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2000 - Volunteers In Defense of Animals (VIDA) - Animal Sheltering and Care ServicesFIRST AMENDMENT TO ANIMAL SHELTERING AND CARE SERVICES VOLUNTEERS IN DEFENSE OF ANIMALS (VIDA) This FIRST AMENDMENT ("Amendment') is made and entered into this 14th day of November 2023 ("Effective Date"), by and between the City of Rosemead, a municipal organization, organized under the laws of the State of California with its principal place of business at 8838 East Valley Blvd., Rosemead, California 91770 ("City") and Volunteers in Defense of Animals (VIDA) with its principal place of business at 19142 E. Walnut Dr. N., Rowland Heights, California 91748 ("Contractor'). City and Contractor are sometimes individually referred to herein as 'Party" and collectively as "Parties." WHEREAS, this First Amendment is to amend the original Professional Services Agreement to include operational costs for animal sheltering services for the calendar year 2024 at a rate of $3,000 per month with a not -to -exceed amount of $36,000 total. NOW, THEREFORE, the Parties agree as follows: SECTION 1. Section 3.3.1(a) shall be added as follows: 3.3.1(a) Year 2024 Monthly Operational Fee. For the calendar year 2024, VIDA shall receive from the City a monthly operational fee of $3,000 per month it provides services to the City (not to exceed $36,000 total). The Operation Fee is separate and in addition to the "compensation" included in Section 3.3.1. SECTION 2. All other terms, conditions, and provisions of the Original Agreement not in conflict with this Addendum, shall remain in full force and effect. SECTION 3. The City Clerk shall certify to the adoption of this Addendum and hereafter the same shall be in full force and effect. IN WITNESS WHEREOF, City and Contractor have caused this Agreement to be executed by their duly authorized representatives as of the day and year first above written. CITY OF ROSEMEAD BY: Ben Kim, ity Manager Attest: City Clerk VOLUNTEERS IN DEFENSE OF ANIMALI <2 none BY: Name: Title: BY: Rachel Richman, City Attorney 2 (If Corporation, TWO SIGNATURES, President OR Vice President AND Secretary, AND CORPORATE SEAL OF CONTRACTOR REQUIRED) BY: Name: Title: c1 PROFESSIONAL SERVICES AGREEMENT VOLUNTEERS IN DEFENSE OF ANIMALS (VIDA) PARTIES AND DATE. This Agreement is made and entered into this July 1, 2023 (Effective Date) by and between the City of Rosemead, a municipal organization organized under the laws of the State of California with its principal place of business at 8838 E. Valley Blvd., Rosemead, California 91770 ("City") and Volunteer in Defense of Animals with its principal place of business at 19142 E. Walnut Dr. N, Rowland Heights, CA 91748 ("Consultant'). City and Consultant are sometimes individually referred to herein as "Party" and collectively as "Parties." 2. RECITALS. 2.1 Consultant. Consultant desires to perform and assume responsibility for the provision of certain professional services required by the City on the terms and conditions set forth in this Agreement. Consultant represents that it is experienced in providing Animal Care and Shelter Services to public clients, is licenced in the State of California and is familiar with the plans of City. 2.2 Project. City desires to engage Consultant to render Animal Care and Shelter Services ("Services") as set forth in this Agreement. 3. TERMS. 3.1 Scope of Services and Term. 3.1.1 General Scope of Services. Consultant promises and agrees to furnish to the City all labor, materials, tools, equipment, services, and incidental and customary work necessary to fully and adequately supply the Animal Care and Shelter Services necessary for the City, herein referred to a "Services". The Services are more particularly described in Exhibit "A" attached hereto and incorporated herein by reference. Volunteers in Defense of Animals (VIDA) Page 2 of 11 All Services shall be subject to, and performed in accordance with, this Agreement, the exhibits attached hereto and incorporated herein by reference, and all applicable local, state and federal laws, rules and regulations. 3.1.2 Term. The term of this Agreement shall be for a three (3) year time period from Effective date, with two, one (1) year optional renewals, unless earlier terminated as provided herein. Consultant shall complete the Services within the term of the Agreement, and shall meet any other established shcedules and deadlines. 3.2 Responsibilities of Consultant. 3.2.1 Control and Payment of Subordinates; Independent Contractor. The Services shall be performed by Consultant or under its supervision. Consultant will determine the means, methods and details of performing the Services subject to the requirements of this Agreement. City retains Consultant on an independent contractor basis and not as an employee. Consultant retains the right to perform similar or different services for others during the term of this Agreement. Any additional personnel performing the Services under this Agreement on behalf of Consultant shall also not be employees of City and shall at all times be under Consultant's exclusive direction and control. Consultant shall pay all wages, salaries, and other amounts due such personnel in connection with their performance of Services under this Agreement and as required by law. Consultant shall be responsible for all reports and obligations respecting such additional personnel, including, but not limited to: social security taxes, income tax withholding, unemployment insurance, disability insurance, and workers' compensation insurance. 3.2.2 Schedule of Services. Consultant shall perform the Services expeditiously, within the term of this Agreement. Consultant represents that it has the professional and technical personnel required to perform the Services in conformance with such conditions. In order to facilitate Consultant's conformance with the Schedule, City shall respond to Consultant's submittals in a timely manner. Upon request of City, Consultant shall provide a more detailed schedule of anticipated performance to meet the Schedule of Services. 3.2.3 Conformance to Applicable Requirements. All work prepared by Consultant shall be subject to the approval of City. 3.2.4 Substitution of Key Personnel. Consultant has represented to City that certain key personnel will perform and coordinate the Services under this Agreement. Should one or more of such personnel become unavailable, Consultant may substitute other personnel of at least equal competence upon written approval of City. In the event that City and Consultant cannot agree as to the substitution of key personnel, City shall be entitled to terminate this Agreement for cause. As discussed below, any personnel who fail or refuse to perform the Services in a manner acceptable to the City, or who are determined by the City to be uncooperative, incompetent, a threat to the adequate or timely completion of the Project or a threat to the safety of persons or property, shall be Volunteers in Defense of Animals (VIDA) Page 3 of 11 promptly removed from the Project by the Consultant at the request of the City. 3.2.5 City's Representative. The City hereby designates the City Manager, or his or her designee, to act as its representative for the performance of this Agreement ("City's Representative"). City's Representative shall have the power to act on behalf of the City for all purposes under this Agreement. Consultant shall not accept direction or orders from any person other than the City's Representative or his or her designee. 3.2.6 Consultant's Representative. Consultant will designate to act as its representative for the performance of this Agreement ("Consultant's Representative"). Consultant's Representative shall have full authority to represent and act on behalf of the Consultant for all purposes under this Agreement. The Consultant's Representative shall supervise and direct the Services, using his/her best skill and attention, and shall be responsible for all means, methods, techniques, sequences and procedures and for the satisfactory coordination of all portions of the Services under this Agreement. 3.2.7 Coordination of Services: Consultant agrees to work closely with City staff in the performance of Services and shall be available to City's staff, consultants and other staff at all reasonable times. 3.2.8 Standard of Care; Performance of Employees: Consultant shall perform all Services under this Agreement in a skillful and competent manner, consistent with the standards generally recognized as being employed by professionals in the same discipline in the State of California. Consultant represents and maintains that it is skilled in the professional calling necessary to perform the Services. Consultant warrants that all employees and subcontractors shall have sufficient skill and experience to perform the Services assigned to them. Finally, Consultant represents that it, its employees and subcontractors have all licenses, permits, qualifications and approvals of whatever nature that are legally required to perform the Services, including a City Business License, and that such licenses and approvals shall be maintained throughout the term of this Agreement. As provided for in the indemnification provisions of this Agreement, Consultant shall perform, at its own cost and expense and without reimbursement from the City, any services necessary to correct errors or omissions which are caused by the Consultant's failure to comply with the standard of care provided for herein. 3.2.9 Laws and Regulations. Consultant shall keep itself fully informed of and in compliance with all local, state and federal laws, rules and regulations in any manner affecting the performance of the Project or the Services, including all Cal/OSHA requirements, and shall give all notices required by law. Consultant shall be liable for all violations of such laws and regulations in connection with Services. If the Consultant performs any work knowing it to be contrary to such laws, rules and regulations and without giving written notice to the City, Consultant shall be solely responsible for all costs arising therefrom. Consultant shall defend, indemnify and hold City, its officials, directors, officers, employees and agents free and harmless, pursuant to the indemnification provisions of this Agreement, from any claim or liability arising out of any failure or alleged Volunteers in Defense of Animals (VIDA) Page 4 of 11 failure to comply with such laws, rules or regulations. 3.2.10 Insurance: Consultant shall maintain prior to the beginning of and for the duration of this Agreement insurance coverage as specified in Exhibit "B" attached to and part of this agreement. 3.2.11 Safety: Contractor shall execute and maintain its work so as to avoid injury or damage to any person or property. In carrying out its Services, the Consultant shall at all times be in compliance with all applicable local, state and federal laws, rules and regulations, and shall exercise all necessary precautions for the safety of employees appropriate to the nature of the work and the conditions under which the work is to be performed. Safety precautions as applicable shall include, but shall not be limited to: (A) adequate life protection and life saving equipment and procedures; (B) instructions in accident prevention for all employees and subcontractors, such as safe walkways, scaffolds, fall protection ladders, bridges, gang planks, confined space procedures, trenching and shoring, equipment and other safety devices, equipment and wearing apparel as are necessary or lawfully required to prevent accidents or injuries; and (C) adequate facilities for the proper inspection and maintenance of all safety measures. 3.3 Fees and Payments. 3.3.1 Compensation. Consultant shall receive compensation, including authorized reimbursements, for all Services rendered under this Agreement and shall not exceed Fifty Thousand Dollars ($50,000) per fiscal year. Extra Work may be authorized in writing, as described below, and will be compensated at the rates and manner set forth in this Agreement. 3.3.2 Payment of Compensation. Consultant shall submit to City a monthly itemized statement which indicates work completed and Services rendered by Consultant. The statement shall describe the amount of Services and supplies provided since the initial commencement date, or since the start of the subsequent billing periods, as appropriate, through the date of the statement. City shall, within 45 days of receiving such statement, review the statement and pay all approved charges thereon. 3.3.3 Reimbursement for Expenses: Consultant shall not be reimbursed for any expenses unless authorized in writing by City. 3.3.4 Extra Work: At any time during the term of this Agreement, City may request that Consultant perform Extra Work. As used herein, "Extra Work" means any work which is determined by City to be necessary for the proper completion of the Project, but which the parties did not reasonably anticipate would be necessary at the execution of this Agreement. Consultant shall not perform, nor be compensated for, Extra Work without written authorization from City's Representative. 3.3.5 Prevailing Wages: Consultant is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code Volunteers in Defense of Animals (VIDA) Page 5 of 11 of Regulations, Title 8, Section 1600, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works' and "maintenance' project, as defined by the Prevailing Wage Laws, and if the total compensation is $1,000 or more, Consultant agrees to fully comply with such Prevailing Wage Laws. City shall provide Consultant with a copy of the prevailing rates of per diem wages in effect at the commencement of this Agreement. Consultant shall make copies of the prevailing rates of per diem wages for each craft; classification or type of worker needed to execute the Services available to interested parties upon request, and shall post copies at the Consultant's principal place of business and at the project site. Consultant shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 3.4 Accounting Records. 3.4.1 Maintenance and Inspection: Consultant shall maintain complete and accurate records with respect to all costs and expenses incurred under this Agreement. All such records shall be clearly identifiable. Consultant shall allow a representative of City during normal business hours to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to the Agreement for a period of three (3) years from the date of final payment under this Agreement. 3.5 General Provisions. 3.5.1 Termination of Agreement. 3.5.1.1 Grounds for Termination: City may, by written notice to Consultant, terminate the whole or any part of this Agreement at any time and without cause by giving written notice to Consultant of such termination, and specifying the effective date thereof, at least seven (7) days before the effective date of such termination. Upon termination, Consultant shall be compensated only for those services which have been adequately rendered to City, and Consultant shall be entitled to no further compensation. Consultant may not terminate this Agreement except for cause. 3.5.1.2 Effect of Termination: If this Agreement is terminated as provided herein, City may require Consultant to provide all finished or unfinished Documents/ Data and other information of any kind prepared by Consultant in connection with the performance of Services under this Agreement. Consultant shall be required to provide such document and other information within fifteen (15) days of the request. 3.5.1.3 Additional Services: In the event this Agreement is terminated in whole or in part as provided herein, City may procure, upon such terms and in such manner as it may determine appropriate, services similar to those terminated. 3.5.2 Delivery of Notices. All notices permitted or required under this Volunteers in Defense of Animals (VIDA) Page 6 of 11 Agreement shall be given to the respective parties at the following address, or at such other address as the respective parties may provide in writing for this purpose: CONSULTANT: Volunteers in Defense of Animals (VIDA) 19142 E. Walnut Drive N Rowland Heights, CA 91748 Attn: Laura Sandoval Phone: (626) 374-1551 CITY: City of Rosemead 8838 E. Valley Boulevard Rosemead, CA 91770 Attn: City Manager Such notice shall be deemed made when personally delivered or when mailed, forty-eight (48) hours after deposit in the U.S. Mail, first class postage prepaid and addressed to the party at its applicable address. Actual notice shall be deemed adequate notice on the date actual notice occurred, regardless of the method of service. 3.5.3 Ownership of Materials and Confidentiality. 3.5.3.1 Documents & Data; Licensing of Intellectual Property: This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were prepared by design professionals other than Consultant or provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 3.5.3.2 Confidentiality. All ideas, memoranda, specifications, plans, procedures, drawings, descriptions, computer program data, input record data, written information, and other Documents and Data either created by or provided to Consultant in connection with the performance of this Agreement shall be held confidential by Consultant. Such materials shall not, without the prior written consent of City, be used by Consultant for any purposes other than the performance of the Services. Volunteers in Defense of Animals (VIDA) Page 7 of 11 Nor shall such materials be disclosed to any person or entity not connected with the performance of the Services or the Project. Nothing furnished to Consultant which is otherwise known to Consultant or is generally known, or has become known, to the related industry shall be deemed confidential. Consultant shall not use City's name or insignia, photographs of the Project, or any publicity pertaining to the Services or the Project in any magazine, trade paper, newspaper, television or radio production or other similar medium without the prior written consent of City. 3.5.4 Cooperation; Further Acts: The Parties shall fully cooperate with one another, and shall take any additional acts or sign any additional documents as may be necessary, appropriate or convenient to attain the purposes of this Agreement. 3.5.5 Attorney's Fees: If either party commences an action against the other party, either legal, administrative or otherwise, arising out of or in connection with this Agreement, the prevailing party in such litigation shall be entitled to have and recover from the losing party reasonable attorney's fees and all costs of such action. 3.5.6 Indemnification: To the fullest extent permitted by law, Consultant shall defend, indemnify and hold the City, its officials, officers, employees, volunteers and agents free and harmless from any and all claims, demands, causes of action, costs, expenses, liability, loss, damage or injury, in law or equity, to property or persons, including wrongful death, in any manner arising out of or incident to any alleged acts, omissions or willful misconduct of Consultant, its officials, officers, employees, agents, consultants and contractors arising out of or in connection with the performance of the Services, the Project or this Agreement, including without limitation the payment of all consequential damages and attorneys fees and other related costs and expenses. Consultant shall defend, at Consultant's own cost, expense and risk, any and all such aforesaid suits, actions or other legal proceedings of every kind that may be brought or instituted against City, its directors, officials, officers, employees, agents or volunteers. Consultant shall pay and satisfy any judgment, award or decree that may be rendered against City or its directors, officials, officers, employees, agents or volunteers, in any such suit, action or other legal proceeding. Consultant shall reimburse City and its directors, officials, officers, employees, agents and/or volunteers, for any and all legal expenses and costs incurred by each of them in connection therewith or in enforcing the indemnity herein provided. Consultant's obligation to indemnify shall not be restricted to insurance proceeds, if any, received by the City, its directors, officials officers, employees, agents or volunteers. 3.5.7 Entire Agreement: This Agreement contains the entire Agreement of the parties with respect to the subject matter hereof, and supersedes all prior negotiations, understandings or agreements. This Agreement may only be modified by a writing signed by both parties. 3.5.8 Governing Law: This Agreement shall be governed by the laws of the State of California. Venue shall be in Los Angeles County. Volunteers in Defense of Animals (VIDA) Page 8 of 11 3.5.9 Time of Essence: Time is of the essence for each and every provision of this Agreement. 3.5.10 City's Right to Employ Other Consultants: City reserves right to employ other consultants in connection with this Project. 3.5.11 Successors and Assigns: This Agreement shall be binding on the successors and assigns of the parties. 3.5.12 Assignment or Transfer: Consultant shall not assign, hypothecate, or transfer, either directly or by operation of law, this Agreement or any interest herein without the prior written consent of the City. Any attempt to do so shall be null and void, and any assignees, hypothecates or transferees shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. 3.5.13 Construction; References; Captions: Since the Parties or their agents have participated fully in the preparation of this Agreement, the language of this Agreement shall be construed simply, according to its fair meaning, and not strictly for or against any Party. Any term referencing time, days or period for performance shall be deemed calendar days and not work days. All references to Consultant include all personnel, employees, agents, and subcontractors of Consultant, except as otherwise specified in this Agreement. All references to City include its elected officials, officers, employees, agents, and volunteers except as otherwise specified in this Agreement. The captions of the various articles and paragraphs are for convenience and ease of reference only, and do not define, limit, augment, or describe the scope, content, or intent of this Agreement. 3.5.14 Amendment; Modification: No supplement, modification, or amendment of this Agreement shall be binding unless executed in writing and signed by both Parties. 3.5.15 Waiver: No waiver of any default shall constitute a waiver of any other default or breach, whether of the same or other covenant or condition. No waiver, benefit, privilege, or service voluntarily given or performed by a Party shall give the other Party any contractual rights by custom, estoppel, or otherwise. 3.5.16 No Third Party Beneficiaries: There are no intended third party beneficiaries of any right or obligation assumed by the Parties. 3.5.17 Invalidity; Severability: If any portion of this Agreement is declared invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions shall continue in full force and effect. 3.5.18 Prohibited Interests: Consultant maintains and warrants that it has not employed nor retained any company or person, other than a bona fide employee working solely for Consultant, to solicit or secure this Agreement. Further, Consultant warrants that it has not paid nor has it agreed to pay any company or person, other than Volunteers in Defense of Animals (VIDA) Page 9 of 11 a bona fide employee working solely for Consultant, any fee, commission, percentage, brokerage fee, gift or other consideration contingent upon or resulting from the award or making of this Agreement. Consultant further agrees to file, or shall cause its employees or subconsultants to file, a Statement of Economic Interest with the City's Filing Officer as required under state law in the performance of the Services. For breach or violation of this warranty, City shall have the right to rescind this Agreement without liability. For the term of this Agreement, no member, officer or employee of City, during the term of his or her service with City, shall have any direct interest in this Agreement, or obtain any present or anticipated material benefit arising therefrom. 3.5.19 Equal Opportunity Employment: Consultant represents that it is an equal opportunity employer and it shall not discriminate against any subcontractor, employee or applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex or age. Such non-discrimination shall include, but not be limited to, all activities related to initial employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or termination. Consultant shall also comply with all relevant provisions of City's Minority Business Enterprise program, Affirmative Action Plan or other related programs or guidelines currently in effect or hereinafter enacted. 3.5.20 Labor Certification: By its signature hereunder, Consultant certifies that it is aware of the provisions of Section 3700 of the California Labor Code which require every employer to be insured against liability for Worker's Compensation or to undertake self-insurance in accordance with the provisions of that Code, and agrees to comply with such provisions before commencing the performance of the Services. 3.5.21 Authority to Enter Agreement: Consultant has all requisite power and authority to conduct its business and to execute, deliver, and perform the Agreement. Each Party warrants that the individuals who have signed this Agreement have the legal power, right, and authority to make this Agreement and bind each respective Party. 3.5.22 Counterparts: This Agreement may be signed in counterparts, each of which shall constitute an original. 3.6 Subcontracting. 3.6.1 Prior Approval Required: Consultant shall not subcontract any portion of the work required by this Agreement, except as expressly stated herein, without prior written approval of City. Subcontracts, if any, shall contain a provision making them subject to all provisions stipulated in this Agreement. [Signatures on next page] Volunteers in Defense of Animals (VIDA) Page 10 of 11 CITY OF ROSEMEAD 7 By: 61i -1d City nager Attest: �c � 'y2 City Clerk w Dat Approved as to Form: City Attorney LIi3 Date I of 2 VIDA In Date Name: [If Corporation, TWO SIGNATURES, President OR Vice President AND Secretary, AND CORPORATE SEAL OF CONTRACTOR REQUIRED] 0 Name: Title: Volunteers in Defense of Animals (VIDA) Page 10 of 11 By. City Manager Date Attest City Clerk Date Approved as to Form Date City Attorney ZoF Z By. J61 -H /23. Date Name: rtl�lycl Title Supervisor [If Corporation. TWO SIGNATURES, President OR Vice President AND Secretary, AND CORPORATE SEAL OF CONTRACTOR REQUIRED] Name: Title EXHIBIT A PROPOSAL FOR SERVICES/ RATE SCHEDULE/RESUME A. VIDA shall maintain humane and sanitary shelter facilities suitable for the impoundment of all animals which may come into its custody from the City. VIDA's shelter shall be located at 19142 E. Walnut Dr. N., La Puente, California. VIDA shall maintain public office hours from Monday through Friday 9:00 a.m. to 6:00 p.m., Saturday from 9:00 a.m. to 5:00 p.m. and be closed Sunday each week and kennels shall be open to public visitation for identification purposes from 9:00 a.m. to 5:00 p.m., on its days of operation. VIDA's offices are closed on Sundays and specified holidays. VIDA will provide access to kennel area to accept animals from City Animal Control personnel 24 hours a day / 7 days a week, including holidays. B. Animals impounded for the City shall be held for redemption, by the owner or animal's custodian for a minimum of seven (7) business days provided that no designated holding period shall be less than that provided by California Food and Agricultural Code — Division 14 or any other applicable state and county laws forthe animal concerned prior to being placed up for adoption. VIDA shall make all reasonable efforts to have animals adopted or transported to other shelters for adoption prior to considering euthanasia. VIDA reserves the right to humanely euthanize any impounded, diseased or injured animal prior to the expiration of the holding period upon the recommendation of a licensed veterinarian and in accordance with state law. All animals held in excess of the minimum period specified above shall become the responsibility of VIDA and the City shall have no further responsibility for such animal unless euthanized which VIDA shall be compensated for said cost in accordance with Section V. C. In the absence of written instructions from City to the contrary, VIDA will not accept stray animals found by private citizens nor any animals voluntarily relinquished by their owners who reside in the City of Rosemead. VIDA will direct all residents of the City of Rosemead to the City's Public Safety Department. D. VIDA shall charge owner or animal's custodian a reasonable redemption fee for the release of an impounded animal that has been identified by the owner or animal's custodian. VIDA may recover costs related to boarding, vaccinations and veterinary medical treatment. VIDA shall not release any impounded dog until owner or animal's custodians provides proof of City licensing. E. VIDA shall not release any animal for the purposes of medical research or vivisection. F. VIDA shall provide all equipment, vehicles, supplies and personnel necessary to perform the services to be furnished by VIDA under the terms and conditions of this agreement. G. VIDA agrees to cooperate with public health authorities in enforcing the provisions of the California Health and Safety Code relating to biting dogs and C-1 animals suspected of being infected with the rabies virus. H. All persons employed by VIDA for the performance of services to be provided pursuant to the terms and conditions of this agreement shall be employees or agents of VIDA. City shall not be called upon to assume any liability for the direct payment of any salaries, wages or other compensation to any VIDA personnel performing such services for City, nor shall City be called upon to pay any liability other than as provided for in this agreement. Notwithstanding the foregoing, it is agreed that City shall have the full cooperation of VIDA's officers, agents and employees and VIDA shall have the full cooperation of City and of the officers, agents and employees of City in the performance and evaluation of the services. VIDA agrees to maintain a comprehensive records management system and provide City with such records relating to the services performed under this agreement. All VIDA records relating to services provided or work performed pursuant to this agreement, including all financial, managerial and operation records, shall be made readily available for inspection by City representatives at all reasonable times following a request by the City. If costs are incurred during compliance with a City request to inspect records or books, such costs shall be documented by VIDA and reimbursed to VIDA by City upon request by VIDA. J. VIDA shall comply with information access provisions in accordance with all applicable requirements as stipulated by the State of California. K. VIDA shall provide, upon request by City, reports showing the number and species of animals impounded or received from the City. L. VIDA shall receive compensation for Animal Shelter Services and Veterinary Medical Services rendered under this Agreement, as specified in accordance with Section V. Total payments to VIDA shall not exceed Fifty Thousand Dollars ($50,000) per calendar year. Extra work may be requested in writing by the City in an amount agreed to by the parties, and if authorized, will be compensated at the agreed upon amount. Contract costs are due and payable in accordance with this agreement. M. During the term of this contract, City agrees to compensate VIDA for all monthly payments due. N. VIDA shall invoice City monthly within one week of completing the previous month's services. City shall pay for each month's completed service within thirty (30) days after receipt of said invoice. Said amount shall fully compensate VIDA for all services provided for City as constituted on the effective date of this Agreement and shall include complete shelter and veterinary services for all impounded animals. O. Shelter services for animals held in quarantine or for animals held as evidence at request of City/County prosecuting attorney or city law enforcement officer and for animals held longer than seven (7) business days pursuant to any applicable Cty ordinance or state law, shall be billed to City at a rate of $20 per day. C-2 EXHIBIT B INSURANCE REQUIREMENTS Prior to the beginning of and throughout the duration of the Work, Contractor will maintain insurance in conformance with the requirements set forth below. Contractor will use existing coverage to comply with these requirements. If that existing coverage does not meet the requirements set forth here, Contractor agrees to amend, supplement or endorse the existing coverage to do so. Contractor acknowledges that the insurance coverage and policy limits setforth in this section constitute the minimum amount of coverage required Any insurance proceeds available to City in excess of the limits and coverage required in this agreement and which is applicable to a given loss, will be available to City. Contractor shall provide the following types and amounts of insurance: Commercial General Liability Insurance: Contractor shall maintain commercial general liability insurance with coverage at least as broad as Insurance Services Office form CG 00 01, in an amount not less than $1,000,000 per occurrence, $2,000,000 general aggregate, for bodily injury, personal injury, and property damage. The policy must include contractual liability that has not been amended. Any endorsement restricting standard ISO "insured contract" language will not be accepted. Business Auto Coverage on ISO Business Auto Coverage form CA 00 01 including symbol 1 (Any Auto) or the exact equivalent. Limits are subject to review, but in no event to be less that $1,000,000 combined single limit per accident. If Contractor owns no vehicles, this requirement may be satisfied by a non -owned auto endorsement to the general liability policy described above. If Contractor or Contractor employees will use personal autos in any way on this project, Contractor shall provide evidence of personal auto liability coverage for each such person. Workers Compensation on a state -approved policy form providing statutory benefits as required by law with employer's liability limits no less than $1,000,000 per accident or disease. Contractor shall submit to Agency, along with the certificate of insurance, a Waiver of Subrogation endorsement in favor of Agency, its officers, agents, employees and volunteers. Excess or Umbrella Liability Insurance (Over Primary) if used to meet limit requirements, shall provide coverage at least as broad as specified for the underlying coverages. Contractor shall obtain and maintain an umbrella or excess liability insurance policy with limits that will provide bodily injury, personal injury and property damage liability coverage at least as broad as the primary coverages set forth above, including commercial general liability, automobile liability, and employer's liability. Such policy or policies shall include the following terms and conditions: • A drop down feature requiring the policy to respond if any primary insurance that would otherwise have applied proves to be uncollectible in whole or in part for any reason; • Pay on behalf of wording as opposed to reimbursement; • Concurrency of effective dates with primary policies; and • Policies shall "follow form" to the underlying primary policies. • Insureds under primary policies shall also be insureds under the umbrella or excess C-3 policies. Professional Liability or Errors and Omissions Insurance as appropriate shall be written on a policy form coverage specifically designed to protect against acts, errors or omissions of the Contractor and "Covered Professional Services" as designated in the policy must specifically include work performed under this agreement. The policy limit shall be no less than $1,000,000 per claim and in the aggregate. The policy must "pay on behalf of the insured and must include a provision establishing the insurer's duty to defend. The policy retroactive date shall be on or before the effective date of this agreement. Requirements not limiting: Requirements of specific coverage features or limits contained in this Section are not intended as a limitation on coverage, limits or other requirements, or a waiver of any coverage normally provided by any insurance. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue and is not intended by any party or insured to be all inclusive, or to the exclusion of other coverage, or a waiver of any type. If the Consultant maintains higher limits than the minimums shown above, the Agency requires and shall be entitled to coverage for the higher limits maintained by the Consultant. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the Agency. Insurance procured pursuant to these requirements shall be written by insurers that are admitted carriers in the state of California and with an AM Bests rating of A- or better and a minimum financial size VII General conditions pertaining to provision of insurance coverage by Contractor. Contractor and City agree to the following with respect to insurance provided by Contractor: Contractor agrees to have its insurer endorse the third -parry general liability coverage required herein to include as additional insureds City, its officials, employees and agents, using standard ISO endorsement No. CG 2010. Contractor also agrees to require all contractors, and subcontractors to do likewise. 2. No liability insurance coverage provided to comply with this Agreement shall prohibit Contractor, or Contractor's employees, or agents, from waiving the right of subrogation prior to a loss. Contractor agrees to waive subrogation rights against City regardless of the applicability of any insurance proceeds, and to require all contractors and subcontractors to do likewise. All insurance coverage and limits provided by Contractor and available or applicable to this agreement are intended to apply to the full extent of the policies. Nothing contained in this Agreement or any other agreement relating to the City or its operations limits the application of such insurance coverage. 4. None of the coverages required herein will be in compliance with these requirements if they include any limiting endorsement of any kind that has not been first submitted to City and approved of in writing. C-4 5. No liability policy shall contain any provision or definition that would serve to eliminate so-called "third parry action over" claims, including any exclusion for bodily injury to an employee of the insured or of any contractor or subcontractor. 6. All coverage types and limits required are subject to approval, modification and additional requirements by the City, as the need arises. Contractor shall not make any reductions in scope of coverage (e.g. elimination of contractual liability or reduction of discovery period) that may affect City's protection without City's prior written consent. 7. Proof of compliance with these insurance requirements, consisting of certificates of insurance evidencing all of the coverages required and an additional insured endorsement to Contractor `s general liability policy, shall be delivered to City at or prior to the execution of this Agreement. In the event such proof of any insurance is not delivered as required, or in the event such insurance is canceled at any time and no replacement coverage is provided, City has the right, but not the duty, to obtain any insurance it deems necessary to protect its interests under this or any other agreement and to pay the premium. Any premium so paid by City shall be charged to and promptly paid by Contractor or deducted from sums due Contractor, at City option. 8. Certificate(s) are to reflect that the insurer will provide 30 days notice to City of any cancellation of coverage. Contractor agrees to require its insurer to modify such certificates to delete any exculpatory wording stating that failure of the insurer to mail written notice of cancellation imposes no obligation, or that any party will "endeavor" (as opposed to being required) to comply with the requirements of the certificate. 9. It is acknowledged by the parties of this agreement that all insurance coverage required to be provided by Contractor or any subcontractor, is intended to apply first and on a primary, noncontributing basis in relation to any other insurance or self-insurance available to City. 10. Contractor agrees to ensure that subcontractors, and any other party involved with the project who is brought onto or involved in the project by Contractor, provide the same minimum insurance coverage required of Contractor. Contractor agrees to monitor and review all such coverage and assumes all responsibility for ensuring that such coverage is provided in conformity with the requirements of this section. Contractor agrees that upon request, all agreements with subcontractors and others engaged in the project will be submitted to City for review. 11. Contractor agrees not to self -insure or to use any self-insured retentions or deductibles on any portion of the insurance required herein and further agrees that it will not allow any contractor, subcontractor, Architect, Engineer or other entity or person in any way involved in the performance of work on the project contemplated by this agreement to self -insure its obligations to City. If Contractor's existing coverage includes a deductible or self-insured retention, the deductible or self-insured retention must be declared to the City. At that time the City shall review options with the Contractor, which may include reduction or elimination of the deductible or self-insured retention, substitution of other coverage, or other solutions. C-5 12. The City reserves the right at any time during the term of the contract to change the amounts and types of insurance required by giving the Contractor ninety (90) days advance written notice of such change. If such change results in substantial additional cost to the Contractor, the City will negotiate additional compensation proportional to the increased benefit to City. 13. For purposes of applying insurance coverage only, this Agreement will be deemed to have been executed immediately upon any party hereto taking any steps that can be deemed to be in furtherance of or towards performance of this Agreement. 14. Contractor acknowledges and agrees that any actual or alleged failure on the part of City to inform Contractor of non-compliance with any insurance requirement in no way imposes any additional obligations on City nor does it waive any rights hereunder in this or any other regard. 15. Contractor will renew the required coverage annually as long as City, or its employees or agents face an exposure from operations of any type pursuant to this agreement. This obligation applies whether or not the agreement is canceled or terminated for any reason. Termination of this obligation is not effective until City executes a written statement to that effect. 16. Contractor shall provide proof that policies of insurance required herein expiring during the term of this Agreement have been renewed or replaced with other policies providing at least the same coverage. Proof that such coverage has been ordered shall be submitted prior to expiration. A coverage binder or letter from Contractor's insurance agent to this effect is acceptable. A certificate of insurance and/or additional insured endorsement as required in these specifications applicable to the renewing or new coverage must be provided to City within five days of the expiration of the coverages. 17. The provisions of any workers' compensation or similar act will not limit the obligations of Contractor under this agreement. Contractor expressly agrees not to use any statutory immunity defenses under such laws with respect to City, its employees, officials and agents. 18. Requirements of specific coverage features or limits contained in this section are not intended as limitations on coverage, limits or other requirements nor as a waiver of any coverage normally provided by any given policy. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue and is not intended by any party or insured to be limiting or all-inclusive. 19. These insurance requirements are intended to be separate and distinct from any other provision in this agreement and are intended by the parties here to be interpreted as such. 20. The requirements in this Section supersede all other sections and provisions of this Agreement to the extent that any other section or provision conflicts with or impairs the provisions of this Section. W: 21. Contractor agrees to be responsible for ensuring that no contract used by any party involved in any way with the project reserves the right to charge City or Contractor for the cost of additional insurance coverage required by this agreement. Any such provisions are to be deleted with reference to City. It is not the intent of City to reimburse any third parry for the cost of complying with these requirements. There shall be no recourse against City for payment of premiums or other amounts with respect thereto. Contractor agrees to provide immediate notice to City of any claim or loss against Contractor arising out of the work performed under this agreement. City assumes no obligation or liability by such notice, but has the right (but not the duty) to monitor the handling of any such claim or claims if they are likely to involve City. C-7 NONPROFITS INSURANCE ALLLINCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) ACCIDENT INSURANCE PROGRAM MASTER POLICY - MHH010307 www.insurancefornonprofits.org Underwritten by: QBE Insurance Corporation Statement of Coverage Part 1 PARTICIPATING ORGANIZATION: VIDA Volunteers in Defense of Animals 19142 E Walnut Dr. N Rowland Heights, CA 91748 CONTROL #: 59581 COVERAGE TERM: 05/10/2023 to 05/10/2024 SUMMARY OF BENEFITS PLAN F Accidental Death Accidental Dismemberment Maximum Accidental Paralysis Aggregate Limit of Liability Excess Accident Medical Deductible COVERED PERSONS Volunteers OPTIONAL COVERED ACTIVITIES None ANNUAL PREMIUM: $100 Please refer to Part 2 of the Statement of Coverage for a more complete description of the benefits provided by this program, including program exclusions and limitations. $50,000 $50,000 $25,000 $1,000,000 $250,000 $250 Date: 04/06/2023 ACCIDENT INSURANCE STATEMENT OF COVERAGE Part 2 Underwritten by: QBE Insurance Corporation This Statement of Coverage confirms that Blanket Accidental Death, Dismemberment, Paralysis and Accident Medical Expense benefits are provided to Covered Persons volunteering, or participating, in activities that are supervised and sponsored by the Participating Organization (Organization) named in Part 1, under Policy # MHH010307, issued by QBE to: Volunteers Insurance Services® Association Alliance Member Services, Nonprofits Insurance Alliance of California, Alliance of Nonprofits for Insurance. Covered Persons - All designated, recorded Volunteers participating in a volunteer project through the Organization's program, if Volunteers are listed in Part 1. All registered Participants participating in supervised and sponsored Organization activities, if Participants are listed in Part 1. Covered Activities Volunteers and Participants are covered while participating in all activities which are supervised and sponsored by the Organization named in Part 1. Accidental Death, Dismemberment & Paralysis (Plegia) Benefits Lossof Life.......................................................................................... $50.000 Loss of any combination of two: hands, feet, 52 weeks eyesight, speech and hearing................................................................ $50,000 Total paralysis of upper and lower limbs, both lower Excess—pays benefits after any other limbs, or upper and lower limbs on one side of the body ............................. $25,000 Loss of one hand, one foot, sight in one eye, speech 100% of Usual and Customary charges, orhearing......................................................................................... $25,000 Loss of thumb and index finger of same hand ............................................ $12,500 Loss of Life due to heart failure............................................................... $10,000 Accident Medical Expense Benefits Maximum Benefits for any one Covered Accident ................ Refer to Part 1 Benefit Period for any one Covered Accident ..................... 52 weeks Deductible.................................................................. Refer to Part 1 Scope of Coverage...................................................... Excess—pays benefits after any other Health Care Plans have paid benefits Benefit Amount Payable ............................................... 100% of Usual and Customary charges, up to Maximum Benefit per Covered Accident Covered Expenses Include ............................................. In & Out -Patient Hospital, Ambulatory Medical Center & Emergency Room, Physician visits & surgery, diagnostic tests, nursing services and ambulance charges Dental Expenses......................................................... $1,000 maximum benefit, up to $300 per tooth Page 1 of 3 Accidental Death, Dismemberment and Paralysis benefits: Loss of hand or foot means complete severance through or above the wrist or ankle joint. Loss of sight means the total, permanent loss of sight of the eye. The loss of sight must be irrecoverable by natural, surgical or artificial means. Loss of speech means total, permanent and irrecoverable loss of audible communication. Loss of hearing means total and permanent loss of hearing in both ears which cannot be corrected by any means. Loss of a thumb and index finger means complete severance through or above the metacarpophalangeal joints (the joints between the fingers and the hand). Severance means the complete separation and dismemberment of the part from the body. Paralysis means loss of use, without severance, of a limb. This loss must be determined by a physician to be complete and not reversible. If the same accident causes more than one of these losses, we will pay the largest amount that applies. Exclusions and Limitations: Coverage is not provided for any accident which is caused by or results from any of the following: - Intentionally self-inflicted injury, suicide or any attempt thereat while sane or insane; - commission or attempt to commit a felony or an assault; commission of or active participation in a riot or insurrection; - bungee -cord jumping, parachuting, skydiving, parasailing, hang-gliding; - declared or undeclared war or act of war; - flight in, boarding or alighting from an aircraft, except as a fare -paying passenger on a regularly scheduled commercial airline; - travel in or on any on -road and off-road motorized vehicle that does not require licensing as a motor vehicle; participation in any motorized race or contest of speed; - an accident if the covered person is the operator of a motor vehicle and does not possess a valid motor vehicle operator's license, unless the covered person holds a valid learners permit and the covered person is participating in a driver's education program; - sickness, disease, bodily or mental infirmity, bacterial or viral infection or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food; - travel or activity outside the United States or Canada, unless advance written approval is provided; - the covered person being legally intoxicated as determined according to the laws of the jurisdiction in which the covered accident occurred; - voluntary ingestion of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a physician and taken in accordance with the prescribed dosage; - injuries compensable under Workers' Compensation law or any similar law; - an accident which occurs while the covered person is driving a private passenger automobile while intoxicated. - Benefits will not be paid for any hospital stay that is not considered appropriate treatment for the condition and locality. - Overnight Supervised and Sponsored Activities and related travel are not covered, unless agreed to in writing by the Company. - In addition, benefits will not be paid for services or treatment rendered by any person who is employed or retained by the policyholder or living in the covered person's household or provided by a parent, sibling, spouse or child of either the covered person or the covered person's spouse, or the covered person. - The Accidental Death, Dismemberment and Paralysis aggregate limit of liability is $1,000,000. Accident Medical Benefit limitations and excluded expenses: - cosmetic surgery, except for reconstructive surgery needed as the result of a covered injury; - any elective or routine treatment, surgery, health treatment, or examination; - blood, blood plasma, or blood storage, except expenses by a hospital for processing or administration of blood; - examination or prescription for initial eyeglasses, contact lenses or hearing aids; - treatment in any Veteran's Administration, Federal, or state facility, unless there is a legal obligation to pay; - services or treatment provided by persons who do not normally charge for their services, unless there is a legal obligation to pay; - rest cures or custodial care; - repair or replacement of existing dentures, partial dentures, braces or bridgework; - personal services such as television and telephone or transportation; - expenses payable by any automobile insurance policy without regard to fault; - services or treatment provided by an infirmary operated by the policyholder; - treatment of injuries that result over a period of time (such as blisters, tennis elbow, etc.), and that are a normal, foreseeable result of participation in the covered activity; Page 2 of 3 treatment or service provided by a private duty nurse; treatment of hernia of any kind. Treatment of injury resulting from a condition that a covered person knew existed on the date of the accident, unless he received a written medical release from his physician. Any covered expenses payable under the Accident Medical Expense benefit will be reduced by 50% if the covered person has HMO or PPO coverage and elects not to use that coverage. Claims Procedures 1. Send the completed and signed QBE Accident Claim Form to the claims administrator as soon as you receive notice that an injury has occurred. The Organization needs to complete and sign Part I. The claimant must complete Part II and sign Part III. Include a copy of Part 1 of the Statement of Coverage with the Claim Form. 2. Since this program provides coverage for medical expenses that are in "excess" of any other Health Care Plan the claimant has, all claims must be submitted to the claimant's primary insurance carrier first. If the claimant has no other insurance, this program will act like primary coverage. 3. Itemized bills for all medical expenses, referred to as a "HCFA" from a doctor's office or a "UB92" from a hospital, must be provided to the claims administrator in order for the claim to be processed. 4. The claimant's primary insurance will send them an Explanation of Benefits (EOB) for all submitted expenses. Copies of all such EOBs must also be submitted to the claims administrator in order for claims to be processed under this program. Claims Administrator: Health Special Risk, Inc. 4100 Medical Parkway Carrollton, TX 75007 Toll Free Number: 1-866-408-3361 E-mail: Claims@hsri.com Important Notice: This information is a brief description of the important benefits and features of the Blanket Accident Medical Insurance underwritten by QBE Insurance Corporation. It is not a contract. Full terms and conditions of coverage, including effective dates of coverage, benefits, limitations and exclusions are set forth in the Master Policy. Page 3 of 3 HSR Health Special Risk, Inc. Toll Free Number: 1-866-408-3361 INSTRUCTIONS FOR HAVING CLAIMS PAID QUICKLY AND EFFICIENTLY Health Special Risk is a Third Party Administrator and processes claims for your organization's Accident policy on behalf of QBE. This is not a liability policy. It is in place to assist you with your medical bills that result from covered accidents. There are three important items that Health Special Risk needs to process your claim. They are: - A completed and signed QBE Accident Claim Form. - Itemized bills from Your Medical Care Provider. Your Primary Health Insurance Carrier's Explanation of Benefits (EOBs). 1) Complete the QBE Accident Claim Form: In the event of an accidental injury, please complete the claim form as follows: Part I —The organization must complete and sign "Part I". All fields must be completed in this section. Organization must also provide the claimant with a copy of the first page of the Statement of Coverage for submission with the claim form. Part 11 - The insured must complete "Part II" and sign "Part III". Since this is excess coverage, the insured's primary medical insurance is a vital piece of information in "Part II". "N/A" cannot be inserted. If the insured has no other insurance, please state "No other insurance". IMPORTANT: Please include a copy of Page 1 of the Statement of Coverage with the Claim form. The quickest and easiest way to get items 2 and 3 below to our office, is to simply provide Health Special Risk's contact information to your medical provider and have them bill Health Special Risk as the secondary payor. Otherwise, you can proceed as follows: 2) Provide copies of your Medical Care Provider's itemized bills: Health Special Risk needs to review the itemized bills from your provider to confirm that the procedures being performed are appropriate for the injury sustained, as well as that the amount being charged is at a reasonable and customary rate. These bills are often referred to as a "HCFA" from a doctor's office and a "UB92" from a hospital. You can either send these bills in to HSR's office yourself or request that the provider send them to Health Special Risk directly. If you already paid these bills and you are requesting reimbursement, please include a copy of your proof of payment, such as the receipt you received from your medical provider. 3) Provide copies of your Primary Health Insurance Carrier's Explanation of Benefits (EOB): This coverage is designed to be "excess" of any other medical insurance you have, meaning that QBE's plan will provide coverage for the out of pocket expenses from your primary coverage (deductibles, co -payments, etc) up to the policy limits for covered accident medical expenses. For Health Special Risk to determine what amounts are not being paid by your primary insurance, we need to review your primary carrier's explanation of benefits. Your primary carrier should automatically provide them to you. If they do not, contact them and ask for them, they are required to provide them to you. Once the claim form has been completed, please mail, fax or email it and any other pertinent information to HSR for processing: Health Special Risk, Inc Toll Free Number: 1-866-408-3361 Fax: 1-469-701-3020 4100 Medical Parkway Claim Status: Maureen Clark, Sr Claims Processor Email: MaureenClark@hsri.com Carrollton, TX 75007 QBE Insurance Corporation & QBES Accident Claim Form Mail/Fax/Scan to Health Special Risk, Inc. E-mail Toll tree 4100 Medical Parkway Claims@hsri.com (866) 408-3361 Carrollton, TX 75007 Fax (972) 512-5820 MHH010307 ANI Caution Any person who, knowingly and with intent to defraud, or helps commit a fraud against, any insurance company or other person: (1) files an application for insurance or statement of claim containing any materially false information; or (2) conceals for the purpose of misleading, information concerning any material fact thereto, commits or may be committing a fraudulent insurance act, which is a crime and subjects such person to criminal and/or civil penalties. Residents of the following states, please see last page: CA, CO, DC, FL, NY, TN, TX and VA. Instructions Eligible covered expenses will be determined after benefits have been paid by other valid and collectible insurance. You must submit your claim to your other insurance company first (this does not apply if the policy provides primary coverage). When you receive their Benefits Statement (EOB) send it to us along with the itemized bills. • Part I - Must be completed by Policyholder. • Part II - Must be completed by Claimant or by the Parent or Guardian, if the Claimant is a minor. • Send copies of itemized bills showing provider's name, address, Tax ID number, diagnosis and procedure codes. • Attach Explanation of Benefits, additional bills with record of payment or denial from primary insurance carrier. • All benefits will be payable to the physicians and providers, unless accompanied by paid receipts. • If employed, but have no other insurance, forward employer(s) letter on employer(s) letterhead to that effect. Claimants eligible for Medicaid benefits must first file for benefits under this policy before submitting expenses to Medicaid. Part I — Name of Policyholder Control number Policy number Policyholder MHH010307 ANI Report Policyholder address City State Zip code Policyholder contact Email Fax Last name of Claimant First name of Claimant Social Security number Date of birth Sex Claimant is ❑ Male ❑ Female ❑ Volunteer ❑ Participant Nature of injury (Describe, fully indicate what part of body was injured — e.g. broken arm, sprained ankle) Must be a bodily injury due to accident Describe how the accident occurred, provide all details. Attach a separate sheet, if necessary (include name of SporUActivity). Did accident occur: While Claimant was Policyholder supervised? ❑ Yes ❑ No During a Policyholder sponsored activity? ❑ Yes ❑ No During scheduled Policyholder hours? ❑ Yes ❑ No While traveling to or from a Policyholder sponsored and supervised activity? ❑ Yes ❑ No Off Policyholder premises, at home, during the weekend, holiday or summer ❑ Yes ❑ No vacation? Date of accident Time of accident Place of accident First treatment dale ❑ AM ❑ PM SPEC033 802005 HSR/ANI (01-16) Page 1 of 3 Name and title of person supervising activity? Was he or she a witness? ❑ Yes ❑ No List other Policyholder insurance. Attach separate sheet, if necessary. Policy number(s) Signature of authorized Policyholder representative Title Date X Part 11— To be Name of Claimant or Father/Guardian Social Security number E-mail address completed by Claimant or Name of Mother or Guardian Social Security number E-mail address Parent/ Guardian, if Street address of Parents or Claimant Guardian City State Zip code Claimant is a minor Telephone number Father or Guardian's insurance company Mother or Guardian's insurance company Name and address of Claimant or Father/Guardian's employer, City if a minor. Name and address of Claimant or Mother/Guardian's employer, City State Zip code if a minor. List all other insurance policies under which Claimant is insured Is the Claimant enrolled in, a member of, or a participant of any of the following as an individual, employee or dependent? If so, please provide a copy of insurance card (front and back). Preferred Provider Organization (PPO) or similar prepaid health plan? ❑ Yes ❑ No If Yes, name of PPO or organization Health Maintenance Organization (HMO) or similar prepaid health plan? ❑ Yes ❑ No If Yes, name of HMO or organization SPEC033 802005 HSR/ANI (01-16) Page 2 of 3 If Claimant has health care coverage as a dependent from a previous marriage as mandated in a divorce decree, please provide the following: Name of Policyholder Name of insurance company Policy number Affidavit I verify that the statement on other insurance is accurate and complete. I understand that the intentional furnishing of incorrect information via the U.S. Mail may be fraudulent and violate federal laws as well as state laws. I agree that if it is determined at a later date that there are other insurance benefits collectible on this claim I will reimburse the Company to the extent for which the Company would not have been liable. Authorization I authorize any Health Care Provider, Doctor, Medical Professional, Medical Facility, Insurance to Release Company, Person or Organization to release any information regarding medical, dental, mental, alcohol Information or drug abuse history, treatment or benefits payable, including disability or employment related information concerning the patient, to any QBE company, its employees, and authorized agents for the purpose of validation and determining benefits payable. I further authorize any QBE company to furnish the Policyholder or its agents, any and all information with respect to my insurance claim for the purpose of assisting with claims adjudication. This data may be extracted for audit or statistical purposes. I understand that I have the right to revoke this authorization in writing at any time and that such a revocation is not effective to the extent that such authorization has already been relied upon. Payment I authorize all current and future medical benefits, for services rendered and billed as a result of this Authorization claim, to be made payable to the physicians and providers indicated on the invoices, unless paid receipts accompany this form. Signature (Parent or guardian, if the claimant is a minor) Date SPEC033 802005 HSR/ANI (01-16) Page 2 of 3 NMINONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart far Nonprofits. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www.insurancefomonprofrts.org COMMERCIAL LINES COMMON POLICY DECLARATIONS PRODUCER: POLICY NUMBER: 2023-59581 CalNonprofits Insurance Services RENEWAL OF NUMBER: 2022-59581 P.O. Box 640 Capitola, CA 95010 NAME OF INSURED AND MAILING ADDRESS: VIDA Volunteers in Defense of Animals 19142 E Walnut Dr. N Rowland Heights, CA 91748 POLICY PERIOD: FROM 05/10/2023 TO 05/10/2024 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Dog and Cat rescue IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR W HICH A PREMIUM IS INDICATED. THESE PREMIUMS MAYBE SUBJECT TO ADJUSTMENT. PREMIUM COMMERCIAL GENERAL LIABILITY COVERAGE PART - OCCURRENCE .............................. $2,331 COMMERCIAL AUTO LIABILITY COVERAGE PART................................................................ $250 COMMERCIAL AUTO PHYSICAL DAMAGE COVERAGE PART .............................................. Not Covered IMPROPER SEXUAL CONDUCT AND PHYSICAL ABUSE COVERAGE PART .......................... Not Covered SOCIAL SERVICE PROFESSIONAL COVERAGE PART.......................................................... Not Covered COMMERCIAL LIQUOR LIABILITY COVERAGE PART.......................................................... INCLUDED TERRORISM COVERAGE (Certified Acts).............................................................................. Not Covered TOTAL: $2,581 FORM(S) AND ENDORSEMENT(S) MADE A PART OF THIS POLICY AT TIME OF ISSUE:* CG 00 01 N 13, CG 00 33 N 13, CG 2010 12 19, CG 201112 19, CG 20 12 04 13, CG 2018 04 13, CG 20 20 11 85, CG 20 2107 98, CG 20 26 12 19, CG 20 3412 19, CG 20 37 12 19, CO21090615, CG 2147 12 07, CG 2173 0115, CG 21950305, CG 22440413, CG 24 07 01 96, IL 00171198, IL 00 2109 08, IL 02 70 12 19, NIAGAL0180, NIAC-E003 GL 0820, NIAGE069 GL 0219, NIAG-FO781120. NIAC-E11 GL 0919, NIAC-E1200919, NAC -E1230919, NIAGE15D920, NIAC-E180GL0121, NIAOE180LL0121, NIAC-E195GL0521, NIAC-E220919. NIAGE251215, NIAOE254 GL 1121, NIAC-E261117, NIAC-U80199, NIAOE282 GL 1221, NIAC- 291209, NIAC-E33 GL 0919, NIAC-E34 09 18, NIAC-E342 GL 0822, NIAGE42 GL 0919, NIAGE50715, NIAC-E560117. NIAGE590212, NIAGE600712. NIAC-E610219, NIAC-E700319, NIAOE720117, NIAOE740314, NIA6GL 0180, NIAC4L 0180, NIAC-NPO-001 05 20, NIAC-X10618, SCHEDULE BA 0180, SCHEDULE G 0180, SCHEDULE L 01 80 *OMITS APPLICABLE FORMS AND ENDORSEMENTS IF SHOWN IN SPECIFIC COVERAGE PART/ COVERAGE FORM DECLARATIONS. (� COUNTERSIGNED: 04/06/2023 BY VA (AUTHORIZED REPRESENTATIVE) THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. Notice: This risk pooling contract is issued by a pooling arrangement authorized by California Corporations Code Section 5005.1. The pooling arrangement is not subject to all of the insurance laws of the State of California and is not subject to regulation by the Insurance Commissioner. Insurance guaranty funds are not available to pay claims in the event the risk pool becomes insolvent. NIAC-CO NONPROFITS INSURANCE -� ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. PRODUCER: NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www.insurancef6monprofits.org COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS CalNonprofits Insurance Services P.O. Box 640 Capitola, CA 95010 NAME OF INSURED AND MAILING ADDRESS: VIDA Volunteers in Defense of Animals 19142 E Walnut Dr. N Rowland Heights, CA 91748 POLICY NUMBER: 2023-59581 RENEWAL OF NUMBER: 2022-59581 POLICY PERIOD: FROM 05/10/2023 TO 05/10/2024 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Dog and Cat rescue IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. LIMITS OF COVERAGE: GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS - COMPLETED OPERATIONS) $2,000,000 PRODUCTS - COMPLETED OPERATIONS AGGREGATE LIMIT .......................... $2,000,000 PERSONAL AND ADVERTISING INJURY LIMIT ................................................. $1,000,000 EACH OCCURRENCE LIMIT................................................................................ $1,000,000 DAMAGE TO PREMISES RENTED TO YOU ....................................................... $500, 000 any one premises MEDICAL EXPENSE LIMIT...................................................................................... $20,000 anyone Person ADDITIONAL COVERAGES: CLASSIFICATION(S) SEE ATTACHED SUPPLEMENTAL DECLARATIONS SCHEDULE G PREMIUM $2,331 FORMS AND ENDORSEMENTS APPLICABLE TO THIS POLICY ARE INCLUDED IN COMMERCIAL LINES COMMMON POLICY DECLARATIONS 0�'ee4 COUNTERSIGNED: 04/06/2023 BY (AUTHORIZED REPRESENTATIVE) THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. NIAC-GL NMINONPROFITS INSURANCE ALLLVVCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. COMMERCIAL GENERAL LIABILITY EXTENSION OF DECLARATIONS POLICY NUMBER: 2023 -59581 -NPO NAME OF INSURED: VIDA Volunteers in Defense of Animals PREMISES CODE/CLASS 45450/Kennels - breeding, boarding or sales ADDITIONAL COVERAGES Activities/Field Trips: Event # # of people 1 N/A 2 N/A 3 N/A Increased Aggregate *LOC 1 Description NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www.insurancefomonprofits.org PREMIUM BASIS 25 Animal Adoptions Dog Foster Home (5) Cat Foster Homes (2) *See Common Declarations for Total Advanced Premium and Schedule'L' for locations. Schedule G Page 1 RATE *ADVANCED PREMIUM 43.745 $1,093 &Jal�ae/. COUNTERSIGNED: 4/6/2023 BY NIAC - SCHEDULE G - NPO (AUTHORIZED REPRESENTATIVE) $500 $500 $50 $188 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heartfor Nonprofits. COMMERCIAL GENERAL LIABILITY EXTENSION OF DECLARATIONS POLICY NUMBER: 2023 -59581 -NPO NAME OF INSURED: VIDA Volunteers in Defense of Animals PREMISES DESIGNATED PREMISES LOC/BLDG ADDRESS, CITY, STATE, ZIP 1 19142 E. Walnut Drive N. Rowland Heights, CA 91748 COUNTERSIGNED: 04/06/2023 BY NIAC - SCHEDULE L - NPO NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www. insurancefomon profiits.org Schedule L Page 1 ADDITIONAL INSUREDS AND OTHER INTERESTS (AUTHORIZED REPRESENTATIVE) NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heartfor Nonprofits. PRODUCER: NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www.insurancefornoriprofits.org COMMERCIAL LIQUOR LIABILITY COVERAGE PART DECLARATIONS CalNonprofits Insurance Services P.O. Box 640 Capitols, CA 95010 NAME OF INSURED AND MAILING ADDRESS: VIDA Volunteers in Defense of Animals 19142 E Walnut Dr. N Rowland Heights, CA 91748 POLICY NUMBER: 2023-59581 RENEWAL OF NUMBER: 2022-59581 POLICY PERIOD: FROM 5/10/2023 TO 5/10/2024 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Dog and Cat rescue IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. LIMITS OF COVERAGE: GENERAL AGGREGATE LIMIT..............................................................$ 1,000,000 EACH COMMON CAUSE LIMIT.............................................................. $ 1,000,000 PREMIUM: Included FORMS AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE PART AND MADE PART OF THIS POLICY AT THE TIME OF ISSUANCE: CG 00 33 04 13 THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. Notice: This risk pooling contract is issued by a pooling arrangement authorized by California Corporations Code Section 5005.1. The pooling arrangement is not subject to all of the insurance laws of the State of California and is not subject to regulation by the Insurance Commissioner. Insurance guaranty funds are not available to pay claims in the event the risk pool becomes insolvent. COUNTERSIGNED: NIAC - LL 4/6/2023 BY 67, /,(01 (AUTHORIZED REPRESENTATIVE) NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) INDEX OF FORMS ATTACHED TO THE POLICY POLICY NUMBER: 2023-59581 NAME OF INSURED: VIDA Volunteers in Defense of Animals LIABILITY FORMS AND ENDORSEMENTS Commercial General Liability Coverage Form Liquor Liability Coverage Form Additional Insured - Owners, Lessees or Contractors Additional Insured - Managers or Lessors of Premises Additional Insured - State or Political Subdivisions - Permits Additional Insured - Mortgagee, Assignee or Receiver Additional Insured - Charitable Institutions Additional Insured - Volunteers Additional Insured - Designated Person or Organization Additional Insured - Lessor of Leased Equipment - Automatic Status - Lease Additional Insured - Owners, Lessees or Contractors - Completed Operations Exclusion - Unmanned Aircraft Employment -Related Practices Exclusion Exclusion of Certified Acts of Terrorism Silica - Exclusion Health or Cosmetic Services Exclusion Products/Completed Operations Hazard Redefined Common Policy Conditions Nuclear Energy Liability Exclusion Endorsement (Broad Form) California Changes - Cancellation and Nonrenewal Business Auto Coverage Part Declarations Member Criteria Fiscal Sponsor Limitation Professional Services - Exclusion Fireworks Exclusion Lead Liability- Exclusion Firearms Sublimit Endorsement Blood Testing Exclusion Communicable Disease - Exclusion Communicable Disease - Exclusion Discrimination Exclusion Asbestos Exclusion Additional Insured - Designated Person or Organization Aggressive Dog - Exclusion Waiver of Transfer of Rights of Recovery Against Others Property Damage to Personal Property in the Care, Custody or Control of the Insured Cyber Incident - Exclusion Employee Personal Auto Reimbursement Mold, Fungus Exclusion This list of forms is not part of the actual policy, but is for your information only. Please refer to the policy(s) for actual limits, coverages and exclusions. www.insurancefomonprofits.org Page: 1 FORM NUMBERIEDITION DATE CG 00 0104 13 CG 00 33 04 13 CG 20 10 12 19 CG 20 11 12 19 CG 20 12 04 13 CG 20 18 04 13 CG 20 20 1185 CG 20 2107 98 CG 20 26 12 19 CG 20 34 12 19 CG 20 37 12 19 CG 2109 06 15 CG 2147 12 07 CG 21 73 01 15 CG 21 96 03 05 CG 22 44 04 13 CG 24 07 01 96 IL 00 17 1198 IL 00 2109 08 IL 02 70 12 19 NIAC-AL-NPO NIAC-EO03 GL 08 20 NIAC-EO69 GL 02 19 NIAC-EO78 11 20 NIAC-E11 GL 09 19 NIAC-E120 09 19 NIAC-E123 09 19 NIAC-E15 09 20 NIAC-E180 GL 0121 NIAC-E180 LL 0121 NIAC-E195 GL 05 21 NIAC-E22 09 19 NAC -E25 12 15 NIAC-E254 GL 1121 NIAC-E26 11 17 NIAC-E28 0199 NIAC-E282 GL 12 21 NAC -E29 12 09 NIAC-E33 GL 09 19 NONPROFITS INSURANCE -� ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) INDEX OF FORMS ATTACHED TO THE POLICY POLICY NUMBER: 2023-59581 NAME OF INSURED: VIDA Volunteers in Defense of Animals www. i nsurancefornon profiits.org Page:2 LIABILITY FORMS AND ENDORSEMENTS FORM NUMBERIEDITION DATE Construction and Conversion Exclusion Anti -Stacking Condition Nuclear, Chemical and Biological Hazard Exclusion Trampoline Bounce House Exclusion Liberalization - GL, SSP, EBL Liberalization - LL Volunteer Medical Payments Additional Insured - Primary and Non -Contributory Endorsement for Public Entities Fundraiser and Event Endorsement Other Insurance - Coverage C Mental Anguish Endorsement Commercial General Liability Coverage Part Declarations Commercial Liquor Liability Coverage Part Declarations Nonprofits' OW N Enhancement Endorsement Improper Sexual Conduct and Physical Abuse Exclusion Business Auto Coverage Schedule Commercial General Liability Class Code Schedule Commercial General Liability Location Schedule This list of forms is not part of the actual policy, but is for your information only. Please refer to the policy(s) for actual limits, coverages and exclusions. NIAC-E34 09 18 NIAC-E342 GL 08 22 NIAC-E42 GL 09 19 NIAC-E5 07 15 NIAC-E56 01 17 NIAC-E59 02 12 NIAC-E60 07 12 NIAC-E61 02 19 NIAC-E70 03 19 NIAC-E72 01 17 NIAC-E74 03 14 NIAC-GL-NPO NIAC-LL 01 80 NIAGNPO-001 05 20 NIAC-X1 06 18 SCHEDULE BA 0180 SCHEDULE G 01 80 SCHEDULE L 0180 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AGGRESSIVE DOG - EXCLUSION This endorsement modffies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM This insurance does not apply to, and the Company shall have no duty to defend any claim or "suit" for "bodily injury", "property damage" or "personal and advertising injury" arising out of the ownership, supervision, custody, fostering, adoption, or investigation of the prior history of an "aggressive dog", that you, or any person, or entity for whom you are legally responsible, has knowledge of any previous incident or history of physical injury caused by that "aggressive dog', which incident or injury took place prior to the occurrence or event that leads to a claim or "suit', regardless of any other acts, errors or omissions which occur concurrently or in any sequence to produce the claim or "suit'. There is no coverage for, and the Company has no duty to defend any claim or "suit" against an "insured" which arises out of: a. the ownership, custody, or care of an "aggressive dog' by an insured or by any other person for whom an insured is legally responsible; b. the negligent supervision of any person or animal that has contact with an "aggressive dog'; c. an allegation of liability arising from an "aggressive dog' on any premises; d. any liability statutorily imposed on any insured or by any other person for whom an insured is legally responsible with respect to an "aggressive dog'; e. the actual or alleged failure to report to the proper authorities the presence or status of an "aggressive dog"; f. the performance or failure to perform a behavioral evaluation on an "aggressive dog'; g. any claim or "suit" for which you, any insured or any other person for whom an insured is legally responsible is legally obligated to pay damages by reason of the assumption of liability in a contract or agreement with respect to an "aggressive dog"; or h. the placement of an "aggressive dog° with a foster or adoption person, home or other entity. "Aggressive dog" as used in this endorsement shall mean a dog, which prior to the incident that forms the basis of a submitted claim or "suit", that was: 1. responsible for inflicting "severe injury' on a human being or animal on public or private property; 2. previously under investigation and deemed to be dangerous by animal control and/or local authorities; or 3. surrendered with a known history of biting resulting in "severe injury' or other violent behavior by the prior owner or a governmental entity, notwithstanding any subsequent finding to the contrary by you, an insured, by any other person for whom an insured is legally responsible or by an animal behavioralist. "Severe injury" means any physical injury that results in death, bleeding, muscle tears or disfiguring lacerations or requires multiple sutures or corrective or cosmetic surgery. This exclusion does not apply to a claim or "suit' for "bodily injury": arising out of services performed by you pursuant to a contract with a government entity for animal control which requires that you pick up, care for and/or retain custody of a dog but this exception does not extend to the placement of an "aggressive dog" with a foster or adoption person, home or other entity. All other terms and conditions of this policy remain unchanged. NIAC-E254 GL 1121 Nonprofits Insurance AllianceTM and NONPROFITS OWN® are brands of Page 1 of t Alliance Member Ser Aces" (AMS). 0 AMS. All rights reserved. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heartfor Nonprofits. POLICY NUMBER: 2023-59581 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT FOR PUBLIC ENTITIES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: A. Section II — WHO IS AN INSURED is amended to include: 4. Any public entity as an additional insured, and the officers, officials, employees, agents and/or volunteers of that public entity, as applicable, who may be named in the Schedule above, when you have agreed in a written contract or written agreement presently in effect or becoming effective during the term of this policy, that such public entity and/or its officers, officials, employees, agents and/or volunteers be added as an additional insured(s) on your policy, 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 negligent acts or omissions; or b. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing operations. No such public entity or individual is an additional insured for liability arising out of the sole negligence by that public entity or its designated individuals. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. B. Section III — LIMITS OF INSURANCE is amended to include: 8. The limits of insurance applicable to the public entity and applicable individuals identified as an additional insured(s) pursuant to Provision A.4. above, are those specified in the written contract between you and that public entity, or the limits available under this policy, whichever are less. These limits are part of and not in addition to the limits of insurance under this policy. C. With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance a. Primary Insurance This insurance is primary if you have agreed in a written contract or written agreement: (1) That this insurance be primary. If other insurance is also primary, we will share with all that other insurance as described in c. below; or NIAC-E61 02 19 Page 1 of 2 NONPROFITS INSURANCE ALLLINCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. POLICY NUMBER: 2023-59581 (2) The coverage afforded by this insurance is primary and non-contributory with the additional insured(s)' own insurance. Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has been added as an additional insured or to other insurance described in paragraph b. below. b. Excess Insurance This insurance is excess over: 1. Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builders Risk, Installation Risk or similar coverage for "your work'; (b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises temporarily occupied by you with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION I — COVERAGE A— BODILY INJURY AND PROPERTY DAMAGE. (e) Any other insurance available to an additional insured(s) under this Endorsement covering liability for damages which are subject to this endorsement and for which the additional insured(s) has been added as an additional insured by that other insurance. (1) When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured(s) against any "suit" if any other insurer has a duty to defend the additional insured(s) against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured(s)' rights against all those other insurers. (2) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self-insured amounts under all that other insurance. (3) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Methods of Sharing If all of the other insurance available to the additional insured(s) permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any other the other insurance available to the additional insured(s) does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. NIAC-E61 02 19 Page 2 of 2 NONPROFITS POLICY NUMBER: 2023-59581 FORM: NIAC-E25 12 15 INSURANCE NAMED INSURED: VIDA Volunteers in Defense of Animals ALLIANCE OF CALIFORNIA A Head for insurance. A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION - FOOD CONTRIBUTIONS OR CLIENT REFERRALS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy, in consideration of food contributions or client referrals you receive from them. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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 the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. NIAC-E25 12 15 Page 1 of 1 POLICY NUMBER: 2023-59581 COMMERCIAL GENERAL LIABILITY Named Insured: VIDA Volunteers in Defense of Animals CG 20 26 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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 the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we Will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 2023-59581 Named Insured: VIDA Volunteers in Defense of Animals COMMERCIAL GENERAL LIABILITY CG 20 34 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT - AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. B. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 34 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 2023-59581 COMMERCIAL GENERAL LIABILITY Named Insured: VIDA Volunteers in Defense of Animals CG 20 11 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): Name Of Person(s) Or Organization(s) (Additional Insured): Any person or organization acting as a manager or lessor of a covered premises that you are required to name as an additional insured on this policy, under a written contract, lease or agreement currently in effect, or becoming effective during the term of this policy. Additional Premium: Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II —Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. 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 insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 11 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1 DC11 CY NJKIBER _-2_ 5-0E8' Named Insured: VIDA Volunteers in Defense of Animals ^MMERCiAL GENERAL A3i i CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization that you are required to All insured premises and operations. add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section It — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". 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 insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 2023-59581 COMMERCIAL GENERAL LIABILITY Named Insured: VIDA Volunteers in Defense of Animals CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Any person or organization that you are required to All insured premises and operations. add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury' caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 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 insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury' or "property damage" occurring after: 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 CG 20 10 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 2 injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. P.Vallabl2 Jnder the apCIICa I t& C Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 10 12 19 © Insurance Services Office, Inc., 2012 Page 2 of 2 FIRST AMENDMENT TO ANIMAL SHELTERING AND CARE SERVICES (VOLUNTEERS IN DEFENSE OF ANIMALS) This FIRST AMENDMENT ("Amendment") is made and entered into this 10th day of December, 2019 ("Effective Date"), by and between the City of Rosemead, a municipal organization, organized under the laws of the State of California with its principal place of business at 8838 East Valley Blvd., Rosemead, California 91770 ("City") and Volunteers in Defense of Animals (VIDA) with its principal place of business at 19142 E. Walnut Dr. N., La Puente, California 91748 ("Contractor"). City and Contractor are sometimes individually referred to herein as "Party" and collectively as "Parties." WHEREAS, City and Contractor entered into an agreement on February 12, 2019, for animal sheltering and care services (the "Agreement"); and WHEREAS, this Agreement is set to expire on December 31, 2019; and WHEREAS, the City and the Contractor may mutually agree to extend the term of this Agreement (Section 1). NOW, THEREFORE, the Parties agree as follows: SECTION 1. Section 1, "Term of Contract" shall be amended to read: The term of this Agreement is amended to continue until December 31, 2020, unless either party gives express written notice of its intent to terminate this Agreement at least thirty (30) days prior to the requested termination date. This Agreement may be extended prior to any expired term by written agreement of the Parties on a month-to-month basis. The City Manager is authorized to negotiate and execute any contract amendments or extension(s) on behalf of the City. SECTION 2. All other terms, condition, and provisions of the Original Agreement not in conflict with this Addendum, shall remain in full force and effect. SECTION 3. The City Clerk shall certify to the adoption of this Addendum and hereafter the same shall be in full force and effect. IN WITNESS WHEREOF, City and Contractor have caused this Agreement to be executed by their duly authorized representatives as of the day and year first above written. CITY OF ROSEMEAD VOLUNTEERS IN DEFENSE OF ANIMALS (VIDA) BY: r _ BY: Gloria Molleda, City Manager \- -0, 1-,0 (A & oJ 11Name: Attest: Il Title: O ? C0 n S VI e r City:;Clerk (If Corporation, TWO SIGNATURES, President OR Vice President AND Secretary, AND CORPORATE SEAL OF CONTRACTOR REQUIRED) BY: .I h - O BY: Rachel "ichman, City Attorney Name: Title: 2 Agreement forAnimal Care and Sheltering Services Page 1 CITY OF ROSEMEAD AGREEMENT FOR ANIMAL SHELTERING AND CARE CONTRACT SERVICES This Agreement entered into this 12th day of February, 2019 between the CITY OF ROSEMEAD herein called "City", and the VOLUNTEERS IN DEFENSE OF ANIMALS (VIDA), a 501(c)3 non-profit organization, hereafter referred to as "VIDA." WITNESSETH The VIDA agrees as an independent contractor to provide comprehensive animal care and sheltering services in support of the City's programs and activities specified in the terms, conditions and special provisions of this contract. SECTION I TERM OF CONTRACT This agreement shall become effective February 12, 2019, and shall also cover the period starting January 31, 2019 and ending on February 11, 2019 to cover the gap in providing services. This agreement shall continue until December 31, 2019, unless either party gives express written notice of its intent to terminate this Agreement at least ninety (90) days prior to the requested termination date. This Agreement may be extended prior to any expired term by written agreement of the Parties SECTION II ANIMAL SHELTER SERVICES A. VIDA shall maintain humane and sanitary shelter facilities suitable for the impoundment of all animals which may come into its custody from the City. VIDA's shelter shall be located at 19142 E. Walnut Dr. N., La Puente, California. VIDA shall maintain public office hours from Monday through Friday 9:00 a.m. to 6:00 p.m., Saturday from 9:00 a.m. to 5:00 p.m. and be closed Sunday each week and kennels shall be open to public visitation for identification purposes from 9:00 a.m. to 5:00 p.m., on its days of operation. VIDA's offices are closed on Sundays and specified holidays. VIDA will provide access to kennel area to accept animals from City Animal Control personnel 24 hours a day / 7 days a week, including holidays. Agreement forAnimal Care and Sheltering Services Page 2 Animals impounded for the City shall be held for redemption, by the owner or animal's custodian for a minimum of seven (7) business days provided that no designated holding period shall be less than that provided by California Food and Agricultural Code — Division 14 or any other applicable state and county laws for the animal concerned prior to being placed up for adoption. VIDA shall make all reasonable efforts to have animals adopted or transported to other shelters for adoption prior to considering euthanasia. VIDA reserves the right to humanely euthanize any impounded, diseased or injured animal prior to the expiration of the holding period upon the recommendation of a licensed veterinarian and in accordance with state law. All animals held in excess of the minimum period specified above shall become the responsibility of VIDA and the City shall have no further responsibility for such animal unless euthanized which VIDA shall be compensated for said cost in accordance with Section V. B. In the absence of written instructions from City to the contrary, VIDA will not accept stray animals found by private citizens nor any animals voluntarily relinquished by their owners who reside in the City of Rosemead. VIDA will direct all residents of the City of Rosemead to the City's Public Safety Department. C. VIDA shall charge owner or animal's custodian a reasonable redemption fee for the release of an impounded animal that has been identified by the owner or animal's custodian. VIDA may recover costs related to boarding, vaccinations and veterinary medical treatment. VIDA shall not release any impounded dog until owner or animal's custodians provides proof of City licensing. D. VIDA shall not release any animal for the purposes of medical research or vivisection. SECTION III INCIDENTAL COSTS AND SERVICES VIDA may provide other services, and charge costs for these services, as agreed upon in writing by the City. Such costs may include but are not limited to reimbursement for contracted veterinarian charges beyond immediate stabilization and comfort to un-owned animals which are authorized by Rosemead personnel. Agreement forAnimal Care and Sheltering Services Page 3 SECTION IV COMPENSATION A. VIDA shall receive compensation for Animal Shelter Services and Veterinary Medical Services rendered under this Agreement, as specified in accordance with Section V. Total payments to VIDA shall not exceed Eighty Thousand Dollars ($80,000) per calendar year. Extra work may be requested in writing by the City in an amount agreed to by the parties, and if authorized, will be compensated at the agreed upon amount. Contract costs are due and payable in accordance with SECTION IV, C. B. During the term of this contract, City agrees to compensate VIDA for all monthly payments due. C. VIDA shall invoice City monthly within one week of completing the previous month's services. City shall pay for each month's completed service within thirty (30) days after receipt of said invoice. Said amount shall fully compensate VIDA for all services provided for City as constituted on the effective date of this Agreement .and shall include complete shelter and veterinary services for all impounded animals. D. Shelter services-for animals held in quarantine or for animals held as evidence at request of City/County prosecuting attorney or city law enforcement officer and for animals held longer than seven (7) business days pursuant to any applicable city ordinance or state law, shall be billed to City at a rate of$15 per day. SECTION V FEE SCHEDULE Intake Rates: Dog $125 per animal (Incl. Boarding/ Bordatella & DHPP Vac.) Cat $30 per animal Rabies Vaccination: $20 Euthanasia Costs: Cats $35 Dogs—40 lbs. and below $65 Dogs—411bs. and above $75 Agreement forAnimal Care and Sheltering Services Page 4 Emergency Veterinarian Medical Services*: $250 max. per animal (*Requires prior approval by City personnel. Limited to immediate stabilization and comfort) SECTION VI EQUIPMENT, SUPPLIES AND PERSONNEL A. VIDA shall provide all equipment,vehicles,supplies and personnel necessary to perform the services to be furnished by VIDA under the terms and conditions of this agreement. SECTION VII PUBLIC HEALTH RESPONSIBILITIES A. VIDA agrees to cooperate with public health authorities in enforcing the provisions of the California Health and Safety Code relating to biting dogs and animals suspected of being infected with the rabies virus. SECTION IX SOCIETY EMPLOYEE STATUS A. All persons employed by VIDA for the performance of services to be provided pursuant to the terms and conditions of this agreement shall be employees or agents of VIDA. City shall not be called upon to assume any liability for the direct payment of any salaries, wages or other compensation to any VIDA personnel performing such services for City, nor shall City be called upon to pay any liability other than as provided for in this agreement. Notwithstanding the foregoing, it is agreed that City shall have the full cooperation of VIDA's officers, agents and employees and VIDA shall have the full cooperation of City and of the officers, agents and employees of City in the performance and evaluation of the services. SECTION X INSURANCE AND LIABILITY A. VIDA will defend, indemnify, save and hold harmless the City its elected or appointed officers and employees from any and all liabilities, losses, demands, claims, causes of action, proceedings, suits, damages, judgments, costs and Agreement forAnimal Care and Sheltering Services Page 5 expenses of litigation including attorney's fees and from all expenses that may be incurred in investigating the same, arising from, or growing out of, any act or omission of VIDA, its contractors, agents or employees, in connection with the operation of VIDA's shelter, or in the performance of related duties under this agreement. VIDA shall fully inform all persons using or being upon VIDA's premises or conducting business at such location of the non-liability of City for any act or neglect of VIDA, by posting an adequate number of notices to that effect in,about,or on said premises. B. VIDA shall at its own cost and expense secure and maintain the following insurance coverage and provide copies of its most current coverage/documents all of the following: I. Comprehensive general liability coverage, including vehicle insurance in an amount no less than $1,000,000 combined single limit per occurrence, 52,000,000 general aggregate. 2. Said policy shall name the City of Rosemead, its elected and appointed officers, officials and employees as additional insureds with regard to damages and defense of claims arising from (1)activities performed by or on behalf of the VIDA; (2) completed operations of the VIDA, of (3) premises owned, leased or used by VIDA. 3. Insurance shall be placed with insurers which are admitted in the State of California and have a current A.M. best rating of no less than A;VII. 4. Said policy shall bear an endorsement and have attached a rider whereby it is provided that, in the event of expiration, cancellation or modification of such policy for any reason whatsoever, the City shall be notified by registered mail, postage prepaid, return receipt requested, not less than thirty (30) days before the expiration, cancellation or modification is effective. 5. The VIDA shall file a Certificate of Liability Insurance and original endorsements affecting coverage required by this section with the City. 6. Proof of Worker's Compensation coverage shall be maintained as required by the State of California and provided to the City prior to the execution of this contract. Agreement forAnimal Care and Sheltering Services Page 6 SECTION XI RECORDS MANAGEMENT AND FINANCIAL ACCOUNTING A. VIDA agrees to maintain a comprehensive records management system and provide City with such records relating to the services performed under this agreement. All VIDA records relating to services provided or work performed pursuant to this agreement, including all financial, managerial and operation records, shall be made readily available for inspection by City representatives at all reasonable times following a request by the City. If costs are incurred during compliance with a City request to inspect records or books, such costs shall be documented by VIDA and reimbursed to VIDA by City upon request by VIDA. B. VIDA shall comply with information access provisions in accordance with all applicable requirements as stipulated by the State of California. SECTION XII CONTRACT ADMINISTRATION A. VIDA shall provide, upon request by City, reports showing the number and species of animals impounded or received from the City. SECTION XIII LEGAL A. In the event that litigation is required to enforce or interpret the provisions of this agreement, the prevailing party shall be entitled to reasonable attorney's fees. SECTION XIV ASSIGNMENT A. VIDA shall not have the right, or power to sell, mortgage or assign this agreement or the powers granted to it or any interest therein. Agreement forAnimal Care and Sheltering Services Page 7 SECTION XV MERGER A. This agreement represents the entire understanding between the parties hereto and supersedes any and all prior written or oral agreements or understanding between the parties. IN WITNESS WHEREOF, the parties have authorized the individuals below to sign this Agreement on its behalf. APPROVED AS TO FORM CITY OF ROSEMEAD 66_ .. , g Ci y Attorney Steven Ly, Mayor Date: /( ' l/ )\ Date: ATTEST: VOLUNTEERS IN DEFENSE OF ANIMALS City Clerk Owner Date: I i3l f NONPROFITS NCE ALLIANCE INSURANCE NONPROFITS INSUOF CAL FORNA (N AC) ALLIANCE OF CALIFORNIA www.insurancefomonprofts.org A Head for Insurance. A Heart for Nonprofits. ACCIDENT INSURANCE PROGRAM MASTER POLICY - MHH010307 Underwritten by: QBE Insurance Corporation Statement of Coverage Part 1 PARTICIPATING ORGANIZATION: VIDA Volunteers in Defense of Animals 19142 E Walnut Dr. N Rowland Heights, CA 91748 CONTROL #: 59581 COVERAGE TERM: 05/10/2023 to 05/10/2024 SUMMARY OF BENEFITS PLAN F Accidental Death $50,000 Accidental Dismemberment Maximum $50,000 Accidental Paralysis $25,000 Aggregate Limit of Liability $1,000,000 Excess Accident Medical $250,000 Deductible $250 COVERED PERSONS Volunteers OPTIONAL COVERED ACTIVITIES None ANNUAL PREMIUM: $100 Please refer to Part 2 of the Statement of Coverage for a more complete description of the benefits provided by this program, including program exclusions and limitations. Date: 04/06/2023 ACCIDENT INSURANCE STATEMENT OF COVERAGE Part 2 Underwritten by: QBE Insurance Corporation This Statement of Coverage confirms that Blanket Accidental Death, Dismemberment, Paralysis and Accident Medical Expense benefits are provided to Covered Persons volunteering, or participating, in activities that are supervised and sponsored by the Participating Organization (Organization) named in Part 1, under Policy # MHH010307, issued by QBE to: Volunteers Insurance Services® Association Alliance Member Services, Nonprofits Insurance Alliance of California, Alliance of Nonprofits for Insurance. Covered Persons - All designated, recorded Volunteers participating in a volunteer project through the Organization's program, if Volunteers are listed in Part 1. - All registered Participants participating in supervised and sponsored Organization activities, if Participants are listed in Part 1. Covered Activities Volunteers and Participants are covered while participating in all activities which are supervised and sponsored by the Organization named in Part 1. Accidental Death, Dismemberment & Paralysis (Plegia) Benefits Lossof Life............................................................. Loss of any combination of two: hands, feet, eyesight, speech and hearing .................................... Total paralysis of upper and lower limbs, both lower limbs, or upper and lower limbs on one side of the body.. Loss of one hand, one foot, sight in one eye, speech orhearing.............................................................. Loss of thumb and index finger of same hand ................. Loss of Life due to heart failure .................................... Accident Medical Expense Benefits ........................... $50,000 ............................ $50,000 ........................... $25,000 ........................... $25,000 ........................... $12,500 .................. I........ $10,000 Maximum Benefits for any one Covered Accident ................ Refer to Part 1 Benefit Period for any one Covered Accident ..................... 52 weeks Deductible.................................................................. Refer to Part 1 Scope of Coverage...................................................... Excess—pays benefits after any other Health Care Plans have paid benefits Benefit Amount Payable ............................................... 100% of Usual and Customary charges, Covered Expenses Include ....................................... Dental Expenses...................................................... up to Maximum Benefit per Covered Accident ... In & Out -Patient Hospital, Ambulatory Medical Center & Emergency Room, Physician visits & surgery, diagnostic tests, nursing services and ambulance charges $1,000 maximum benefit, up to $300 per tooth Page 1 of 3 Accidental Death, Dismemberment and Paralysis benefits: Loss of hand or foot means complete severance through or above the wrist or ankle joint. Loss of sight means the total, permanent loss of sight of the eye. The loss of sight must be irrecoverable by natural, surgical or artificial means. Loss of speech means total, permanent and irrecoverable loss of audible communication. Loss of hearing means total and permanent loss of hearing in both ears which cannot be corrected by any means. Loss of a thumb and index finger means complete severance through or above the metacarpophalangeal joints (the joints between the fingers and the hand). Severance means the complete separation and dismemberment of the part from the body. Paralysis means loss of use, without severance, of a limb. This loss must be determined by a physician to be complete and not reversible. If the same accident causes more than one of these losses, we will pay the largest amount that applies. Exclusions and Limitations: Coverage is not provided for any accident which is caused by or results from any of the following: - Intentionally self-inflicted injury, suicide or any attempt thereat while sane or insane, - commission or attempt to commit a felony or an assault; commission of or active participation in a riot or insurrection; - bungee -cord jumping, parachuting, skydiving, parasailing, hang-gliding; - declared or undeclared war or act of war; - flight in, boarding or alighting from an aircraft, except as a fare -paying passenger on a regularly scheduled commercial airline; - travel in or on any on -road and off-road motorized vehicle that does not require licensing as a motor vehicle; participation in any motorized race or contest of speed; - an accident if the covered person is the operator of a motor vehicle and does not possess a valid motor vehicle operator's license, unless the covered person holds a valid learners permit and the covered person is participating in a driver's education program; - sickness, disease, bodily or mental infirmity, bacterial or viral infection or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food; - travel or activity outside the United States or Canada, unless advance written approval is provided; - the covered person being legally intoxicated as determined according to the laws of the jurisdiction in which the covered accident occurred; - voluntary ingestion of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a physician and taken in accordance with the prescribed dosage; - injuries compensable under Workers' Compensation law or any similar law; - an accident which occurs while the covered person is driving a private passenger automobile while intoxicated. - Benefits will not be paid for any hospital stay that is not considered appropriate treatment for the condition and locality. - Overnight Supervised and Sponsored Activities and related travel are not covered, unless agreed to in writing by the Company. - In addition, benefits will not be paid for services or treatment rendered by any person who is employed or retained by the policyholder or living in the covered person's household or provided by a parent, sibling, spouse or child of either the covered person or the covered person's spouse, or the covered person. - The Accidental Death, Dismemberment and Paralysis aggregate limit of liability is $1,000,000. Accident Medical Benefit limitations and excluded expenses: - cosmetic surgery, except for reconstructive surgery needed as the result of a covered injury; - any elective or routine treatment, surgery, health treatment, or examination; - blood, blood plasma, or blood storage, except expenses by a hospital for processing or administration of blood; - examination or prescription for initial eyeglasses, contact lenses or hearing aids; - treatment in any Veteran's Administration, Federal, or state facility, unless there is a legal obligation to pay, - services or treatment provided by persons who do not normally charge for their services, unless there is a legal obligation to pay; - rest cures or custodial care; - repair or replacement of existing dentures, partial dentures, braces or bridgework; - personal services such as television and telephone or transportation; - expenses payable by any automobile insurance policy without regard to fault; - services or treatment provided by an infirmary operated by the policyholder; - treatment of injuries that result over a period of time (such as blisters, tennis elbow, etc.), and that are a normal, foreseeable result of participation in the covered activity; Page 2 of 3 treatment or service provided by a private duty nurse; treatment of hernia of any kind. Treatment of injury resulting from a condition that a covered person knew existed on the date of the accident, unless he received a written medical release from his physician. Any covered expenses payable under the Accident Medical Expense benefit will be reduced by 50% if the covered person has HMO or PPO coverage and elects not to use that coverage. Claims Procedures 1. Send the completed and signed QBE Accident Claim Form to the claims administrator as soon as you receive notice that an injury has occurred. The Organization needs to complete and sign Part I. The claimant must complete Part II and sign Part III. Include a copy of Part 1 of the Statement of Coverage with the Claim Form. 2. Since this program provides coverage for medical expenses that are in "excess" of any other Health Care Plan the claimant has, all claims must be submitted to the claimant's primary insurance carrier first. If the claimant has no other insurance, this program will act like primary coverage. 3. Itemized bills for all medical expenses, referred to as a "HCFA" from a doctor's office or a "UB92" from a hospital, must be provided to the claims administrator in order for the claim to be processed. 4. The claimant's primary insurance will send them an Explanation of Benefits (EOB) for all submitted expenses. Copies of all such EOBs must also be submitted to the claims administrator in order for claims to be processed under this program. Claims Administrator: Health Special Risk, Inc. 4100 Medical Parkway Carrollton, TX 75007 Toll Free Number: 1-866-408-3361 E-mail: Claims@hsri.com Important Notice: This information is a brief description of the important benefits and features of the Blanket Accident Medical Insurance underwritten by QBE Insurance Corporation. It is not a contract. Full terms and conditions of coverage, including effective dates of coverage, benefits, limitations and exclusions are set forth in the Master Policy. Page 3 of 3 HSR Health Special Risk, Inc. Toll Free Number: 1-866-408-3361 INSTRUCTIONS FOR HAVING CLAIMS PAID QUICKLY AND EFFICIENTLY Health Special Risk is a Third Party Administrator and processes claims for your organization's Accident policy on behalf of QBE. This is not a liability policy. It is in place to assist you with your medical bills that result from covered accidents. There are three important items that Health Special Risk needs to process your claim. They are: - A completed and signed QBE Accident Claim Form. - Itemized bills from Your Medical Care Provider. - Your Primary Health Insurance Carriers Explanation of Benefits (EOBs). 1) Complete the QBE Accident Claim Form: In the event of an accidental injury, please complete the claim form as follows: Part I —The organization must complete and sign "Part I". All fields must be completed in this section. Organization must also provide the claimant with a copy of the first page of the Statement of Coverage for submission with the claim form. Part II - The insured must complete "Part II" and sign "Part III". Since this is excess coverage, the insured's primary medical insurance is a vital piece of information in "Part II". "N/A" cannot be inserted. If the insured has no other insurance, please state "No other insurance". IMPORTANT: Please include a copy of Page 1 of the Statement of Coverage with the Claim form. The quickest and easiest way to get items 2 and 3 below to our office, is to simply provide Health Special Risk's contact information to your medical provider and have them bill Health Special Risk as the secondary payor. Otherwise, you can proceed as follows: 2) Provide copies of your Medical Care Provider's itemized bills: Health Special Risk needs to review the itemized bills from your provider to confirm that the procedures being performed are appropriate for the injury sustained, as well as that the amount being charged is at a reasonable and customary rate. These bills are often referred to as a "HCFA" from a doctor's office and a "UB92" from a hospital. You can either send these bills in to HSR's office yourself or request that the provider send them to Health Special Risk directly. If you already paid these bills and you are requesting reimbursement, please include a copy of your proof of payment such as the receipt you received from your medical provider. 3) Provide copies of your Primary Health Insurance Carrier's Explanation of Benefits (EOB): This coverage is designed to be "excess" of any other medical insurance you have, meaning that QBE's plan will provide coverage for the out of pocket expenses from your primary coverage (deductibles, co -payments, etc) up to the policy limits for covered accident medical expenses. For Health Special Risk to determine what amounts are not being paid by your primary insurance, we need to review your primary carrier's explanation of benefits. Your primary carrier should automatically provide them to you. If they do not, contact them and ask for them, they are required to provide them to you. Once the claim form has been completed, please mail, fax or email it and any other pertinent information to HSR for processing: Health Special Risk, Inc Toll Free Number: 1-866-408-3361 Fax: 1-469-701-3020 4100 Medical Parkway Claim Status: Maureen Clark, Sr Claims Processor Email: MaureenClark@hsri.com Carrollton, TX 75007 QBE Insurance Corporation a QBES Accident Claim Form Mail/Fax/Scan to Health Special Risk, Inc. E-mail Toll free 4100 Medical Parkway Claims@hsri.com (866) 408-3361 Carrollton, TX 75007 Fax (972) 512-5820 MHH010307 ANI Caution Any person who, knowingly and with intent to defraud, or helps commit a fraud against, any insurance company or other person: (1) files an application for insurance or statement of claim containing any materially false information; or (2) conceals for the purpose of misleading, information concerning any material fact thereto, commits or may be committing a fraudulent insurance act, which is a crime and subjects such person to criminal and/or civil penalties. Residents of the following states, please see last page: CA, CO, DC, FL, NY, TN, TX and VA. Instructions Eligible covered expenses will be determined after benefits have been paid by other valid and collectible insurance. You must submit your claim to your other insurance company first (this does not apply if the policy provides primary coverage). When you receive their Benefits Statement (EOB) send it to us along with the itemized bills. • Part I - Must be completed by Policyholder. • Part 11 - Must be completed by Claimant or by the Parent or Guardian, if the Claimant is a minor. • Send copies of itemized bills showing provider's name, address, Tax ID number, diagnosis and procedure codes. • Attach Explanation of Benefits, additional bills with record of payment or denial from primary insurance carrier. • All benefits will be payable to the physicians and providers, unless accompanied by paid receipts. • If employed, but have no other insurance, forward employer(s) letter on employer(s) letterhead to that effect. Claimants eligible for Medicaid benefits must first file for benefits under this policy before submitting expenses to Medicaid. Part I — Name of Policyholder Control number Policy number Policyholder MHH010307 ANI Report Policyholder address City State Zip code Policyholder contact Email Fax Last name of Claimant First name of Claimant Social Security number Date of birth Sex Claimant is ❑ Male ❑ Female ❑ Volunteer ❑ Participant Nature of injury (Describe, fully indicate what part of body was injured — e.g. broken arm, sprained ankle) Must be a bodily injury due to accident Describe how the accident occurred, provide all details. Attach a separate sheet, if necessary (include name of Sport/Activity). Did accident occur: While Claimant was Policyholder supervised? ❑ Yes ❑ No During a Policyholder sponsored activity? ❑ Yes ❑ No During scheduled Policyholder hours? ❑ Yes ❑ No While traveling to or from a Policyholder sponsored and supervised activity? ❑ Yes ❑ No Off Policyholder premises, at home, during the weekend, holiday or summer ❑ Yes ❑ No vacation? Date of accident Time of accident Place of accident First treatment date ❑ AM ❑ PM SPEC033 802005 HSR/ANI (01-16) Page 7 of 3 Name and title of person supervising activity? Was he or she a witness? ❑ Yes ❑ No List other Policyholder insurance. Attach separate sheet, if necessary. Policy number(s) Name and address of Claimant or Father/Guardian's employer, City State Zip code if a minor. Name and address of Claimant or Mother/Guardian's employer, City State Zip code if a minor. List all other insurance policies under which Claimant is insured Policy number Is the Claimant enrolled in, a member of, or a participant of any of the following as an individual, employee or dependent? If so, please provide a copy of Insurance card (front and back). Preferred Provider Organization (PPO) or similar prepaid health plan? ❑ Yes ❑ No If Yes, name of PPO or organization Health Maintenance Organization (HMO) or similar prepaid health plan? ❑ Yes ❑ No If Yes, name of HMO or organization Signature of authorized Policyholder representative Title Date X state laws. I agree that if it is determined at a later date that there are other insurance benefits Part 11— To be Name of Claimant or Father/Guardian Social Security number E-mail address completed by I authorize any Health Care Provider, Doctor, Medical Professional, Medical Facility, Insurance to Release Company, Person or Organization to release any information regarding medical, dental, mental, alcohol Claimant or Name of Mother or Guardian Social Security number E-mail address Parent/ purpose of validation and determining benefits payable. I further authorize any QBE company to furnish the Policyholder or its agents, any and all information with respect to my insurance claim for the purpose Guardian, if Street address of Parents or Claimant Guardian City State Zip code Claimant is revocation is not effective to the extent that such authorization has already been relied upon. Payment I authorize all current and future medical benefits, for services rendered and billed as a result of this a minor Telephone number Father or Guardian's insurance company Mother or Guardian's insurance company Name and address of Claimant or Father/Guardian's employer, City State Zip code if a minor. Name and address of Claimant or Mother/Guardian's employer, City State Zip code if a minor. List all other insurance policies under which Claimant is insured Policy number Is the Claimant enrolled in, a member of, or a participant of any of the following as an individual, employee or dependent? If so, please provide a copy of Insurance card (front and back). Preferred Provider Organization (PPO) or similar prepaid health plan? ❑ Yes ❑ No If Yes, name of PPO or organization Health Maintenance Organization (HMO) or similar prepaid health plan? ❑ Yes ❑ No If Yes, name of HMO or organization SPEC033 802005 HSR/ANI (01-16) Page 2 of 3 If Claimant has health care coverage as a dependent from a previous marriage as mandated in a divorce decree, please provide the following: Name of Policyholder Name of insurance company Policy number Affidavit I verify that the statement on other insurance is accurate and complete. I understand that the intentional furnishing of incorrect information via the U.S. Mail may be fraudulent and violate federal laws as well as state laws. I agree that if it is determined at a later date that there are other insurance benefits collectible on this claim I will reimburse the Company to the extent for which the Company would not have been liable. Authorization I authorize any Health Care Provider, Doctor, Medical Professional, Medical Facility, Insurance to Release Company, Person or Organization to release any information regarding medical, dental, mental, alcohol Information or drug abuse history, treatment or benefits payable, including disability or employment related information concerning the patient, to any QBE company, its employees, and authorized agents for the purpose of validation and determining benefits payable. I further authorize any QBE company to furnish the Policyholder or its agents, any and all information with respect to my insurance claim for the purpose of assisting with claims adjudication. This data may be extracted for audit or statistical purposes. I understand that I have the right to revoke this authorization in writing at any time and that such a revocation is not effective to the extent that such authorization has already been relied upon. Payment I authorize all current and future medical benefits, for services rendered and billed as a result of this Authorization claim, to be made payable to the physicians and providers indicated on the invoices, unless paid receipts accompany this form. Signature (Parent or guardian, if the claimant is a minor) Date SPEC033 802005 HSR/ANI (01-16) Page 2 of 3 California and Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a Texas residents crime and may be subject to fines and confinement in state prison. Colorado It is unlawful to knowingly provide false, incomplete or misleading facts or information to an insurance residents company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to settlement or award payable from insurance proceeds shall be reported to the Colorado division of insurance within the department of regulatory agencies. District of WARNING: It is a crime to provide false or misleading information to an insurer for the purpose of Columbia defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an residents insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant. Florida Any person who knowingly and with intent to injure, defraud or deceive any insurer files a statement of residents claim or an application containing any false, incomplete or misleading information is guilty of a felony of the third degree. New York Any person who knowingly and with intent to defraud any insurance company or other person files an residents 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 shall also be subject to a civil penalty not to exceed $5,000 and the stated value of the claim for each such violation. Tennessee It is a crime to knowingly provide false, incomplete or misleading information to an insurance company residents for the purpose of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits. Virginia Any person who, with the intent to defraud or knowing that he is facilitating a fraud against an insurer, residents submits application or files a claim containing a false or deceptive statement may have violated state law. SPEC033 802005 HSR/ANI (01-16) Page 3 of 3 NMINONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www.insurancefornonprofits.org COMMERCIAL LINES COMMON POLICY DECLARATIONS PRODUCER: POLICY NUMBER: 2023-59581 CalNonprofits Insurance Services RENEWAL OF NUMBER: 2022-59581 P.O. Box 640 Capitola, CA 95010 NAME OF INSURED AND MAILING ADDRESS: VIDA Volunteers in Defense of Animals 19142 E Walnut Dr. N CG 00330413, Rowland Heights, CA 91748 CG 20111219, POLICY PERIOD: FROM 05/10/2023 TO 05/10/2024 CG 20 18 04 13, AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE CG 20 2107 98, BUSINESS DESCRIPTION: Dog and Cat rescue CG 20 3412 19, IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THESE PREMIUMS MAYBE SUBJECT TO ADJUSTMENT. CG 2173 01 15, PREMIUM COMMERCIAL GENERAL LIABILITY COVERAGE PART - OCCURRENCE .............................. $2,331 COMMERCIAL AUTO LIABILITY COVERAGE PART................................................................ $250 COMMERCIAL AUTO PHYSICAL DAMAGE COVERAGE PART .............................................. Not Covered IMPROPER SEXUAL CONDUCT AND PHYSICAL ABUSE COVERAGE PART .......................... Not Covered SOCIAL SERVICE PROFESSIONAL COVERAGE PART.......................................................... Not Covered COMMERCIAL LIQUOR LIABILITY COVERAGE PART.......................................................... INCLUDED TERRORISM COVERAGE (Certified Acts).............................................................................. Not Covered TOTAL: $2,581 FORM(S) AND ENDORSEMENT(S) MADE A PART OF THIS POLICY AT TIME OF ISSUE:' CG 00 0104 13, CG 00330413, CG20101219, CG 20111219, CG 20120413, CG 20 18 04 13, CG 20201185, CG 20 2107 98, CG 20 26 12 19, CG 20 3412 19, CG 20 37 12 19, CG 2109 0615, CG 2147 12 07, CG 2173 01 15, CG 21960305, CG 22440413, CG 24 07 01 96, IL 00 17 1198, IL 00210908. IL 02 70 12 19, NIAC-AL 0180, NAC -E003 GL 0820, NIAC-EO69 GL 0219, NIAC-EO781120. NIAC-E11 GL 0919, NIAC-E120 09 19, NIAGE1230919, NIAC-E150920, NIAC`E180 GL 0121, NIAC-EI80 LL 0121, NIAC-E195 GL 0521, NIA6E220919, NIAOE251215. NIAC-E254 GL 1121, NIAC-E261117, NIAC-080199, NAC -E282 GL 1221, NIAGE291209. NIAG-E33 GL 0919, NIAGE340918, NIAC-E342 GL 0822, NIAC-E42 GL 0919, NIAGE50715, NIAGE%0117, NIAGE590212. NIAOE600712, NIAC-E61 02 19. NIAC-E70 03 19, NIAC-E72 01 17, NIAC-E74 03 14, NAC -GL 0180, NIAC-LL 0180, NIAGNPO-0010520, NIAG-X10618, SCHEDULE BA 0180, SCHEDULE G 0180, SCHEDULE L 0180 'OMITS APPLICABLE FORMS AND ENDORSEMENTS IF SHOWN IN SPECIFIC COVERAGE PART/ COVERAGE FORM DECLARATIONS. (/ COUNTERSIGNED: 04/06/2023 BY VA (AUTHORIZED REPRESENTATIVE) THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. Notice: This risk pooling contract is issued by a pooling arrangement authorized by California Corporations Code Section 5005.1. The pooling arrangement is not subject to all of the insurance laws of the State of California and is not subject to regulation by the Insurance Commissioner. Insurance guaranty funds are not available to pay claims in the event the risk pool becomes insolvent. NIAC-CO NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head far Insurance. A Heartfor Nonprofits. PRODUCER: NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www.insurancefornonprofits.org COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS CalNonprofits Insurance Services P.O. Box 640 Capitola, CA 95010 NAME OF INSURED AND MAILING ADDRESS: POLICY NUMBER: 2023-59581 12INWIV-AwiraUnukk]�aWiPWmex31 VIDA Volunteers in Defense of Animals 19142 E Walnut Dr. N Rowland Heights, CA 91748 POLICY PERIOD: FROM 05/10/2023 TO 05/10/2024 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Dag and Cat rescue IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. LIMITS OF COVERAGE: GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS - COMPLETED OPERATIONS) $2,000,000 PRODUCTS - COMPLETED OPERATIONS AGGREGATE LIMIT .......................... $2,000,000 PERSONAL AND ADVERTISING INJURY LIMIT ................................................. $1,000,000 EACH OCCURRENCE LIMIT................................................................................ $1,000,000 DAMAGE TO PREMISES RENTED TO YOU ....................................................... $500, 000 anya- promises MEDICAL EXPENSE LIMIT...................................................................................... $20,000 any one Person ADDITIONAL COVERAGES: CLASSIFICATION(S) SEE ATTACHED SUPPLEMENTAL DECLARATIONS SCHEDULE G PREMIUM $2,331 FORMS AND ENDORSEMENTS APPLICABLE TO THIS POLICY ARE INCLUDED IN COMMERCIAL LINES COMMMON POLICY DECLARATIONS COUNTERSIGNED: 04/06/2023 BY '0. (AUTHORIZED REPRESENTATIVE) THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. NIAC-GL NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. COMMERCIAL GENERAL LIABILITY EXTENSION OF DECLARATIONS POLICY NUMBER: 2023 -59581 -NPO NAME OF INSURED: VIDA Volunteers in Defense of Animals PREMISES CODE/CLASS 45450/Kennels - breeding, boarding or sales ADDITIONAL COVERAGES Activities/Field Trips: Event # # of people 1 N/A 2 N/A 3 N/A Increased Aggregate NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www.insurancefornonprofits.org *LOC PREMIUM BASIS 1 25 Description Animal Adoptions Dog Foster Home (5) Cat Foster Homes (2) *See Common Declarations for Total Advanced Premium and Schedule 'L' for locations. Schedule G Page 1 RATE *ADVANCED PREMIUM 43.745 $1,093 K��e/0-. COUNTERSIGNED: 4/6/2023 BY NIAC - SCHEDULE G - NPO (AUTHORIZED REPRESENTATIVE) $500 $500 $50 $188 NMINONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. COMMERCIAL GENERAL LIABILITY EXTENSION OF DECLARATIONS POLICY NUMBER: 2023 -59581 -NPO NAME OF INSURED: VIDA Volunteers in Defense of Animals NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www.insurancefornonprofits.org Schedule L Page 1 PREMISES DESIGNATED PREMISES ADDITIONAL INSUREDS LOC/BLDG ADDRESS, CITY, STATE, ZIP AND OTHER INTERESTS 1 19142 E. Walnut Drive N. Rowland Heights, CA 91748 COUNTERSIGNED: 04/06/2023 BY NIAC - SCHEDULE L - NPO (AUTHORIZED REPRESENTATIVE) NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. PRODUCER: NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www.insurancefornonprofits.org COMMERCIAL LIQUOR LIABILITY COVERAGE PART DECLARATIONS CalNonprofits Insurance Services P.O. Box 640 Capitola, CA 95010 NAME OF INSURED AND MAILING ADDRESS: VIDA Volunteers in Defense of Animals 19142 E Walnut Dr. N Rowland Heights, CA 91748 POLICY NUMBER: 2023-59581 RENEWAL OF NUMBER: 2022-59581 POLICY PERIOD: FROM 5/10/2023 TO 5/10/2024 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Dog and Cat rescue IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. LIMITS OF COVERAGE: GENERAL AGGREGATE LIMIT.............................................................. $ 1,000,000 EACH COMMON CAUSE LIMIT.............................................................. $ 1,000,000 PREMIUM: Included FORMS AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE PART AND MADE PART OF THIS POLICY AT THE TIME OF ISSUANCE: CG 00 33 0413 THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. Notice: This risk pooling contract is issued by a pooling arrangement authorized by California Corporations Code Section 5005.1. The pooling arrangement is not subject to all of the insurance laws of the State of California and is not subject to regulation by the Insurance Commissioner. Insurance guaranty funds are not available to pay claims in the event the risk pool becomes insolvent. COUNTERSIGNED: NIAC - LL 4/6/2023 BY (AUTHORIZED REPRESENTATIVE) NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heartfor Nonprofits. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) INDEX OF FORMS ATTACHED TO THE POLICY POLICY NUMBER: 2023-59581 NAME OF INSURED: VIDA Volunteers in Defense of Animals LIABILITY FORMS AND ENDORSEMENTS Commercial General Liability Coverage Form Liquor Liability Coverage Form Additional Insured - Owners, Lessees or Contractors Additional Insured - Managers or Lessors of Premises Additional Insured - State or Political Subdivisions - Permits Additional Insured - Mortgagee, Assignee or Receiver Additional Insured - Charitable Institutions Additional Insured - Volunteers Additional Insured - Designated Person or Organization Additional Insured - Lessor of Leased Equipment - Automatic Status - Lease Additional Insured - Owners, Lessees or Contractors - Completed Operations Exclusion - Unmanned Aircraft Employment -Related Practices Exclusion Exclusion of Certified Acts of Terrorism Silica - Exclusion Health or Cosmetic Services Exclusion Products/Completed Operations Hazard Redefined Common Policy Conditions Nuclear Energy Liability Exclusion Endorsement (Broad Form) California Changes - Cancellation and Nonrenewal Business Auto Coverage Part Declarations Member Criteria Fiscal Sponsor Limitation Professional Services - Exclusion Fireworks Exclusion Lead Liability - Exclusion Firearms Sublimit Endorsement Blood Testing Exclusion Communicable Disease - Exclusion Communicable Disease - Exclusion Discrimination Exclusion Asbestos Exclusion Additional Insured - Designated Person or Organization Aggressive Dog - Exclusion Waiver of Transfer of Rights of Recovery Against Others Property Damage to Personal Property in the Care, Custody or Control of the Insured Cyber Incident - Exclusion Employee Personal Auto Reimbursement Mold, Fungus Exclusion This list of forms is not part of the actual policy, but is for your information only. Please refer to the policy(s) for actual limits, coverages and exclusions. www.insurancefornonprofits.org Page: 1 FORM NUMBER/EDITION DATE CG 00 01 04 13 CG 00 33 04 13 CG 20 10 12 19 CG 20 11 12 19 CG 20 12 04 13 CG 20 18 04 13 CG 20 20 1185 CG 20 2107 98 CG 20 26 12 19 CG 20 34 12 19 CG 20 37 12 19 CG 2109 06 15 CG 2147 12 07 CG 21 73 01 15 CG 21 96 03 05 CG 22 44 04 13 CG 24 07 01 96 IL 00 17 1198 IL 00 21 09 08 IL 02 70 12 19 NIAC-AL-NPO NIAC-EO03 GL 08 20 NIAC-EO69 GL 02 19 N IAC-EO78 1120 NIAC-E11 GL 09 19 NIAC-E120 09 19 NIAC-E123 09 19 NIAC-E15 09 20 NIAC-E180 GL 0121 NIAC-E180 LL 0121 NIAC-E195 GL 05 21 NIAC-E22 09 19 NIAC-E25 12 15 NIAC-E254 GL 1121 NIAC-E26 11 17 NIAC-E28 0199 NIAC-E282 GL 12 21 NIAC-E29 12 09 NIAC-E33 GL 09 19 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heartfor Nonprofits. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) INDEX OF FORMS ATTACHED TO THE POLICY POLICY NUMBER: 2023-59581 NAME OF INSURED: VIDA Volunteers in Defense of Animals www.insurancefornonprofits.org Page:2 LIABILITY FORMS AND ENDORSEMENTS FORM NUMBER/EDITION DATE Construction and Conversion Exclusion NIAC-E34 09 18 Anti -Stacking Condition NIAC-E342 GL 08 22 Nuclear, Chemical and Biological Hazard Exclusion NIAC-E42 GL 09 19 Trampoline Bounce House Exclusion NIAC-E5 07 15 Liberalization - GL, SSP, EBL NIAC-E56 01 17 Liberalization - LL NIAC-E59 02 12 Volunteer Medical Payments NIAC-E60 07 12 Additional Insured - Primary and Non -Contributory Endorsement for Public Entities NIAC-E61 02 19 Fundraiser and Event Endorsement NIAC-E70 03 19 Other Insurance - Coverage C NIAC-E72 01 17 Mental Anguish Endorsement NIAC-E74 03 14 Commercial General Liability Coverage Part Declarations NIAC-GL-NPO Commercial Liquor Liability Coverage Part Declarations NIAC-LL 0180 Nonprofits' OWN Enhancement Endorsement NIAC-NPO-001 05 20 Improper Sexual Conduct and Physical Abuse Exclusion NIAC-X1 06 18 Business Auto Coverage Schedule SCHEDULE BA 0180 Commercial General Liability Class Code Schedule SCHEDULE G 0180 Commercial General Liability Location Schedule SCHEDULE L 0180 This list of forms is not part of the actual policy, but is for your information only. Please refer to the policy(s) for actual limits, coverages and exclusions. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AGGRESSIVE DOG - EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM This insurance does not apply to, and the Company shall have no duty to defend any claim or "suit"for "bodily injury", "property damage" or "personal and advertising injury" arising out of the ownership, supervision, custody, fostering, adoption, or investigation of the prior history of an "aggressive dog", that you, or any person, or entity for whom you are legally responsible, has knowledge of any previous incident or history of physical injury caused by that "aggressive dog", which incident or injury took place prior to the occurrence or event that leads to a claim or "suit", regardless of any other acts, errors or omissions which occur concurrently or in any sequence to produce the claim or "suit". There is no coverage for, and the Company has no duty to defend any claim or "suit" against an "insured" which arises out of: a. the ownership, custody, or care of an "aggressive dog" by an insured or by any other person for whom an insured is legally responsible; b. the negligent supervision of any person or animal that has contact with an "aggressive dog"; c. an allegation of liability arising from an "aggressive dog" on any premises; d. any liability statutorily imposed on any insured or by any other person for whom an insured is legally responsible with respect to an "aggressive dog"; e. the actual or alleged failure to report to the proper authorities the presence or status of an "aggressive dog"; f. the performance or failure to perform a behavioral evaluation on an "aggressive dog"; g. any claim or "suit" for which you, any insured or any other person for whom an insured is legally responsible is legally obligated to pay damages by reason of the assumption of liability in a contract or agreement with respect to an "aggressive dog"; or h. the placement of an "aggressive dog" with a foster or adoption person, home or other entity. "Aggressive dog" as used in this endorsement shall mean a dog, which prior to the incident that forms the basis of a submitted claim or "suit', that was: 1. responsible for inflicting "severe injury" on a human being or animal on public or private property; 2. previously under investigation and deemed to be dangerous by animal control and/or local authorities; or 3. surrendered with a known history of biting resulting in "severe injury" or other violent behavior by the prior owner or a governmental entity, notwithstanding any subsequent finding to the contrary by you, an insured, by any other person for whom an insured is legally responsible or by an animal behavioralist. "Severe injury" means any physical injury that results in death, bleeding, muscle tears or disfiguring lacerations or requires multiple sutures or corrective or cosmetic surgery. This exclusion does not apply to a claim or "suit" for "bodily injury": arising out of services performed by you pursuant to a contract with a government entity for animal control which requires that you pick up, care for and/or retain custody of a dog but this exception does not extend to the placement of an "aggressive dog" with a foster or adoption person, home or other entity. All other terms and conditions of this policy remain unchanged. NIAC-E254 GL 1121 Nonprofits Insurance Alliance'"' and NONPROFITS OWN® are brands of Page 1 of 1 Alliance Member Services- (AMS). V AMS. All rights reserved. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heartfor Nonprofits. POLICY NUMBER: 2023-59581 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT FOR PUBLIC ENTITIES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: A. Section It —WHO IS AN INSURED is amended to include: 4. Any public entity as an additional insured, and the officers, officials, employees, agents and/or volunteers of that public entity, as applicable, who may be named in the Schedule above, when you have agreed in a written contract or written agreement presently in effect or becoming effective during the term of this policy, that such public entity and/or its officers, officials, employees, agents and/or volunteers be added as an additional insured(s) on your policy, 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 negligent acts or omissions; or b. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing operations. No such public entity or individual is an additional insured for liability arising out of the sole negligence by that public entity or its designated individuals. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. B. Section III — LIMITS OF INSURANCE is amended to include: 8. The limits of insurance applicable to the public entity and applicable individuals identified as an additional insured(s) pursuant to Provision A.4. above, are those specified in the written contract between you and that public entity, or the limits available under this policy, whichever are less. These limits are part of and not in addition to the limits of insurance under this policy. C. With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance a. Primary Insurance This insurance is primary if you have agreed in a written contract or written agreement: (1) That this insurance be primary. If other insurance is also primary, we will share with all that other insurance as described in c. below; or NIAC-E61 02 19 Page 1 of 2 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heartfor Nonprofits. POLICY NUMBER: 2023-59581 (2) The coverage afforded by this insurance is primary and non-contributory with the additional insured(s)' own insurance. Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has been added as an additional insured or to other insurance described in paragraph b. below. b. Excess Insurance This insurance is excess over: 1. Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for .your work"; (b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises temporarily occupied by you with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION I — COVERAGE A— BODILY INJURY AND PROPERTY DAMAGE. (e) Any other insurance available to an additional insured(s) under this Endorsement covering liability for damages which are subject to this endorsement and for which the additional insured(s) has been added as an additional insured by that other insurance. (1) When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured(s) against any "suit" if any other insurer has a duty to defend the additional insured(s) against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured(s)' rights against all those other insurers. (2) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self-insured amounts under all that other insurance. (3) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Methods of Sharing If all of the other insurance available to the additional insured(s) permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any other the other insurance available to the additional insured(s) does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. NIAC-E61 02 19 Page 2 of 2 NONPROFITS POLICY NUMBER: 2023-59581 FORM: NIAC-E25 12 15 INSURANCE NAMED INSURED: VIDA Volunteers in Defense of Animals ALLIANCE OF CALIFORNIA A Head for Insurance. A Heartfor Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION - FOOD CONTRIBUTIONS OR CLIENT REFERRALS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy, in consideration of food contributions or client referrals you receive from them. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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 the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted bylaw; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. NIAC-E25 12 15 Page 1 of 1 POLICY NUMBER: 2023-59581 Named Insured: VIDA Volunteers in Defense of Animals COMMERCIAL GENERAL LIABILITY CG 20 26 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART �-IH:I4rlr114 Name Of Additional Insured Person(s) Or Organization(s): Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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 the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 2023-59581 COMMERCIAL GENERAL LIABILITY Named Insured: VIDA Volunteers in Defense of Animals CG 20 34 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT - AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury' caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. B. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 34 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 2023-59581 Named Insured: VIDA Volunteers in Defense of Animals COMMERCIAL GENERAL LIABILITY CG 20 11 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): Name Of Person(s) Or Organization(s) (Additional Insured): Any person or organization acting as a manager or lessor of a covered premises that you are required to name as an additional insured on this policy, under a written contract, lease or agreement currently in effect, or becoming effective during the term of this policy. Additional Premium: Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. 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 insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 11 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 2023-59581 COMMERCIAL GENERAL LIABILITY Named Insured: VIDA Volunteers in Defense of Animals CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization that you are required to All insured premises and operations. add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". 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 insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section 111— Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 2023-59581 COMMERCIAL GENERAL LIABILITY Named Insured: VIDA Volunteers in Defense of Animals CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Any person or organization that you are required to All insured premises and operations. add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 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 insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury' or "property damage" occurring after: 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 CG 20 10 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 2 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. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 10 12 19 0 Insurance Services Office, Inc., 2012 Page 2 of 2 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ANTI -STACKING CONDITION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to include the following: 10. a. No coverage shall be afforded by this policy to an "Insured", other than the First Named Insured identified in the policy Declarations to which this endorsement is attached, if coverage for the claim or "suit' is afforded under any other policy issued by us to that other "Insured". b. Subject to a. above, if coverage is afforded by this policy, which damages are also covered under any other coverage form within a policy issued by us, the aggregate maximum limit of insurance under all coverages within all policies issued by us applicable to the claim or "suit", shall not exceed the highest applicable Limit of Insurance under any one coverage within any one policy. We shall, at our discretion identify the policy to which coverage for the submitted claim applies, and such policy shall be the sole and only policy written by us applicable to all such damages, regardless of the number of "Insureds", claimants, claims or "suits". Condition 10. a. above does not apply: To any "Insured", with whom the First Named Insured has agreed to indemnify under a contract or agreement for damages arising out of "bodily injury", "property damage". and/or "personal and advertising injury" for the claim or "suit". 2. To any coverage afforded within a policy issued by us to an 'Insured" which specifically applies as excess insurance over the coverage included within the policy to which this endorsement is attached. NIAC-E342 GL 08 22 Nonprofits Insurance Alliance*"' and NONPROFITS OWN® are brands Page 1 of 1 of Alliance Member Services'"' (AMS). 0 AMS. All rights reserved. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for lnsorante. A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ASBESTOS EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM This insurance does not apply to any claim, "suit" or rause of action for damages due to: 1. "Bodily injury', 'property damage", or "personal and advertising injury" arising or contributed, in whole or in part, by the actual, alleged, threatened or suspected inhalation of, contact with, exposure to, existence of or presence of asbestos or asbestos containing materials. 2. Any loss, cost or expense arising out of any: a. Request, demand or order that any "insured" or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to or assess the effects of asbestos or asbestos -containing materials; or b. Claim or suit by or on behalf of a governmental agency or entity for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to or assessing the effects of asbestos or assesses containing materials. We shall have no duty or obligation to provide or pay for the investigation or defense of any loss, cost, expense, claim or "suit" excluded under any provision set forth above. Defense and Supplementary Payments shall not apply to any loss, cost, expense, claim or "suit" excluded under any provision set forth above. NIAGE22 09 19 Page 1 of 1 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heort for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY BLOOD TESTING - EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SOCIAL SERVICES PROFESSIONAL LIABILITY COVERAGE FORM This insurance does not apply to any claim for damages arising out of: 1. Services in connection with the donating, drawing, or testing of blood, except for any evaluation, consultation or advice given by or on behalf of any insured in connection with such services; 2. Any error, omission, defect or deficiency in any such test performed; 3. The handling, transportation, distribution or storage of any blood product by any insured; or 4. The liability of any insured for the negligent hiring or supervision of any employee, volunteer, independent contractor, or agent of the insured with respect to any activities listed in 1. through 3. above. If coverage is extended under the Coverage Form to which this endorsement is attached for liability arising out of the acts, errors or omissions of a phlebotomist, this exclusion will nbt apply to the damages arising out of that liability. NIAC-E15 09 20 Page 1 of 1 IL 02 70 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALIFORNIA CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraphs 2. and 3. of the Cancellation 3. All Policies In Effect For More Than 60 Days Common Policy Condition are replaced by the a. If this policy has been in effect for more following: than 60 days, or is a renewal of a policy we 2. All Policies In Effect For 60 Days Or Less issued, we may cancel this policy only upon If this policy has been in effect for 60 days or the occurrence, after the effective date of less, and is not a renewal of a policy we have the policy, of one or more of the following: previously issued, we may cancel this policy by (1) Nonpayment of premium, including mailing or delivering to the first Named Insured, payment due on a prior policy we issued at the mailing address shown in the policy, and and due during the current policy term to the producer of record, advance written covering the same risks. notice of cancellation, stating the reason for (2) Discovery of fraud or material cancellation, at least: misrepresentation by: a. 10 days before the effective date of (a) Any insured or his or her cancellation if we cancel for: representative in obtaining this (1) Nonpayment of premium; or insurance; or (2) Discovery of fraud by: (b) You or your representative in (a) Any insured or his or her pursuing a claim under this policy. representative in obtaining this (3) A judgment by a court or an insurance; or administrative tribunal that you have (b) You or your representative in violated a California or Federal law, pursuing a claim under this policy. having as one of its necessary elements an act which materially increases any of b. 30 days before the effective date of Y the risks insured against. cancellation if we cancel for any other reason. IL 02 70 1219 0 Insurance Services Office, Inc., 2019 Page 1 of 4 (4) Discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or regulations establishing safety standards, by you or your representative, which materially increase any of the risks insured against. (5) Failure by you or your representative to implement reasonable loss control requirements, agreed to by you as a condition of policy issuance, or which were conditions precedent to our use of a particular rate or rating plan, if that failure materially increases any of the risks insured against. (6) A determination by the Commissioner of Insurance that the: (a) Loss of, or changes in, our reinsurance covering all or part of the risk would threaten our financial integrity or solvency; or (b) Continuation of the policy coverage would: (i) Place us in violation of California law or the laws of the state where we are domiciled; or (ii) Threaten our solvency (7) A change by you or your representative in the activities or property of the commercial or industrial enterprise, which results in a materially added, increased or changed risk, unless the added, increased or changed risk is included in the policy. b. We will mail or deliver advance written notice of cancellation, stating the reason for cancellation, to the first Named Insured, at the mailing address shown in the policy, and to the producer of record, at least: (1) 10 days before the effective date of cancellation if we cancel for nonpayment of premium or discovery of fraud; or (2) 30 days before the effective date of cancellation if we cancel for any other reason listed in Paragraph 3.a. B. The following provision is added to the Cancellation Common Policy Condition: 7. Residential Property This provision applies to coverage on real property which is used predominantly for residential purposes and consisting of not more than four dwelling units, and to coverage on tenants' household personal property in a residential unit, if such coverage is written under one of the following: Commercial Property Coverage Part Farm Coverage Part — Farm Property — Farm Dwellings, Appurtenant Structures And Household Personal Property Coverage Form a. If such coverage has been in effect for 60 days or less, and is not a renewal of coverage we previously issued, we may cancel this coverage for any reason, except as provided in b. and c. below. b. We may not cancel this policy solely because the first Named Insured has: (1) Accepted an offer of earthquake coverage; or (2) Cancelled or did not renew a policy issued by the California Earthquake Authority (CEA) that included an earthquake policy premium surcharge. However, we shall cancel this policy if the first Named Insured has accepted a new or renewal policy issued by the CEA that includes an earthquake policy premium surcharge but fails to pay the earthquake policy premium surcharge authorized by the CEA. c. We may not cancel such coverage solely because corrosive soil conditions exist on the premises. This restriction (c.) applies only if coverage is subject to one of the following, which exclude loss or damage caused by or resulting from corrosive soil conditions: (1) Commercial Property Coverage Part — Causes Of Loss — Special Form; or (2) Farm Coverage Part — Causes Of Loss Form — Farm Property, Paragraph D. Covered Causes Of Loss — Special. Page 2 of 4 © Insurance Services Office, Inc., 2019 IL 02 7012 19 d. If a state of emergency under California Law is declared and the residential property is located in any ZIP Code within or adjacent to the fire perimeter, as determined by California Law, we may not cancel this policy for one year, beginning from the date the state of emergency is declared, solely because the dwelling or other structure is located in an area in which a wildfire has occurred.However, we may cancel: (1) When you have not paid the premium, at any time by letting you know at least 10 days before the date cancellation takes effect; (2) If willful or grossly negligent acts or omissions by the Named Insured, or his or her representatives, are discovered that materially increase any of the risks insured against; or (3) If there are physical changes in the property insured against, beyond the catastrophe -damaged condition of the structures and surface landscape, which result in the property becoming uninsurable. C. The following is added and supersedes any provisions to the contrary: Nonrenewal 1. Subject to the provisions of Paragraphs C.2. and C.3. below, if we elect not to renew this policy, we will mail or deliver written notice, stating the reason for nonrenewal, to the first Named Insured shown in the Declarations, and to the producer of record, at least 60 days, but not more than 120 days, before the expiration or anniversary date. We will mail or deliver our notice to the first Named Insured, and to the producer of record, at the mailing address shown in the policy. 2. Residential Property This provision applies to coverage on real property used predominantly for residential purposes and consisting of not more than four dwelling units, and to coverage on tenants' household property contained in a residential unit, if such coverage is written under one of the following: Commercial Property Coverage Part Farm Coverage Part — Farm Property — Farm Dwellings, Appurtenant Structures And Household Personal Property Coverage Form a. We may elect not to renew such coverage for any reason, except as provided in b., c. and d. below. b. We will not refuse to renew such coverage solely because the first Named Insured has accepted an offer of earthquake coverage. However, the following applies only to insurers who are associate participating insurers as established by Cal. Ins. Code Section 10089.16. We may elect not to renew such coverage after the first Named Insured has accepted an offer of earthquake coverage, if one or more of the following reasons applies: (1) The nonrenewal is based on sound underwriting principles that relate to the coverages provided by this policy and that are consistent with the approved rating plan and related documents filed with the Department of Insurance as required by existing law; (2) The Commissioner of Insurance finds that the exposure to potential losses will threaten our solvency or place us in a hazardous condition. A hazardous condition includes, but is not limited to, a condition in which we make claims payments for losses resulting from an earthquake that occurred within the preceding two years and that required a reduction in policyholder surplus of at least 25% for payment of those claims; or (3) We have (a) Lost or experienced a substantial reduction in the availability or scope of reinsurance coverage; or (b) Experienced a substantial increase in the premium charged for reinsurance coverage of our residential property insurance policies; and the Commissioner has approved a plan for the nonrenewals that is fair and equitable, and that is responsive to the changes in our reinsurance position. c. We will not refuse to renew such coverage solely because the first Named Insured has cancelled or did not renew a policy, issued by the California Earthquake Authority, that included an earthquake policy premium surcharge. IL 02 70 12 19 © Insurance Services Office, Inc., 2019 Page 3 of 4 d. We will not refuse to renew such coverage solely because corrosive soil conditions exist on the premises. This restriction (d.) applies only if coverage is subject to one of the following, which exclude loss or damage caused by or resulting from corrosive soil conditions: (1) Commercial Property Coverage Part — Causes Of Loss — Special Form; or (2) Farm Coverage Part — Causes Of Loss Form — Farm Property, Paragraph D. Covered Causes Of Loss — Special. e. If a state of emergency under California Law is declared and the residential property is located in any ZIP Code within or adjacent to the fire perimeter, as determined by California Law, we may not nonrenew this policy for one year, beginning from the date the state of emergency is declared, solely because the dwelling or other structure is located in an area in which a wildfire has occurred. However, we may nonrenew: (1) If willful or grossly negligent acts or omissions by the Named Insured, or his or her representatives, are discovered that materially increase any of the risks insured against; (2) If losses unrelated to the postdisaster loss condition of the property have occurred that would collectively render the risk ineligible for renewal; or (3) If there are physical changes in the property insured against, beyond the catastrophe -damaged condition of the structures and surface landscape, which result in the property becoming uninsurable. 3. We are not required to send notice of nonrenewal in the following situations: a. If the transfer or renewal of a policy, without any changes in terms, conditions or rates, is between us and a member of our insurance group. b. If the policy has been extended for 90 days or less, provided that notice has been given in accordance with Paragraph C.1. c. If you have obtained replacement coverage, or if the first Named Insured has agreed, in writing, within 60 days of the termination of the policy, to obtain that coverage. d. If the policy is for a period of no more than 60 days and you are notified at the time of issuance that it will not be renewed. e. If the first Named Insured requests a change in the terms or conditions or risks covered by the policy within 60 days of the end of the policy period. f. If we have made a written offer to the first Named Insured, in accordance with the timeframes shown in Paragraph C.1., to renew the policy under changed terms or conditions or at an increased premium rate, when the increase exceeds 25%. Page 4 of 4 © Insurance Services Office, Inc., 2019 IL 02 70 12 19 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY PROPERTY DAMAGE TO PERSONAL PROPERTY IN THE CARE, CUSTODY OR CONTROL OF THE INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. It is agreed that the following is added to COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Number 2. Exclusions., Letter j. "Property damage" to: Item (4): (a) This exclusion applies to "property damage" to personal property in the care, custody or control of the insured when the personal property is valued greater than $25,000. This is excess over any other valid collectible insurance. (b) Defense costs arising from "property damage" to personal property in the care, custody or control of the insured are limited to $25,000 per claim or suit. NIAC E28 0199 Page 1 of 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - CHARITABLE INSTITUTIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. WHO IS AN INSURED (Section II) is amended to include as an insured: 1. Your members but only with respect to their liability for your activities or activities they perform on your behalf; and 2. Your trustees or members of the board of governors while acting within the scope of their duties as such on your behalf. CG 20 20 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 ❑ COMMERCIAL GENERAL LIABILITY CG 00 0104 13 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. (2) The "bodily injury" or "property damage" Read the entire policy carefully to determine rights, occurs during the policy period; and duties and what is and is not covered. (3) Prior to the policy period, no insured listed Throughout this policy the words "you" and "your" under Paragraph 1. of Section II — Who Is refer to the Named Insured shown in the Declarations, An Insured and no "employee" authorized and any other person or organization qualifying as a by you to give or receive notice of an Named Insured under this policy. The words "we", "occurrence" or claim, knew that the "bodily "us" and "our" refer to the company providing this injury" or "property damage" had occurred, insurance. in whole or in part. If such a listed insured The word "insured" means any person or organization or authorized "employee" knew, prior to the "bodily qualifying as such under Section II — Who Is An policy period, that the injury" or Insured. "property damage" occurred, then any continuation, change or resumption of such Other words and phrases that appear in notation P PP q "bodily injury" or "property damage" during marks have special meaning. Refer to Section V — or after the policy period will be deemed to Definitions. have been known prior to the policy period. SECTION I — COVERAGES c. "Bodily injury" or "property damage" which COVERAGE A — BODILY INJURY AND PROPERTY occurs during the policy period and was not, DAMAGE LIABILITY prior to the policy period, known to have 1. Insuring Agreement occurred by any insured listed under Paragraph 1. of Section II — Who Is An Insured a. We will pay those sums that the insured or any "employee" authorized by you to give or becomes legally obligated to pay as damages receive notice of an "occurrence" or claim, because of "bodily injury" or "property damage" includes any continuation, change or to which this insurance applies. We will have resumption of that "bodily injury" or "property the right and duty to defend the insured against damage" after the end of the policy period. any "suit" seeking those damages. However, d. "Bodily injury" or "property damage" will be we will have no duty to defend the insured deemed to have been known to have occurred against any "suit" seeking damages for "bodily 'property at the earliest time when any insured listed injury" damage" to which this under Paragraph 1. of Section II — Who Is An insurancea does not apply. We may, at our discretion, investigate any "occurrence" and Insured or any "employee" authorized by you to "occurrence" settle any claim or "suit" that may result. But: give or receive notice of an or claim: (1) The amount we will pay for damages is Re (1) Reports all, or any Part, of the "bodily injury" limited as described in Section III — Limits or "property damage" to us or any other Of Insurance; and insurer; (2) Our right and duty to defend ends when we (y) Receives a written or verbal demand or have used up the applicable limit of claim for damages because of the "bodily insurance in the payment of judgments or injury" or "property damage"; or settlements under Coverages A or B or medical expenses under Coverage C. (3) Becomes aware by any other means that No other obligation or liability to pay sums or "bodily injury" or "property damage" has perform acts or services is covered unless occurred or has begun to occur. explicitly provided for under Supplementary e. Damages because of "bodily injury" include Payments — Coverages A and B. damages claimed by any person or b. This insurance applies to "bodily injury" and organization for care, loss of services or death "bodily "property damage" only if: resulting at any time from the injury". (1) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place in the "coverage territory"; CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 1 of 16 2. Exclusions This insurance does not apply to: 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" resulting from the use of reasonable force to protect persons or property. b. Contractual Liability "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an "insured contract", reasonable attorneys' fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of "bodily injury" or "property damage", provided: (a) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same "insured contract"; and (b) Such attorneys' fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability "Bodily injury" or "property damage" for which any insured may be held liable by reason of: (1) Causing or contributing to the intoxication of any person; (2) The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol; or (3) Any statute, ordinance or regulation relating to the sale, gift, distribution or use of alcoholic beverages. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in: (a) The supervision, hiring, employment, training or monitoring of others by that insured; or (b) Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol; if the "occurrence" which caused the "bodily injury" or "property damage", involved that which is described in Paragraph (1), (2) or (3) above. However, this exclusion applies only if you are in the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages. For the purposes of this exclusion, permitting a person to bring alcoholic beverages on your premises, for consumption on your premises, whether or not a fee is charged or a license is required for such activity, is not by itself considered the business of selling, serving or furnishing alcoholic beverages. d. Workers' Compensation And Similar Laws Any obligation of the insured under a workers' compensation, disability benefits or unemployment compensation law or any similar law. e. Employer's Liability "Bodily injury" to: (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an "insured contract". Page 2 of 16 © Insurance Services Office, Inc., 2012 CG 00 0104 13 f. Pollution (d) At or from any premises, site or location (1) "Bodily injury" or "property damage" arising on which any insured or any contractors or out of the actual, alleged or threatened or subcontractors working directly discharge, dispersal, seepage, migration, "pollutants": indirectly on any ins hed's behalf are if t performing operations f the "pollutants" release or escape of are brought on or to the premises, site (a) At or from any premises, site or location or location in connection with such which is or was at any time owned or operations by such insured, contractor occupied by, or rented or loaned to, any or subcontractor. However, this insured. However, this subparagraph subparagraph does not apply to: does not apply to: (i) "Bodily injury" or "property damage" (i) "Bodily injury" if sustained within a arising out of the escape of fuels, building and caused by smoke, lubricants or other operating fluids fumes, vapor or soot produced by or which are needed to perform the originating from equipment that is normal electrical, hydraulic or used to heat, cool or dehumidify the mechanical functions necessary for building, or equipment that is used to the operation of "mobile equipment" heat water for personal use, by the or its parts, if such fuels, lubricants building's occupants or their guests; or other operating fluids escape from (ii) "Bodily injury" or "property damage" a vehicle part designed to hold, store for which you may be held liable, if or receive them. This exception does you are a contractor and the owner not apply if the "bodily injury" or or lessee of such premises, site or "property damage" arises out of the location has been added to your intentional discharge, dispersal or policy as an additional insured with release of the fuels, lubricants or respect to your ongoing operations other operating fluids, or if such performed for that additional insured fuels, lubricants or other operating at that premises, site or location and fluids are brought on or to the such premises, site or location is not premises, site or location with the and never was owned or occupied intent that they be discharged, by, or rented or loaned to, any dispersed or released as part of the insured, other than that additional operations being performed by such insured; or insured, contractor or subcontractor; (iii) "Bodily injury" or "property damage" (ii) 'Bodily injury" or "property damage" arising out of heat, smoke or fumes sustained within a building and from a "hostile fire"; caused by the release of gases, (b) At or from any premises, site or location fumes or vapors from materials brought into that building in which is or was at any time used by or connection with operations being for any insured or others for the performed you or your behalf handling, storage, disposal, processing by a contractor or subcontractor; or or treatment of waste; (c) Which are or were at any time (iii) "Bodily injury" or "property damage" arising out of heat, smoke or fumes transported, handled, stored, treated, l from a "hostile fire". disposed of, or processed as waste by or for: (e) At or from any premises, site or location (i) Any insured; or on which any insured or any contractors or subcontractors working directly or (it) Any person or organization for whom indirectly on any insured's behalf are you may be legally responsible; or performing operations if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants". CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 3 of 16 (2) Any loss, cost or expense arising out of any: (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants"; or (b) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". However, this paragraph does not apply to liability for damages because of "property damage" that the insured would have in the absence of such request, demand, order or statutory or regulatory requirement, or such claim or "suit" by or on behalf of a governmental authority. g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 26 feet long; and (b) Not being used to carry persons or property for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; or (5) "Bodily injury" or "property damage" arising out of: (a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged; or (b) The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment". h. Mobile Equipment "Bodily injury" or "property damage" arising out of: (1) The transportation of "mobile equipment" by an "auto" owned or operated by or rented or loaned to any insured; or (2) The use of "mobile equipment" in, or while in practice for, or while being prepared for, any prearranged racing, speed, demolition, or stunting activity. L War "Bodily injury" or "property damage", however caused, arising, directly or indirectly, out of: (1) War, including undeclared or civil war; (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. j. Damage To Property "Property damage" to: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; Page 4 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the contents of such premises, rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III — Limits Of Insurance. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products - completed operations hazard". k. Damage To Your Product "Property damage" to "your product" arising out of it or any part of it. I. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products - completed operations hazard". This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. m. Damage To Impaired Property Or Property Not Physically Injured "Property damage" to "impaired property" or property that has not been physically injured, arising out of: (1) A defect, deficiency, inadequacy or dangerous condition in "your product" or "your work"; or This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to "your product" or "your work" after it has been put to its intended use. n. Recall Of Products, Work Or Impaired Property Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: (1) "Your product"; (2) "Your work"; or (3) "Impaired property" if such product, work, or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it. o. Personal And Advertising Injury "Bodily injury" arising out of "personal and advertising injury". p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data. However, this exclusion does not apply to liability for damages because of "bodily injury". As used in this exclusion, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD- ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. q. Recording And Distribution Of Material Or Information In Violation Of Law "Bodily injury" or "property damage" arising directly or indirectly out of any action or omission that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; (2) The CAN -SPAM Act of 2003, including any amendment of or addition to such law; (2) A delay or failure by you or anyone acting (3) The Fair Credit Reporting Act (FCRA), and on your behalf to perform a contract or any amendment of or addition to such law, agreement in accordance with its terms. including the Fair and Accurate Credit Transactions Act (FACTA); or CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 5 of 16 (4) Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN -SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or information. Exclusions c. through n. do not apply to damage by fire 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. COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "personal and advertising injury" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit' seeking damages for "personal and advertising injury" to which this insurance does not apply. We may, at our discretion, investigate any offense and settle any claim or "suit' that may result. But: (1) The amount we will pay for damages is limited as described in Section III — Limits Of Insurance; and (2) Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments — Coverages A and B. b. This insurance applies to "personal and advertising injury" caused by an offense arising out of your business but only if the offense was committed in the "coverage territory" during the policy period. 2. Exclusions This insurance does not apply to: a. Knowing Violation Of Rights Of Another "Personal and advertising injury" caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict "personal and advertising injury". b. Material Published With Knowledge Of Falsity "Personal and advertising injury" arising out of oral or written publication, in any manner, of material, if done by or at the direction of the insured with knowledge of its falsity. c. Material Published Prior To Policy Period "Personal and advertising injury" arising out of oral or written publication, in any manner, of material whose first publication took place before the beginning of the policy period. d. Criminal Acts "Personal and advertising injury" arising out of a criminal act committed by or at the direction of the insured. e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement. f. Breach Of Contract "Personal and advertising injury" arising out of a breach of contract, except an implied contract to use another's advertising idea in your "advertisement". g. Quality Or Performance Of Goods — Failure To Conform To Statements "Personal and advertising injury" arising out of the failure of goods, products or services to conform with any statement of quality or performance made in your "advertisement'. h. Wrong Description Of Prices "Personal and advertising injury" arising out of the wrong description of the price of goods, products or services stated in your "advertisement". Page 6 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413 I. Infringement Of Copyright, Patent, Trademark Or Trade Secret "Personal and advertising injury" arising out of the infringement of copyright, patent, trademark, trade secret or other intellectual property rights. Under this exclusion, such other intellectual property rights do not include the use of another's advertising idea in your "advertisement". However, this exclusion does not apply to infringement, in your "advertisement", of copyright, trade dress or slogan. j. Insureds In Media And Internet Type Businesses "Personal and advertising injury" committed by an insured whose business is: (1) Advertising, broadcasting, publishing or telecasting; (2) Designing or determining content of web sites for others; or (3) An Internet search, access, content or service provider. However, this exclusion does not apply to Paragraphs 14.a., b. and c. of "personal and advertising injury" under the Definitions section. For the purposes of this exclusion, the placing of frames, borders or links, or advertising, for you or others anywhere on the Internet, is not by itself, considered the business of advertising, broadcasting, publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards "Personal and advertising injury" arising out of an electronic chatroom or bulletin board the insured hosts, owns, or over which the insured exercises control. I. Unauthorized Use Of Another's Name Or Product "Personal and advertising injury" arising out of the unauthorized use of another's name or product in your e-mail address, domain name or metatag, or any other similar tactics to mislead another's potential customers. m. Pollution "Personal and advertising injury" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants" at any time. n. Pollution -related Any loss, cost or expense arising out of any: (1) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants" or (2) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". o. War "Personal and advertising injury", however caused, arising, directly or indirectly, out of: (1) War, including undeclared or civil war; (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. p. Recording And Distribution Of Material Or Information In Violation Of Law "Personal and advertising injury" arising directly or indirectly out of any action or omission that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; (2) The CAN -SPAM Act of 2003, including any amendment of or addition to such law; (3) The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accurate Credit Transactions Act (FACTA); or (4) Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN -SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or information. CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 7 of 16 COVERAGE C — MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations; provided that: (a) The accident takes place in the "coverage territory" and during the policy period; (b) The expenses are incurred and reported to us within one year of the date of the accident; and (c) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for: (1) First aid administered at the time of an accident; (2) Necessary medical, surgical, X-ray and dental services, including prosthetic devices; and (3) Necessary ambulance, hospital, professional nursing and funeral services. 2. Exclusions We will not pay expenses for "bodily injury": a. Any Insured To any insured, except "volunteer workers". b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d. Workers' Compensation And Similar Laws To a person, whether or not an "employee" of any insured, if benefits for the "bodily injury" are payable or must be provided under a workers' compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing, instructing or participating in any physical exercises or games, sports, or athletic contests. f. Products -Completed Operations Hazard Included within the "products -completed operations hazard". g. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS — COVERAGES A AND B 1. We will pay, with respect to any claim we investigate or settle, or any "suit" against an insured we defend: a. All expenses we incur. b. Up to $250 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. c. The cost of bonds to release attachments, but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. 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 $250 a day because of time off from work. e. All court costs taxed against the insured in the "suit". However, these payments do not include attorneys' fees or attorneys' expenses taxed against the insured. f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. Page 8 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance. 2. If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the "suit", we will defend that indemnitee if all of the following conditions are met: a. The "suit" against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an "insured contract" b. This insurance applies to such liability assumed by the insured; c. The obligation to defend, or the cost of the defense of, that indemnitee, has also been assumed by the insured in the same "insured contract"; d. The allegations in the "suit" and the information we know about the "occurrence" are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee; e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee; and f. The indemnitee: (1) Agrees in writing to: (a) Cooperate with us in the investigation, settlement or defense of the "suit"; (b) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the "suit"; (c) Notify any other insurer whose coverage is available to the indemnitee; and (d) Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee; and (2) Provides us with written authorization to: (a) Obtain records and other information related to the "suit"; and (b) Conduct and control the defense of the indemnitee in such "suit". So long as the above conditions are met, attorneys' fees incurred by us in the defense of that indemnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.(2) of Section I — Coverage A — Bodily Injury And Property Damage Liability, such payments will not be deemed to be damages for "bodily injury" and "property damage" and will not reduce the limits of insurance. Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above, or the terms of the agreement described in Paragraph f. above, are no longer met. SECTION II —WHO IS AN INSURED 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. CG 00 01 04 13 0 Insurance Services Office, Inc., 2012 Page 9 of 16 2. Each of the following is also an insured: a. Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for: (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 employment 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; (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 Paragraph (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. (2) "Property damage" to property (a) Owned, occupied or used by; (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by; you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). b. Any person (other than your "employee" or "volunteer worker"), or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period, whichever is earlier; 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. 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. SECTION III — LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard": and c. Damages under Coverage B. Page 10 of 16 © Insurance Services Office, Inc., 2012 CG 00 0104 13 3. The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard". 4. Subject to Paragraph 2. above, the Personal And Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of: a. Damages under Coverage A; and b. Medical expenses under Coverage C because of all "bodily injury" and "property damage" arising out of any one "occurrence". 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 any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. You and any other involved insured must: (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or "suit", (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit" and (4) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative. CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 11 of 16 4. Otherinsurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance (1) This insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (i) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (ii) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; (iii) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; or (iv) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I — Coverage A — Bodily Injury And Property Damage Liability. (b) Any other primary insurance available to you covering liability for damages arising out of the premises or operations, or the products and completed operations, for which you have been added as an additional insured. (2) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. (3) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self- insured amounts under all that other insurance. (4) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; Page 12 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding web sites, only that part of a web site that is about your goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. "Auto" means: a. A land motor vehicle, trailer or semitrailer designed for travel on public roads, including any attached machinery or equipment; or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However, "auto" does not include "mobile equipment". 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time. 4. "Coverage territory" means: a. The United States of America (including its territories and possessions), Puerto Rico and Canada; b. International waters or airspace, but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above; or c. All other parts of the world if the injury or damage arises out of: (1) Goods or products made or sold by you in the territory described in Paragraph a. above; (2) The activities of a person whose home is in the territory described in Paragraph a. above, but is away for a short time on your business; or (3) "Personal and advertising injury" offenses that take place through the Internet or similar electronic means of communication; provided the insured's responsibility to pay damages is determined in a "suit" on the merits, in the territory described in Paragraph a. above or in a settlement we agree to. 5. "Employee" includes a "leased worker". "Employee" does not include a "temporary worker". 6. "Executive officer" means a person holding any of the officer positions created by your charter, constitution, bylaws or any other similar governing document. 7. "Hostile fire" means one which becomes uncontrollable or breaks out from where it was intended to be. 8. "Impaired property" means tangible property, other than "your product" or "your work", that cannot be used or is less useful because: a. It incorporates "your product" or "your work" that is known or thought to be defective, deficient, inadequate or dangerous; or b. You have failed to fulfill the terms of a contract or agreement; if such property can be restored to use by the repair, replacement, adjustment or removal of "your product" or "your work" or your fulfilling the terms of the contract or agreement. CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 13 of 16 9. "Insured contract" means: 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 to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract" b. A sidetrack agreement; c. Any easement or license agreement, except in connection with construction or demolition operations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road -beds, tunnel, underpass or crossing; (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (2) above and supervisory, inspection, architectural or engineering activities. 10. "Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker". 11."Loading or unloading" means the handling of property: a. After it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or "auto'; b. While it is in or on an aircraft, watercraft or "auto"; or c. While it is being moved from an aircraft, watercraft or "auto" to the place where it is finally delivered; but "loading or unloading" does not include the movement of property by means of a mechanical device, other than a hand truck, that is not attached to the aircraft, watercraft or "auto". 12."Mobile equipment" means any of the following types of land vehicles, including any attached machinery or equipment: a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public roads; b. Vehicles maintained for use solely on or next to premises you own or rent; c. Vehicles that travel on crawler treads; d. Vehicles, whether self-propelled or not, maintained primarily to provide mobility to permanently mounted: (1) Power cranes, shovels, loaders, diggers or drills; or (2) Road construction or resurfacing equipment such as graders, scrapers or rollers; e. Vehicles not described in Paragraph a., b., c. or d. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: (1) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment; or (2) Cherry pickers and similar devices used to raise or lower workers; f. Vehicles not described in Paragraph a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. Page 14 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413 However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" but will be considered "autos": (1) Equipment designed primarily for (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; (2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. However, "mobile equipment" does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered "autos". 13."Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions. 14."Personal and advertising injury" means injury, including consequential "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, committed by or on behalf of its owner, landlord or lessor; d. Oral or written publication, in any manner, of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral or written publication, in any manner, of material that violates a person's right of privacy; f. The use of another's advertising idea in your "advertisement"; or g. Infringing upon another's copyright, trade dress or slogan in your "advertisement". 15."Pollutants" mean any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed. 16."Products-completed operations hazard": a. Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and arising out of "your product" or "your work" except: (1) Products that are still in your physical possession; or (2) Work that has not yet been completed or abandoned. However, "your work" will be deemed completed at the earliest of the following times: (a) When all of the work called for in your contract has been completed. (b) When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. (c) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. b. Does not include "bodily injury" or "property damage" arising out of: (1) The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading" of that vehicle by any insured; (2) The existence of tools, uninstalled equipment or abandoned or unused materials; or (3) Products or operations for which the classification, listed in the Declarations or in a policy Schedule, states that products - completed operations are subject to the General Aggregate Limit. 17. "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this insurance, electronic data is not tangible property. CG 00 0104 13 © Insurance Services Office, Inc., 2012 Page 15 of 16 As used in this definition, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD- ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 18. "Suit" means a civil proceeding in which damages because of 'bodily injury", "property damage" or "personal and advertising injury" to which this insurance applies are alleged. "Suit' includes: a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 19."Temporary worker" means a person who is furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or short- term workload conditions. 20."Volunteer worker" means a person who is not your "employee", and who donates his or her work and acts at the direction of and within the scope of duties determined by you, and is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. 21. "Your product': a. Means: (1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a) You; (b) Others trading under your name; or (c) A person or organization whose business or assets you have acquired; and (2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your product'; and (2) The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 22. "Your work": a. Means: (1) Work or operations performed by you or on your behalf; and (2) Materials, parts or equipment furnished in connection with such work or operations. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your work" and (2) The providing of or failure to provide warnings or instructions. Page 16 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 0413 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declara- tions may cancel this policy by mailing or deliv- ering to us advance written notice of cancella- tion. 2. We may cancel this policy by mailing or deliver- ing to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancel- lation if we cancel for nonpayment of pre- mium; or b. 30 days before the effective date of cancel- lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be ef- fective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be suffi- cient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and re- cords as they relate to this policy at any time dur- ing the policy period and up to three years after- ward. D. Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at any time; IL 00 17 1198 b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in- surability and the premiums to be charged. We do not make safety inspections. We do not un- dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes in- surance inspections, surveys, reports or rec- ommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recom- mendations we may make relative to certifica- tion, under state or municipal statutes, ordi- nances or regulations, of boilers, pressure ves- sels or elevators. E. Premiums The first Named Insured shown in the Declara- tions: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representa- tive. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. IL 00 17 1198 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 13 NONPROFITS INSURANCE -M ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart far Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMUNICABLE DISEASE - EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM This insurance does not apply to, and we shall have no duty to defend, any claim or "suit" for "bodily injury", "property damage" or "personal and advertising injury" arising out of: 1. The actual or alleged transmission of a "communicable disease'; and/or 2. An act, error or omission by or on behalf of any "insured" in: a. The supervision, hiring, employment, training or monitoring of any person who transmits, is infected with, and/or alleged to be infected with a "communicable disease"; and/or b. Testing for a "communicable disease"; and/or c. The actual or alleged failure to prevent the spread of a "communicable disease"; and/or d. The actual or alleged failure to report a "communicable disease" to the authorities, including but not limited to the reporting or failure to report any person who is infected with or is alleged to be infected with a "communicable disease", and/or any place where there is or is alleged to be a presence or spread of a "communicable disease". "Communicable Disease" as used in this endorsement shall mean any contagious disease, illness or syndrome which is or has been transmitted to a person or place by bacteria, virus, fungi, protozoa, a toxic agent or any combination of these. All other terms and conditions of the Coverage Form to which this endorsement is attached remain unchanged. Optional Coverage Available Liability coverage for damages for "bodily injury", "property damage" or "personal and advertising injury" arising out of a "communicable disease" may be purchased as an optional coverage. This optional coverage is provided only if an additional premium has been paid and the Communicable Disease Liability Coverage endorsement has been attached to the Commercial General Liability Coverage Form. NIAC-E180 GL 0121 Includes copyrighted material of Insurance services Office, Inc. with its Page 7 of I permission. NONPROFITS INSURANCE _M ALLIANCE OF CALIFORNIA A Head for Insurance. A Neart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMUNICABLE DISEASE - EXCLUSION This endorsement modifies insurance provided under the following: LIQUOR LIABILITY COVERAGE FORM This insurance does not apply to, and we shall have no duty to defend, any claim or "suit" for damages because of "injury" arising out of: 1. The actual or alleged transmission of a "communicable disease"; and/or 2. An act, error or omission by or on behalf of any "insured" in: a. The supervision, hiring, employment, training or monitoring of any person who transmits, is infected with, and/or alleged to be infected with a "communicable disease"; and/or b. Testing for a "communicable disease"; and/or c. The actual or alleged failure to prevent the spread of a "communicable disease"; and/or d. The actual or alleged failure to report a "communicable disease" to the authorities, including but not limited to the reporting or failure to report any person who is infected with or is alleged to be infected with a "communicable disease", and/or any place where there is or is alleged to be a presence or spread of a "communicable disease". "Communicable Disease" as used in this endorsement shall mean any contagious disease, illness or syndrome which is or has been transmitted to a person or place by bacteria, virus, fungi, protozoa, a toxic agent or any combination of these. All other terms and conditions of the Coverage Form to which this endorsement is attached remain unchanged. NIAGE180 LL 01 21 Includes copyrighted material of Insurance Services Office, Inc. with its Page 1 of 1 permission. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONSTRUCTION AND CONVERSION EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM This insurance does not apply to "bodily injury", "property damage", "personal and advertising injury" or any claim for "damages" caused by or arising out of or in any way related to the following: 1. Any "construction" conducted by you or on your behalf; or, 2. "Your work" on any building or other structure which is deemed completed for which a claim relating to "construction" has been presented; or, 3. "Your work" which is completed and may need correction, replacement or repair. For purposes of this endorsement, "your work' will be deemed completed at the earliest of the following times: 1. When all of the work called for in your contract has been completed. 2. When all of the work to be done at each specific job site has been completed if your contract calls for work at more than one job site. 3. When that part of the work done at the job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. For the purpose of this endorsement, "construction" is defined as all operations, including "your work" caused by, arising out of or in any way related to original construction, development, conversion, demolition, remodeling and all other changes, structural and non-structural, to any building or structure. For purposes of this endorsement, "your work" is defined to mean work or operations performed by you or on your behalf and materials, parts or equipment furnished in connection with such work or operations. "Your work" is defined to include warranties or representation made at any time with respect to the fitness, quality, durability, performance or use of "your work"; and the providing of or failure to provide warnings or instructions. This exclusion does not apply to: 1. Service or maintenance of a building or structure which is owned by or leased to you; or, 2. "Construction", including "your work", that has not yet been completed or has not otherwise been abandoned. NIAC-E34 09 18 Page 1 of 1