Tombleson Insurance 04-22-2014

8/10/2019 Tombleson Insurance 04-22-2014

1/8

t

CERTIFIC TE OF LI BILITY SUR NCE DATE (MMIDDIYYYYI4122/2014

THIS CERTIFICA TE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER . THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW . THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER (S), AUTHOR IZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.IMPORTANT : If t he certificate holder Is an ADDITlONAL INSURED, the po l lcy les) must be endorsed . If SUBROGATION IS WAIVED, subJect tothe terms an d conditions of the policy, certain polic ies may requ ire an en dorsemen t. A statement on this certificate does not confer rights to thecertificate holder In lieu of such endorsements .

PRODUCERArthur J. Gallagher & Co .Insurance Brokers of CA . In c . LIC 0726293321 Fifth StreetHo llis ter CA 95023

INSURED

Tombleson IncorporatedP .O . Box 1388Sa l inas, CA 93901

COVERAGES CERTIFICATE NUMBER: 631295744INSURERF:

REVISION NUMBER :THIS IS TO CERTIFYTHAT THE POLICIES OFINSURANCE LISTED BELOWHAVE BEENISSUED TO THE INSURED NAMEDABOVEFOR THE POLICYPERIODINDICATED. NOTYVITHSTANDINGANY REQUIREMENT, TERM OR CONDITIONOF ANY CONTRACTOR OTHER DOCUMENTIMTH RESPECT TO WHICHTHISCERTIFICATE MAY BE ISSUEDOR MAY PERTAIN, THE INSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREINIS SUBJECT TO ALL THE TERMS,EXCLUSIONSANDCONDITIONSOF SUCH POLICIES. LIMITS SHOW NMAYHAVEBEEN REDUCEDBY PAIDCLAIMS.

INSRTYPEOFINSURANCE INSRIWVD POUCYNUMBER

l t ~ U C Y E X PLIMITSTR

A GENERAL LIABILITY y G2710082A 001 11/2013 111201


2/8

POLICY NUMBER: G2 7 1 8 2 A 1 COMMERCIAL GENERAL LIABILITYCG2 1 413

THIS ENDORSEMENTCHANGES THE POLICY. PLEASE READ1T CAREFULlY.

DDITION L INSURED OWNERS LESSEES ORCONTRACTORS SCHEDULED PERSON OR

ORG NIZ TION

This endorsement modifies insurance provided under the following :

COMMERCIALGENeRAL LIABILITYCOVERAGE PARTSCHEDULE

Name Of Addlllonaf Insured Person(s)Or Organlzatlon(s) Locatlon(s) Of Covered Operations

As R e q u i r e d by W r i t t e n o n t r a c t As R e q u i r e d by W r i t t e n o n t r a c t

Information required to complete this Schedu le , i not shown above, willbe shown In the Declarations .

A. Section If -Who Is An Insured Is amended to include as an addit ional Insured the person(s) ororganization(s) shown in the Schedule, but only with respect to liability for bodily injury , propertydamage or personal and advertising Injury caused, in whole or In part, by:

1. Your acts or omissions; or

2. The acts or omissionsof

those acting on your behalf;in the performance of your ongoing operations for the additional insured(s) at the location( a)designated above.However:

.1 T h ~j n ~ u a n c ~a f f ~ r d ~ ~~ o~ u c h ~ d i t i ~ n a Ji n ~ ~ r e < f o ~ l ya p p l l ~ ~t ? t h ~ ~ x t ~ n ~p er l i ~ t e ~ yI a ~ and2. if coverage provided to the additional insured is required by a contract or agreement, theinsurance afforded to such additional insured will not be broader than that which you arerequired by the contract or agreement to provide for such additiona l insured.

B. With respect to the Insurance afforded to these additional insureds, the following additiona lexclusions apply :

This insurance does not apply to bodily Injury or property damage occurring after:1. Allwork, including materials, parts or equipment furnished in connection with such work, onthe project (other than service, ma intenance or repairs) to be performed by or on behalf of the

. additional lnsured(s) at the location of the covered operations has been completed; or2. That portion of your work out of which the Injury or damage arises has been put to itsIntended use by any person or organization other than another contractor or subcontractorengaged in performing operations for a principal as a part of the same project.


3/8


4/8

POUCV NUMBER: G271 82A 1 COMMERCIALGENERALLIABJLITYCG 2 31 413

THIS ENDORSEMENT CHANGES THE POLICY . PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED OWNERS LESSEES ORCONTRACTORS COMPLETED OPERATIONS

This endorsement modifies Insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PARTPRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

SCHEDULEName Of Additional Insured Person(s)

Or Organlzatlon(s) Location And Description Of Completed Operations

s Required by Wri t t en Cont rac t s Required y Wri t t en Cont rac t

Informationrequired to complete this Schedule ifnot shown above wlll be shown In the Declarations.A Section II Who Is An Insured Is amended to include as an additional insured the person(s) ororganlzation(s) shown in the Schedule, but only with respect to liability for bodily injuryMor propertydamage caused in whole or in part by ''your work at the location designated and described in theSchedule of this endorsement performed for that additional insured and included tn the p r o d u c t s ~completed operations hazard .

However :1. The insurance afforded to such additional Insured only applies to the extent permitted by law;and2. Ifcoverage provided to the additional Insured is required by a contract or agreement, theInsurance afforded to such additional insured will not be broade r than that which you arerequired by the contract or agreement to provide for such additional insured.

8. With respect to the insurance afforded to these additional Insureds, the following Is added toSection Ill - Llmlls Of Insurance :If coverage provided to the additional Insured Is required by a contract or agreement, the mostwe will pay on behalf of the additional insured Is the amount of Insurance :1. Required by the contract or agreement; or2. Available under the applicable Limits of Insurance shown in the Dec larations;whichever is less.


5/8

THIS ENDORSEMENTCHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CONDITION 4 OTHER INSURANCEAMENDED - NON CONTRIBUTORY

Paragraph 4.c. Is deleted In Its entirety and replaced by the following :

c If all of the other Insurance permits contribution by equal shares we willfollow this methodunless the insured is requ ired by contract to provide insurance that is primary and non-contributory and the insured contract is executed prior to any loss. Where required bycontract this Insurance will be primary only when and to the exte nt as required by thatcontract. However under the contributory approach each Insurer contributes equal amountsuntil it has paid its applicable limit o nsurance or none o he loss rema ins , whichever comesfirst.

If a ny of the other insurance does not perm it contribution by eq ual sha res we w ill contributeby limits . Under th is method , each insurer's share is based on the ra tio of its applicable limitof insu ra nce to the total applicable limits of nsurance o all insure rs.

GLE 0007 01 96


6/8

COMMERCIAL AUTO GOLD ENDORSEMENT

THISENDORSEMENTCHANGESTHE POLICY. PLEASEREAD IT CAREFULLY.

This endorsement modifies insurance provided under the foll owing :

BUSINESSAUTO COVERAG E FORM

SECTION LIABILITYCOVERAGE

A COVERAGE1 WHO IS AN iNSURED

The following is added :

d. Any organization, other than a partnersh ip or joint venture , over which you maintain ownership ora ma jority Interest on the effective date of this Coverage Form, if there is no similar insuranceavailable to that organization.

e. Any organization you newly acquire or form other than a partnership or joint venture, and overwhich you maintain ownership of a majority interest. However, coverage under th is provision doesnot apply :

(1) If there is similar insurance or a self-insured retention plan available to that organization ; or

2) To ~ o d i l yinjury or property damage that occurred before you acquired or formed the organization.

f Any volunteer or employee of yours while using a covered auto you do not own, hire or borrow inyour business or your personal affairs. Insurance provided by this endorsement is exces s overa ny other insurance available to any u r ~ te e ror employee .

g. Any p e rson, organi zation; trustee, eslate or governmental entity with respect to th e operation,maintenance or use of a covered auto by an insured, it.

(1) You are obligated to add that person, organizatio n, trustee, estate or governmenta l entity asan additio nal insured to this policy by :

(a) an express ed provision of an Minsuredcontract , or-written ag reem ent; orb) an expressed condition of a written pennit issued to you by a governmental or public

autho rity.

2) The bodily Injury or property damage is cau sed by an acc ident which takes p lace afte r:

(a) You executed the insured contract or written agreemen t; or. .(b) the permit has been Issued to you.

2. COVERAGE EXTENSIONS

a . Supplementary Payments .

Subparagraphs (2) and (4) are amended as follows :

(2) Up to $2500 for cost of bail bonds (includ ing bonds for re lated traffi c law violations) requiredbecause of an accident we cover . We do not have to furnish these bonds.

(4) All reasonable expenses incurred by lhe Insured at our request, inc lud ing actua l loss ofea rning up to $500 a day beca use of time off from work .

Includes copyrigh ted material of Insu rance Services Offices. Inc. with lts perm issionGECA 701 (01/07) age 1 o f


7/8

SECTION f l l PHYSICALDAMAGE COVERAGE

A. COVERAGE

The followingis added:

5. Hired Auto Physical Damage

a. Any "auto" you lease, hire, rent or borrow from someone other than your employees or partners ormembers of their household is a covered a u t o ~for each of your physical damage coverages.

b. The most we willpay for Joss" in any one "accident"Is the smalfest of:

(1) $50,000

2) The actua l c;:ash value of the damaged or stol n property as of the lime of the "Joss; or

(3) The cost of repairing or replacing the damaged or stolen property withother propert)l of likekind and quality.

If you are liable for the naccident", we will also pay up to $500 per Kaccidenr for the actual loss ofuse to the owner of the covered "auto".

c. Our obligationto pay for, repair, return or replace damaged or stolen property willbe reduced byan amount that is equal to the amount of the largest deductible shown for any owned auto" for

that coverage. However, any Comprehensive Coverage deductible shown In the Declarationsdoes not apply to loss caused by fire or lightning.

d. or this coverage, the insurance p r o v ~ d e dIs primary for any covered auto you hire without adriver and excess over any other collectible insurance for any covered "auto" that you hire with adriver.

6. Rental Reimbursement Coverage

We will pay up to $75 per day for up to 30 days, for rental reimbursement expenses Incurred by youfor the rental of an auto because of "loss to a covered "auto. Rental Reimbursement will be basadon the rental o a comparable vehicle, which In many cases may be subStantiallyless than $75 perday , and willonly be arrowed for a period of time fi should take to repair or replace the vehicle withreasonable speed and similar quality , up to a maximum o 30 days. We willalso pay up to $500 forreasonable and necessary expenses Incurred by you to remove and replace your materials and

equipment from the covered "auto".If"loss"results From the total theftof a o v ~ r e dauto of the privata passenger type, we will pay underthis coverage only that amount of your rental reimbursement expenses which is not already providedunder paragraph 4. Coverage Extension .

7. Lease Gap Coverage

If a long-termleased rtauto" is a covered "auto" and the lessor is named as an Additional Insured -Lessor, In the event of a total loss, we will p c ~ yyour additional legal obligation to the lessor for anydifference between the actual cash value of the auto at the time of the loss and the outstandingba lance .of the lease .

Outstanding balance means the amount you owe on the lease at the time of loss less any amountsrepresenting taxes; overdue payments; penalties, interest or charges resulting from overduepayments; addilional mileage charges; excess wear and tear charges; and lease termination fees.

B. EXCLUSIONS

The followingis added to Paragraph 3

The exclusion for "lossw caused by or resulting from mechanical or electrical breakdown does notapply to the accidental discharge of an airbag,

Includes copyrightedmaterial or Insurance Servlc:es Offices, Inc. wi h ItspermissionGECA 701 (01/07) Page o 3

a


8/8

Paragraph 4 is replaced with the following:

4. We will notpay for loss to any of the following :

a. Tapes , records, disks or other similar audio, visual or data electronic de vices designed for usewith audio, visual or data electronic equipment .

b . Equipment designed or used for the detection or location of radar .

c. Any electronic equipment that receives or transmits audio , visual or da ta signals .Exclus ion 4.c does no t apply to:

1) Electronic equipment that receives or transmits audio, visual or data signals, whether or notdesigned solely for the reproduction of sound , if the equipment is permanently Instal led ln thecove red auto at the time of the loss and such equipment is designed to e solely operatedby use of the power from the auto's electrical system, in or upon the covered auto ; or

{2 Any other electronic equipment that Is:

(a) Necessary for the normal operation of the covered auto or the monitoring of the coveredauto's operating system; or

(b) An integral part of the same u tt housing any sound reproducing equipment described In (1)above and permanently installed in the opening of lhe dash or console of the covered autonormally used by the manufacturer for installation of a radio.

D. DEDUCTIBLE

The followingis added : No deductible applies to glass damage if the glass is repaired rather than replaced .

SECTION IV. BUSINESS AUTO CONDITIONS

A. LOSS CONDITIONS

Item 2.a . and b. are replaced with:

2. Duties In The Event of Accident, Claim, Suit, or Loss

a . You must promptly notify us . Your duty to promptly notify us is effective when any of yourexecutive officers, partners, members, or lega l representatives is aware of the accident, claim,suit , or loss . Knowledge of an accident, claim, suit , or loss, by other employee(s) does not

imply you also have such knowledge.

b. To the extent possible, notice to us should include :

I) How, when and where the accident or loss took p lace;

(2) The names and addresses of any in jured persons and witnesses; and

(3) The nature and location of any injury or damage arising out o f the accident or loss.

The following is added to 5.

We waive any right of recovery we may have against any additional insured unde r Coverage A. 1.Who Is An lnsmed g., but only as respects loss arising out of the operation, maintenance or us e r acovered auto pursuant to the provisions of the insured cont ract , written ag reement , or permit.

B. GENERAL CONDITIONS

9. is added

9. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS

Your unintentional failure to disclose any hazards existing at t he effective date of your policy willnot prejudice the c overage afforded . However, we ha ve the right to collect additional premium forany sue]) ha zar d.

COMMONPOLICY CONDITIONS

2.b. is replaced by the following :

b. 60 days before the effective da te of cance llation ifwe cancel for any other reason.

Includes copyrighted material of Insura nce Services Offi ces In c . with Its pe rmissio n

GECA 701 {01/07) Page 3 of 3

Documents

Tombleson Insurance 04-22-2014