) If the Limits of Insurance of any other insurance policy have been exhausted; or • (3) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow but only for acts within the scope of their employment by you. Insurance provided by this endorse- ment is excess over any other insurance available to any "employee". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties re- lated to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee". 3. ADDITIONAL INSURED BY CONTRACT.AGREEMENT OR PERMIT SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: h. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract, agreement,or permit issued to you by governmental or public authority,to add such person,or organization,or governmental or public authority to this policy as an "insured". However, such person or organization is an "insured": (II Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract,agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para- graphs(2)and 14)are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations) required because of an "accident" we cover.We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including actual loss of earn- ings up to$500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law,fellow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule, or similar protection, the following provision is added: SECTION Il - LIABILITY, exclusion B.S. FELLOW EMPLOYEE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. SECTION Ill-PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4.Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE, is amended by adding the following: if hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Lass or Collision coverage are provided under the Business Auto Coverage Form for any "auto" you own,then the Physical Damage coverages provided are extended to "autos": a. You hire,rent or borrow; or @20,0 Liberty Mutual Insurance Company.All rights reserved. CA 88 t0 Of f f7 tncfudes copyrighted material of insurance Services Office Inc,with its Permission. Page 2 of 7 b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of: (1) $50,000; or (2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. D. Subject to a maximum of $750 per "accident", we will also cover the actual loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss. E. This coverage extension does not apply to: (1) Any "auto" that is hired, rented or borrowed with a driver; or (2) Any "auto" that is hired, rented or borrowed from your "employee". For the purposes of this provision,SECTION V-DEFINITIONS is amended by adding the following: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. 7. TOWING AND LABOR SECTION III - PHYSICAL DAMAGE COVERAGE, paragraph A.2.Towing, is amended by the addition of the following: We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is dis- abled: a. For private passenger type vehicles, we will pay up to$50 per disablement. b. For "light trucks", we will pay up to$50 per disablement. "Light trucks" are trucks that have a gross vehicle weight(GVW)of 10,000 pounds or less. c. For "medium trucks" ,we will pay up to$150 per disablement. "Medium trucks" are trucks that have a gross vehicle weight(GVW)of10,001 -20,000 pounds. However, the labor must be performed at the place of disablement. 8. PHYSICAL DAMAGE-ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a., Coverage Extension of SECTION III - PHYSICAL DAMAGE COVERAGE, is amend- ed to provide a limit of$50 per day and a maximum limit of$1,500 020)0 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc..with its Permission. Page 3 of 7 9. RENTAL REIMBURSEMENT SECTION III- PHYSICAL DAMAGE COVERAGE,A.COVERAGE,is amended by adding the following: a. We will pay up to$75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident" or "loss", to an "auto" for which we also pay a "loss" under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those expenses incurred after the first 24 hours following the "accident" or "loss" to the covered "auto." - b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage does not apply unless you have a business necessity that other "autos" avail- able for your use and operation cannot fill. e. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4.Coverage Extension. f. No deductible applies to this coverage. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11. 10. EXTRA EXPENSE-BROADENED COVERAGE Under SECTION III -PHYSICAL DAMAGE COVERAGE,A.COVERAGE,we will pay for the expense of returning a stolen covered "auto" to you.The maximum amount we will pay is$1,000. 11. PERSONAL EFFECTS COVERAGE A. SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance. B. SECTION V- DEFINITIONS is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible property that is worn or carried by an insured." "Personal effects" does not include tools, equipment, jewelry, money or securities. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the follow- ing: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other cov- erage or warranty. 13. AUDIO,VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclu- sions 4.c.and 4.d. is deleted and replaced with the following: 02010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc,with its Permission. Page 4 of 7 Exclusion 4.c.and 4.d. do not apply to: • a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of the "loss" and such equipment Is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto" and • physical damage coverages are provided for the covered "auto"; or If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property • will be reduced by a$100 deductible. 14. LOAN/LEASE GAP COVERAGE A. Paragraph C., LIMIT OF INSURANCE of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any one "accident" is the greater of the: 1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the"loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the "loss", b. Financial penalties imposed under a lease due to high mileage, excessive use or ab- normal wear and tear, c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, e. Final payment due under a "Balloon Loan", f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered "auto", g. Security deposits not refunded by a lessor, h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto", i. Any amount representing taxes, j. Loan or lease termination fees; or 2. The actual cash value of the damage or stolen property as of the time of the "loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss". This adjustment is not applicable in Texas. B. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto" that incurred the foss serves as collateral,or lease written on the covered "auto" that incurred the loss. C. SECTION V- DEFINTIONS is changed by adding the following: As used in this endorsement provision, the following definitions apply: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. 02010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 5 of 7 15. GLASS REPAIR-WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 16. PARKED AUTO COLLISION COVERAGE(WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible does not apply to "loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs.or less as defined by the manufacturer as maximum loaded weight the"auto" Is designed to carry while it is: a. In the charge of an "insured"; b. Legally parked; and c. Unoccupied. The "loss" must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or organization engaged in the automobile business. SECTION IV-BUSINESS AUTO CONDITIONS is amended as follows: 17. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS, Paragraph B.2.is amended by adding the following: If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery,and we have the right to collect additional premium for any such hazard or exposure. 18. AMENDED DUTIES IN THE EVENT OF ACCIDENT,CLAIM,SUIT,OR LOSS SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.2-a. is replaced in its entirety by the following: a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when it is known to: 1- You, if you are an Individual; 2. A partner, if you are a partnership; 3. Member,if you are a limited liability company; 4. An executive officer or the "employee" designated by the Named Insured to give such notice, if you are a corporation. To the extent possible, notice to us should include: (1) How,when and where the"accident" or"loss" took place; (2) The "insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 19. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV • BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others to Us,is amended by the addition of the to/lowing: If the person or organization has waived those rights before an "accident" or "loss", our rights are waived also. 020,0 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of insurance Services Office Inc.,with Its Permission. Page 6 of 7 20. HIRED AUTO COVERAGE TERRITORY SECTION IV - BUSINESS AUTO CONDITIONS, paragraph 8.7., Policy Period, Coverage Territory, is amended by the addition of the following: f. For "autos" hired 30 days or less,the coverage territory is anywhere in the world, provided that the insured's responsibility to pay for damages is determined in a "suit", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. SECTION V-DEFINITIONS is amended as follows: 21. BODILY INJURY REDEFINED Under SECTION V-DEFINTIONS,definition C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. COMMMON POLICY CONDITIONS 22. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS, paragraph A. - CANCELLATION condition applies except as fol- lows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancella- tion. 02010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.with its Permission. Page 7 of 7 Page 1 of 2 Consumer tools Agent and Company Lookup Orders Independent Review Decisions OHIO SECURITY INSURANCE COMPANY Licensing I Appointments I Complaints I Orders I National Info I Ratings I Tax Filings Back to Search General information Contact information Name: OHIO SECURITY INSURANCE COMPANY Registered address Mailing address Corporate family group: LIBERTY MUT GRP O 62 MAPLE AVE 175 BERKELEY ST Organization type: PROPERTY KEENE, NH 03431 BOSTON, MA 02116 WAOIC: 1007 Telephone Telephone NAIC: 24082 513-867-3023 617-357-9500 Status: ACTIVE Admitted date: 06/11/1974 Ownership type: STOCK ^: back to top Types of coverage authorized to sell p Insurance types Casualty Marine Ocean Marine Property Surety Vehicle T back to too Agents and agencies that represent this company (Appointments) o View agents View agencies T back to top Company complaint history o View complaints x back to top Orders issued since 2015 0 Most Recent Issue Order NumberDate Order Summary 16-0044 03/04/2016 Fine levied for failure to file and obtain approval for a fully earned premium additional insured endorsement form with the htinc•//ixnxnxi incl lrnnrP um nnu/rnncl nnartnnllc i/Pnm'ntnv/rmmUnnuPrnflo aonv7WA Cli r= A/2 ROMA A.M. Best's Consumer Insurance Information Center Page 1 of I A.M.�/rr��__( .QQBe��s��t''srr (p,�Q�pF 1���s//��Q ((!�ppr�G�rrpp _. R,Quaurueg tnaM.rafge een teu 1!&Member Center:Lao In I Sian Up Need Coverage? How Coos Your Insurer Rate? State Insurance Information Find insurers by state or coverage type. Enter a Company Name [ Iseied a stale v1 Consumer Home I Terms to Know I wfiy a Bests Rating is Important I Contact Us Q Life&Retirement 0 Health&Disability O Car&Home O Other Life Events Ohio Security Insurance Company 8 Print this page la mnde,DI iio.m minus mm:nCe companies) A M see a 07379 NAIL I 240B2 FEIN a 31-0541777 Address 175 Berkeley Street Phone: 617-357-9500 Boston,MA 02116 Fax: 513-603-3179 UNITED STATES Web. www LibenyMutualGrouo Lem Best's Ratings View ocroilan Need Moro information? Financial Strength Rating A >AMic�� ti .Ys Purchase an insurer report,complete with Outlook: Stable di +�"rf.' rating history,market share and a list of 'Credit,�Repdrt- competitive insurers fors 995. Effective Date: October 08,2015(Affirmedre -;PitBriar'_; View Sample Report Financial Size Category: %V($2 Billion or greater) Licensing: The company is licensed in the District of Columbia,AL,AK,AZ,AR,CA,CO,CT,DE,FL,GA,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT,NE,NV, NH,NJ,NM,NY,NC,ND,OH,OK,OR,PA,RI,SC,SD,TN,TX,UT,VT,VA,WA,VW,WI and WY, Top Line(s)of Business leased upon Direct Premwms wweani 1. Commercial Multiple Peril Mew Denneee) 2. Auto(Commercial)Mew Deueiwnl 3 Workers'Ceniiiensation Mew Densimn) 4 Other Liability(Occurrence)View Deenilmn 1 5 Products Liability mow Definition Top State(s)of Business teased upon Dirac Premiums woin.m 1, California 2. Texas 3 Washington 4. New Jersey 5. Florida Visit our NewsRoom for the latest News and Press Releases for this company and its A.M.Best Group. Terms of Use All information provided on the A.M.Best website,including but not limited to text,data,ratings,ropons,images,photos,graphics,and charts is owned by or licensed to A.M.Bost Company and is protected by United States copyright laws and international treaty provisions.A.M.Best and its licensors retain all copyright and other proprietary rights to the website content. Best's Credo Ratings,obtained through any source,may not be reproduced,distributed to Third Parties,or stored in a database or retrieval system in any form for commercial purposes without the prior wniten permission of the A.M.Best Company.All uneuthonzed use of Bests Credit Ratings or other published information is strictly prohibited.By logging into Best's Member Center or accessing this site,you accept and agree to be bound by our complete Terms of Ilse. Customer Service I Product Support I Member Center I Contact Into 1 canfas About A M Best I$Ito Map I Privacy Policy I5ecuriiy I Terms of Use I Local&Licensinn Copyright 0 2016 A.M.Best Company,Inc.and/or its affiliates ALL RIGHTS RESERVED. httn://www3.amhest.com/Consumers/ComnanvProfi le.asnx?R1=36&amhnum=002 379&P... 6/2R/2016 Page I of 2 Consumer tools Agent and Company Lookup Orders Independent Review Decisions. OHIO CASUALTY INSURANCE COMPANY THE Licensing I Appointments I Complaints I Orders I National Info I Ratings I Tax Filings Back to Search General information Contact information Name: OHIO CASUALTY INSURANCE COMPANY THE Registered address Mailing address Corporate family group: LIBERTY NUT GRP 0 62 MAPLE AVE 175 BERKELEY ST Organization type: PROPERTY KEENE, NH 03431 BOSTON, MA 02116 WAOIC: 1001 Telephone Telephone NAIL: 24074 513-603-2400 617-357-9500 Status: ACTIVE Admitted date: 04/10/1926 Ownership type: STOCK t back to top Types of coverage authorized to sell a Insurance types Casualty Disability Marine Ocean Marine Property Surety Vehicle t back to Lop Agents and agencies that represent this company (Appointments) o View agents View agencies 1"back LO top Company complaint history a View complaints t back to top Orders issued since 2015 a No orders are found t back to top httnc•//unnnu incnrnnre wa onv/rnncnmertnnikit/Cmmnanv/PmmnanvPrnfi la ncnv7WAnlr= An2nm,c A.M. Best's Consumer Insurance Information Center Page 1 of 1 A,.M.. BeSt''s AY4eQQ6Lbr tok11''rra^�QpQ Center r se Member Center Loo In I Sian Up Need Coverage? How Does Your Insurer Rate? State Insurance Information Find insurers by state or coverage type. 'Enter a Company Name I1=111 'Soled a Slate vl Consumer Home I Terms to Know I why a Best's Rang is Imponant I Contact Us 0 Life&Retirement O Health&Disability Q Car Home O Other Life Events Ohio Casualty Insurance Company a Pnnt this page u m ntx 4t basely Mutual'nuance Campane. AM BeN00237a NAICa240i4 FEW•31-0346250 Address 175 Berkeley Street Phone. 513-603-2400 Boston.MA 02116 Fax: 513-603-3179 UNITED STATES Web. www LibernvMuluaiGroup cam Best's Ratings View Definition 1 0704,1t Need More information? 1te.17 �I�1�# Purchase an insurer report,complete with Financial Strength Rating: A �iIAMBils iqW l rating history.market share and a list of Outlook, Stable "w Credit Re rF� Effective Date: October 08,2015(Affirmed) �,;rs View pSample Report $9.95. Financial Size Category: XV($2 Billion or greater) ��� Licensing: The company is licensed in the District of Columbia and all states Top Line(s)of Business pane apes meal Prerrums Wesaei 1. Other Liability(Occurrence)mew Defn4en) 2. Commercial Multiple Peril mss.DVBmrian 3 Surety(Mew Definrlen) 4 Auto(Commercial)New Definition I 5 inland Marine Mew Dearman) Top Stato(s)of Business tutees epee erred Premiums wrmem 1. California 2. Washington 3 New Jersey 4 Texas 5. New York Visa our NewsRoom for the latest News and Press Releases for this company and its A M.Best Group. Terms of Use All information provided on the A.M.Best website,including but not limited to text,data,ratings,reports,images,photos,graphics,and charts is owned by or licensed to A.M.Best Company and is protected by United States copyright laws and international Treaty provisions A.M.Best and its licensors retain oil copyright and other proprietary rights to the website content. Best's Credit Ratings,obtained through any source,may not be reproduced,distributed to Third Parties,or stored in a database or retrieval system in any form for commercial purposes without the prior written permission of the A.M.Best Company.All unaulhonzed use of Best's Credit Ratings or other published information is strictly prohibited.By logging into Best's Member Center or accessing this site,you accept end agree to be bound by our complete Terms of Use Customer Service !Product Support I Member Center I Contac)Info I Careers About AM Best I Site Mao I privacy Policy I 5 _.irity I Terms of Use I Legf B Licensing Copyright 652016 A.M Best Company,Inc and/or Its affiliates ALL RIGHTS RESERVED. htto://www3.ambest.com/Consumers/Com oanvProfile.asox?BL=36&ambnum=0023 78&P... 6/28/2016 Carriers I Surplus Lines Association of Washington Page I of I Cecumenls Memoersmp I Cmenoar of E en:s I FADS I Conaa Us I SEARCH Asoul Us I Hews I Filing in:ar s:i n I Bouemce Erns I Lamers I SLIP I Laws°.Regulations I Ecuca:ion I Lirks I Maqual Home > Cerner Carrier Requirements Carriers List di Active Carriers Inclusion on Ibis 1151 does not indicate that the carrier meets the requirement as en appropnale insurer.The Surplus Line Broker is solely responsible for determining the qualifications of each carrier.Being on this list means the carrier is recognized by the Surplus Line Associalion of Washington and flings by brokers for the earner will be accepted for erammation. Search By Insurer Name or Clly:i enter search ten.. '- Search Insurer dame Address City : State +CCEPTANCE CASUALTY INSURANCE COMPANY 702 OBERLIN ROAD RALEIGH NC ACE EUROPEAN GROUP LTD. 1O0 LEADENHALL STREET LONDON UK CUAJIMALPA, ACE SEGUROS S A. ! BOSCUE DS ALISOS Ar-a MX CP ADMIRAL INSURANCE COM'Atty 1255 CALD'AELL ROAD CHERRY HILL NJ ADRIATIC INSURANCE CO^JPAAI3501 N CAUSEWAY BLVD. METAIRIE j LA I j WINSTON- �AGENT ALLIANCE INSURANCE COMPANY 5O0 Y:EST FIFTH STREET Ni: SALEM AIG EUROPE LIMITED FKA CHART'S EUROPE LIMITED THE AIG BUILDING ; LONDON UK t ' AIG SPECIALTY INSURANCE COMIPAn Y FKA CHARTIS SPECIALTY 1 j 17512:ATER STREET NEW YORK INY INSURANCE COMPANY AIX SPECIALTY INSURANCE COMPANY 72O EXCHANGE STREET BUFFALO NY I j ALLIANZ GLOBAL CORPORATE L SPECIALTY SE i., FRIT'_SCHAEFFER-STRASSE 9 : MUNICH DE '.._____. 17— r l O 2 J 2 5 e ] 8 9 10 .._,_! 1-1O of 211 Jane Await Us I Ne-vs I Filing I nlormaeon I Brokerage Firms I Camers I SLIP I Laws&Repulnipns I EUvevmn I Links I .Manual Home I Doeumonls I a ternaelshm I Calendar or Events I FOOS I Contact Un Copynghl @2010 Surplus Lina Association of Washington.All Rights Reserved.I IMU httn://www.suroluslines.ore/carriers/ 612X%2016 A.M. Best's Consumer Insurance Information Center Page 1 of 1 A.M. Be sst''s dgate t letasyuypgQen a is Member CemerLLo��n 1 a9nQg Need Coverage? +- How Does Your Insurer Rate? State Insurance Information Find insurers by state or coverage type. Her a Company Name II= [Select a Slate , Consumer Home I Terme to Know I Why a Bests Ratng Is Important I Contact Us Life 8.Retirement 0 Health&Disability 0 Car&Home O Other Life Events Admiral Insurance Company 8 Pnni This page la maneerelw R Berkley Ineurenom Global A M Baer a 0,020 MAIC a 24859 FEIN a 212225730 Address' 7233 East Butherus Drive Phone: 480-951-0905 Scottsdale,AZ 85260-2410 Fax: 480251-0910 UNITED STATES Web: www admiralins corn Best's Ratings View Definition Need Moro information? Financial Strength Rating: Aa J a rchase an insurer repoq complete with Outlook: Stable AM9r rating history,market share and a list of Effective Date: February26,2016(Affirmed }CpredxitsRI�ee,pdrt� competitive insurers far 89.95. Financial Size Category: XV(S2 Billion or greater) I_q 511tfiF 1' View Sample Report Licensing: The company is licensed in Delaware and New Jersey.II also operates on a surplus lines or non-admitted basis in the District of Columbia,American Samoa,Guam, Northern Mariana Islands,Puono Rico,U.S.Virgin Islands,AL,AK,AZ,AR,CA,CO,CT,FL,GA,HI,10,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT,NE,NV,NH,NM, NY,NC,ND,OH,OK,OR,PA.RI,SC,SO,TN,TX,UT,VT,VA,WA,WV,WI and WY. Top Llne(s)of Business (barge upon oiren Prenumswnae) 1. Other Liability(Occurrence)(view opnnibon) 2. Other Liability(Ciaims-rnado)Mew Dennmmn 3. Medical Professional Liability maw Dennison 1 4 Products Liability name Dennninn 1 5. Fire(View Definition Top Sestets)of Business pbasea Wen Dna Pmmume Written) 1. California 2. Texas 3 Now York 4. Florida 5. New Jersey Visit our NewsRoom for the latest News and Press Releases for This company and its A.M.Best Group. Terms of Use ATI information provided on the A.M.Best website,including but not limited to teat,data,ratings,reports,images,photos,graphics,and charts is owned by or licensed to A.M.Best Company and is protected by United States copyright laws and international treaty provisions A.M.Best and as licensors retain oil copyright and other proprietary rights to the website content. Best's Credit Ratings,obtained through any source,may not be reproduced,distributed to Third Parties,or stored in a database or retrieval system in any form for commercial purposes without the prior written permission of the A.M.Best Company.All unauthorized use of Best's Credit Ratings or other published Information is strictly prohibited.By logging into Best's Member Cantor or accessing this site,you accept and agree to be bound by our complete Terms of Use. Customer Service.1 Product Support I Member Center I Contact Info I Careers About A M Best I Site Map I Privacy Policy I Security I Terms of Use I Legal B Licensing Copyright®2016 A.M.Best Company,Inc.andlor Its affiliates ALL RIGHTS RESERVED. htto://www3.ambest.com/Consumers/ComoanvProfiIe.asox?B L=36&ambnum=003026&P... 6/2R/2016