2016-10-07_REVISION - C1981025

• Permit No: C1981025
• IBM Index Class Name: Revision
• Doc Date: 10/7/2016
• Doc Name: Certificate of Insurance
• From: J. E. Stover & Associates, Inc.
• To: DRMS
• Permit Index Doc Type: Insurance
• Email Name: CCW
• Email Name: JRS
• Media Type: D
• Archive: No

E. FIRE, LIGHTNING OR EXPLOSION DAMAGE
Except where it is used in the term "hostile fire", the
word fire includes fire, lightning or explosion
wherever it appears in the Coverage Form.
Under Section I — Coverage A, the last paragraph
(after the exclusions) is replaced with the following:
Exclusions c. through n. do not apply to damage by
fire, 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
this coverage as described in Section III — Limits
of Insurance.
F. MEDICAL PAYMENTS
If Section I — Coverage C. Medical Payments
Coverage is not otherwise excluded from this
Coverage Form:
The requirement, in the Insuring Agreement of
Coverage C., that expenses must be incurred and
reported to us within one year of the accident date
is changed to three years.
G. SUPPLEMENTARY PAYMENTS
Supplementary Payments — Coverages A and B
paragraphs 1.b. and 1.d. are replaced by the
following:
1.b.Up to $5,000 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.
1.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.
H. SUBSIDIARIES AS INSUREDS
Section II — Who Is An Insured is amended to add
the following:
1.f. Any legally incorporated subsidiary in which
you own more than 50% of the voting stock on
the effective date of this policy. However,
insured does not include any subsidiary that is
an insured under any other general liability
policy, or would have been an insured under
such a policy but for termination of that policy
or the exhaustion of that policy's limits of
liability.
BLANKET ADDITIONAL INSUREDS — AS
REQUIRED BY CONTRACT
1. Section II — Who Is An Insured is amended to
include as an additional insured any person(s)
or organization(s) subject to provisions in
Paragraph 2. below, (hereinafter referred to as
additional insured) when you and such
person(s) or organization(s) have agreed in a
written contract or written agreement that such
person(s) or organization(s) be added as an
additional insured on your policy provided that
the written contract or agreement is:
a. Currently in effect or becomes effective
during the policy period; and
b. Executed prior to an "occurrence" or
offense to which this insurance would
apply.
However, the insurance afforded to such
additional insured:
a. Only applies to the extent permitted by law;
and
b. Will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured; and
c. Applies only if the person or organization is
not specifically named as an additional
insured under any other provision of, or
endorsement added to, Section II — Who
Is An Insured of this policy.
2. As provided herein, the insurance coverage
provided to such additional insureds is limited
to:
a. Any Controlling Interest, but only with
respect to their liability arising out of their
financial control of you; or premises they
own, maintain, or control while you lease or
occupy these premises.
This insurance does not apply to structural
alterations, new construction and
demolition operations performed by or for
that person or organization.
b. Any architect, engineer, or surveyor
engaged by you but only with respect to
liability for "bodily injury", "property
damage" or "personal and advertising
injury" caused, in whole or in part, by your
acts or omissions or the acts or omissions
of those acting on your behalf:
(1) In connection with your premises; or
(2) In the performance of your ongoing
operations.
With respect to the insurance afforded to
these additional insureds, the following
additional exclusion applies:
This insurance does not apply to "bodily
injury", "property damage" or "personal and
advertising injury" arising out of the
rendering of or the failure to render any
professional services by or for you,
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.
CG7578(5-15) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 2 of 6