HomeMy WebLinkAboutC-1689 - General liability and auto insurance• :.i;.y miwLt St
Named
Insured City of Newporeach
CERTIFICATE OF INSURANCE FOR.LEASE OF STATE -OWNED PROPERTY
This Is to certify that the zimperial Insurance Comp�a d
OF _nyy . mp y - C'_ / P�
Of Los Angeles, California
ess of mpany)
Has issued to City of Newport Beach
3300 Newport Boulevard, Newport Bea a `t914 is 92660
ess or insured)
the policy of General Liability Insurance herein described, which by the attachment of the State -Owned Property
Endorsement has been changed in accordance with the terms of the Endorsement. Coverages and limits of liability
under the policy are not less than:
Bodily Injury
$100,000 each person
$200,000 each occurrence
Property Damage
$50,000 each person
$50,000 each occurrence
STATE -OWNED PROPERTY ENDORSEMENT
This endorsement is attached to the policy described herein to assure compliance by the named insured with the
terms and provisions of the lease (or rental agreement) entered into between the insured as Lessee and the State
of California as Lessor.
The Company amends the policy described herein as follows:
1. If the policy is canceled or changed so as to affect the coverages, at least fifteen (15) days' prior written
noticeof such cancellation or change will he sent to the Lessor State of California at the following address:
Box 2304 Terminal Annex, Los Angeles, California 90051
• 2. If the policy contains any clause excluding coverage as to property in the care, custody or control of the in-
sured, such clause shall not apply with regard to any liability of the State of California, its officers, agents,
or employees.
3. The Lessor State of California, its officers, agents, and employees are hereby declared to be additional in-
sureds Mille policy described insofar as they may be held liable for injuries, deaths, or damage to property oc-
curing in or about the leased premises.
This endorsement, countersigned by an authorized representative of the Company, becomes applicable endorsement
number 9
Effective Date of Policy: February 1, 1975
Expiration Date of Policy: February 1,. 1976
Dated: March 31 1975 , at Newport Beach, California
iy ae
Name of Agent or Broker: American National General Agencies, Inc.
IMPORTANT - . THIS FORM IS THE ONLY CERTIFICATE OF INSURANCE ACCEPTABLE TO THE
STATE OF CALIFORNIA
I. MAN-42 JULY 77 R..
a
�i
j
1
Policy NO. GLA 91 IU99
Named
Insured City of Newport Beach
CERTIFICATE OF INSURANCE FOR.LEASE OF STATE -OWNED PROPERTY
This is to certify that the . Imperial insurance : 2 . C- AW
�e oTC�n y
Of Los Angeles, California
(Address of mpany) .
Has issued to Ci
3300 Newpo
of Newport Beach
rt Boulevard
the policy of General Liability insurance herein described• which by the attachment of the State -Owned Property
Endorsement has been changed in accordance with the terms of the Endorsement. Coverages and limits of liability
under the policy are not less than
Bodily Injury Property Damage
$100,000 each person $50,000 each person
$200,000 each occurrence $50,000 each occurrence
STATE -OWNED PROPERTY ENDORSEMENT
This endorsement is attached to the policy described herein to assure compliance by the named insured with the
terms and provisions of the lease for rental agreement) entered into between the Insured as Lessee and the State
of California as Lessor.
The Company amends the policy described herein as follows:
1. If the policy is canceled or Changed so as to affect the coverages, st least fifteen (15) days' prior written
noticeof such cancellation or change will he sent to the Lessor State of California at the following address:
Box 2304 Terminal Annex, Los Angeles, California 90051
• 2. If the policy contains any clause excluding coverage as to property in the care, custody or control of the in-
sured, such clause shall not apply with regard to any liability of the State of California, its officers, agents,
or employees.
3. The Lessor State of California, its officers, agents, and employees are hereby declared to be additional in-
sureds inthe policy described insofar as they may be held liable for injuries, deaths, ordamageto propertyoc-
curing in or about the leased premises.
This endorseiribnt.countersigned by an authorized representative of the Company, becomes applicable endorsement
number 10
Effective Date of Policy: February 1, 1975
Expiration Date of Policy: February 1, 1976
Dated: April 1 lg 75 at Newoort Beach, California
cy ae
Name of Agent or Broker: American National General Agencies, Inc.
A dress of Agent Broker: 3200 Wilshire Blvd., South Tower Suite 1208
Qyj _ , , `j% n/ , -,., Los Angeles, California 900111
IMPORTANT - THIS FORM IS THE ONLY CERTIFICATE OF INSURANCE ACCEPTABLE TO THE
STATE OF CALIFORNIA.
1 NAN.tf 1111r 0 1 No
�i ui, aeastiore DR & S.A.
Policy No. GLA' 9i 7099 River, NptBch
Named
Insured CITY OF NEWPORT BEACH
CERTIFICATE OF INSURANCE FOR LEASE OF STATE -OWNED PROPERTY
This is to certify that the IMPERIAL INSURANCE COMPANY 1
JIMMIM 0 omP Y
of-Los Angeles, California
(Address of mpany)
Has issued to Q
3300 NEWPORT BOULEVARD, NEWPORT BEA Ham CA Wf IA 92tK
ess or nsure
the policy of General Liability Insurance herein described, which by the attachment of the State -Owned Property
Endorsement hasbeenehanged in accordance with the terms of the Endorsement. Coverages and limits of liability
under the policy we not less than:
Bodily Injury Property Damage
$100,000 each person $50,000 each person
$200,000 each occurrence $50,000 each occurrence
STATE -OWNED PROPERTY ENDORSEMENT
This endorsement is attached to the policy described herein to assure compliance by the named insured with the
terms and provisions of the lease (or rental agreement) entered into between the Insured as Lessee and the State
of California as Lessor.
The Company amends the policy described herein as follows:
1. If the policy is canceled or changed so as to affect the coverages, at least fifteen (15) days' prior written
noticeof such cancellation or change willbe senttd the Lessor State of California at the following address:
Box 2304 Terminal Annex, Los Angeles, California 90051
2. If the policy contains any clause excluding coverage as to property in the care, custody or control of the in-
sured, such clause shall not apply with regard to any liability of the State of California, its officers, agents,
or employees.
3. The Lessor State of California, its officers, agents, and employees are hereby declared to be additional in-
sureds inthe policy described insofar as they may be held liable for injuries, deaths, or damage to property oo
curing in or about the leased premises.
This endorsement. countersigned by an authorized representative of the Company, becomes applicable endorsement
number R
Effective Date of Policy: Fphruar;g 1 . 1975
Expiration Date of Policy:. February 1, 1976
Dated: 3/17 7875 , at Newport Beach California
.y ae
Name of Agent or Broker: AMERICAN NATIONAL GENERAL AGENCIES, INC.
RESOLUTION NO. 8437
A RESOLUTION OF THE CITY COUNCIL OF THE CITY
OF NEWPORT BEACH AWARDING A CONTRACT FOR
i AUTOMOTIVE AND COMPREHENSIVE PUBLIC LIABILITY
INSURANCE COVERAGE
WHEREAS, the Insurance Committee has held a number
of meetings with the City's Insurance Broker for the purpose
of reviewing the City's insurance specifications "and the
bids received for the City's coverage for 1975; and
WHEREAS, the Insurance Committee has recommended
that the City's general liability policy for next year should
be awarded to Imperial Insurance Company as the primary carrier
and Signal Insurance Company as the excess carrier;
NOW, THEREFORE, BE IT RESOLVED that the City Council
of the City of Newport Beach accepts the recommendation of the
Insurance Committee and hereby awards the City insurance
contract for the period commencing on February 1, 1975, and
ending on January 31, 1976, to Imperial Insurance Company as
the primary general liability carrier and Signal Insurance
Company as the excess umbrella liability carrier.
BE IT FURTHER RESOLVED that the Mayor and City Clerk
are hereby authorized and directed to execute a contract in
accordance with this award and on behalf of the City of Newport
Beach.
ADOPTED this 10th day of February , 1975
Mayor
ATTEST:
City Clerk
DDO /bc
2/6/75
Acs - 44
" 6/25/75 Ansunnee broken, ino.
MI M /GARVEY
1617 WESTCLIFF DRIVE I SUITE 2041 NEWPORT BEACH, CALIFORNIA 91660
012 -02740 714/6454M
FCITY OF NEWPORT BEACH ReA Address: 3720 Campus Drive
3300 NEWPORT BOULEVARD Newport Beach, Ca. 92890
NEWPORT BEACH, CAL. 92660 5714) 549.9952
1.--
N! 9759
V
PLEASE RETURN THIS
PORTION TO INSURE
PROPER
THANK YOUEOIT.
S
0
Payment Enclosed
DENT
MORTGAGEE:
..Ne. BIKING PERIOD C 6 T POLICY NO. 6 DESCRIPTION BALANCE
CHARGE CREDIT.
19 5/27/75- 543 Policy # VEL304756 -$2 751.
2/1/76 eturnPremium:
Cancellation of Umbrella
Excess Liability issued � i'� ``V ;.
through Signal Ins. Co.
ff. 5/27/75 r J
(Coverage re /written ,,�L?1''•
• �r Df
Premiums Due and Payable on Effective Dares of Policy .jTNi,0?5 Br w
MILUM /GARVEY �• CAUf. j
01T, O-CeLkg
FiLc
Ss4n ~c.. Cr. .
5
PREMIUM
Premiums Due and Payable on Effective Dares of Policy .jTNi,0?5 Br w
MILUM /GARVEY �• CAUf. j
01T, O-CeLkg
FiLc
Ss4n ~c.. Cr. .
5
` ENDORSEMENT RETURN PREMIUM $14,245.
r IN CONSIDERATION OF A RETURN PREMIUM OF $14,245. IT IS UNDERSTOOD AND
AGREED THAT THIS POLICY IS CANCELLED EFFECTIVE:
MAY 27, 1975
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the inception date of the
policy to which it is attached unless otherwise stated below.
The following spaces are to be completed only if this endorsement is not attached to the policy when issued.
12:01 A. 14. PAY 27, 1975m ^„ i Vi1 ' MAY 29 _^
POLICY NO. ISSUED TO .
VEL 304756 CITY OF NEWPORT BEACH -�
Countersigned on behalf of It Signal Insurance Company
O Imperial Insurance Company
B y
GrOWtlBRi ULY AUTHORISED REPRESENTATIVE OF THE C...
51.123. (S/)41
y
0 ENDORSEMENT RE7W PREMIUM $14,245.
IN CONSIDERATION OF A RETURN PREMIUM OF $14,245. IT IS UNDERSTOOD AND
AGREED THAT THIS POLICY IS CANCELLED EFFECTIVE:
MAY 27, 1975
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the inception date of the
policy to which it is attached unless otherwise stated below.
The following spaces are to be completed only if this endorsement is not attached to the policy when issued.
AFTER I CND.
12:01 A.M. MAY 27. 1975
POLICY NO. ISSUED TO
VEL 304756 CITY OF NEWPORT BEACH - -�'
Countersigned on behalf of X Signal Insurance Company
C1 Imperial Insurance Company
Presi By ULY AUTHORIZED REPRESENTATIVE OF THE COMPAN
SI'IZ3A 12(] +1
I
NERAL LIABILITY- AUTOMOBILE POLO
DCLARATIONS.— Y
IVs. GLA 917099
Item 1: Named Insured and Address (Na �trgp ;.,lTgwi, or city, county, state)
EAC
THE CITY OF NEWPORT BH
3300 NEWPORT BLVD.
NEWPORT BEACH, CALIFORNIA 92660 ; ,=
Item 2. Policy Period: (Mo. Day Yr.)
From FEBRUARY 1,, 1975 to Y 1, 1978
12:01 A.M., standard time at the address of the named insured as stated herein.
IMPERIAL IN
F
Los Af4
A SS
FORMA, C
1Ny
MILUZA /GARV Y
_ The named insured is: _
❑ Individual ❑ Partnership ❑ Corporation ❑ Joint Venture ® Other: MUNICIPALITY
Business of the named insured is: (ENTER BELOW) Audit Period: Annual, unless otherwise stated. (EnTEa .FLOW)
MUNICIPALITY FLAT CHARrE
Item 3. The insurance afforded is only with respect to the Coverage Partls) indicated below by specific premium charge(s) and attached to and forming a
part of this policy.
Advance
Premiums
Coverage
Part No(s).
Coverage Part(s)
Advance
Premiums
Coverage
Part No(s),
Coverage Part(s)
-
$
Automobile Medical Payments Insurance
$
Manufacturers and Contractors Liability
Insurance
$
Automobile Physical Damage Insurance
( Dealers)
$
Owner's and Contractors Protective Liability
Insurance
$
INCLUDED
A 120a
Automobile Physical Damage Insurance
(Fleet Automatic)
$
Owners, Landlords'and Tenants' Liability
Insurance
$
Automobile Physical Damage Insurance
(NomFlmrt)
$
Personal Injury Liability Insurance
$
Completed Operations and Products Liability
Insurance
$
Physicians,Surgeons'and 0emists'Professionel
Liability Insurance
$
Comprehensive Automobile Liability Insurance
$
Premises Medical Payments Insurance
$
Comprehensive General Liability Insurance
$
Protection Against Uninsured Motorists Insurance
$
Comprehensive Personal Insurance
$
Special Protectiveand Highway Liability Insurance
Mew York Department at Transportation
$
Contractual Liability Insurance
$
Druggists' Liability Insurance
$
Storekeeper's Insurance
$
Elevator Collision Inwronce
$
171,939.
MUNICIPALITY POLICY —
AS PER ATTACHED FORM
$
Farm Employers Liability and Farm Employees
Medical Payments Insurance
$
Farmer's Comprehensive Personal Insurance
$
$
Farmers Medical Payments Insurance
$
Garage Insurance
$
is
Hospital Professional Liability Insurance
Form numbers of endorsements,
SI -123A, SI -207 other than Moss entered as
$ Coverage Perlis), attached at issue
1$ 171,939, Total Advance Premium for this policy. 1
"If the Policy Period is more than one year and the premium is to be paid in installments, premium is payable on:
Effective Date 1st Anniversary 2nd Anniversary
$171,939. STO BE DETERMINED TO BE DETERMINED.
Item 4. During the past three years no insurer has cancelled insurance, issued to the named insured, similar to that afforded hereunder, unless otherwise
stated herein:
Countersigned: FEBRUARY 19, 1975 JV
-Not applicable in Texas -
BY -
Authorized Representative
IMP 213 (1 -73)
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sasiwaJtl wail Aeme sun000 pue pauopuege Jo palaldwoa uaaq alley suopwado vans
Jal ;e sw000 aHewep Aliadoid Jo Aunful Appoq awl;! Alan inq'olauayl laadsau glim
awg Aug le apew Aluellem Jo uoileluasaudau a each aouepai Jo suogeuado ;o ;no
Hwsue aHewep Aluadoud pue Aunful Appoq sapnhw „Puezey suoileuado palaldwoa„
P
awnsse si A i i ei of m Jo 1139Jlu03 le ;uaP!ou! lie Japan paunsu! awl Aq
1.1.q .I 4 .4 t (E) Jo 'Puezey aHewep A ;uadoud punwauapun awl Jo
piezeq suapeuado palaldwoo awl u!yl!m papnlou! (Z) uo 'suolaeu;uoa luapuadapul
Aq paunsw paweu awl Jo; pawuo }uad suogeuado ;o Ina 8uisue (1) aHewep Aliadoid
apnhu! 10u saop Puezey asdepoo awl 'loauayl luoddns Ieunjanils Aue 10 8u!PlingaJ
Jo ]enowaJ Jo aun ;onuls Jo 8wpllnq Aue to uog!lowap uo 8u!sleu '8uwuidiapun
'8uuoys '8ulnow (Z) Jo quoin uOsSIE3 uo quoin wepuagoo '8u!Aup alid '8uplauunl
'8uio1; -goeq 'Hap]!; 'Huimwuoq '8ul ;eHM 'pue] 10 Hu1po,? lu of anp ainlowas
10 8u!pl!ng Aug of Aunful lwnlowis uo ;o asdei)oo ay; sueaw „aHewep Aliadoid
-yeunlo4%, 'uroutaiayl Hugmsau awl; Aue le Aliadoid uaglo Aug of aHewep Aliadoid
Pug uiauay pawaap se „aHewep Aliadoid leinlanils, sapnlou! „plez¢y asdepoo„
8u1 nsai awi Aug a 'wowauayl
ll 3 3 43eap 8ulpnloui 'polJad Ao!lod awl 8ulunp vn000 yoiym
uosuad Aug Aq pawelsns aseaslp Jo ssaugo!s 'AJnfui Alpoq sueaw „Aunful Alipoq„
. o aia - ;luawdinba lllgow apnhoi,lou-saop anq
13 47 payoelle sn ;euedde JO ,cJaui4dULU due lUlpnloul) spew DHgnd uo IM11
allg'SaP Jal!wl [was Jo Jal!eq 'ahlyan Jolow puel a sueaw „apgowolne„
!Pewuoo leluap!ou! up Japan pwnsui awl Aq pawnsse s!.Al!l!ge!l yoiym Jot p
Jot (q) Jo 'Puezey aHewep Aliadoid punouHiapun awl Jo Puezey suogeuado palald
#I SN0111NId30
poauay lied a HWwJOl sluawasioowa 8uipnhup Aogod s!yl ui pasn uayM
'Aallod siyl ;o swat ay1 ;o pfohloafgns Out }oauay aJed a apew soopeuehap ay) u! sluawalels awl uodn aauenai u! 'wn!uJaJd a all osuawded awl awl y;im saw8e
I . - ,.z,.” -,X. awl t l to uopeuap!suoo w
(Auedwoa awl papeo waJay'Auedwou aouemsui yaolS y)
INVJKOJ DMIISNI 7VIIIdWI
1 ENDORSEMENT
EXCLUSION
MALPRACTICE AND PROFESSIONAL SERVICES
i
IT IS AGREED THAT THIS INSURANCE DOES NOT APPLY TO BODILY INOURY OR
PROPERTY DAMAGE DUE TO:
1. THE RENDERING OF OR FAILURE TO RENDER
(A) MEDICAL, SURGICAL, DENTAL, X -RAY OR NURSING SERVICE OR
TREATMENT, OR THE FURNISHING OF FOOD OR BEVERAGES IN
CONNECTION THEREWITH;
(B) ANY SERVICE OR TREATMENT CONDUCIVE TO HEALTH OR OF A
PROFESSIONAL NATURE; OR
(C) ANY COSMETIC OR TONSORIAL SERVICE OR TREATMENT;
2. THE FURNISHING OR DISPENSING OF DRUGS OR MEDICAL, DENTAL OR SURGICAL
SUPPLIES OR APPLIANCES; OR
3. THE HANDLING OF OR PERFORMING OF AUTOPSIES ON DEAD BODIES.
4. BODILY INJURY OR PROPERTY DAMAGE DUE TO THE RENDERING OF OR FAILURE
TO RENDER ANY PROFESSIONAL SERVICE.
i
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the inception date of the policy
to which it is attached unless otherwise stated below.
The following spaces are to be completed only if this endorsement is not attached to the policy when issued.
THIS ENDORSEMENT EFFECTIVE FROM AND APTLR END. NO. DATE
4
POLICY NO. ISSUED TO
GLA 917099
Countersign on behalf of ❑ Signal Insurance Company
IMP03, lnsurence Company
PrasiEent By DY LY gYTNORIZED RL PRESENTATIVE OF THR COMPANY
.^.. Ar ilJ' II"%8.'::•'.�i"Y�_�iG6.^yLY`.ic '" :... �' " "{.fir w. '�i.Ai�`� K��t��
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ENDORSEMENT
EXCLUSION
( VOLUNTEER WORKERS )
IT IS AGREED THAT COVERAGE A - BOWY INJURY LIABILITY EXCLUDES
COVERAGE FOR BODILY INJURY TO OR SICKNESS, DISEASE OR DEATH OF
ANY VOLUNTEER WORKER ENGAGED IN RESCUE SQUAD AND AMBULANCE CORPS
OPERATIONS WHO IS INJURIED OR KILLED IN THE COURSE OF ACTIVITIES
AS A VOLUNTEER WORKER IN RESCUE SQUAD OR AMBULANCE CORPS OPERATIONS.
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the inception date of the I
Policy to which it is attached unless otherwise stated below -
The following spaces are to be completed only if this endorsement is not attached to the policy when issued.
TXIS ENDORSEMENT EFFECTIVE FROM Arve •c��-
GLA 917099
SI -12.A (2/7.)
7 NO.
ATE
Countersigned on behalf of ❑ Signal Insurance Company
lm penal Insurance Company
President By
DULY AVTHORI U REPRESENTATIVE OF THE CDMPANY
ENDORSEMENT
EXCLUSION '
HOSPITALS AND.A10PORTS
1N.CONSIDERATfON-4F.,4."W, REDUCED PREMIUM CHARGES, IT IS AGREED.
THAT THE POLICY1XItMES ALL CLAIMS ARISING OUT OF OR PROXIMATELY
CAUSED BY THE OWNERSHIP, MAINTENANCE, OPERATION OR USE OF THE
FOLLOWING: ;
I., .HOSPITALS AND CLINICS
2. AIRPORTS
This endorsement when countersigned by a duly authorized representative of the Company shall take effect an the inception date of the
policy to which it is attached unless otherwise sfiked-below.
The following spaces are to Abe completed only if this endorsement is not attached to the policy when issued.
THIS ENDORSEMENT EFFECTIVE FROM AND AFTER END. NO. DATE
GLA 917099
5
Countersigned on be I half of 0 Signal Insurance C6mpanV
)(XInjWriaI Insurance Company
By—
DULY AUTHORIZED REPRESENTATIVE OF THE COMPANY
xr -.,�
nom•.. -
3VL T hn�^ 9'1 '1"
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ENDORSEMENT .
EXCLUSION
( VOLUNTEER FIREMAN )
IT IS AGREED THAT THE INSURANCE DOES NOT APPLY TO BODILY INJURY
TO ANY VOLUNTEER FIREMAN, WHETHER OR NOT A MEMBER OF THE NAMED
INSURED'S ORGANIZATION, WHILE IN THE COURSE OF HIS DUTIES AS SUCH.
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the inception date of the
policy to which it is attached unless otherwise stated below.
The following spaces are to be completed only if this endorsement is not attached to the policy when issued.
THIS ENDORSEMENT EFFECTIVE FROM ANO AFTER END. NO. DATE
6
POLICY NO. ISSUED TO
Countersigned on behalf of ❑ Signal Insurance Company
J /
A1Iurance Company
O�Ljvel_ / o 1/ .
FIE itl211t By DULY AUTHORIZED REPRESENTATIVE OF THE COMPANY
SI -123A (2 /)4)
.
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• ENDORSEMENT
AMENDATORY ENDORSEMENT
IT IS AGREED THAT ITEM 3 DEFINITIONS: (A) OCCURRENCE ON PAGE 6 OF
MUNICIPALITY POLICY IS AMENDED TO READ AS FOLLOWS:
"OCCURRENCE" MEANS AN ACCIDENT, INCLUDING CONTINUOUS OR
REPEATED EXPOSURE TO CONDITIONS, WHICH RESULTS IN BODILY
INJURY OR PROPERTY DAMAGE NEITHER EXPECTED NOR INTENDED
FROM THE STANDPOINT OF THE INSURED.
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the inception date of the
policy to which it is attached unless otherwise stated below.
The following spaces are to be completed only if this endorsement is not attached to the policy when issued.
TO
GLA 917099
Presitl ent
51 -123A (2/74)
Countersigned on behalf of ❑ Signal Insurance Company
C( Imperial Insurance Company
By
DULY AUTHORIZED REPRESENTATIVE OF THE COMPANY
{
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it
ENDORSEMENT
EXCLUSION
( INVERSE CONDEMNATION }
"IN CONSIDERATION OF THE PREMIUM CHARGED, IT IS AGREED THAT SUCH
INSURANCE AS IS PROVIDED BY THE POLICY DOES'NOT APPLY TO`CLAIMS
OR SUITS ARISING OUT OF, RESULTING FROM, OR PRONIMATELY CAUSED BY,
INVERSE CONDEMNATION. THERE SHALL BE NO OBLIGATION OR DUTY ON
BEHALF OF THE COMPANY TO INVESTIGATE OR DEFEND OR PAY FOR THE COST
OF INVESTIGATING OR DEFENDING SUCH CLAIMS OR SUITS."
This endorsement when countersigned by a duly authorized 'representative of the Company *Wi take effect on the inception date of the
policy to which it is attached unless otherwise stated below.
The following spaces are to "be completed only if this endorsement is not attached to the policy when issued.
2 °-
POLICY No. ISSUED TO
GLA 917099
Countersigned on behalf of ❑ Signal Insurance Company
[M Imperial Insurance Company .`
i
/ BY -:1
PfEeident DULY AUTHORIZED REPRESENTATIVE OF THE COMPANY '
SP-1$3A IZ /Tll
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MAK -1
-70071777 MY
• ENDORSEMENT
POLLUTION AND CONTAMINATION
( EXCLUSION )
IT IS AGREED THAT THE INSURANCE DOES NOT APPLY TO BODILY INJURY
OR-PROPERTY DAMAGE ARISING OUT OF THE DISCHARGE, DISPERSAL, RELEASE
OR ESCAPE OF.SMOKE, VAPORS, SOOT, FUMES, ACIDS, ALKALIS, TOXIC
CHEMICALS, LIQUIDS OR GASES, WASTE MATERIALS OR OTHER IRRITANTS,
CONTAMINANTS OR POLLUTANTS INTO OR UPON LAND, THE ATMOSPHERE OR ANY
WATERCOURSE OR BODY OF WATER; BUT THIS EXCLUSION DOES NOT APPLY IF
SUCH DISCHARGE, DISPERSAL, RELEASE OR ESCAPE IS SUDDEN AND ACCIDENTAL.
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the inception date of the
policy to which it is attached unless otherwise stated below.
The following spaces are to be completed only if this endorsement is not attached to the policy when issued.
THIS ENDORSEMENT EFFECTIVE FROM AND AFTER END, NO. DATE
_ 3
POLICY NO, ISSUED TO
GLA 917099
Countersigned on behalf of El Signal Insurance Company
X.Xlmper ial Insurance Company
�l t�,y{/G /jQGLfQ•j
PI251tl 211' By DULY AUTHORIZED REPRESENTATIVE OF THE COMPANY
SI -I"A 131741
or 1
7MYT PHT,TgMT rj7qnj ?I Ti
173"A WrAn 7232010 n''
"T 1472A 1:1, AM- M"? 7pr''y wyny2,,fin --qlzq -r'
77M. - 77
AM rT OTRI 270- * SP A -TV 7MAM'
TM bit f M 47— 7 ' T T9SqPjTfK 10 10 7"
r"n F7q7-7 yj 7nnn?� 110517P WAY700" 300""27' 917
MUNICIPALITY POLICY ,
COMPREHENSIVE GENERAL — AUTOMOBILE LIABILITY FORM
DECLARATIONS
THE INSURANCE AFFORDED IS ONLY WITH RESPECT TO SUCH AND SO MANY OF THE FOLLOWING
COVERAGES AS ARE INDICATED BY SPECIFIC LIMITS OF LIABILITY. THE LIMITS OF THE
COMPANY'S LIABILITY AGAINST EACH SUCH COVERAGE SHALL BE AS STATED HEREIN, SUBJECT
TO ALL OF THE TERMS OF THIS POLICY HAVING REFERENCE THERETO.
COVERAGES
A. BODILY AND PERSONAL
INJURY LIABILITY
LIMITS OF LIABILITY
$300,000. EACH OCCURRENCE
$300,000. AGGREGATE PRODUCTS
B. PROPERTY DAMAGE LIABILITY $100,000. EACH OCCURRENCE
AUTOMOBILE
C. PROPERTY DAMAGE LIABILITY —
EXCEPT AUTOMOBILE
D. ERRORS AND OMISSIONS
LIABILITY
$100,000. EACH OCCURRENCE
$100,000. AGGREGATE PRODUCTS
$ 50,000. EACH PERSON
$150,000. AGGREGATE
ATTACHED TO AND FORMING PART OF POLICY NO.: GLA 917099
ISSUED TO: THE CITY OF NEWPORT BEACH
DATED: FEBRUARY 19, 1975 "IMP IAL IINNSURANCE COMPANY
BY : .!. X�/' !t/.s.. •
DULY AUTHORIZED REPRESENTATI E OF THE
COMPANY
1 '
—1—
pagw ;
ANYTHING TO THE CDAIRARY IN THE PUL,CY JACKET iIOT WITHSTAiiDING
THE IMPERIAL INSURANCE CUPPANY (MLRV!iI CALLED THE COMPANY) HEREBY
AGREES WITH THE INSURED, NAMED IN IHL DECLARATIONS MAD! A PART HERE-
OF, IN CONSIDERATION OF THE PAYMENT OF THE PREMIUM AND IN RELIANCE
UPON THE STATEMENTS IN THE DECLARATIONS FADE A PART HEREOF AND SUBJECT
TO ALL OF THE TERMS OF THIS POLICY AS FOLLOWS:
INSURING AGREEMENTS
COVERAGE A-- BODILY AND PERSONAL INJURY LIABILITY
To pay up behalf of the insured all sums which the insured shall
become obligated to pay by reason of liability imposed by law, includ-
ing Chapter 1681 of the State of California Statutes of 1963, or lia-
bility assumed by contract, insofar as the named insured may legally
do so, for damages:.
(1) because of bodily injury, sickness, or disease, including death
at any time resulting therefrom and also including care and loss of
services, sustained by any person or persons, or
(2) because of any other injury a person may suffer to his person,
reputation, character or feelings, including but not limited to mal
practice, false arrest, detention or imprisonment, malicious prose-
cution, libel, slander, defamation of character, invasion of privacy,
wrongful eviction or wrongful entry.
COVERAGE B-- PROPERTY DAMAGE LIABILITY -- AUTOMOBILE
J
To pay on behalf of the insured all sums which the insured
shall become obligated to pay by reason of liability imposed by
law, including Chapter 1631, of the State of California Statutes
of 1963, or liability assumed by contract, insofar as the named
insured may legally do so, for damaJes because of injury to or
destruction of property, including the loss of use thereof arising
out of the ownership, maintenance or use of any automobile.
COVERAGE C--PROPERTY DAMAGE LIABILITY -- EXCEPT AUTOMOBILE
To pay on behalf of the insured all sums which the insured shall
become obligatud to pay by reason of liability imposed by law, includinq
Chapter 1631 of the State of California Statutes of 1963, or liability
assumed by contract, insofar as the named insured may legally do so,
for damages because of injury to or destruction of property, including
the loss of use thereof.
COVERAGE U--ERRORS OR OMISSIONS LIABILITY -
To pay.on behalf of the insured all sums which the insured shall
become legally obligated to pay, insofar as such coverage is not afford-
ed under Coverages A or C, on account of any claim for breach of duty
_ 1
�, PAGE 3
mode against the Aced by reason nr any neg u gentit, error or omis- .
sion of the insured if inch negligent act, error or omission is cOw ml LLed
during the policy period and diseovo ed during the policy period or
within twenty -four months after termination of the policy.
11. UEFEPiSE, SETTLEMENT, SUPPLEMENTARY PAYMENTS
As respects such insurance as is afforded by this policy, the company
shall;,
(a) defend in his named and behalf any suit against the insured claim-
ing such damages even if such suit is groundless, false or fraudulent;.
but the company shall have the right to make such investigation, nego-
tiation and settlement of any claim or suit as it deems expedient;,
(b) defend any claim against the named insured or its employee for dam-
ages under Section 3294 of the Civil Code or otherwise for the sake of
example or by way of punishment, where such claim arises from an act
or omission in the scope.of employment;,
(c) (1) pay all premiums and furnish bonds to release attachments for
an amount not in excess of the applicable limit of liability of this
policy, all premiums on appeal bonds required in any such defended suit,
the cost of bail bonds required of the insured in the event of automobile
occurrence ar automobile traffic law violation during the policy period,
not to exceed $250. per bail bond;,
(2) pay all expenses incurred by the company, all costs taxed against
the insured in any such suit and all interest accruing after entry of
judgment until the company has paid or tendered or deposited with the
court such part of such ,judgment as does not exceed the limit of the
company's liability thereon;,
(3) pay expenses incurred by the.insured for such immediate medical
and surgical relief to others as shall be necessary at the time of the
injury;.
(4) reimburse the ins:irred for all reasonable expenses, other than loss
of earnings, incurred at the company's request.
The company agreed to pay the amounts incurred under this insuring agree-
ment, except settlements of claims and suits, in addition to the applic-
able limit of this policy.
111. PERSONS INSURED
Each of the following is an insured to the extent set forth below;,
(a) the named insured;,
OF
page 4
(b) while acting within the scope of his employment as such:
(1) any officer, servant, or employee of the named insured, except
that the insurance so provided any officer, servant or employee does
not apply to bodily injury to or death of another officer, servant or
employee of the named insured injured in the course of or .arising out
of his employment;,
(2) any member of the governing body of the named insured;,
(3) any member of boards or commissions of the named insured;,
(c) under coverages A and D, any person while using an owned automobile
or a hired automobile and any person or organization legally respon-
sible for the use thereof, provided the actual.use of the automobile
is by or with the permission of the named insured.
The insurance with respect to any person or organization other
than the named insured does not apply under division (c) of this
insuring agreement.
(1) to any person or organization, or to any agent or employee
thereof, engaged in selling, repairing, servicing, delivering, testing
road testing, parking or storing automobiles, with respect to any
occurrence arising out of any such occupation, if there is other valid
and collectible insurance available to such person as a named insured
or as an agent or employee of a named insured under a policy with limits
at least equal to the requirements of the applicable Financial Respon-
sibility Laws;,provided that, in the event there is no such other valid
and collectible insurance, coverage shall be afforded such person or
organization with limits of liability equal to the requirements of the
Financial Responsibility Laws;,
(2) with respect to any hired automobile, to the owner, or lessee
thereof other than the named insured, or to any agent or employee of
such owner of lessee.
IV. POLICY PERIOD, TERRITORY
This policy applies only to occurrences which take place during,
the policy period anywhere in the world.
EX CIHSi0NS
This policy does not apply:
(a) under coverages A and C to liability arising out of the maintenance
i �I
• page "5
and use of any aircraft (1) owned by, hired by, or loaned to the insured
or (2) in flight (meaning the time commencing with the actual take -off
run of the aircraft and continuing thereafter until it has completed
its landing run) by or for the account of the insured;,
(b) under coverage A, to any obligation for which the insured or any
carrier as his insurer may be held liable under any workmen's compen-
sation, unemployment compensation or disability benefits lad, or under
any similar law;,
(c) under coverage A, except with respect to liability assumed by the
insured under contract, to bodily injury to or sickness, disease or
death of any employee of the insured arising out of and in the course
of his employment by the insured;,
(d) under coverages I1 and C, to injury to or destruction of (1) pro-
perty owned by the insured, or (2) property rented to or leased to the
insured where the insured has assumed liability for damage to or destruc-
tion of such property unless the named insured would have been liable
in the absence of such assumption of liability.
(e) under coverage C, (1) to injury to or destruction of aircraft in
the care, custody or control of the insured, or (2) to the ownership,
maintenance or use of any automobile;,
(f) under coverage D, to injury to, destruction or disappearance of
any tangible property (including money) or tine loss of use thereof;,
(g) to liability arising under Article 1, Section 14 of the Constitu-
tion of California.
CONDITIONS
THE CONDITIONS, EXCEPT CONDITIONS 4,5,6 and 7, APPLY TO ALL COVERAGES.
CONDITIONS 4,5,6 and 7 APPLY ONLY TO THE COVERAGE OR COVERAGES NOTED
THEREUNDER.
1. PREMIUM The premium stated in the declarations is an estimated annual
premium only for the automobiles and a flat annual charge for exposures
other than automobiles. At the end of each annual period of this policy,
the earned premium for automobiles shall be computed in accordance with
the company's rules, rates, rating plans,, premiums and minimum premiums
applicable to this insurance. If the earned premium thus computed exceeds
the estimated advance premium paid, the nanad insured shall pay Lhe excess
to the comipany;,if less, the company shall return to the named insured
the unearned portion paid by such insured.
The named insured shall maintain, for each hazard, records of the
information necessary for premium computation. , -1
• pa ye b
2. INSPECTION AND AUDIT The company shall be permitted but not
obligated to inspect the named insured's property and operations
at any time. Neither the company's right to make inspections nor
the making thereof nor any report thereon shall constitute an under-
taking, on behalf of or for the benefit of the named insured or
others, to 'determine or warrant that such property or operations
are safe.
The company may examine and audit the named insured's books
and records at any time during the policy period and extensions
thereof and within three years after the final termination of this
policy, as far as they relate to the subject matter of this in-
surance.
3. DEFINITIONS
(a) OCCURRENCE. The word "occurrence" means an event or a continuous
or repeated exposure to conditions which causes injury to persons or
damage to property during the policy period that is neither knowingly
nor intentionally caused by or at the direction of the insured.
(b) AUTOMOBILE. Except where stated to the contrary, the word
"automobile" means a land motor vehicle or trailer as follows;,
(1) OWNED AUTOMOBILE - -an automobile owned by the named insured;,
(2) HIRED AUTOMOBILE - -an automobile used under contract in behalf
of, or loaned to, the named insured provided such automobile is not
owned by or registered in the names of (a) the named insured or (b)
an officer, servant, or employee of the named insured who is granted
an operating allowance of any sort for the use of such automobile;,
(3) NON -OWNED AUTOMOBILE,- -any other automobile.
The following described equipment shall be deemed an automobile while
towed by or carried on an automobile not so described, but not otherwise;.
if of the crawler -type, any tractor, power crane or shovel, ditch or trench
digger;,any farm -type tractor;,any concrete mixer other than of the mix -in-
transit type; any grader, scraper, roller or farm implement;,and, if not
subject to motor vehicle registration, any other equipment not specified
below, which is designed for use principally off public roads.
The following described equipment shall be deemed an automobile while
towed by or carried on an automobile as above defined solely for purposes
of transportation or while being opera Led solely for locomotion, but not
otherwise: if of Lhe non - crawler type, any power crane or shovel, ditch
digger;,and any air- congiressing, building or vacuum cleaning, spraying
or welding equipment or well drilling machinery.
(c) SEMI TRAILER. The word "trailer" includes semi trailer.
(d) TWO OR 14ORE AUTOMOBILES. The terms of this policy apply separately
to each automobile insured hereunder, but a motor vehicle and a trailer
or trailers attached thereto shall be held to be one automobile as
respects limits of liability.
• Page !.
(e) USE. Use of an automobile or aircraft includes the loading and
unloading thereof.
n. LIMITS OF LIABILITY The limit of liability stated in the decla-
rations under Coverage A as applicable to "each person" is the limit
of company's liability for all damages, including damages for care and
loss of services, arising out of bodily injury, sickness, or disease or
arising out of any other injury a person may suffer to his person, in-
including death at any time resulting therefrom, sustained by one person
as the result of any one occurrence;.the limit of such liability stated
in the declarations as applicable to "each Occurrence" is, subject to
the above provision respecting each person, the total limit of the
company's liability for all damages, including damages for care and loss.
of services, arising out of bodily injury, sickness, or disease or aris-
ing out of any other injury a person may suffer to his person, includ-
ing death at any time resulting therefrom, sustained by two or more persons
as the result of any one occurrence.
5. LIMITS OF LIABILITY The limit of liability stated in the decla-
rations under coverage I1 and C as applicable to "each Occurrence" is
the total limit of the company's liability for all damages arising out
of injury to or destruction of all property of one or more persons or
organizations, including the loss of use thereof, as the result of any
one occurrence.
G. LIMITS OF LIADILITY -- PRODUCTS Subject to the limit of liability
with respect to "each occurrence." the limits of liability under cover-
ages A and C stated in the declarations as "aggregate products" are
respectively the total limits of the company's liability for.all damages
arising out of the use of or the existence of any condition in water
sold or distributed by the insured during each annual period.
7. LIMITS OF LIABILITY The limit of errors or omissions liability
stated in the declarations as applicable to "each person" is the total
limit of the company's liability for all sums payable under coverage D
to any one person or organization.
Subject to the above provision with respect to "each person", the
limit of errors and omissions liability stated in the declarations as
"aggregate" is the total limit of the company's liability for all sums
payable under coverage D during each annual period.
H. LIMITS OF LIARIIIrY For the purpose ofdetermining the limit of
the company's liability, all bodily and personal 'injury and property
damage arising out of continuous or repeater) exposure to substantially
the same general conditions shall be considered as arising out of
one occurrence.
9. SEVERPRILITY OF INTERESTS The term "the insured" is used serverally
and not collectively but the inclusion herein of more then one insured
shall not operate to increase the limits of the company's. liability.
• page 8
10. FINANCIAL RESPONSIBILITY LA41S When this policy is certified as
proof of financial responsibility for the future under the provisions
of any motor vehicle financial responsibility law, such insurance as is
afforded by this policy for bodily injury liability or for property damage
liability shall comply with the provisions of.such law to the extent
of the coverage and limits of liability required by such law. The
insured agrees to reimburse the company for any payment made by the
company which it would not have been obligated to make under the terms
of this policy except for agreement contained in this paragraph.
11. NOTICE OF AN OCCURRENCE Upon the happening of an occurrence
+ written notice shall be given by or on behalf of the insured to the
company or any of its authorized representatives as soon as practicable
after an officer or an employee in charge of reporting such losses
to insurance companies learns of the occurrence. Such notice shall
contain particulars sufficient to identify the insured and also reason-
ably obtainable information with respect to the time, place and circum-
stances of the occurrence, the names and addresses of the injured and
of available witnesses.
12. NOTICE OF CLAIM OR SUIT If claim is made or suit is brought
against the insured, the insured shall immediately forward to the
company every demand, notice, summons or other process received by
him or his representative.
13. ASSISTANCE AND COOPERATION OF THE INSURED The insured shall
cooperate with. the company and, upon the company's request, shall .
attend hearings and trials and shall assist in effecting settlements,
securing and giving evidence, obtaining the attendance of witnesses
and in the conduct of suits, and the company shall reimburse the in-
sured for any expense, other than loss of earnings, incurred at the
company's request. The insured shall not, except at his own cost,
voluntarily make any payment, assume any obligations or incur any ex-
pense other than for such immediate medical or surgical relief to others
as shall be imperative at the time of injury. The breach of any war-
ranty or failure to comply with any condition of this policy on the
part of any additional' insured shall not affect or prejudice the rights
of the insured. The insured may, at the insured's own cost, have the
insured's attorneys participate in the defense of any suit or.in the
prosecution of any appeal.
14. ACTION AGAINST COi1PANY No action shall lie against the company
unless, as a condition precedent thereto, the insured small have fully
complied with all the terms of this policy., nor until the amount of the
insured's obligation to pay shall have been finally determined either
by judgment: against the insured after actual trial or by written
agreement of the insured, the claimant and the company.
Any person, organization or the legal representative thereof who
_!
Page 1
lias secured such judgment or written agreement shall thereafter be
entitled.to recover under this policy in the same manner and to the
same extent as the insured. Nothing contained in this policy shall
give any person or organization any right to join the company as
a co- defendant in any action against the insured to determine the
insured's liability.
Bankruptcy or insolvency of the insured or of the insured's estate
shall not relieve the company of any of its obligations hereunder.
15. OTHER INSURANCE If the insured has other valid and collectible
insurance against a loss covered by this policy, the insurance ex-
' tended by this policy shall be excess insurance only and not primary
or contributing.
16. SUBROGATION In the event of any payment under this policy,
the company shall be subrogated to all the insured's rights of re-
covery therefor against any person or organization not affiliated with
or under the control of the insured, and the insured shall execute
and deliver instruments and papers and do whatever else is necessary
to secure such rights. The insured shall do nothing after loss to
prejudice such rights.
17. CHANGES No notice to any representative or knowledge possessed
by any other person shall be held to effect a waiver or change in any
part of this policy or stop the company from asserting any right under
the terms of this policy; nor shall the terms of this policy be waived
or changed, except by.endorsement issued to form a part of this policy.
i8. CANCELLATION This policy may be cancelled by the named insured
by mailing to the company written notice stating when thereafter the
cancellation shall be effective. This policy may be cancelled by the
company by mailing to the named insured-at the address shown in this
policy written notice stating when not less than thirty days there-
after such cancellation shall be effective. The mailing of notice as
aforesaid shall be sufficient proof of notice. The time of the surrender
or the effective date of cancellation stated in the notice shall be-
come the end of the policy period. Delivery of such written notice
either by the named insured or by the company shall be equivalent to
mailing.
If the named insured cancels, earned premium shall he computed in
accordance with the customary short rate table and procedure. If the
company cancels, earned premium shall be computed pro rata. Premium
adjustment may be made either at the time cancellation is effected or
i
Y
1 .
•
• page le.
as soon as practicable after cancellation becomes effective, but
payment or tender of unearned premium is' not a condition of can-
cellation.
19. ACT, OMISSIONS OR ERRORS Any act, omission or error, on the part
of any insured under the policy shall not prejudice the interest of
any other insured under this policy.
0
I
-
aCP 00 33 (Ed. 0 -74)
COVERAGE PART GLA 917O9 Ed. 8 -74) UTOMOBILE PHYSICAL DAMAGE INSURANCE (F�tofnatic) , A 120a
For attachment to Policy No. to complete said policy.
SCHEDULE
PHF Item 1. The insurance afforded is only with respect to such of the following Coverages as are indicated by specific premium charge or charges and, under each
such Coverage, applies only to such covered automobiles as are indicated, by entry herein, of one or more of the designating numerals for that purpose appearing in
PHF Item 4. The limit of the company's liability against each such Coverage shall be as stated or designated herein, subject to all the terms of this insurance having
reference thereto.
ADVANCE
LIMIT OF LIABILITY — Each covered automobile.
COVERED
F ACTUAL CASH VALUE (ACV)
IF STATED AMOUNT THE E, Enter: "S'
PREMIUM
1
COVERAGES
nter:
Amount or "ACV" and Deductible
Enter:
Enter: meaMg "as separately
AUTOMOBILES
$
$
$
$
$
$
$
AS PER
"ACV" and DEDUCTIBLE
AMOUNT and I DEDUCTIBLE stated in PHF Item 21cL
3
X X X
P — Collision
$
$
$
R — Theft
1S — Windstorm, Hail, Earthquake
5
— —
— — — — — — —
— — — — —
0— COMPREHENSIVE
"ACV" _= ACTUAL CASH VALUE
7
Auto
Coverage 0 Coverage P Coverage Q
— —
(b) Facts Respecting
Purchase
Coverage V
Auto List
— —
$— — — —
— — —
— — — —
— — —
P — COLLISION
$
appear to the named insured and the Loss Payee named below:
$
— — — — —
— — — — —
$
INCLUDED
2
$ — — —
�
_ _ _ _ _
—FIRE, LIGHTNING OR
_ _ _Q_ _
$
$
$
3
$
TRANSPORTATION
$
$
$
$
5
$
$
4
6
$
$
$
7
S —WINDSTORM, HAIL,
$
$
_ _ _
$
_ _ _ _ _
_ _ _ _ _
EARTHQUAKE OR EXPLOSION
$
— —
+xs�.
T— COMBINED ADDITIONAL
$
$
6
$
$
$25 for each disablement
— — _ _ —
V— TOWING (Not available
$
in California)
$ Form numbers of endorsements attached at issue
$ INCLULIED Total Advance Premium
Maximum Limit of Liability
Any one covered automobile All covered automobiles
PHF Item 2. Covered Automobiles as of Effective Date of this Insurance:
(a) Description; Purposes of Use IP & B = Pleasure and Business; C Commercial)
All covered automobiles
at any one location
$ 11E] Monthly
Records to be submitted:
Semi-
❑ Quarterly ❑ Annually
Auto
Year Trade Name early Type — Capacity ()mock load, Gallonage, Bus Seating); IdentlNCation (1), Prineiyally Garaged In Purpose Classi.
Model
automobile
covered for:
Serial (S), Motor (M) No.; Cylinders (Na.); Model
(Town, State) of Use ncation
1
Collision
nter:
Amount or "ACV" and Deductible
Enter:
"ACV" I and Deductible
I
2
3
4
5
6
7
2
$
$
$
$
$
$
$
AS PER
SCHEDULE ON FILE WITH COMPANY
3
X X X
P — Collision
4
R — Theft
1S — Windstorm, Hail, Earthquake
5
IT — Combined Additional
X X X
6
"ACV" _= ACTUAL CASH VALUE
7
Auto
Coverage 0 Coverage P Coverage Q
ADVANCE PREMIUM
Coverage R
(b) Facts Respecting
Purchase
Coverage V
Auto List
Actual
Purchased Rating
Any loss under Coverages other than Towing is payable as interest may
Price
cost
Mo. & Yr.—New (N); Used (u) symbol
appear to the named insured and the Loss Payee named below:
1
2
$
2
$
AS PER
SCHEDULE ON FILE WITH COMPANY
3
$
S
3
$
4
$
$
$
$
5
$
$
4
6
$
$
$
7
$
$
(c) Limit of Liability (if not stated in PHF Item 1); Net Rates; Advance Premium
Ault
LIMIT OF LIABILITY —Each covered
described in (a) above and
automobile
covered for:
Net Rates
Coverages
Covera es other than Collision
Collision
nter:
Amount or "ACV" and Deductible
Enter:
"ACV" I and Deductible
I
2
3
4
5
6
7
$
$
$
$
$
$
$
$
$
$
$
$
$
$
ACV
ACV
ACV
ACV
ACV
ACV
ACV
$
$
$
$
$
$
$
0— Comprehensive
X X X
P — Collision
Q— Fire, Lightning or Transportation
R — Theft
1S — Windstorm, Hail, Earthquake
or Explosion
IT — Combined Additional
X X X
IV — Towing
"ACV" _= ACTUAL CASH VALUE
Auto
Coverage 0 Coverage P Coverage Q
ADVANCE PREMIUM
Coverage R
Coverage S
Coverage T
Coverage V
2
$
$
$
$
$
$
S
3
$
$
$
$
$
$
$
4
$
$
$
$
$
$
$
5
$
$
$
$
$
$
$
6
$
$
$
$
$
$
7
$
$
$
$
$
$
otal
$
$
$
PHF Item 3. Except with respect to bailment lease, conditional sale, purchase agreement, mortgage or other encumbrance, the named insured is the sole owner of
every covered automobile designated in PHF Item 1 as covered under this insurance, unless otherwise stated herein:
PHF Item 4. Explanation of entries in PHF Item 1 for designating the covered automobiles to which this insurance applies, under each Coverage afforded:
1 all covered automobiles 2 = all registered covered automobiles
3 - all covered automobiles of the private passenger type 4 all covered automobiles of the commercial type
5 = the covered automobiles described in PHF Item 2 (including newly acquired vehicles, subject to the provisions of paragraph (b) of the "covered
automobile" definition)
When so entered in addition to numerals 1, 2, 3 or 4: 6 = excluding vehicles leased to the named insured
7 - excluding, under Collision Coverage, any vehicle not having an actual cash value of at least $
(over) A 1Y0a
(Ed. 8 -74)
• r
Dill _211111Y
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'any 301 aapeq 19410 10 jauj03 hue ;o J1lauaq - iapgowalne pajamas auo Aug MlDadsa suols'n0m. anoge auo
Pill o; Ag3ajlpul jo Apaanp ainul pegs aODemsui said In suo!slnold a44 10 auoN o;;3afgns 'o;aia4; age3gdde , hlgigeg ;0 4!w0 wnw!xew„ ;:%l se alnpayas Dql
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'aauemsul eqs ampo3 pue pgen jay4o sey pamsul paweu 241 43!gm lswe8e ssel :Paaoxa ;oil peys S .-O SSOJ ga!gm 10 Ina Huluadtle4
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841 8uljnp Pamb3e Almou allgowolne pajppis Aue 0l Joadsa y11m 'janamoy 'pap!noid � � „aNgowolne paaaeoa auo
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ions ;o u0SlgJ A tl 1a;ea18 e 10} a3UJR2e 5!44 japun also!, an IOU pegs Auetlwoo a4J ,amen ysea lepton„ Aq
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al a !void se aulwia a s! ssal a unowe a 'aouemsul sill 31 lunowe palels a se passaidxa s! Alp!ge!I 10 1!w0 yans 11 Ie41 pap(nold 'apq
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pit ;( ;elm (q)
'lesiaidde oil jo !SSG] 10 awll le '4jed 43ns ;0 amen ysea len13e aql JoaayJ
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andwn pue slunowe 8u!mo0o; aql to ;seal Pill paaaxa IOU
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maul m A4uale ualols ;o Ajano3a jo} piema Aue Aed in jago 'uope8!lgo Aug Dense of asel of (a)
'luawhed Aug e Dyne Alue ;union yso3 umo sly le ldaaxa you peys pamsu paweu apt 1ng, _ _ �uoreu!weJuoa an!laeu!Pe: I!p
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(1111801
OWNS)
WNISHOON3 NOISOUX3
LUVBV l ABON3 mmonN
%h Coverage Part(s) and Endorsement(s) (If ADO
CONDITIONS
1. Premium: All premiums for this policy shall be computed in accordance with
the company's rules, rates, rating plans, premiums and minimum premiums appli-
cable to the insurance afforded herein.
Premium designated in this policy as "advance premium" is a deposit premium
only which shall be credited to the amount of the earned premium due at the
end of the policy period. At the close of each period for part thereof terminating
with the end of the policy period) designated in the declarations as the audit
period the earned premium shall be computed for such period and, upon notice
thereof to the named insured, shall become due and payable. If the total earned
premium for the policy period is less than the premium previously paid, the
company shall return to the named insured the unearned portion paid by the
named insured.
The named insured shall maintain records of such information as is necessary
for premium computation, and shall send copies of such records to the company
at the end of the policy period and at such times during the policy period as the
company may direct.
2. Inspection and Audit: The company shall be permitted but not obligated to
inspect the named insured's property and operations at any time. Neither the
company's right to make inspections nor the making thereof nor any report there-
on shall constitute an undertaking, on behalf of or for the benefit of the named
insured or others, to determine or warrant that such property or operations are
safe or healthful, or are in compliance with any law, rule or regulation.
The company may examine and audit the named insured's books and records at
any time during the policy period and extensions thereof and within three years
after the final termination of this policy, as far as they relate to the subject
matter of this insurance.
3. Financial Responsibility Laws: When this policy is certified as proof of financial
responsibility for the future under the provisions of any motor vehicle financial
responsibility law, such insurance as is afforded by this policy for bodily injury
liability or for property damage liability shall comply with the provisions of such
law to the extent of the coverage and limits of liability required by such law.
The insured agrees to reimburse the company for any payment made by the com-
pany which it would not have been obligated to make under the terms of this
policy except for the agreement contained in this paragraph.
4. Insured's Duties in the Event of Occurrence, Claim or Suit:
(a) In the event of an occurrence, written notice containing particulars sufficient
to identify the insured and also reasonably obtainable information with respect
to the time, place and circumstances thereof, and the names and addresses of
the injured and of available witnesses, shall be given by or for the insured to
the company or any of its authorized agents as soon as practicable.
(b) If claim is made or suit is brought against the insured, the insured shall im-
mediately forward to the company every demand, notice, summons or other
process received by him or his representative.
(c) The insured shall cooperate with the company and, upon the company's
request, assist in making settlements, in the conduct of suits and in
enforcing any right of contribution or indemnity against any person or
organization who may be liable to the insured because of injury or damage
with respect to which insurance is afforded under this policy; and the insured
shall attend hearings and trials and assist in securing and giving' evidence
and obtaining the attendance of witnesses. The insured shall not, except at
his own cost, voluntarily make any payment, assume any obligation or incur
any expense other than for first aid to others at the time of accident.
5. Action Against Company: No action shall lie against the company unless, as a
condition precedent thereto, there shall have been full compliance with all of the
terms of this policy, nor until the amount of the insured's obligation to pay shall
have been finally determined either by judgment against the insured after actual
trial or by written agreement of the insured, the claimant and the company.
Any person or organization or the legal representative thereof who has secured
such judgment or written agreement shall thereafter be entitled to recover under
this policy to the extent of the insurance afforded by this policy. No person or
organization shall have any right under this policy to join the company as a party
to any action against the insured to determine the insured's liability, nor shall
the company be impleaded by the insured or his legal representative. Bankruptcy
or insolvency of the insured or of the insured's estate shall not relieve the com-
pany of any of its obligations hereunder.
6. Other Insurance: The insurance afforded by this policy is primary insurance,
except when stated to apply in excess of or contingent upon the absence of other
insurance. When this insurance is primary and the insured has other insurance
which is stated to be applicable to the loss on an excess or contingent basis, the
amount of the company's liability under this policy shall not be reduced by the
existence of such other insurance.
When both this insurance and other insurance apply to the loss on the same
basis, whether primary, excess or contingent, the company shall not be liable
under this policy for a greater proportion of the loss than that stated in the
applicable contribution provision below:
(a) Contribution by Equal Shares. If all of such other valid and collectible insur-
ance provides for contribution by equal shares, the company shall not be liable
for a greater proportion of such loss than would be payable if each insurer
contributes an equal share until the share of each insurer equals the lowest
applicable limit of liability under any one policy or the full amount of the loss
is paid, and with respect to any amount of loss not so paid the remaining
insurers then continue to contribute equal shares of the remaining amount
of the loss until each such insurer has paid its limit in full or the full amount
of the loss is paid.
(b) Contribution by Limits. If any of such other insurance does not provide for
contribution by equal shares, the company shall not be liable for a greater
proportion of such loss than the applicable limit of liability under this policy
for such loss bears to the total applicable limit of liability of all valid and
collectible insurance against such loss.
7. Subrogation: In the event of any payment under this policy, the company shall
be subrogated to all the insured's rights of recovery therefor against any person
or organization and the insured shall execute and deliver instruments and papers
and do whatever else is necessary to secure such rights. The insured shall do
nothing after loss to prejudice such rights.
8. Changes: Notice to any agent or knowledge possessed by any agent or by any
other person shall not effect a waiver or a change in any part of this policy or
estop the company from asserting any right under the terms of this policy; nor
shall the terms of this policy be waived or changed, except by endorsement issued
to form a part of this policy.
9. Assignment: Assignment of interest under this policy shall not bind the com
parry until its consent is endorsed hereon; if, however, the named insured shall
die, such insurance as is afforded by this policy shall apply (1) to the named
insured's legal representative, as the named insured, but only while acting within
the scope of his duties as such, and (2) with respect to the property of the
named insured, to the person having proper temporary custody thereof, as insured,
but only until the appointment and qualification of the legal representative.
10. Three Year Policy: If this policy is issued for a period of three years any
limit of the company's liability stated in this policy as "aggregate" shall apply
separately to each consecutive annual period thereof.
11. Cancellation: This policy may be cancelled by the named insured by sur
render thereof to the company or any of its authorized agents or by mailing to
the company written notice stating when thereafter the cancellation shall be
effective. This policy may be cancelled by the company by mailing to the named
insured at the address shown in this policy, written notice stating when not less
than ten days thereafter such cancellation shall be effective. The mailing of notice
as aforesaid shall be sufficient proof of notice. The time of surrender or the ef-
fective date and hour of cancellation stated in the notice shall become the end
of the policy period. Delivery of such written notice either by the named insured
or by the company shall be equivalent to mailing.
If the named insured cancels, earned premium shall be computed in accordance
with the customary short rate table and procedure. If the company cancels,
earned premium shall be computed pro rata. Premium adjustment may be made
either at the time cancellation is effected or as soon as practicable after cancel-
lation becomes effective, but payment or tender of unearned premium is not a
condition of cancellation.
12. Declarations: By acceptance of this policy, the named insured agrees that
the statements in the declarations are his agreements and representations, that
this policy is issued in reliance upon the truth of such representations and that
this policy embodies all agreements existing between himself and the company
or any of its agents relating to this insurance.
IN WITNESS WHEREOF, this Company has executed and attested these presents; but this policy shall not be valid unless countersigned by
the duly authorized Representative of this Company.
ii /'v
Secretory ///
President
NOTICE OF CANCELLATION OF INSURANCE POLICY S II
To all Insureds, Mortgagees, and Loss Pa ees, if any, named in the policy described below: 'I
You are hereby notified that the said pi in its entirety, including any mortgagee or • �` �'""Ya C^
payable clause, is Canceled as to all interests insured, at 12:01 A.M. Standard Time, on the date shown below.
Premium adjustment: If premium for said policy has not been paid, the earned premium due
and payable shall be computed as provided in the policy, and demand is hereby made for
payment thereof. If premium has been paid, the excess paid premium, if any, above the
earned premium, if not tendered with this cancellation notice, will be refunded as soon as
practicable after cancellation becomes effective.
y..
POLICY NUMBER
EFFECTIVE DATE OF CANCELLATION
VEL 304756
1OS A.NGgA&Dq%WORNIA
I hereby certify, or declare, under the penalties of perjury, that on the postmarked
In a United States Post Office, a Notice Of Cancellation
DATE
REASON F R CANCELLATION (SEE REVERSE
FOR EXPLANATION OF CODE)
APRIL 23, 1975
COMPANY ELECTION
rCITY OF NEWPORT BEACH
3300 NEWPORT BOULEVARD
NEWPORT, CALIFORNIA
J J
® SIGNALS,MSU,RANCECOMPANY
;I ERIALINSURANCECO� ANY
B r p
AUTHOR IZEDR PR E TATI VE
'HULL AND COMPANY
1OS A.NGgA&Dq%WORNIA
I hereby certify, or declare, under the penalties of perjury, that on the postmarked
In a United States Post Office, a Notice Of Cancellation
Z
W
1450 EAST 17TH STREET
date I personally mailed
Of Insurance Policy, in a sealed envelope with proper postage prepaid addressed to
_
SANTA ANA, CALIFORNIA 92711
each of the addresses exactly as shown on this page; and at the same time
recce :roe and received a Postal Receipt for each such marling, which Is a part
L
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handy.
'
I Ito,
(Signature)
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SI 100D (11/68)
ORIGINAL
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p Pamsu! al!gowolne uesaleiado AOftolsno oqm ioleiado iaylo Aue io painsu! paweu ayl "L
'po!iad A311od ay1 6uunp uo!1e30nai io uo!suadsns iapun uaaq sey A3!l0d 8y1 iapun painsu! apgowolne_g2 a ,latl -
Al!iewolsn3 io ployasnoy awes ay1 u, sap!sai ia41!a 04M ioleiado iagio Aue 1 (i�jQS%Py(Amj ayl ;o asuao!14;5aI1j a
42� ` "g
P41 io; swn!waid 10 luawAed a - v03ai8y4 luawllelsu! Aue io'Ao!lod
yi yi!M uo!loauuo3 u! suo!ie6!lgo s!q to Aue anp uayM a6ie43s!p 01 spel painsut paweu ayl .5
iainsw a41 01 algelda33eun srAl y-03f jeiiu tfi;(0 6u!nnollob s ' Ctdg a �6w
"q
(AINO NOlONIHSVM j0 31V1S 3Hl 01 3l8VOIlddV)
w0oy '1aai1S 41x!S 1saM 05L£ io "501b6 o3s!ouei ue .., J00(16 so a6uy so daG�
a3ueinsu! pasua3!l Aup fe) y6noi S 'laailS 3;lilieyy SIZ le 11sp ueld'lai j-+(q� ydlii 3q ib; 1
y1 pa11!wgns put woi; pau!e190 �q Aew ueld ay1 y6noi4l alddAtjui• J '-�y� } f'
veld ay1 y6noiyl 11 u!elgo o1 noA iol alq!ssod s! 1! 'ue a i l)mb" 'E
-insui yons io a !6! a Id 4130 spiepuels alplylil(d3�u6}'i,w33e i71 a3ue�.
3 I4 I gi!el pooh u! aie noA pue spoylaw Aieu!Pio y6noiyl a3ueinsw Lions ainooid of alqeun aie noA 31 'Z
a3ueinsw Alipgey 13sueil 01 pazuoyine iainsw ue 01 PBuBlsse aq Aew eaueinsu! Aupgep 86ewep Aliadoid
pue Aipfuy?1's4gi alSq,)TT -,,, , sgwogdde y3igm Aq sueaw a sap!noid ueld >Is! a pau6!ssy a!!gowolny e!wol!le0 ayl • ;„
�• :YellT Pa!Plou Agaiay aie noA 'apoo a3ueinsul emio;!Ie0 ayl 1.. col llu sin
)fl fy mil. Iujp d
•awo3lno ayl uo 6u!pu p ga i �� '-
aq Am Auedwo si H FYI
yl io noA '1!sodap a Aq pa!uedwwoe a 1 V ��) ,�� u w y1�y� ieyo
a3ueinsu q lsnw s eadd sa So j i�adbisLs`�ufwo0
I, ayl ;o sao!1 ;o ay1 woil pou!elgo aq Aew 019ia43 6u!u!elied suo!leln6ai ay1 pue leadde y3ns iol swio j •a3!1ou s!yl
w y1io; is uo!IellaDue3 ;o 810P an113a ;1a ayl aio ;aq pal!; aq Plnoys leaddV v0!lella3ue3 s!yl leadde o1 Mel Aq pall!wiad am noA
- eoonai io uo!suadsns iapun uaaq sey A3yod ayl iapun painsu! ol!gowolne ue soleiado Al!iewolsn 'poijad o ploy snoyuawes ayi woll
ul sap!sai iayl!a OW ioleiado iaylo Aue 10 io Painsui paweu ayl ;o u01leils!6ai al3149n iolow ayi io asua3!l s,ian!ip aq.L
'io ;aiayl uawpelsu! Aue io 'A3god ayi io; sw n! ward ;0 ivawAed 941 43!M uo!13auuo3 u! !l9s14 10
Aue anp uayM 06ie43sip of
. . sl!e1 painsu pawu
o;e ao gZg L ayl
-qns Aluessaoau si uo!legaoue3 43ns AuV -ia uo!loaS 10 suo!s!noid ayi of loaf y l algelda3oeun s's a 41'anss!
'Z
leu!6uo 6ulMopo; sAep pg ayl 6u!in0 •1
(AINO VINHOjIlVO j0 31V1S 3H1 01 3l8VOIlddV)
Sla
• ENDORSEMENT .
IT IS UNDERSTOOD AND AGREED THAT ENDORSEMENT #8, IS HEREBY DELETED AND
REPLACED WITH THE FOLLOWING:
FOLLOWING FORM ENDORSEMENT
IT IS UNDERSTOOD AND AGREED THAT EXCEPT INSOFAR AS COVERAGE IS PROVIDED TO THE
INSURED BY THE UNDERLYING INSURANCE, WITH LIMITS OF AT LEAST $50,000. AND
$150,000. IN THE AGGREGATE, THIS POLICY SHALL NOT APPLY TO:
MUNICIPALITIES ERRORS AND OMISSIONS
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the inception date of the
policy to which it is attached unless otherwise stated below.
The following spaces are to be completed only if this endorsement is not attached to the policy when issued.
THIS ENDORSEMENT EFFECTIVE FROM AND AFTER I END. NO. DATE
POLICY NO. 111.1. iO
VEL 304756 CITY OF NEWPORT BEACH
Countersigned on behalf of EXSignal Insurance Company
❑ Imperial Insurance Company
President
iSI -123A 12/701
THE
ENDORSEMENT
EXCLUSION
IT IS HEREBY UNDERSTOOD AND AGREED THAT THIS POLICY EXCLUDES ANY
COVERAGE FOR:
MUNICIPALITIES
ERRORS AND OtIISSIONS
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the inception date of the
policy to which it is attached unless otherwise stated below.
The following spaces are to be completed only if this endorsement is not attached to the policy when issued.
(2/)<)
AFTER
19
ISSUED TO
Countersigned on behalf of r7 Signal Insurance Company
❑Imperial Insurance Company
PIBSiABM By DULY AUTHORIZED REPR ESE ATIVE OF THE COI. PAN�
i
Yi
SIGNA INSURANCE CO&PANY
LOS ANGELES, CALIFORNIA
RNINAL ::
{
INRURANCR
CONPANY
UMBRELLA EXCESS LIABILITY
SIGNAL INSURANCE COMPANY OF LOS ANGELES, CALIFORNIA
(A stock insurance company, herein called the Company)
Agrees with the Insured, named in the Declarations made a part hereof, in consideration of the payment of the premium and in reliance upon the statements in
the Declarations and subject to the limits of liability, exclusions, conditions and other terms of this policy.
INSURING AGREEMENTS
COVERAGE:
The Company agrees to indemnify the Insured for ultimate net loss in
excess of the retained limit hereinafter stated, which the Insured may sustain
by reason of the liability imposed upon the Insured by law, or assumed by the
Insured under contract:
(a) Personal Injury Liability
Far damages including damages for care and loss of services, because of
personal injury, including death at any time resulting therefrom,
sustained by any person or persons;
(b) Property Damage Liability
For damages because of direct injury to or destruction of tangible
property, including the loss of use thereof, caused by an occurrence as
defined herein;
(c) Advertising Liability
For damages because of libel, slander, defamation, infringement of
copyright title or slogan, piracy, unfair competition, idea
misappropriation or invasion of rights of privacy, in any advertisement,
publicity article, broadcast or telecast and arising out of the Named
Insured's advertising activities.
DEFENSE, SETTLEMENT, SUPPLEMENTARY PAYMENTS
With respect to any occurrence not covered by the underlying policies
listed in Schedule A hereof or any other underlying insurance collectible by
the Insured, but covered by the terms and conditions of this policy except for
the amount of Retained Limit specified in the Declarations, the Company shall
(a) defend any suit against the Insured alleging such injury or destruction
and seeking damages on account thereof, even if such suit is groundless,
false or fraudulent; but the Company may make such investigation,
negotiation and settlement of any claim or suit as it deems expedient;
(b) pay all premiums on bonds to release attachments for an amount not
in excess of the applicable limit of liability of this policy, all premiums
on appeal bonds required in any such defended suit, but without any
obligation to apply for or furnish any such bonds;
(c) pay all expenses incurred by the Company, all costs taxed against the
Insured in any such suit and all interest accruing after entry of
judgment until the Company has paid or tendered or deposited in
court such part of such judgment as does not exceed the limit of the
Company's liability thereon;
(d) reimburse the Insured for all reasonable expenses other than loss of
earnings, incurred at the Company's request;
and the amounts so incurred, except settlements of claims and suits are
payable by the Company in addition to the applicable limit of liability
of this policy.
er6 -eat (,/it)
In jurisdictions where the Company may be prevented by law or otherwise
from carrying out this agreement, the Company shall pay any expense
incurred with its written consent in accordance with this agreement.
The Insured shall promptly reimburse the Company for any amount of
ultimate net loss paid on behalf of the Insured within the Self Insured
Retention specified in the Declarations.
III. DEFINITION OF "NAMED INSURED" AND "INSURED ":
"Named Insured, wherever used, includes any subsidiary company of the
Named Insured and any other company coming under the Named insured's
control of which it assumes active management.
The unqualified word "Insured ", wherever used, includes the Named
Insured and also:
(a) any person, organization, trustee or estate to whom or to which the
Named Insured is obligated by virture of a written contract to provide
insurance such as is afforded by this policy, but only with respect to
operations by or in behalf of the Named Insured or to facilities of or
used by the Named Insured;
(b) except with respect to the ownership, maintenance or use, including
loading or unloading, of automobiles while away from premises owned
by, rented to or controlled by the Named Insured or the ways
immediately adjoining, or of aircraft, (1) any executive officer, other
employee, director or stockholder thereof while acting within the
scope of his duties as such; (2) any organization or proprietor with
respect to real estate management for the Named Insured;
(c) any person while using an automobile owned by the Named Insured or
any automobile or aircraft loaned to the Named Insured or hired for
use in behalf of the Named Insured and any person or organization
legally responsible for the use thereof, provided the actual use of such
automobile or aircraft is by the Named Insured or with the Named
Insured's permission, and any executive officer, director or
stockholder of the Named Insured with respect to the use of an
automobile or aircraft not owned by the Named Insured in the
business of the Named Insured. The insurance with respect to any
person or organization other than the Named Insured does not apply
under this Division (c) of this Insuring Agreement:
(1) to any person or organization, or to any agent or employee
thereof, operating an automobile sales agency, repair shop, service
station, storage garage or public parking place, with respect to any
occurrence arising out of the operation thereof;
(2) with respect to any automobile or aircraft hired by or loaned to
the Named Insured, to the owner or a lessee thereof other than the
'JalaeaJ Jealanu Aue'(
suciftimoes Jeapn0„
: ;oaiayl (Z) J deu6aied Japun
Alppe) Jealanu ;o uot1!uyap ayl wyl!m j sae; Jealanu Aue
10 u01lez!ue6JO JO uosJad Aue Aq u0!letado ayi woJ; buglnsai (Z) pue
leualew lonpOtdAq 6u!wewoo (I) leiialew alsem Aue sueaw „a15¢M„
fJOioeai
Jealanu e w uoue!PeJ 01 pasodxa to pasn uaaq sey 4ol4m pmb!l
uo pgos 'luau OtlwOa (an) uo luawala lan; Aue sueaw „tan; luads„
:) oaiayl AJO3epuawe mel Aue u! Jo 4561
;o lay A6Jau3 aiwoly aql u! wayl u9n16 s6wueaw ayl aney „1e1ja3ew
lanpoidAq„ pue ' „leualew Jealanu lemads„ '„ leualew aomos„
:le!Jalew lonpoidAq
AD leualew Jealanu 1e!oads 'leualew awnos sueaw „ leua3ew Jealanu„
aaliedoid
amsoltl %e Jo mxol 'an!la¢o!p¢J apnWw , sailiadoid snopiezey„
:Aa!lod s,41 w pasn se (6)
:A3!Ipe) Jealanu Lions le Aliadoid ;o uoilonASap uo
01 Ainfw at ADD sagdde (S) uo!snlaxo siyt 'epeueo to suoissassod
AD sauoluual si! ' eauawy 10 salelS pal!uN ayi mglim Deleon,
si A1!Ipe1 Bons j! inq 'Alipae; ueapnu Aue ;o asn Jo uogeiado
'aoueualuiew 'u O!lanulsu0a '6uuue,d agl ylim u0!laau um w
wawdinba uo slued 'sleualew 'saa!nuas ;o painsul ue Aq 6w ysiwn;
ay1 ;o lno sasue uoponilsap to y3eap'aseas!p'ssauilais'AJnfu! ayi 'S
io:painsul ue 1o;leyaq uo to Aq ;o
pasods!p Jo paliodsueil 'paiols'passaooid'pasn 'palpuey 'possassod
awp Aue AS alsem JO Ian; luads ui pauleluw sl leualew Jealanu aql 'Z
:woJ ;aJa41 pasladslp to
pafitegas!p uaaq sey (q) Jo painsul ue ' ;o peyaq uo Jo Aq pa3eiado
AD 'Aq paumo A1!lpe; Jealanu Aue 1e si (e) ,eualew JeaWnu aq, .i
Jeapnu ;!
sopiezey 'leua3ew
ay1 woJ; 6wtlnsai uo!lonilsop
to yleap 'aseasip 'ssauilais 'AJnfu! of '(q)i pue (e)! a6eianop u,pun ( ;)
:uo1lez1ue6JO uo uosJad Aue 4UM ; oaiagl Aoua6e
Aue Jo 'eauawy 10 salelS Dalian awl oiui paialua wawaai6e hue
Japun ' ;oaiayl A3ua6e Aue to'eauawy ;o salels pal!un ayl woJ;
Al!uwapw w pappue'aq pinom panssi uaaq loo Aagod s!gl peg
to -si painsul ayl (q) io' ;oaiayl AJwepuawe mel hue Jo'pg61 ;o
laV A6Jau3 a!UJOIy ay] at wensind uorlaalwd le!aulu!) welwew
01 paumbei s! uo!lez!ue6JO Jo uosJad Ape (e) 43IgM Ol loadsaJ 4 1!m
pue ,eualew JeaWnu ;o sagiadoid snopiezey 841 woJ1 6uialnsai 'Z
,a!Ai,l!ge!I )01!wg si! )o uopsnegxa
uodn uogeulwial sl! Jo; lnq Aa!lod vans Aue iapun painsul ue aq
pinom AD'epeueO )o uopepossy aouainsul leapnN to sial!Jmiapun
Aplige!-1 A6Jau3 a!wwy Ienln Nl 'uogeloossy aaueJnsul Al!pge! I
A6Jau3 JeapnN Aq pan god Alipge!1 A6taua Jealanu a Japun
painsul ue osle s! AD go pun paunsul ue ya!gm of loadsai yl!m ;
uogonJlsap uo
gleap 'aseasip 'ssau>Iws 'Amfu! of '(q)1 pue (e)1 a6elanoO Japun (a)
'aaud pas!tuanPe w a>lels!w (q)
uo:Alipowwoo uo ap!lJe Aue ;o uo!lduosep loalJwu! (8)
:sue6ols to sallii of alelai too lleys siyl
1nq'pas!lJanpe Jo ales Jo; paia;;o'plos s231nta5 to spoo6 ;o aweu
apeil to lliew aa!ntas 'J1Jew apeJl P2Ja3s169i ayi se ;oaiayl asn Aq
aweu apeui to 1pew wlnJas 'MJew apeJl PaJ9151691 ;o JuawaBuu ;u! (Z)
:loeJluw uanum ;O aouewio ;Jad ;o aJnl!e; (1)
:JO; Al!I!ge!I 01'(3)1 aBeJOA00 Japun (p)
a O;alagl aaualnsul OPIAOJO 01 laeJluw Japun
si painsul ayi ;! 'Aliadoid vans ;o uoilaniisap to 01 AJnfu! Jo; (Z)
JO:Mel UOwwaa JO AJOlnlels Aq
painsul ayl uodn pasodw! Atipgep ayi;a uo!suaixe ue s! Al!l!ge!l
yaps leyl lualx0 ayi of painsul aql 10 l0iluw Jo Apoisna 'aieo
aql u! to Aq pasn to pa!dnwo 'w paluai Awadoid ;o uoiionJ3sap
Jo of AJnfu! Jo; loetluw Aue Japun painsul ayi Aq pawnsse (31
:Ai!I!ge!l o3'(q)l eBaianoo Japun
(3)
aasue aauaiin000 ayi goiym )o lno'painsul aql
Jo; to Aq paialdwoa Niom io'painsul aq Aq palnqu3s!p to palpuey
'Plos 'painlae;nuew ;oaiayl siaweluw to slonpoid 'spoo6 Aue (Z)
Jo:painsuI aql Aq paumo A1Jadoid (I.)
: ;o uou3misap Jo 01 AJnful at'(q)I a6eiano3 iapun
(q)
:loeiluw iapun painsul PaweN
ayi Aq pawnsse sJaglo;a Ai!I!ge!I of Aldde too saop uoisn Wxe siyl leyl
'JaAeMOy 'papinoid 'Mel Jel!w!s Jo sl!)auaq A3!I!ges!p 'uo!lesuadww
tuawAoldwaun uo s,uawxJOm Aue iapun algell play aq Aew sia.msu! s1!
;o Aue uo painsul ayi g014m Jo; uoile6!igo Aue of '(e)1 a6aianoo iapun
(e)
:AlddV ION 11VHS A0110d
SIHI
SNOISf11OX3
'aoueinsu! 6u!Aliapun se eau O; u! anu!luw
Ileys'uopsnegxa ;o 1.uana eat u! (Z) AD:t!w!1 Bu!A,Japun poonpau ayl ;o ssaoxa
ayi Aed Ileys'uoponpau 10 luana aql w (H Aapod s!yl'Japunwagl pied sassol
;o uoseai Aq „y„ aln Degas u! pazs!1 (sa!)Aa!lod 6u!A1Japun ayl ;o Al!l!ge!I
10 (s)1!w!I alel3aJ66e ayl ;o uo!isnegxa to uo!tonpau ay1 ;o loan, aql ul
'pouad Ao!1od ayl 10 syluow (Z 1) anlaml an!lnaasuw
yoea Buunp'painsu! ayi;o;leyaq uo to Aq'e!paw Aue Aq 6u!Jtnaoo ianauaym
sau!AIl0e 6u!sptanpe lie ;o lno Bu!sue s6wpaaaoid to sw!e1a pe ;o wnowe uo
til!1!gelq ;0 l!w!q„ alll se suolieiepao ayl u! paleu6!sap lunowe ayl paaaxa
IOU Heys Auedwoo aql ;o Atgige!, aql '(a)l 86aiano0 of loadsai yLM
'pouad Ao!1od aql ;o syluow
(Zl) anlaMl BAIinoaspw yaea 6u1Jnp 6u!uaddey saouaiinwo )le ;o lun000e uo
Alg!ge!-j ;O l!w!'l„ aql pue suo!leJeload ayl u! Paleu61sap iunowe agl paaaxa
1ou pegs Auedwoo ayl ;o A1!I!ge!I aql '(q)1 a6euanoo 01 loadsaJ gl!M
'pouad Aogod ayl ;o syluow Q: L) 94,aM1 angnaasuw yaea fiuunp 6u!uaddeg
saouaiunwo 112 ;o lunwoe uo , tilp!ge!l ;0 liw!-,„ agi se suoµe)elaad
ayl of paleu6!sap lunowe aql paaaxa iou Heys piezey slanpoid ay1
10 lno 6u!s!ue Auedwoo 041 ;o A3p!geg ayl'(e)I a6etano3 of loadsai g1iM
'pap!noid ualleu!aiay se ldeaxa
'pouad Ao!1od awl fiuunp uaddey saauaiuwoo vans pap!notd'uapunauay apew
aq Aew swrep yolgm Jo; saauaitwao ;o uagwnu ayl of 3!w!l ou s! atagl
'aauaiinaao
auo Aue ;o llnsai aql se „Alq!ge!-1 10 1!w!-,„ ayl se suo!laiepap
aql u! paleu6!sap iunowe 041 '(a)l OBeuaAO3 01 laadsat Ulm (a)
Jo:aauautnaoo auo Aue ;o
llnsat ayl se „Al!l!ge!-1 )o i!w!-,„ ayl se suo!lete1084 agi u! paleu61sep
lunowe ay1'Pau!gww yloq to'(q)i uo (e)l a6euan00 of loadsai 411M (p)
6wpawxa
IOU lunowe of an uayi pue (uo!lualaa paunsul ;lag ayl palled u!auay)
:palsy os (sa!)Aagod ayl Aq patanw loo aauaiinaao
auo Aue ;0 11nsai ayl se „uouualaa painsul ;,as„ se suo!leuepa4
941 W paleuB!sap lunowe 943 '(o)l a6et8noD 01 loadsai y11M (a)
Jo:patnsul a41 Aq alq!Jaallw
aoueinsu! 6w AlJapun Jaylo Aue 10 (s)i!w11 algeopdde ayl (Z)
JO:palsg as (sal)A3!lod
aql Aq PaJanoa loo aauaiinaao au0 hue ;O llnsat ayl se „uo!lualaa
painsul ;,as„ se suo!leiepaf) ay1 up paleu6!sap iunowe ayl (L)
:Jay 1!a
;o JaleaJ6 ayl 'pau!gww yloq Jo (q)1 io (e)l
06eianop 01 loadsai ql!m (q)
to:;oaiay
alnpayaS w pals!, (sap AOpod 6u!Apopun aql ;o (s)I!wg algeopdde ayl (e)
;o ssaoxa
up ssol lau alew!iln ayi Jo; A1uo aq keys Ai!,!ge!1 ;0 1!wp s,Auedwoo awl
:11WI1O3NIV138— AlIl18VI13OI1W11 'A
'sloe sno!Jnlu! 10 Jagwnu 1e1o1 ayl Jo le!Jalew
snounfu! ;o asn ale6aJ66e ayl of sJeaq pouad ley, fiuunp sloe snounlw
;o Jagwnu aq Jo leua3ew snounlu! )o asn a41 ya!ym woyaiayl 6u!11 nsai
sa6eweD lelol aql ;o uo!lJOdotd 1ey1 at paliwg aq Begs Al!I!geg s Auetlwoo
agi'po!uad 3eyl ual ;e uo 6winp panwluw pue p011111 A1!11d ayl of Jo!Jd ue6aq
wuauuwao yens Aue ;!'W)I a6eianop of laadsat yl!M'tegl idaaxa:pliom ayl w
alaymAue pouad Aailod ayi fiuunp saauaim000 01 Aluo sapdde Aagotl s!yl
AHO11HU3I'OOla3d AO11Od 'Al
'painsul PaweN ayi of algeo!ldde 1241 ueyl ssal aq loo ,legs
1s2Ja3U1 !euo!1!ppe vans of algwydde 1!w!, pau!elau ayi leyl pap!nwd
pue uapunauagl painsul leuo!1!ppe yens 01 PaP!AOid s! aauetnsm
1ey1 luaixe OUT 01 Aluo lnq ' „y„ alnpayaS u! pals!, (sa!)AO!1od
6u!Altapun ayi w papnlaw Iluawaau6y 6uunsul s!yl ;o (a) to (q) '(e)
sydeJ6eled w paquosap spainsul ayl uo painsul PaweN ayl ueyl Jaylo
'15aJalu! leoo11!ppe Aue 'sloala as paunsul PaweN aql awg Aue le ;i (p)
'; oaiayl uo!leuado ayl ;o ino 6u!sue aauaiinaao Aue of laadsai yl!m
'slua6e Jo saaAOldwa aAlloadsai Jiayl to Joletado ue6uey Jo liodne
Jo uo!lez!ue6JO J!edau to aol"as io sales uo!leine Aue Jo 'sauossawe
uo!1eMe Jo sau!6ua i)eJOJIe 13;eJ3J!e ;o Jainlae ;nuew Aue of (£)
auawaalov
6uunsul s!yi ;o (p) Jo (e) uo!s!ni❑ up pap!noid se ldaaxa 'aassal
Jo Jaumo vans ;o aaAOldwa Jo lua6e Aue of Jo 'painsul PaweN
SIGN INSURANCE CSMPANY
LOS ANGELES, CALIFORNIA
DECLARATIONS This Declaration Page together with Policy Provisions
completes the below numbered Insurance Policy
UMBRELLA EXCESS LIABILITY - e
1. Named Insured and Address (Number, Street, Town, County, State,
CITY OF NEWPORT BEACH
3300 NEWPORT BOULEVARD
NEWPORT, CALIFORNIA
POLICYNUMBERVtL 3U4 /bb
2. Policy Period
from FEB. 1, 1975 to FEB. 1 1976 (12 Mo.)
12:01 A.M., Standard Time at the ad3ress of the Named
Insured as stated herein.
New A Renewal
REPRESENTATIVE: Broker or Agent HULL AND COMPANY
Address 1450 EAST 17TH STREET
SANTA ANA, CALIFORNIA 92711
1
FEBRUARY 25 1975 mho f
Date of Issue • Countersigned b /u`•�
Authorized Representative .�
SIG-802 (2,17 I)
ORIGINAL
Location of Coverage: SAME
and as further defined in the Primary Policy.
3.
Primary Insurance: (1) Insurer, (2) Policy number (including renewals /or replacements thereof)
(1) IMPFRTAI INSURANCE COMPANY
(2)
4.
Description of Coverage:
5.
The insurance afforded is only with respect to such of the following coverages as are indicated by specific premium charge or charges. The limit of
the Company's liability against each such coverage shall be as stated herein, subject to all the terms of this policy having reference thereto.
Coverages
Premium
SECTION 1 IN EXCESS OF SECTION 11 SECTION III
Company umlts
Underlying Umlts
Total Limits
A. Bodily Injury —Auto
$
$ Each Person
$
$
$
$ Each Accident or Occurrence
$
$
Bodily Injury —Other
$
$ Each Person
$
$
$
$ Each Accident or Occurrence
$
$
$ Aggregate Products
$
$
B. Property Damage Automobile
$
$ Each Accident or Occurrence
$
$
C. Property Damage
$
$ Each Accident or Occurrence
$
$
Except Automobile
$
$ Aggregate Operations
$
$
$
$ Aggregate Protective,
$
$
$
$ Aggregate Products
$
$
$ Aggregate Contractual
$
$
D. Combined Single Limit Bodily
$ ENDS. #3
$ PER ENDS .#I Each Accident or Occurrence
$ PER ENDS.#2
$5,000,000.
Injury and/or Property Damage
Aggregate
$
$
E. Self- Insured Retention
(V -(I) Retained Limit) 10,000.
Total $ FNDnR4;FMFNT #1
6.
Premium Computation ENDS, ATTACHED: - 04 • 5 6•SI -5 9• 853:
Premium Basis
Estimated Exposure
Rate
Premium
SEE
FLAT CHARGE
---- - - - - --
FLAT
ENDORSEMENT #3
Deposit Premium: $ ENDORSEMENT #3 Minimum Premium $ 37.000. Audit Period --- - - - - --
1
FEBRUARY 25 1975 mho f
Date of Issue • Countersigned b /u`•�
Authorized Representative .�
SIG-802 (2,17 I)
ORIGINAL
MANDATORY EXCLUSIONS
It is agreed that:
A. As respects all operations, this policy does not apply to liability for:
1. The discharge, dispersal, release or escape of smoke, vapors, soot, fumes, acids,
alkalis, toxic chemicals, solids, liquids or gases, waste materials, or other
irritants, contaminants or pollutants into or upon land, the atmosphere or any
watercourse or body of water unless such discharge, dispersal, release or escape
is sudden or accidental.
2. Fines, penalties, punitive or exemplary damages.
B. As respects oil or other petroleum operations over water, this policy does not apply
to liability for:
1. Personal Injury or Bodily Injury or loss.of, damage to, or loss of use of property
directly or indirectly caused by seepage, pollution or contamination.
2. The cost of removing, nullifying or cleaning -up seeping, polluting or contaminat-
ing substances.
3. Loss of, damage to, or loss of use of property directly or indirectly resulting
from subsidence caused by subsurface operations of the Insured.
4. Removal of, loss of or damage to subsurface oil, gas or any other substance, the
property of others.
C. As respects oil or other petroleum operations on land only, this policy does not
apply to liability for:
1. Removal of, loss of or damage to subsurface oil, gas or any other substance, the
property of others, provided always that this paragraph (Cl) shall not apply to
any liability which would otherwise be covered under this Insurance for such re-
moval, loss, or damage directly attributable to blow -out, cratering or fire of an
oil or gas well owned or operated by, or under the control of, the Insured.
2. Loss of, damage to, or loss of use of property directly or indirectly resulting
from subsidence caused by subsurface operations of the Insured.
3. Personal Injury or Bodily Injury or loss of, damage to, or loss of use of prop-
erty directly or indirectly caused by seepage, pollution or contamination resulting
from the discharge, dispersal or release, or escape of any substance into or upon
any watercourse or body of water.
4. Personal Injury or Bodily Injury or loss of, damage to, or loss of use of property
directly or indirectly caused by seepage, pollution or contamination other than
as described in Paragraph (0) above, provided always that this Paragraph (C4)
shall not apply to liability for Personal Injury or Bodily Injury or loss of or
physical damage to or destruction of tangible property, or loss of use of such
property damaged or destroyed where such seepage, pollution or contamination is
caused by sudden, unintended and unexpected happening during the period of this
Insurance.
5. The cost of removing, nullifying or cleaning -up seeping, polluting or contaminat-
ing substances unless the Seepage, pollution or contamination is caused by a sudden,
unintended and unexpected happening during the period of this Insurance.
This Clause shall not extend this Insurance to cover any liability which would not have
been covered under this Insurance had this Clause not been attached.
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the Inception date of
the policy to which It is attached union otherwise stated below.
The following spaces are to be completed only It this endorsement is not attached to the policy when Issued.
THIS ENDORSEMENT EFFECTIVE FROM AND AFTER
POLICY NO ,�
ISSUED 7- h.,idant
END. NO 9 Countersigned on behalf of )d] Signal Insurance Company
❑ ZIM l Insurance Company
Data B
DULY AUTNORIZZO RSME59NTATJVK OF TNZ COMP AY
SI -853 (3172)
ENDORSEMENT .
CANCELLATION FOR NON- PAYMENT OF PREMIUM
IT IS AGREED THAT IRRESPECTIVE OF ANY OTHER ITEMS OR CONDITIONS CONTAINED
IN THIS POLICY OR ENDORSEMENTS ATTACHED HERETO, THIS POLICY MAY BE CANCELLED
BY THE COMPANY FOR NON - PAYMENT OF ANY UNPAID PORTION OF THE PREMIUM BY
DELIVERY TO THE INSURED OR BY SENDING TO THE INSURED BY HAIL, REGISTERED
OR UNREGISTERED, AT THE INSURED'S ADDRESS AS SHOWN HEREIN, NOT LESS THAN
TEN (10) DAYS' WRITTEN NOTICE STATING WHEN THE CANCELLATION SHALL BE
EFFECTIVE.
This endorsement when countersigned by a duly authorized, representative of the Company shall take effect on the inception date of the
policy to which it is attached unless otherwise stated below.
The following spaces are to be completed only if this endorsement is not attached to the policy when issued.
Prs,lO�nt
Countersigned on behalf of
kI Signal Insurance Company
SI -539 (11/74)
c
ENDORSEMENT �.
EXCLUSION. OF VOLUNTEER FIREMEN
IT IS UNDERSTOOD AND AGREED THE COVERAGE AS IS PROVIDED BY THIS
POLICY EXCLUDES ANY LIABILITY FOR VOLUNTEER FIREMEN WHILE ACTING
WITHIN THEIR SCOPE AS SUCH.
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the inception date of the
policy to which it is attached unless otherwise stated below.
The following spaces are to be completed only if this endorsement is not attached to the pplicy.t + issued.
Pre)itlent
i
Countersigned on behalf of X1 Signal Insurance Company
❑ Imperial Ins ce Company
BY YLY AY NORIS RRi ATIV i'DI TN CON�AN
t
pyA[�e4:,c'M sew „.: %��.}+�vVF+ :.. arty'- �” -v- a•.""..aaxea_s+_a�= t'...`ee.
0
ENDORSEMENT
MALPRACTICE EXCLUSION _
IT IS UNDERSTOOD AND AGREED THAT THE COVERAGE AS IS PROVIDED BY THIS
POLICY DOES NOT APPLY TO BODILY INJURY OR PROPERTY DAMAGE DUE TO:
1. THE RENDERING OF OR FAILURE TO RENDER
(a) MEDICAL, SURGICAL, DENTAL, X-RAY OR NURSING SERVICE OR
TREATMENT, OR THE FURNISHING OF FOOD OR BEVERAGE IN
CONNECTION THEREWITH;
(b) ANY SERVICE OR TREATMENT CONDUCIVE TO HEALTH OR OF
A PROFESSIONAL NATURE; OR .
(c) ANY COSMETIC OR TONSORIAL SERVICE OR TREATMENT;
2. THE.FURNISHING OR DISPENSING OF DRUGS. OR MEDICAL, DENTAL OR
SURGICAL SUPPLIES OR APPLIANCES; Ott "
3. THE HANDLING OF OR PERFORMING OF AUTOPSIES ON DEAD BODIES.
i -
E
i
t
This endorsement when countersigned by a duly authorized representative of the Company shall - takeeffect on the inception date of the policy
to which it is attached unless otherwise stated below. ..
Fhe following spaces are to be completed only if this endorsement is not attached to the policy when issued.
F;. THIS ENDORSEMENT EFFECTIVE FROM AND AFTER{` END. XO. DATE j
i
POLICY NO. ISSUED TO
p,. ' .... Countersigned on behalf of )(0 Signal Insurance Company
A. It is agreed tha0his policy shall not apply tolo liability for personal
injury or property damage arising �,rt of:
1) any riot, riot attending a strike, civil commotion, civil disturbance,
protest or demonstration or out of any act or condition incident to
the prevention or suppression of any of the foregoing;
2) the complete or partial failure to supply electricity, gas or water;
3) the ownership, maintenance, use or operation of airfields, runways,
hangars, buildings or other properties in connection with aviation
activities.or airports;
4) (a) any claims for loss or damage or any liability of any and all
assureds arising out of or in any way connected with the operation
of the principles of eminent domain, condemnation proceedings, or
inverse condemnation by whatever name called regardless of whether
such claims are made directly against the assured or by virtue of
any agreement entered into by or on behalf of the assured.
(b) with respect to any provision in this policy concerning any
duty of underwriters to investigate or defend claims such provisions
shall not apply to claims excluded by paragraph (a) above.
B. It is further agreed that this policy shall not apply to any liability for:
1) property damage to property (a) owned or occupied by or rented to the
insured (b) used by the insured, or (c) in the care, custody or control
of the insured or as to which the insured is for any purpose exercising
physical control;
2) property damage arising out of (a) the explosion hazard (b) the collapse
hazard, or (c) the underground property damage hazard as defined in the
underlying insurance policies;
3) personal injury arising out of (a) false arrest, false imprisonment,
wrongful eviction, wrongful entry, wrongful detention or malicious
prosecution, or (b) libel, slander, defamation of character, humili-
ation, or invasion of the rights of privacy;
unless such liability is covered by valid and collectible underlying insur-
ance as described in the schedule of underlying insurance, and then only
for such hazards for which coverage is afforded under said underlying insur-
ance.
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the inception date of
the policy to which It is attached unless otherwise stated below.
The following spaces are to be completed only if this endorsement is not attached to the policy when issued.
THk, ENDORSEMENT EFFECTIVE FROM AND AFTER —
POLICY NO. � D
ISSUED TO / nI {T•'A'5�.,,'r,C/c/�/'r/J- G%L2U/
Ppsidenf
END, NO. 4 Countersigned on behalf of Signal Insurance Company
❑ Imperial Insurance Company
Date c LY j2 D E NT ATIVE -
/�xO.o.-
OF THE C N ANY
5 1207 (10/69)
ENDORSEMENT
-
IT IS UNDERSTOOD AND AGREED THAT THE ANNUAL PREMIUM IS PAYABLE AS FOLLOWS:
f,
DUE
PREMIUM
4
INCEPTION
$14,800.
MAY 1, 1975
$11,100.
AUGUST 1, 1975
$11,100.
TOTAL ANNUAL
$37000.
7
r�
i
This endorsement when countersigned by a duly authorized
representative of the Company shall take effect on, the inception date of the,
policy
to which iris attached unless otherwise stated below.
t
The following spaces are to be completed only if this endorsement is not attached to the policy when issued..
r THIS ENDORSEMENT HFFECYIVE FROM AND APTBR
END. NO. DAYS
J
,
POLICY NO.
ISSUED TO
Countersigned on behalf of X7, Signal Insurance Company
O�fl01pprial In urance Company
I
A"""'
�YAnt�
Plesitl,nt.
B
DULY AYTNORIkED'RBPR Jr8X�T1VE OF T"IrCO PP Y
rl
Tc' "�
..s... eiia.c. w.c. n -
_k, .�xi —�... '� �..
.)aYii_._2�3•®•,:�
_
h'
�.;'
i
i
ENDORSEMENT
SCHEDULE A - SCHEDULE OF UNDERLYING POLICIES
It is warranted by the Insured that the Insured shall maintain in force valid and
collectible underlying insurance as set out below, or, for the purpose of this
insurance, it shall be deemed such insurance is in force:
Comprehensive General Liability, including Products - Completed Operations, written
without special restrictive endorsements on standard form'in general use, with limits
of at least:
Bodily Injury $ -- - - - - --
$ 300,000.
$ 300,000.
Property Damage $ 100,000.
$ 100,000.
-- - - - - -- -each re$perCrson
aggatVR&ts
each OCCURwR�FFNCE
aggregate where applicable
Comprehensive Automobile Liability on standard forms in general use with limits of at
least:
Bodily Injury $
100,000,
each
person
$
300,000,
each
accident
Property Damage $
100,000,
each
accident
Statutory Workmen's Compensation, with coverage b - Employers' Liability with limit
of at least:
$ 100,000, each accident
This endorsement when countersigned by a duly authorized representative of the Company shall take effect on the Inception date of
the policy to which it is attached unless otherwise stated below.
The following spaces are to be completed only it this endorsement is not attached to the policy when Issued.
THIS ENDORSEMENT EFFECTIVE FROM AND AFTER
� POLICY NO
ISSUED TO W.'Q
h�Ndnnf
i
END. NO. 2 Countersigned on behalf of )(11 Signal Insurance Company
❑ Imperial Insurance Company
Date By L42�2 x
DULY AUTHORIZED R[FnESENT TIvE OF TN[ COMFANY
I
SI 804 (2/71)
• • U#EHENT # 1
DIFFERENCE IN LIMITS ENDORSEMENT
Item 5 of the Declarations shall read as follows:
Item 5 Limit of Liability:
(a) Limit in all in respect of each occurrence: That
amount which, when added to the amount in excess of
which this policy applies, equals $5.000,000-
(b) Limit in the aggregate for each annual period where
applicable: That amount which, when added to the amount
in excess of which this policy applies, equals $�(mp-000-
,I 1.
i
Attached to and forming a part of Policy 11 VEL 304756
i Issued to CITY OF NEWPORT BEACH
Issued by SIGNAL INSURANCE COMPANY
Date effective 12:01 A.M. FEBRUARY 1. 1975
/Wj
.
thorized Represe-ntative
i
Insert Declarations p (Part Two) here so that top edge butts Inst fold of Contract.
ATTACH ENAMMENTS, IF ANY, TO TOP BACK O CLARATIONS.
2. any equipment or device designed or used for (a) separating the
isotopes of uranium or plutonium, Ito) processing or utilizing spent
fuel, or (c) handling, processing or packaging waste,
3. any equipment or device used for processing, fabricating or allaying
of special nuclear material if at any time the total amount of such
material in the custody of the Insured at the premises where such
equipment or device is located consists of or contains more than 25
grams of plutonium or uranium 233 or any combination thereof, or
more than 250 grams of uranium 235,
4. any structure, basin, excavation, premises or place prepared or used
for the storage or disposal of waste, and includes the site on which
any of the foregoing is located, all operations conducted on such
site and all premises used for such operations;
"nuclear reactor" means any apparatus designed or used to sustain
nuclear fission in self - supporting chain reaction or to contain a critical
mass of fissionable material;
3. for improper or inadequate performance, design or specification;
but nothing herein contained shall be construed to exclude claims
made against the Insured for personal injuries or property damage
(other than damage to a product of the Insuredl resulting from
improper or inadequate performance, design or specification;
(i) under Coverage Ila) and I(b), except with respect to occurrences
taking place in the United States of America, its territories or
possessions or Canada, to any liability of the Insured directly or
indirectly occasioned by, happening through or in consequence of war,
invasion, acts of foreign enemies, hostilities, (whether war be declared
or not), civil war, rebellion, revolution, insurrection, military or
usurped power or confiscation or nationalization or requisition or
destruction of or damage to property by or under the order of any
government or public or local authority;
With respect to injury to or destruction of property, the word "injury" or
"destruction" includes all forms of radioactive contamination of property; Ili except insofar as coverage is available to the Insured in the underlying
insurance as set out in Schedule A of the policy, this policy shall not
(h) under Coverage I(b), to claims road= against the Insured apply under Coverage Ila) and I(b), to liability arising out of the
1. for repairing or replacing any defective product or products ownership, maintenance, operation, use, loading or unloading of
manufactured sold or supplied by the Insured or any defective part aircraft owned by the Insured or chartered on behalf of the Insured
or parts thereof nor for the cost of such repair or replacement; without crew, but this exclusion shall not apply to liability for
2. for the loss of use of any such defective product or products or part personal Injury to any employee of the Insured arising out of and in
or parts thereof; the course of his employment by the Insured.
:Ze7ils7i1i[sTitF:
A. PREMIUM
The premium for this policy shall be: (a) if a fixed charge is shown in the
Declarations, such fixed charge for the entire policy period; or (b) if a rate is
shown in the Declarations, the product of the actual exposure during the
policy period, in accordance with the premium basis indicated, and such rate,
subject to the annual minimum premium for each twelve (12) months of the
policy period. Upon expiration of the policy or its termination during the
Policy period, if the earned premium thus computed exceeds the deposit
premium the Named Insured shall immediately pay the excess to the
Company, if less the Company shall return the difference to the Named
Insured.
In any event, the Company shall receive and retain not less than any
applicable minimum premium shown in the Declarations.
B. INSPECTION AND AUDIT
The Company shall be permitted at all reasonable times to inspect the
Insured's premises and equipment, and to examine the Named Insured's books
and records at any time during the policy period and within one 111 year after
its termination, for the purpose of determining the actual premium earned,
and within one 0 1 year after final settlement of all claims so far as the books
and records relate to any occurrences happening during the policy period but
the Company waives no rights and undertakes no responsibility by reason of
such inspection or examination or the omission thereof.
C. SEVERABILITY OF INTERESTS
Except with respect to liability assumed by the Insured under contract, the
term "Insured" is used severally and not collectively, but the inclusion in this
policy of more than one Insured shall not operate to increase the limits of the
Company's liability.
D. OTHER DEFINITIONS
(a) "Personal injury" means (1) bodily injury, sickness, disease, disability,
shock, mental anguish and mental injury; (2) false arrest, false
imprisonment, wrongful eviction, wrongful detention, malicious
prosecution or humiliation; (3) libel, slander, defamation of character
or invasion of rights of privacy, unless arising out of any advertising
activities; (4) racial or religious discrimination not committed by or at
the direction of the Insured; and (51 assault and battery not committed
by or at the direction of the Insured, unless committed for the purpose
of preventing or eliminating danger in the operation of aircraft or for
the purpose of protecting the property of the Insured or the person or
property of others.
Ib) "Automobile" means a land motor vehicle, trailer or semi- trailer.
(c) "Ultimate net loss" means the sum actually paid in cash in the
settlement or satisfaction of losses for which the Insured is liable,
either by adjudication or compromise with the written consent of the
Company, after making proper deductions for all recoveries and
I salvages collectible, but excludes all salaries of employees and office
L, expenses of the Insured incurred in investigation, adjustment and
litigation.
Nothing herein requries the Insured to enforce by legal action any rights of
subrogation before the Company shall pay any loss for which it may be liable
hereunder.
Except as provided in Insuring Agreement V as to the exhaustion of
aggregate limit(s) of underlying policy(ies) listed in Schedule "A" or in
Condition L, other loss expenses and legal expenses llncluding attorney's fees,
court costs and interest on any judgement or award) incurred with the consent
of the Company shall be apportioned in proportion to the respective interests
as finally determined.
(d) "Products hazard" means
(1) the handling or use of or the existence of any condition in or a
warranty of goods or products manufactured, sold, handled or
distributed by the Named Insured or by others trading under his
name, if the occurrence happens after possession of such goods or
products has been relinquished to others by the Named Insured or
by others trading under his name and if such occurrence happens
away from premises owned by, rented to or controlled by the
Named Insured; provided, such goods or products shall be deemed
to include any container thereof, other than a vehicle, but shall not
include any vending machine or any property, other than such
container, rented to or located for use of others but not sold; or
(21 operations, if the occurrence happens after such operations have
been completed or abandoned and happens away from premises
owned by, rented to or controlled by the Named Insured;
provided, operations shall not be deemed incomplete because
improperly or defectively performed or because further operations
may be required pursuant to an agreement; provided further, the
following shall not be deemed to be "operations" within the
meaning of this paragraph: (aa) pick -up or delivery, except from or
onto a railroad car, (bb) the maintenance of vehicles owned or used
by or in behalf of the Insured, (cc) the existence of tools,
uninstalled equipment and abandoned or unused materials.
(e) Occurrence. With respect to Coverage I(b), "occurrence" means either
an accident happening during the policy period or a continuous or
repeated exposure to conditions which unexpectedly and
unintentionally causes direct injury to or destruction of tangible
property during the policy period. All damages arising out of such
exposure to substantially the same general conditions shall be
considered as arising out of one occurrence.
With respect to Coverage I(a) and Coverage I(b), a series of occurrences
arising out of one event not covered by underlying insurance collectible by the
Insured shall be deemed to be one occurrence.
With respect to Coverage I(c), all damages involving the same injurious
material or act, regardless of the frequency of repetition thereof, the number
or kind of media used, and the number of claimants shall be deemed to arise
out of one "occurrence".
E. NOTICE OF OCCURRENCE
Upon the happening of an occurrence reasonably likely to involve the
Company hereunder, written notice shall be given as soon es practicable to the
Company or its authwized representative. Sudr, notiaa.lbod gpivaiADainckulrs
- -
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ayi le algeu!elgo uo!lewio ;u! Iselin; 841 pue paJnsul ayi Aoluapl of wa!oq ;ns