HomeMy WebLinkAbout92-007 Chang, Doug, Robert, Chris & Judy 92-007 CHANG, DOUG, ROBERT, CHRIS & JUDY
z
CiN of cWty ro"o
10300 Torrey Avenut- VoO Box 560
Cupertino,CA 950 1 4-3255 Cupertino,CA 95015-0580
Iafephone:(408;252-4505
'SAX (40e)252-0753
April 17, 1992
Mr. Doug Chang
1571 Finch Way
Sunnyvale, CA 94087
Dear Mr. Chang:
We are enclosing to you for your files and information one (1) copy of the
AWmamt by and between the City of 0q)ertino and Chris Chang, Doug
(hang, Robert T. Chang and Judy (Mang, along with one (1) certified copy
of Resolution M. 8632, which was enacted by the City Cowicil of the City
of Cupertino, at their regular neeting of Monday, April 6, 1992.
S/in fly,
DORCY HY
CITY CLERK
CITY OF CUPERTINO
Drjso
encl.
cc: Department of Public Works
Di
•:i ce... 11 ► :� - 11=lb • =�.lC � • ♦l: -•.a'_1 a:-VI - { 1 'r- G -
IN•] r• Win'- • • •.•-a' : ^t - - .•r.- •' w •_:• -- - �•
- U .`a i(:- ��- s : sf �. :;. - fir_' r. •-,. � •1.__.DIY_
'• ,. • to • •I �::=il. - •.. •:J" •- ":•_- _ •.•! r -..• a.. _
�1
- •' ..ice^ f" _•
.�., - art.-• - - - - �.
1 -
't
y, � r
RESOLWION NO. 8632
E)CMIT 1°A"
DEVELOPMEKT: SINGLE-FAMILY DWELLINGS
C RIS CHANG, DOUG CHANG, FDBEFU' T. CHANG, AND 3UDY
W. aim,
LOCATION: 10750 RAE LANE
A. Faithful Performance Band: $ 24,913.00
TWERN FOUR 'THOUSAND NINE HUNDRED THMM ,AND 00/100 DOLLARS
B. La bpr and Material Bond: $ 24,913.00
FOUR THWSAND NINE HENXMiHnzWN AND 00/100 DOLLARS
C. Checking and Inspection Fee: $ 1,246.00
ONE THOUSAND TW HUN01= FORTY SIX AND 00/100 DOLLARS
D. Indirect City Expenses: $ 187.00
ONE HUNDRED EIGHTY SEVEN AND 00/100 DOLLARS
E. De<relopTent Maintenance Program: $ 1,000.00
ONE TES AND 00/100 DOLLARS
F. Storm Drainage Fee: $ 464.00
FOUR HUNDRED SI?CT'Y FOUR AND 00/100 DOLLARS
G. One Year Power Cost: N/A
H. Street Trees: By Developer
I. Map Qmmkin9 Fee: $ 180.00
ONE HUNDRED EIGHTY AND 00/100 DOLLARS
J. Park Fee: ZONE: II, ACCT # 480-416-022 $ 31,500.00
THIRW ONE THOUSAND Fn7E HUNDRED AND 00/100 DOLLARS
K. Water Tin Reimbursement Fee: $
FOUR THOUSAND NINE HtAMM SEV7EMY UMEE AND 00/100 DOLLARS
L. and/or Isprovement Plans As specified in Item
No. 23 of Agreem
AGREEMENT
10750 Rile Lane
AFN 356-7-20
This AGREErMENr made and entered into this
Of 19 9oZ , by and between the CITY OF
CUPERTINO, a municipal corporation of the State of California, hereink--ffter
designated as CITY, and CHRIS CHAW, DOW CHAM, l T. CHANG AND JUIN
W. CHAM hereinafter designated as DEVELOPER.
WITNESSETH
L2F.AS, THE DEVELOPER has made application to the CITY for a PARCEL
MP AND EKMDDC PAWT to construct and maintain 2 S.DME FMMX
DWEUJNGS hereinafter referred to as "Project".
WHEREAS, CITY hereby approves the improvement plans and. specifications
prepared for the Project by Hf5SM-MUC, a true copy of which
improvement plans and specifications are on file in the office of the City
Engineer of Cupertino; and
WHEREAS, the same are incorporated herein by reference, the same as
though set out in full;
NOW, 11MZEFORE, said inprovement plans and specifications shall be
hereinafter called the "Plans", and the work to be done under the Plans
shall be called the "Work".
1 File: 51,905
WHERE'S, Pursuant to the provisions of this AmFI', the CITY hereby
established the amounts of Bonds, Fees, and Deposits as set forth in the
following schedule:
sC�7LE OF BMW, FEES AND DEPOSITS
Street Improvement Category:
PART A. Faithful Performance Bond: $24,913.00
PART B. Labor and Material Bond: $24,913.00
PART C. Chec3cing and li�pection Fee: $ 1,246.00
PART D. Indirect City Expenses: $ 187.00
PAPIT h- Development Maintenance Deposit: $ 1,000.00
PART F.. Storm. Drainage Fee: $ 464.00
PART G. One Year Power Cost: N/A
PART H. Street Trees: By Developer
PART I. Map Checking Fee: $ 180.00
PART J. Park F'ee: ZONE: II $31,500.00
ACCT#:480--416-022
PART K. Water Main Reimbursement Fee: $ 4,973.00
PART L. Maps and/or L:provement Plans
A- Specified in Item #23
2 File: 51,905
NOW, 'SORE, IT IS HEREBY MLMAT ZY AGREED by and between the
parties hereto as fellows, TO WIT:
J . DEDICATION
A. She DEVEMPER offers to dedicate the real property shown on
Exhibit "A", which is attached hereto and made a part hereof by
reference. Said dedicated property shall be free and clear of all
liens or a cumbrances exeent those which the CITY shall waive in
writing. The DEVELOPER agrees not to revoke said offer of dedication,
and to keep said offer open until the CITY accepts offer by
resolution.
B. Upon axecution of this AGREHUM the DEVELOPER agrees to deliver
a properly executed grant deed to the CTI'Y of the real property
described in Exhibit "A", and such other executed conveyances, or
instruments necessary to convey clear title as herein required. The
DEVELOPER shall provide, at the DEVELOPER'S sole cast and expense, to
the City:
(1) A preliminary title report issued by a title insurance
company relating to the property offered for dedication.
(2 A standard policy of title insurance issued by a title
insurance company and insuring the CITY in the sum of: N/A,
and which shall show said property free and clear of all
liens or encumbrances except those as the CITY shall
expressly waive in writing; said policy shall be furnished
at the time of acceptance of dedication and recordation of
deed.
C. Upon the condition precedent that the DEVELOPER shall perform
each and every covenant and condition of this AGREEMENT, tiie CITY
agrees to wept said real property offered for dedication.
2. INSTALLATION OF woRK
It is further agreed that:
A. The DEVELOPER shall install and complete the Work within one (1)
year from tha date of execution of this AGREEMEar, or such longer
period as may be specifically authorized in writing by the City
Engineer. In the event the DEVELOPER fails or refuses to cotigalete the
Work within the specified period of time, the CITY, at it::, sole
option, shall be authorized to complete the Work, in whatever manner
the CITY shall decide. In the event the CITY completes the Work, the
CITY may recover any and all costs incurred thereby from the DEVELOPER
or the DEVELOPER'S surety or both.
B. The DEVELOPER shall install and complete the Work in a goad and
workmanlike manner in accordance with the plans as approved by the
City Engineer of Cupertino. The Work shall be done in accordance with
existing ordinances and resolutions of the CITY and in accordance with
all plans, specifications, standards, sizes, lines, and grades
approved by the City Engineer. Zhe Work shall be done in accordance
with all State and County Statutes applicable hereto. Zhe decision of
the City Engineer shall be final as to whether any material or
workmanship meets the standards, specifications, plans, sizes lines
and grades as set forth.
3
C. It is further agreed that the Work shall be done in accordance
with the most current Standard Specifications of the Department of
Public Works, California Department of 'Transportation, Stave of
California, and in accordance with the specifications of the Q43ertino
Sanitary District where applicable.
Wherever the words "State" or "California Division of Highways" are
mentioned in the State Specifications, it shall be considered as
referring to the CrT'Y of Cupertino; also wherever the "Director" or
"Director of Public Works" is mentioned, it shall be considered as
referring to the City Engineer.
in case of conflict between the State Specifications and the
specifications of the CITY, and/or the Guertin Sanitary District,
the specifications of the CITY and/or the Cupertino Sanitary District
shall take precedence over and be used in lieu of such conflicting
portions.
3. EXCAVATION PERMIT
It is further agreed that the :DEVELOPER shall comply with Section
Three of Ordinance No. 130 of the CITY by obtaining an excavation
permit from the City Engineer before the cor:-unencement of any
excavation in, cn, or under the surface of any existing public street,
lane, alley, sidewalk, or other public place. It is further agreed
that the DDTWPER shall notify the City Engineer of the exact date
and time when the proposed excavation is to camence.
4. QUITCLAIM DEED
It is further agreed that the DETIIAPER, when requested by the CITY,
shall quitclaim all his rights and interests in, and shall grant to
CITY authorization to extract water from the underground strata lying
beneath said project arrd DEM-OPER agrees to execute a "Quitclaim Deed
and Authorization" in favor of CITY, when presented to him for
signature.
5. BONDS AND OTHER SECURITY
A. Upon the execution of this JING2EEMMr, the DEV WPER shall file
with the CITY a faithful performance bond to assure his full and
faithful performance of this AGR01MENr. The penal sum of said
faithful performance bond shall be the full cost of any payment to be
made under this AGREEMENT, the value of any land agreed to be
dedicated, and any improvements are to be made under this AGRFEME�T.
In the event that improvements are to be made under this AGREEMENT,
the DEVELOPER shall, in addition to said faithful performance, file
with the CITY a labor and materials bond in a penal sun adequate to
assure full payment of all labor and materials required to construct
said improvements. The amount of said bonds shall be as designated by
the City Engineer. Said bonds shall be executed by a surety eaagpany
authorized to transact a surety business in the State of California
and must be approved by the City Attorney as to form and by the City
Engineer as to suf f iciency. In the event that the DEVELOPER R shall
fail faithfully to perform the covenants and conditions of this
AGREEKENt', or to make any payment, or any dedication of land, or any
improvements herein required, the CITY shall call on the surety to
perform this AGREEi`UM or otherwise indemnify the CITY for the
DEVEU)PE:R'S failure to so do.
4
B. In lieu of a surety bend, the DEVELOPER may elect to secure this
DTI' by depositing with the CITY:
1. Cash.; or,
2. A cashier's check, or a certified check payable to the order
of the City of Cupertino; or,
3. A. certificate of deposit, or instrument of am'It meeting
the requirements of Government Code Section 66499 (b) or
(c) .
C. The amount of said cash, checks, certificate of deposit, or
instrument of credit shall be as designated by the City trgineer, and
shall be the equivalent to that which would have been required had the
DEVELOPER furnished the CITY with a surety bond. In the event that
the DEVELOPER shall fail faithfully to perform the asvenants and
conditions of this AGREsma, or to make any payment, or any
dedication of land, or any improvements herein required, the CITY may
apply the proceeds of said security thereto.
D. No release of surety bond, cash deposit, check, or certificate of
deposit, shall be made except upon approval of the City Council.
1. Schedule for bond and insurance release for paver bonds are
as follctas:
A. Release of 90 percent of the faithful performance bond
upon acceptance by City Council
B. Release of the remaining 10 percent of the performance
bond at one year fram acceptance after all deficiencies have
been corrected and in the absence of any claim against such
bond.
C. Release of the entire laixw and material bond at six
months from acceptance after all deficiencies h?ve been
corrected and in the absence of any claim against such bond.
D. Liability insurance, provided by the developer to hold
the City harmless in the event of liability arising from the
project, to be retired at the end of one year if all
deficiencies have been corrected and in the absence of any
claim against such insurance.
2. Schedule for Pond and Insurance Release for Cash, CD,
Set-Aside Letter are as Follows:
A. Release of 45% of bond upon acceptance by City Council.
B. Release of additic-al 45% at six months from acceptance
after all deficienci:;:s have been corrected and in the
absence of any claim against such bond.
C. Release of remaining 10% at one year from date of
acceptance after all deficiencies have been cmxected and in
the absence of any claim against such bonx1.
5
D. Release of the liability insurance, provided by the
developer or contractor to hold the City harmless in the
event of liability arising fram the subject project, at the
end of one year if all deficiencies have been corrected and
in the absence of any claims against such innurance.
E. No interest shall be paid on any security deposited with
the CITY.
6. C-EC KING AND INSPECTION FEE
It is further agreed that DEVELOPER shall pay any and all necessary
direct expenses for inspection, checking, etc., incurred by CITY in
connection with said Project, and that DEVELOPER shall have deposited
with CITY, prior to execution of this AGREEMENT, the amount as set
forth herein at Page 2 (Part C.) . Should construction cost vary
materially from the estimate from V i.ch said sun is calculated, the
City Engineer shall notify DEVELOPER of any additional sum due and
owing as a result thereof.
7. INDIRECT EXPENSES
It is further agreed that DEVELOPER shall. pay to CITY, prior to
execution of this AGREEMENT, indirect expense allocable to processing
these improvements, the amount as set forth herein at Page 2 (Part D) .
8. MAP CHECKING FEE
It is further agreed that the DEVELOPER shall deposit with CITY,
prior to execution of this AGREEMENT, for office checking of final
map and field checking of street monuments, in compliance with Section
4:1 of Ordinance No. 47 (Revised 12/04/61) of CITY, the amount as set
forth herein at Page 2 (Part I) .
9. DEVELOPMENT MA.INMiANC E DEPOSIT
It is further agreed that the DEVELOPER shall pay to the CITY, prior
to execution of this AGREEMENT, the amount set forth herein at Page 2
(Part E) as a development maintenance deposit to insure proper dust
control and cleaning during the construction period. The development
maintenance deposit may be utilized for repairs of defects and
imperfections arising out of or due to faulty workmanship and/or
materials appearing in said work during the period until release of
the surety bonds or other security permitted under paragraph 5.B by
the CITY.
Should the DEVELOP_-M ccuplete the required repairs to the entire
satisfaction of the CITY, the unused balance will be returned after
the release of the surety bond or other security permitted under
paragraph 5.B.
10. STORM DRAINAGE FEE
It is further agreed that the DEVELOPER shall deposit with the CITY,
prior to execution of this AGREE, a storm drainage charge in
eoraecticn with the said Project in accordance with the requirements
established in Resolution 4422, March 21, 1977, in the amount as set
forth herein at Page 2 (Part F) .
6
11. WATER MAIN EXTENSIOPJ DEPOSIT
The DEVELOPER R further agrees to deposit with the CITY those monies
required to comply with "Policy on Water Main Extensions Work and
Deposits" dated 9/30/77. The deposit shall bc, held by the CZ'i"Y until
said monies are needed to implement impraveamts outlined by the
Director of Public Works or irprovements outlined within the adopted
Water Master Plan.
She amount shown herein at Part K, Page 2, shall be the full amount
due.
12. ONE YEAR POWER COST
It is further agreed that the DEVFd-JPER shall pay to the CITY prior to
execution of this AGRFEMEffT, the amount as set forth herein at page 2
(Part G) , which amount represents the power cost for street lights for
one year.
13. THE INSTALLATION OF SI12F.k.T INEES
It is further agreed that '.-e DEVELOPER shall, at such time as deemed
appropriate by the City Engineer, plant street trees in conformance
with the standards of the City of Cupertino. Variety' of tree shall be
selected from the City approved list.
14. PARK FEES
It is furth--x agreed that the DEVELOPER shall pay such fees and/or
dedicate such lard to the CITY, prior to execution, as is required
within Section 18-1.602 Park Land Dedication, Cupertino Municipal
Code, and which is further stipulated under Part J. Page 2 herein.Fees
are also in accordance with action adopted by the City Council on
March 19, 1991 and Chapter 14.05 or Section 18-1.602 of the Cupertino
Municipal Code.
15. MAINTENANCE OF WORK
It is further agreed that the DEVELOPER shall maintain the Work until
all deficiencies in the Work are corrected to conform to the Plans and
the City Standards and Specifications for the Work. The DEVELOPER
shall, upon written notice thereof, immediately repair or replace,
without cost or obligation to the City of Cupertino, and to the entire
satisfaction of said CITY, all defects and imperfections arising out
of or due to faulty workmanship and/or materials appearing in said
Work.
16. SANITARY DISTRICT
It is further agreed that the DEVELOPER shall file with CITY, upon
execution of this AGREEMENT, a letter from the Cupertino Sanitary
District stating that the DEVELOPER has entered into a separate
AGREEMr, with the said District to install sanitary sewers to serve
all lots within said Project and stating that a bond to insure full
and faithful performance of the construction of the said sanitary
sewers and to insure maintenance of said sanitary sewer in conformance
with the provisions as set forth in Paragraph 15 above has been filed.
7
17. GOVERNIIriEW CODE
It is further agreed that DEVELOPER shall file with CITY, upon
execution of this AGREEMER17, Tubstantial evidence that all
provisions of Section 66493, Article 8, Chapter 4 of the Gcrve Tm*m
Code, pertaining to special assessments or bonds, have been omplied
with.
18. CERMAL FIRE DISTRICT'
It is further agreed that the DEVELOPER shall file with the CITY,
upon execution of this AGE2EEtUNr, a letter fray+ the Central Fire
Protection District of Santa Clara County, stating that the
DEVELOPER has entered into an AGREEKENr with said District to
install fire hydrants to serve said Project and stating that all
necessary fees have been deposited with said District to insure
installation and five (5) year rental. fee of said hydrants.
19. PACIFIC GAS AND ELFJCI C/2ACIFIC BELL
It is further agreed that the DEVELOPER shall pay to Pacific Gas
and Electric Company and/or to PACIFIC BELL Company any and all fees
required for installation of overhead and/or underground wiring
circuits to all electroliers within said property and any and all
fees required for undergrounding as provided in Ordinance No. 331 of
CITY when DEVELOPER is notified by either the City Engineer or the
Pacific Gas and Electric Company and/or PACIFIC BELL Company that
said fees are due and payable.
29. EASEMENTS AND RIGHT-OF-WAY
It is further agreed that any easement and right-of-way necessary
for completion of the Project shall be acquired by the DEVELOPER at
his awn cost and expense.
It is provided, however, that in the event eminent domain
proceedings are required the CITY for the purpose of securing said
easement and right-of-way, that the DEVELOPER shall deposit with
CITY a sum covering the reasonable market value of the land proposed
to be taken and to be included in said sum shall be a reasonable
allowance for severance damages, if any. It is further provided
that in addition thereto, such sums as may be required for legal
fees and costs, engineering, and other incidental costs in such
reasonable amounts as the CITY may require shall be deposited with
the City of Cupertino.
21. HUID HAMYREW
It is further agreed that, commencing with the performance of the
Work by the DEVELOPER or his contractor and continuing until the
completion of the maintenance of the Work, the DEVELD.?ER shall
indemnify, hold harmless and defend the CITY from and against any or
all loss, cost, expense, damage or liability, or claim thereof,
occasioned by or in any way whatsoever arising out of the
performance or nonperformance of the Work or the negligence or
willful miscorktact of the DEVELOPER or the DEVELOPER'S agents,
employees and independent contractors, except to the extent any of 8
8
the foregoing is caused by the negligence or willful misconduct of the
City or the City's agents, eMloyees and independent contractors.
22. INSURANCE
It is further agreed that: The DEVELOPER shall take out, or shall
require any contractor engaged to pei-fo:m the Work to take out, and
maintain at all times during the performance and maintemn�,e of the
Work called for or required to be done here-wider, a policy of
insurance naming the CITY and members of the City Council of the City
of Cupertino individually and collectively, and the officer:3, agents
and employees of the City individually and collectively, as insured.
Said separate policy shall provide bodily injury and property damage
coverage to the foregoing namE3d CITY and individuals covering all the
work performed by, for, or on behalf of said DEVELOPER. Both bodily
injury- and property damage insurance :mast be on an occurrence rence basis;
and said policy or policies shall provide that the coverage afforded
thereby shall be primary coverage to the full limit of liability
stated in the declarations, and if the city, its members of the City
Council individually and collectively, and the officers, agents, and
Employees of the CITY, i;xlividually and collectively, have other
insurarr.;e against the lass covered by said policy or policies, that
other insurances shall be Excess insurance only.
The insurance carrier shall provide proof of their ratings. All
ratings shall be a minimum of "Best A-7" in accordance with ABAG
policies.
A. Each of said policies of insurance shall provide coverage in the
following minimum amounts: For beadily injury, $100,000 each person;
$300,000 each occurrence, property damage, $50,000 on account of any
one occurrence with an aggregate limit of not less than $200,000.
B. The DEVELOPER shall file with the City Engineer at or prior to
the time of execution of this AGRFEKERr by the Da=PER such evidence
of said foregoig policy or policies of insurance as shall be
satisfactory to said City Engineer. Each such policy or policies
shall bear an endorsement precluding the cancellation or reduction, in
coverage without giving the City Engineer. at lust ten (10) days
advance notice thereof. The City shall be shown as additionally
insured on a separate "Additional Insured Owners, Lessm or
Contractors" (Form A) or (Form B) Endorsement provided along with the
evidence of said foregoing policy of policies of Insura.,ce
In the event that the Project covered herein should be mutually
situated in or affect the area of jurisdiction of a separate
municipality or political subdivision of the State of California, the
policies of insurance rErguired herein and above shall co-name such
municipality or political subdivision and the provision set forth
herein and above for the protection of the CITY shall equally apply to
municipality and political subdivision.
23. MAPS AND/OR I1440VEKERr PLANS
It is further agreed that the CITY shall obtain the following map
and/or plans at the DEVEMPER'S expense:
9
t
A. A mylar sepia and seven (7) prints of fully executed oaroel
map-
B. A mylar sepia and ten (10) prints of fully executed
improvement plans.
C. A direct duplicating silver negative microfilm aperture
card of all executed improvement plans and map.
The DEVELOPER agrees to pay the CITY from the developnent maw
deposit the cost for all prints of plans and map required under Item
23.
24. SUERS
This AGREFPMPr shall bind the heirs, administrators, executors,
successor, assignee and transferees of the DEVELOPER. The assignment
of this AGREI-MU shall not be made without approval by the City
Council of the City of Cupertino.
10
INDIVIDUAL ACKNOWLEDGMENT
Stat On this thec�._4_day of _GJe ' �W�"j _ 19 y�before me,
e of __� __
SS. Af
County of
iA the undersigned N2 Public,personally appeared U
r
l � fL
L] personally known to me
�( proved to me on the basis of satisfactory evidence
OFFICIAL to be the personis)whose name(s) _ ��____ subscribed to the
ar �£�' ,
' Sa!lye W MC 'enzte.,
AL!FORA within instrument,and acknowledged that - _._. . _._.- executed it.
(� NOTARY PUBLIC RanaxeN
c:v a co�mv of san t t�.,<,y�
cow A�To ' WITNESS my hand and official seal
�{ ,4oiary's Si#ure 1
a � r
ATTENTION NOTARY:Although the,nlormation requested below is OPTIONAL,it Could prevent fraudulent attachment of this certificate to another document
THIS CERTIFlCATE Title or Type of Docu ment
1 MUST BE ATTACHED NumbPages.
er of _ _ Date of Document
TO THE DOCUMENT
DESCRIBED AT RIGHT: Signers)Other Than Narned Above __ _.._ __ ___ _ ___.____
g;, NATK)NAL W)TARY ASSOCWl)N•82X Re"wl Ave.•PO.Box 7184•Cancaa Park.C/1 91304-7 i84
ALL-PURPOSE ACKNOWLEDGMENT NO209
State of_1! - "L CAPACITY CLAIMED BY SIGNER
County of� —�
r•. C t t t c NDIVIDUAL(S)
= G Q CORPORATE
On ,r< Y l before me, r� `��'�7 /�'-� �� i z` �� OFFICER(S)
DATE NAME,TITLE OF OFFICER.•E.G..'JANE DOE,NC.TARY PUBLIC' TITLE(S)
❑ PARTNER(S)
personally appeared f_/"I/`" 6 ❑ ATTORNEY-IN-FACT
NAME(S)OF SIGNER(S) ❑ TRUSTEE(S)
personally known to me-OR- ❑ proved to me on the basis of satisfactory evidence
❑ SUBSCRIBING WITNESS
to be the person(s) whose name(s) is/are ❑ GUARDIAN/C;Ui!SERVATOR
p subscribed to the within instrument and ac- „y
knowledged to me that he/she/they executed ❑ OTHER:
the same in his/her/their authorizes U
capacity(ies), and that by his/her/their
i signature(s) on the instrument the person(s),
orthe entity upon behalf of which the person(s) SIGNER IS REPRESENTING:
; ;f0`,
O�FICIAL NOTARY SEAL acted, executed the instrument. NAME OF PERSONS)OR ENTITY(IES)
,: �oN(;FA HWANGWitness my hand and officioii seal.� jt NoC3f'y Puolir--California
j SANTA CLARA COUNTY (� J
My Comm.Expires APR 11 u;jl
V
�(GNATURE OF NOTARY 7r
1 ATTENTION NOTARY:Although the Information requested below is OPTIONAL,it could prevent fraudulent attachment of this certificate to unauthorized document. V'
THIS CERTIFICATE Title or Type of Document I
y
MUST BE ATTACHED
TO THE OOCUMEN? Number of Pages _Date of tocument_
DESCRIBED AT Rf;�HT: Signers) Other Than Named Above
Y
0 1991 NATIONAL NOTARY ASSOCIATION,3236 Rommel Ave.-P.O.Box 7184-Canoga Park,CA 91304.7184
1 �
® STATE OF —
COUNTY OF '—"t �i��G -- SS. Capacity Claimed by Signer.
On f t'b 1- ; / Aq_2-- before me,the undersigned,a Notary Public in and for said State X individual(s)
D (,A.' 1 G S A/ r ki a y, � � �~�r t].tv o e r ' ❑ Corporate Officer(s)
personally appeared — Urne(s)of Sign )
Tdle(ai
C . Chi, ) r _
[I Personally known tome OR proved to me on the basis of satisfactory evidencU
❑ Partner(s)
to be the person(s)whose name(s)is/ subscribed ❑ Attorney-in-Fact
to the within instrument and acknowi6dged tome that
nFvt he/she/they executed the same in his/her/their ❑ Trustee(s,
F.Af �LSEAL authorized capacity(ies), and that by his/her/their
J1�t FR INSWORTFt signature(s) on the instrument the person(s), or the ❑ Subscribing Witness
` W7.0PUALtC-C LLIKA 'A entity upon behalf of which Elthe person(s) acted, Guardian/Conservator
u SANTAUARACOUN TY executed the instrument.
MY CONIMtSStOPJ EXPIRES ❑ Other:
,tl he Ofi.t
Witness my hand and official seal.
Signer is Representing:
S— Signature o1 Notary Name of person(s)or Entity(ies)
I _
(1 his area for official notarial seal) t t ! -f'"C�,f- L����f 7 •L� - v—
Name(Typed or Printed)
ATTENTION NOTARY: Although the information requested below is optional,it could prevent fraudulent attachment of this certificate to another document.
THIS CERTIFICATE Title or Typer 0 V 1f1—j- .r ---
MUST BE ATTACHED f) ()
TO THE DOCUMENT Number of Pages-A_f—Date of Document ---
DESCRIBED AT THE
RIGHT: Signer(s)Other Than Named Above_.___
SAV-191(11/91) �/
IN WITNESS WHERDOF, CITY has cared its name to be hereunto affixed by
its Mayor and City Clerk, there-unto duly authorized by resolution of the
City Council and said DE'✓ELOPER has hereunto caused his name to be affixed
the day and year first above written.
CITY OF CUPERrM:
Approved as to form:
r l Yam'
City Attorney City Clap
DEVELOPER:
0
f /
i
Notary Acknowledgment Required r
L,
Exhibit A Attached
s
r
6 11
CrrY OF CUPERTWO
INTERDEPARTMENTAL Date rrtb 7, 1992
To CITY I.LEFu. From PUBLIC WORKS--BUNT.
® Information MESSAGE:_ Ck?RIS CHANG, ET AL. — ^ (CC, 4/Bl92)
0 Implement 10750 PAE LA14E
® Investigate
® Discuss TRAt$SKITTED ARE THREE SETS OF PITROVEI ENT AGREDIEN FOR
® See me PROCESSING.
Q Reply
1 5M
attach.
Reply: Doug Chang
-
1571, F'i,ncc Way
SIGNED: DATE —
Forward part I Retain part 2
CITY OF CUPERTINO
INTERDEPARTMENTAL Date April 7. 1992,
To CITY_CLERK a— From PUBLIC WORKS---SUMI
® Information MESSAGE:- CHRIS CHANG, ET AL 416792)
_
® Implement 10750 RAE LANE ' '
® Investigate —`—` — ---
C] Discuss _i. THREE SETS OF IMPROVEMENT AGREEMENT FOR PROCESSING.
Cl See me 2. TRUCK INSURANCE EXCHANGE--INTERIM CERTIFICATE AS TO
C� Reply EVIDENCE OF INSRUANCE. i
3. BOND--CASH ON DEPOSIT.
Reply:______-Doug Chan___-_
1571 Finch Way
—w_ 94 08 7------- -- --
SIGNED: —.— -- ---_DATE —Forward part part I Retain part 2 ~-
TRUCK INSURANCE EXCHANGE
INTERIM CERTIFICATE AS TO EVIDENCE OF INSURANCE
THIS IS NOT AN 0 "i,S S ONLY A iT 0, W1, A'AY WEN," EXTEND OF,At T-n THE
COVERAGE PROVICEII Wf YHE BELOW
Iftw ad
Insured . CHRIS & DOUG & ROBERT & JUDY CHANG 60078 54 92
Addym . 257 CASTRO ST. RN.107
MTN VIEW CA 94041 96 88 329 1""''n"Wb
Agent Iftficy 0-Auto Lob.
Pcgicy,--CARGO
This is to certify that policies for the above named insured are in force as follows:
PolityWork C'amp.
This Interi rr, rtificate As To Evidence of Irisurance shall expire upto cancelled- 12:01A C9 from
3— __. , 19 42 uniess cancelled prior to such date by written notice to the named insured.
1110 Pleaso issue a Permanent Certificate
COVERAGE COMBINED LIMITS OF LIABILITY
COVERED NOT AUTO
COVERED LIABILITY
[j Owned Bodily Injuty $ 000 each parson
1:1 El Hired $ '000 each meunence
0 El Non-Owned Property Dimage $ 000 each occurrence
Employer's Non-Ownership
E3 Contingent Liability
Single Limit Liability for Coverages chocked X above $ 000 each occurrence
GENERAL LIABILITY Bodily Injury 10
M&C-OLT --0,000 each person
1
Owners & Contractors $----__.M0,000 each occurrence
Contractual $ '000
Elevators Property Damage $_______5_0,000 each occurrence
Products and i or 0 Completed Operations $ 000 a
Singly Limit Liability for Coverages checked (K above each occurrence
$ 000 an a,aj"ja,*e El 0 CARGO $ 000 each vehicle
$ 000 each occurrence
WORKE ,
COMPENSATION Statutory
Includes Goods or Products Warranty, Written Lease of Premises, Easement Agreement, Municipal Ordinance
Agreement, Sidetrack Agreement Elevator or Escalator Maintenance Agreement only, unless accompaniqd by
specifk; endorsement providing additional Contractual Coverage.
E] Descnbea ❑ Description
bell-, waived
OWNED YEAR,MAKE,TYPE OF BODY,LOAD CAPACITY IDENTIFICATION NUMBER
AUTO-
MOBILES,
IF LAST 3
COVERED DIGITSSHOWN
--Umbrella Liability $ 000 retained limit
POLICY NUMBE,14 $ each occurrence
$. aggregate
If the Interim Certificate As To Evidence Of Insurance is to be cancelled prior to the expiration date, we shall
provide days advance notice in writing to whom this certificate is issued.
PROPERTY ADDRESS:10750 RAF LANE CUPERTINO CA 95014
Certificate issued to:
Lease/Loan
Name Number
And * CITY OF CUPERTINO
Address . 10300 TORRE AVE.
. CUPERTINO CA 95014
Countersign R BFkT CHAAk,
Not Applicable in Texas. j Aoft.Ued R-pres�
In Texas the aggregate also applies to owners and contractors protective,contractual and/or completed operations.
56-0514 2-90 1651 W/200 C1 12W)
GENERAL CONDITIONS
APPLICABLE TO SECTION
1. Consequential Loss: This policy covers rsnaequen',al foss to personal pros 6. Nuclear Clause: The - •a lire — ,t).5 policy Is -et :r.'e"ded to piles
erty covered hereunder ca„sed by change e"per'+vie or I'-- :iny resui• does r'' e••c,arr; no,Cd1 led"-", I.T. r.,, ra' ,uf:alon a, radioactive coniami-
mg tro,>ti dar.eage by the pe,.i. r uteri iya�nst en�,p en, „sed for na,.o., a tiers er cr,n,, cd cry •u'ea. and loss by nuclear react,an
,® refngeta+nq cooi;ng, h m,d,fy,ng de) r- J iy ng a. nd 3 a,heating, of n,: e - on or r t a, ve c)n aT:,na,.on ,s or .mended to be and
generai,ng or conversing power i n.,uritna 'he,r canne airs •d -upp Y c s o' ns.,,ed ago nst b,, s policy, whether such toss be direct or indirect,
transmiss,or lines and pipesl only wi-.en ,if d o•, tt-e des.-beo Pre,"ses ,ro.,�-- r. - v,e he r, w:�u'e or in can'caused by, cowr,bwed to, or
The Company shall _t be liable however far any loss spec-`taffy c'xU'vde� qa-a,a d�Cy�� a^v ot�e, pe,:is Insured aga,nsr by this pohcyi how-
under r,o', vanda"„s.n and malrt pus :c'--e; c,tovs"ons of n s :y 7r,s ever subject to the to cro acd a'! p,ov,s.ons of Th,s p11,cy, direct loss by
paragraph does not increase the m,ts of bab�f'ty or 'hc a• c,ms recoverah'e f re' r ; 'Ira fro'•, ru ci .. . r nuclear (ad,al.on ar radioactive con-
as spec:f ed u• prov,iled for elsewhere •,, ri put ry apoiicatle to the prop •311131;•) .s insured aga ns• by ' s ,tz cy
erty covered when the +oss coots, 7, Nuclear Exclusion: Loss by uudear rear rn or nvvear radianon or radio-
2. Loss Clause: Any :Ss f ereu^der sha" not reduce •le on u r,t cf th s pc;- a , -. con,am a!,or, .," wht ,her cont'o'ea of uncon•to'ted or due to any
ac+ , ;.nnd,r oil ;..der• to any of the io,egoatg :s na' insured against by
icy. c -_, r:
ohs poll,,, whether such- �oss be d,.ecT ar indirect, prof rate or remote, or
3. Coinsurance Clause: The Ce^'aanv stall net be (,able far a greater pro be n v,ho'e or in part G)used by, co-'but(fd to, or aggravated by any of
porticri or any loss io the property covered under this policy than the C,-, t},e tier is insured aaa,rs: by th s po+,cy, and nuclear reaction or nuclear radi-
pany's percentage cr she spec`ed -r r Or i,abi`:'y to, all Cc,--,busing Ins,, - )•, n ,r ra-'oac ve con,3,rinalicn, all wile-her con+rolled or uncontrolled, is
ante bears to the sire-•r eo cansvrance : rozn,sge 'as set torch c on the fae v e.n'c - srnrrke. " This clause apples to aft perils insured against
!' of this policy) of the actual cash value e' aallproperty insured at the time of erevrj - excep' the per-.s of fire and I:g—ning which are otherwise pro-
loss. ,aed rot r: she Nuclea, Cla.,se above.
If the aggregate clam for any ?osn, is be•h less than $10 G0 and less •f•an
5;� of the I,nn of l,abrl:ty for all n ,but:no Insurance applicable to the S. Ne Control:
property involed at -he me s h t ss occurs no sperial inventory and fn.s rSu. o siafl not be ^erudi,ed:
s a a. b• a,.p act ar r,e sec or tr:e owner of any building if the insured is not
appralsen,ert of the undamaged arnae^v all be require.,. provided 'hat } g
nothing herein shall be construed ss, -e d,e apoii at.on o; The first pair tl,e ov ne !hereof, or by any act or i egiecr of any occupant (other than the
Y graph of :his clause
insuredl c� any bu,laina when such act or neglect of the owner or occupant
if insurance unde• Section I of ill s ci;: • s diwded into serarate limns of s not w n the owrcl of 'he ,nsur d, or
liability, the forego rig snafi apply separayefv to the property covered ureter I), b} fa e o° he insured to cat pty wrh any warranty at condition con-
each sLch Lm•T of tiabjlu a,rle:'f -5nv ,utm Or endorsement a,-ached to This policy with regard to any
y pari,an ct the pr,:mfses over which the insured has no control.
This clause shall not apply to ceverane on rer•s cr extra expense ar earr.ngs.
f Coveragr under Cove-saes A anti 3 and c st of sort ,val of 9, Protective Safeguards: it is a condition of this insurance that the insured
Extensions
debr,s shalt, not be cons derect n the deter^)"na,-on of actul' :ash vLlve w':en
shalt r_)inta"n so far as s withlr, h.s control such protective safeguards as
applying :he Coins.+ranee C'auze. were ,T pulared n the application for this insurance Or for which credit in
are has nee`) a,anted-
4. Mortgagee Clause: (Applicable onil, to Cuverage A.) Thrs entire- clause is f aiiury to ^,-,"tarn Such pratective safeguards shall suspend this insurance,
void unless na,ne of mortgagee of trustee is inserted hn The Declarat,ocs. only as respects the location or situo'ton ar`ected, for the time of such dis-
loss or damage, if any, on buildings under this policy, shall be payable to com:nuence.
the aforesaid as mortgagee or itustee as interest ,nay appear, and this inurr- 10. No Benefit to BaUee: This insurance shall not inure directly or indirectly
ante, as to the interest of the mortgagee or trustee only therein, s'nall not be to the benefit of any carrier or other bailee for hire.
mvalidared by any act rr neglect of the mortgagor or owner of the Within
described property, nor by any foreclosure of other proceedings or no iceof 11. Loss Payable Clause: Loss shall be adjusted with the named insured and
safe retating tc The property, nor ty any charge in the t,Tle or ownership of shall be payable to hen unless other payee is specifically named hereunder.
The property, nor by the occupat,on cf 'he press„ses for ourposes snore haz 12 Report to Police: When either a loss or occurrence takes place the in-
aidous than are permi•ted by ill's p.-,',cy, p rov,ded, that +, ca,e the mort- sured shah give nonce thereof to the proper police authority, it loss or eccur-
gagor or owner shall neglect io pay any piem-v,n clue under this policy, the
sortie ,, due to a violation of a law.
mc:tna(lee or ru sec shall or) de nano pay the s'rrt.
provided also the the ,ror;gagee or srus e stall )a v the C.,inpanv of any 13. Other insurance:
cupancy or inc,e)se :f hazard v.hich shall cone tc. -) Sec,a, r--.!ass by f re or other perils of provided for in b below:
change or ownersh,o or e:
the knnwfcdae of saki n o,`aadee or ire s_e anti unless per tied by This If al the time of the loss, there is other insurance available to the insured or
policy , sha i be re'e i ihe,ecn ind The n ffoaoee or er,er•e sha!i an. do any u i r iweiested party covering such loss or which would have covered
,Nand, pay rl aiui-ivrr for such :,c-VaSed h,uanf for the Term of the use such Ics, er:cer lcr the ex,stence of rh s insurance, then the Company shall
thereof; oihe"v ,e thi_ col,ty shall be null and vo,d" be a` e as 1u to vs:
The Company reserves the right to cancel this policy at any time as provided i li c'n �n o )i.ce �.s Cont('buiuty insurance, defined as any insurance
by ifs terns. but in such case this ool,cy shall continue in force for The ber•,e- w'nrte in the na),e o= the insured, upon the same plan, terms, conditions
fit only of the mortgagee �r trustee far ;0 dais after notice To Th or_ and p 3•sions as contained in iia; policy whether collectible or not, the
gagee or trustee of such cancellation and shall then cease, and site Cg 7iany Cor,t- y shal be l ib e for no greater proportion of any loss than the limit
shall have the r ght, on like notice. To cancel 111.s agree"Ien' of iiat, . r: under this polio', bears to the whole amount of insurance covering
m Whenever the Co•t)pany shall pay t-e r•o:tgage•e or trustee any sum for loss such property.
or l d •ama e under this ,c and shall clalr, that, as to 'h n,e ortpayor er If such .rSUrance is Specific insurance, defined as any insurance other
owner t,ab...ty therefor existed, the Cc,,rpany st zid, to the extent of such than chat described as Contributing Insurance in I j above, the Company
p nos hall not be ',able Tor any loss hereunder until the habi!oy of such Specific
payment, be thereupon legally subrogated to all the ,Ights of the par,y to Insurance has been e':haysted, aed Cher ,hvl cover onlysuch amount as may
o whom such payment shall be made, I,,nde, all secv it,es held as collateral to excaed The amaunr due from such SpeC,flC insurance ( hether collectible or
othe mortgage debt, or may at its option, pay to The mortgagee or trustee the not, 'fief appt ca':on of any conrnbu!ion, cpinsviance, average aT distribution
a whore p,utcipr)1 due or TO grow due on the moogage with interest, and shall
n o- other clauses con,a,ned ,n policies of Such Specific Insurance affecting the
thereupon receive a full asslgnmew and transfer of the mortgage and of all
such other securities; but no subrogation shall impair the right of the moo ameunT collectiblft thereunder, not exceeding however, the applicable limit of
n gagee or trustee to recover the full a•!aunt of said mortgagee"s or trustee"s liab.}".+ under this palicy
v b. Section )—Loss by burola:-y, robbery or theft or loss of personal property
o c(a,,,,
e covered on an unspecified peril basis: Insurance under this policy shall apply
An Loss or damage under this policy shall be payable to the aforesaid mortgagee
appear under all present or future (nor, a es, in as excess y In t rite over any other valid and collectible insurance which
or trustee as :ntviest may f P pr g g weu'c apply m the absence of this policy.
cm ardor of precedence of such mortgayes, u) acordance with the terms of this c W'cen loss under this policy is subject to a deductible, the Company shall
so Standard Mortgagee? Clause. It being understood that no notice of increase or no, be liable fcr more thin its pro Tara share of such loss fit excess of the
w decrease in any mortgagees interest is required, dedvctible amount.
S. All Peril Deductible Clous>: 14. Impairment of Recovery: The Company shall nor be bound to pay any
An amount as stated If, the Decloro•,ors shall be deducted from the amount lots i -he insured shall have in-.paired any right of recovery for loss to the
® of loss to all property coverer hereunde, •,, tiny one occurrence resuh'ng p,oc,( 'v r ..red, however it is agreed that:
from damage by any of the pe, '.s insureci against This deduc14.-'e shall I. a spec-s r-operty while on the premises of the insured, permission is
apply separately to each bonding c strucrcre i,ncled•nq personal ptopert}t gi`t- n he )sured to release others in writing from liability for loss prior to
separately to oe(sono- grope,;y -f no coveroge is prov led on the con',a,n,ng "d smash re ease shall not affect the tight of the insured to recover
building, and separately to personal property ,n the open. This deductible I'c-eunde,, and
shall not opoly to coverage on earn nos, extra expense. tuition fees or rents as resgec+s property in t(anstr, The insured nav, without prejudice to this
rns,.r•sncc. accept such bills of iadmg receipts or contracts of transportation
as are ordinarily issued by carriers cor•a•^+mg a i.m,tai on as -a the •slue of .,ch prods ct tnetc^an&se. x r amount of the insureds obligation to pay shall have been finally determined request, assist in making settlements, in the conduct of suits and in enforcing
either by judgment against the insured after actual trial or by written ai;,ree any right of contribution or indemnity against any person of organisation
merit of the insured. the claimant and the Company, and (b) as respects who may be liable to the insured because of bodily injury or property dem-
Cove rages J, K and l until thirty days after proof at loss is filed and the age w,th respect to which insurance is afforded under this policy; and to
amount of tos- rs determined as provided to this policy iisored shall ar,end hear,ngs and trials and assist in securing and giving evi-
APPLICAB!E TO SECTION 11 derice and obtaining the attendance of witnesses. The insured shay not,
Any person or crgamrat=on or + e legal represer-a•rve thereof f who hats except at h s own cost. vo;untari,y make any payment, assume any obiige-
secci such ud r ent or whiten agreement shall Thereafter be entitled to
T, premium , t{ t�r t: my s th .try a'` c<,:enses recurred by or a•* behalf of 1 g•• g" %=an of mrur any expense other than for first aid to others at the time of
s recover under this pot,cy to the extent of the insurance afforded by this
Pnsm,.;m base: and rates far Iia:s'ds s'a ••: :r 'hit <-,;; its' s„• ' 'v „tiers w a s,,s'a n bid=; .nluy as The result of any one accident, but the named Inca/ed shell promptly take at his expense all res-
it theca applicable in accordance w th the n anva�s n .Ise ry +*r < ..pan,. it " '}e"' policy- No person or ctgar,ta'�on she l bave any right under this policy to satiable steps to prevent other bodily injury or property damage from arising
jam the Company as a parry ,a any a .n a?a ost the insured to defer,nrne o t of the same or similar conditions, and such expense shall not be recover-
The em,um stated in. the Decarations .s an es,=n and Pre,,-c^ At the 3 FINANCIAL RESPONSIBILITY LAWS the insured s Lab,i,ry nor shad the i,i,f,any t:ee "r*P!eaderi by the it su,t.d or
Pr ^"y' 3bl.e under this policy.
and of each policy period -tie earned prer-tim shall tie r. F e: ,n acrrrd e it s ; ,.v s tried ,s pre-f of {manual trispaniib0ily for the future his legal n•p'esematr+p
once with the Company s rules, rates ra rig pl1rs ;Jr ,s .ir:l •r r pit, s nsPof any o c �,r vph c�, financial respori"b,liry law, such Bankro• Tc or tnsalvenc of the insured or f s estate sh,il n: - relieve the
premiums applicable to this insurance ar f trr•nn n p fir eof , s"ra as .s iff--led h -f:a Do'icy for bodily injury hahrlity or for n Y y S. MODIFICATION OF TERMS
Y Y I rY Company of any of its obi gat,ons he=e=order
insured, shall become due and payable ,f Tt:e eel p'ri !h s I,"i • '�_ ah'r'y 0 itco-ply w th if e pfav+s+C.^d of such law to the G•n..s=tons of the Fire Statutory Conditions elsewhere in this polity, other than
puted exceeds the estimated advance p-e'-'urn pa-J the ranted c su e'1 sl.r' re' •• it e ;.,t,ragt and limits of hisbi-'y required by such law. The 4. ASSISTANCE AND COOPERATION OF THE INSURED -rise pertaining to waiver, cancellation and concealment and fraud, do not
pay the excess to the Company; if less, The Company sha'i net::fn +o if-,e ssi, J M1irl ees it) rcv—horse ti,e Company for any payment made by the ih,- insured sha'i cooperate v:.h •tie Ccn•r:any arid, ;;n •hit- C.orr,pany s app'y '-,`;ec•Los It and III,
named insured the unearned portion paid by such ^.,'ed y w :.;h :T wa d nri hate been vbiigated to make under the terms
The narned insured shall maintain for each hazaru records of^he r.forrre;:.n of Th,s po!,cy except for the r_greerr,ent contained in this paragraph.
necessary for premium computation on the basis stated in the Decliraiinrs,
and shall send copies of such rer,ords to the Company at the end of each 4. MEDICAL REPORTS, PROOF AND PAYMENT OF CLAIM
policy period and at such times during the pcli y period as the Company Tmav Coverages F, C, H SPECIAL STATE PROVISIONS
direct. As soon as praci cable the injured person or someone on his behalf shall give
to 'he Company :vrvtten pteaf of claim, under oarh if required. and shall, {Applicable only when the address in Item 1 of the Declarations is in one
2. LIMITS OF LIABILITY after each request from, the Company, execute authorization to enable the of the states indicated)
Coverages C, D, E „.•Tiny to obtain medical reports an.-1 copies of records. The injured person
Regardless of the number of it) insureds under ift s oolicy, (:) persons or Thai! subn.it 'o physical examination by physicians selected by the Company
v0 tin and as often as The Company may reasonably require. The Company INDIANA torte to, onyone egoged n. the business of selling, repairing, servicing,
organizations brought
who sustain bodily injury iu prof eery damage, 13) or(4) rode •v pay 'he inje;red persort or any person of organization rendering the storing, leasing et park rg rotor vehicles and the owner of those vehicles
or suits brought on amount of bodily i th y or property damage tit lal aura- sere ees and such payment shall reduce the amount a able hereunder for Under !-bnd eons oppi,coFle to Sec'.or, it r^"� rz 'r: c. m ;cl s dp person or organization the following
mobiles to wh:,h this folic applies, the Company Itabil,t• is Lriifed as p Y P y 'antis rents or eases one o another
follows; Y P y suet' injury. Payment hereunder shall not constitute admission of liability of feted and tea!oced with The fcr low,o 'equ renews opoi}
he insured or except hereunder. of the Company. i 4, a^or r•s When Twq
The limit of bad,y injory liability stated in the Declarations as applicable to P P Y (c) Excess Insorance red 'rid Nrn hw •ter 1 The awe ers nscrrtnre s primary ,f the other person has no policy cov-
"each person' is the lir,it of the Company's liability for all damages because S. OTHER INSURANCE poGaes providing I nh+'y =ns,rgnce u.iv y 'c v rr.TO orid one o,ov des er,ng the vch r, e and tf'e owner s policy provides for extension of coverage
of bodily injury sustained by one person as the result of any one occurrence- Coverages C, D, E coverage to a named nso,ecf �naogee.l n .be 1•- s'•.e•ss . se. q It•astng. •a •he hnr,owe, enter o, 'essee
,ut subject to the above provjslon respecting "each person", the total lit- the insurance afforded by this policy is primary insurance, except when. repan r.inq, servicta, de'!ver� u test"1<1 •vad s 1 c k•,q ct star na
bility of the Company far ail damages because of bodily inj,try sustained by stated 'o apply in excess of or contingent upon the absence of other incur- autos: and the other provides .o,e''ige ,o .s ne -, e,imoed n 'hat If •tie bor'owe, 'ew a, lessee has a policy in force providing the
two or more persons as the result of any one occurrence t,ha❑ not exceed once eri ,rsurance is priv,aty and the insured has other insurance business Then if or -he ',me of an a c t!pn' g pe^s e r • eno.7gp(i .n thy' overoges above th;Tt cis,rnnce ,s primary and the owners coverage is
the limit of bodilyi, I,sbihi stated ,n the Declarations e business 's coeraiwo •lip auto 'hot verso„ s .it- :1y ns 'trite s fir,a•a'1' ess ,,s saner
t j,ny 'y e ens - app,;cable to which is stated to he applicable t, the Voss on an excess or contingent basis,
"each occurrence` . the amount of the Company's liability under this policy shall not be reduced and the po',cy issued to tiny b„s mess des- ie i of ci p s e.r 1. 1 any
The total keboity of the Company for all damages because of all property by the existence of such other insurance, insurance crvodable to thrr+ option
damage sustained by one or more persons or organizations as the result of When both this insurance and other insurance apply to the loss on the same When a person hcving •rotor veh,r'e iioh,l,ty mofonci' 'eases on outomo OKLAHOMA
any one occurrence shall not exceed the lirnit of property damage liability basis, whether primary, excess or contingent, the Company shall not be liable bile train another and oorees n w tp tract dp I ih!rp cove^r je for II Other Insurance item c is de-
stated in the Declarations as applicable to 'each occurrence' under this policy for a greater prppor-ri of the loss than that stated in the f Under Cond,nons 000t cs,b e o Section1 )
damage resulrmq row. That ne-son s ooe,w cn of 'hit e nett rnitamat)to feted grid replaced w+'h The fa'low+ng.
The limits of bpdrfy injury liability and property damagee
liability stated in applicable contribution provision below- the lessee coverage wit', he c,:.^art v'd ,i,e 'rx s sveroge w,U be
the Declarations os aggregate limit, are rpipectively the total limits of the (a) Contribution by Equal Shares. If all of such other valid and collectible excess Icl Excess Insurance Hired and Non Owned Automobiles _ When two
Company's liability for all damages arising out of the products hazard and insurance provides for cowribution cy equai shares, The Company shall not polices providing Iroh+l,,y insurance apply to an outc and one provides
completed operations hazard during the twelve month period beginning with be li,,b'e for a greater proportion of such foss than would be payable if each coverage to a norned insured who is an authorized motor vehicle dealer,
the effective date of such coverage p,av�ded the bodily injury or property hisur,>r conTnbutr•s an caua! she e until the share of each insurer equals the MINNESOTA and SOUTH DAKOTA and The other provides coverage to a person not engaged in that business,
damage occurs whi'e the praL:y is in '�rce Such aggregate li it's shall apply apj-lln,bie limit of 1:ability undef any one policy or the full amount Sect on !1 ntrd cal Pny„ents s on•rnded . =i'.1 •e •he ";is one yen, then at tl,c r e of an ncc+dent a person not engaged in that business
during each sucreed,ng tw•°!.e rtpnTh r,pfjod fotfew,og renewal cf the poh7r cfvthe loss is paid- and with respect to any amount of loss not so paid the and sulivil,in The vvr.rt e'er, s ooer(Tt,n the auto that person s liability insurance is primary and the
.p is wa tents 'h r g P Y P Y
by payment of 'he regv.re;i hrrmwm When dire re••.a,ninc insurers then onrnue to romr,i uwe eacial shares of the remaining dealer s Ilability ins„nonce :s excess over any insurance available to that
For the purpost! of rfe irvr ny Tt,e !wo at the Company's liability, all bad!y ae„cunt of the loss unrl each such insurer has paid its limit in full or the person
in ury and p dam sge ar cut f nnt,nuous or t.-.e.'ed ta,:ua f,,'ii v otmt of the loss is paid. NORTH DAKOTA
i property -� s
to substantially• the same cmeta conef , shad be considereei as arisin Conditions apph,oh!e to 5ect.en It "`ir•r• Tns •acre tpnl s s', de T"h s prov sion nppiies if The following conditions are met:
1 q (bj Contribution by limits. If any of such other insurance does opt provide Under
out of one occurrence. for contribution by equai shares, the Company shall not be liable for a letvd and ifirilaced w•Th the following The person net engaged ❑ business is operating the auto with the per-
greater proportion of such loss than the applicable limit of liability under this trl Excess Inswonce - Hired i on Non '_awned Avtomoh,'es---When on auto- mission of the dealer the change in financial responsibility is evidenced
Coverages F, G poltry for such loss bears to the total applicable limit of liability of all valid
The limit of liability' stated ,n The Declirat cns as applicable to '"each person" and collectible insurance against such loss. n,pbile policy indudinq autac,ohi!e abil ty cuve'age .•min;red mororTST by a rr•leose signed by the person operating the auto, and no fee or lease
is the limit of the Comp:.ny s iiah,lity for all expenses incurred by or on be (c) Excess Insurance—Hired and Non-Owned Automobiles coverage and a+ton obJe medical payments for no la,.+t benefits) is in charge has been made by the dealer for the use of the auto.
half of each person vine• svviins bodily injury in any one a,.r,dprit With vesper, to a hired automobile or a non-owned automobile, ;his insur-
ance shall be evress insurance over any other valid and collectible insurance
Coverage H acaiiable to the insured.
The limit of habit 1y stated it if,r Dec vat-ons as applicable to 'each person'
is the limit of 'he ':gmpat,y s Lab To) for all expenses incurred by or on be- Coveraget F, G
half of each person w;o s,,srains bodily injury as the result of any one acci With respect to a non-owned automobile, Coverages F and G shall be excess
dent; the limi' of i,ib,iity stated in Tht> Drrlaia;,ons as applicable to "each over anv other collectible medical payments insurance applicable to such
accident' is, tuhleri to flip Mimi, p,_»•,tan tespeciinq each person, the total a„romohde
APPLICABLE TO SECTIONS 11 AND 111
su'cd's spouse, if a resident of the same household at the tirne of such
In the event of an accident %, ,u=recce fir Iris, written notice containing death, and legal representative as named insureds,. and (2) under Coverages
particu!ars sufficient to ,da+ntfy 1).c ,r•sti yid and also .reasonably obtawable C and D, subject otherwise ra the provisions of Form LIAB-1 Insuring Agree-
information with n_spe<t in the >...e. I-,:e and c:rcums'ances thereof, and anent 111. any person having proper temporary custody of the automobile, as
the names and addresses of the -lured at J of available witnesses, shall be an insured and under coverage G while The automobile is used by such
given by or for the insured to the Cnrnpany or any of its authorized agents person, until the appointment and qualifications of such legal representative;
as soon as practicable, and in case of theft, the insured shali promptly notify provided that notice of cancellation addressed to the insured named in Item
the police I of the Declarations and mailed to the address shown in t)iis policy shall
If claim is made or suit is brou7ivt against the insured, the insured steal! be sufficient notice to effect cancellation of this policy.
immediately forward to the Cor.=pony every demand, notice, summons or
other process received by him or his representative, 3. ACTION AGAINST THE COMPANY
2, CHANGE OF INTEREST No action shall lie against the Company under any coverage unless,as a can.
dition precedent thereto, there shall have been full compliance with all the
If the named #,suited shall die thls polwy shall cover 11) the named in- tem.s of this policy, nor (a) as respects Coverages C, D and E until the
APPLICABLE TO ENTIRE POLICY
T INSPECTION AND AUDIT ass.,+--ea by •fie -s-,ed .ode, a^, je-o •A, or under any .riupp e
.••aa ^a- be oe—+'ed bur vo' obl,gaied 'o rspec' the +^-ed ...C•..a•Y Favn•erts p•o, s r. •e.a, ,•e •^ed..a'. or surgical relief.
n�
•.s„ e•',s grape„y and coos rations a, arq +me. Na'he' the Corr,aany s gf' ._.re•ages a^rj r, r•e..• . „c- y snA'! no- 60p:y to
tee xnr 'cos 'f e ak ng he eel nc, any repo, There s a :+s^ `)AS oci t act y d .-Ag J s ;J r ect y u •c!•ec 'y by or d1e
+^ der'e< g b eha''f of ri ,he 'oer•�e=, -f the ^a it r`. ed a a cc^a , c de Ci- aC.. g
._ _ o dete re o na^an• 'r a' ,th property or opefar,Ors ape safe a i.v e , .va• .e a-c, ,-e cr _:r.e wa, „d•^g a,,,or-
it
-nary -ay exa'^ne pro dud' the rar,ed insured s books and records ae aa'r de'e-7, n; hga• c,a• ovd .-wend-r c, expected a!
d.,,,•g • e wo L:y pe,�od and ex^ens,ons thereof and it rep A'x^ by any gcve rr.,-en' :,r sove,e gn e., .de ;,,,e c• d, ractol- or by
.lass , `e ^a •err+•na';an of ,,., aol ry, as far as .hey •elan^ 'o the any authority n•,r.;rta."'ng o .$, g r "ary, na."T a, feces. or t21 by
s,r e:' s'•a• 't•s nsirance ta,y navy o, a, fo-cesr . ,3' br, on age-- cf ary such govern-ent
2 L1R4RALIZATION CLAUSE power. autho^' a, forces be rig u,rie•s+ oil '"'a' any d.sche,ge, explosion
i or use of any weapon cf wa- e^•p,oy_rg .,.'ea, rss-.on a• fux,on shall be
• •tee fn a policy being issued by the Company shall later 6e •ev,sed 'c
e.'e-1 r.prove coverage affordectf the insured under this or,gina'' policy -tutu;us tie'y oresun-ed to be s-ch a host,!e o, wa,>..e acr-m by-such A gov-
s...ct• e..te^s,on shalt ,nurr To the benefit of the insured hereunder ern-rent.. lower, authon•y or forces. b'. ,u^er-t or, label, on. revolution.
Civil war, usurped power, or action taken by go•,ernmewaf authoray in h,n-
J C3IANGEa Bering. comnat'ng or. defending against such an occurrence: seizure or de-
struction under gvaranr..ee or .usro,nx regularons confiscation by order of
oe,son shall no! ef{ect a v,aiver or a change in any part of this policy or any government or pab:. iuthoii:y. or asks of contraband or illegal trans-
es•;,P the Company frog asserting any right under the terms of this policy; portation or trade.
no, shag the terms of :his policy be waived or _hanged, except by endorse
me^t ss.,ed to forma part of this policy. 8. CANCELLATION
4. DECLARATIONS: POLICY TERMS CONFORM TO STATUTE The words "five days in the cancellation provision on the reverse hereof
IL By acceptance of this policy the named insured agrees that the statements in are deleted and the words ten days are substituted therefor.
a the Declarations are his agreements and representations and that this, policy 9. RECIPROCAL PROVISIONS
embodies all agreements existing between himself and the Company or any As used in these provisions the terra Underwriters Association" means the
m of 's agents relating to this insurance. Farmers Underwriters Association or Truck Underwriters Association reaper:-
of 'his policy which are in conJ,icr with the statutes of the state lively, a!tomey-in-fact for the Insurance Exchange issuing the policy,
wherein this policy is Issued are hereby amended to conform to such This policy ;s made and accepted in consideration of the Payment of the pre-
statutes mium herein provided, and the execution of a power of attorney to the
S. SUDROGATION Underwriters Association, herein called the Association, authorizing it to
(o) jn the event of any payment under this policy, the Company shall be execute inter-insurance policies oerween the holder of this policy, herein
subrogated to all The insureds rights of recovery against any person or called the "named insured,' and other subscribers to the Insurance Exchange
organization and the Insured sho'l execute and deliver instruments and issuing the policy.
papers and do whatever else is necessary to secure such rights. The insured No t rm or condition of the policy is intended to create, creates, or shall be
shall do nothing after loss To prejudice such rights. construed to create a partnership or mutual insurance association, or to give
lb', The Company shall not be bound to pay any loss if the insured has rise to or create any joint liability
impaired any right of recovery for loss. however, it is agreed that the To enforce any claims arising under this policy the Exchange shall be sued or
insured may sue in its own name as in the case of an individual. Service of ptucass in
I)) as respects property while on The premises of the insured, release any such suit against the Exchange shall be upon the Underwriters Associa-
others in writing from liability for loss prior to loss, and such release tion, Atty.-in-fact
Shall nor affect the right of the inspired to recover hereunder, and Membership Fees paid for membership in the Exchange are not a part of the
f21 as respects property in transit. acc+pt such bills of lading, receipts or premium and are fully earned upon membership being granted and coverage
contracts of !ransportotior as at._ ordinarily issued by carriers contain- effected. It is net returnable but shall be transferred to any subsequent
:ng a hrnitot.on as to The value of such goods or merchandise. owner of the property covered by this policy.
The annual meeting of the members of the Farmers Insurance Exchange shall
6. POLICY PERIOD; TERRITORY be held at the Home Office of the Exchange at Los Angeles, California, on
Section f of this nohcy applies only 'o loss to property during the policy Pie the Grst Monday following the 151h day of March of each year, at the hour
cod while such property ;s within the 4f9 contiguous states of the United of 7 P M, (if this policy is issued by the Truck Insurance Exchange such
S,arr_s n1 Amer+ca and the Divan of Columbia meeting of its members shall be held at the same place on the first Tuesday
Except with respect to the cwnership, maintenance or use of an automobile iollowrng the Lrsf Monday follew;ng the )5th day of March of each year)
fnri as otherwise o o ided htltre.n the insurance aflorded under Section 11 rr unless the Board of Governors shall elect to change the time and place ^s
it,s. po'�cy app�,es only 'r odi'y ,nfury or property damage which occurs such meeting, in which case, but nor otherwise, written or printed
du•=g the ooi,ry „cord with n !I the United States of America its Teril- shall be mailed each member at his last known address at least ten days
rages or possesssons or Canada, or i2) internmioneit waters or a,r space prior thereto. The Board of Governors shall be chosen by the subscribers
wov.ded the bcdUy injury o, property damage does not occur in the course from among Themselves, at the annual meeting, or any special meeting held
r, t'a,; o• rraesper•a•on •c o+ on. any other country, state or nation, or for that purpose and shall have full power and authority to establish rules
31
anywhere in 'he wn%ire with respect to damages because of bodly injury „rid regulations for the management of the Exchange not inconsistent with
or properly cTAn•age a,sin rul of a product which
c was sold for use x subsc fibers agreements,
onsu,rr>'on w,'h r. r,e 'rr.rury described fir• subdiv,s,on 11) hereof, provided The P,armum o- this policy and all payments made for its continuance shaii
'he ongrnal su' for such damagesi brought within such territory be payable to the Exchange at the Home Office of the Exchange. The funds y'h4
m W h tespec, 'o the owne,sh p ma rienance of use of an auromobite, the .n paid shall be placed to The credit of the named insured upon the records
rsurance afforded .,nda, Sections IT and III of this policy applies only to of the Exchange and applied to the payment of insureds proportion of losses
f bod iy injury o^ property, da,nage which occurs. or to josses_ to the automobile and expenses and to the establishment of reserves and general surplus. All
z which happen during the policy period within the territory described in sub such funds may be deposited and withdrawn or invested and reinvested as
t Pp the
O div,sron 11r or :1) above so a The insurance al lies while the automobile is Board of Governors or its Executive Committee designates. The insured
o being used for t-ips into 'hat PAT' of the Republic of Mexico lying not more agrees that any amount allocaied to the surplus fund of the Exchange by the
u than 7S .+.files from the bouncit of the United States of America. r
o y Board of Governors may be retained by the Exchange and applied, slier procr
-
7. WAR RISK EXCLUSION viding for the payment of all liabilities of the Exchange, to any purpose
Under Section I as respects pe•,Is other than fire (which is otherwise pro- deemed proper and advantageous to policyholders.
v rded for on the reverse hereof) and under Section 11 as respects liability This policy is non-assessable.
a
e
FIRE STATUTORY CONDITIONS
In Consideration of the Provisions and Stipulations Herein or Added Hereto and of the premium charged, this Company, for the term from (shown on the Dec-
Iarahons) in (shown on the Declarations) at noon, standard time at location of property involved, to an amount not exceeding that above (shown on the Decla-
rations) specified, does insure (the insured named in the Declarations) and legal representatives, to the extent of the actual cash value of the property at the time
of loss, but not exceeding the arnount which it would cost to repair or replace the property with material of like kind and quality within a reasonable time
offer such loss without allowance for any increased cost of repair or reconstruction by reason of any ordinance or law regulating construction or repair, and
without compensat,on for loss resulting from interruption of business or manufacture, nor in any event for more than the (ntsirest of the insured, against all
LOSS BY FIRE, LIGHTNING AND BY REMOVAL FROM PREMISES ENDANGERED BY THE PERILS INSURED AGAINST IN THIS POLICY, EXCEPT AS HEREINAFTER
PROVIDED, to The property descrlbe:f he(einlafter) while located or contained as described in this policy, or pro raft for five days at each proper place to
which any of the property shall necessarily he removed for preservation from the perils insured against in this policy, but not elsewhere.
Assignment of this policy shall not be valid except with tl.e written consent of this Company.
Th�s po!,cv ,s made and accepted subject to he foregoing provisions and st'pulations and those hereinafter stated, which are hereby made a pert of this
policy. together w,,'h such other prnv,s,ons st,pvlat,ons and agreements as may be added hereto, as provided in this policy.
In the appl,cat,nr) of the u,ecedmq provisions of the policy, and those provisions on the reverse hereof, wherever the word fire appears, there That; be substl•
ruled therefo, the pent involved or The loss caused thereby, its The case requires.
COND-2•CAL
I Concealment, fraud. This entire policy th.7` t•e void it, whether 80 Pro rate liability. This company shall not be fable for a
2 before- or after a loss. the insured has w.11fklly concealed or miv 31 greater proportion of any loss than the amount hereby insured
3 represented any maieria! fats or c,rcumstsnces concerning this g; sf a' h•ar tr •fee whsle —....arise covering the property against
4 insurance of the subject thereof. or -he in erest of the insured 81 the lit„i ,nso-ed, -her", collectable C•, not
3 therein, or in case of any fraud nr false swearing by the insured. 84 Requirements In Cass less Occurs. the insured shot! give ,writ•
6 relating thereto 85 ten notice to this crrrpany of any lost without unnecessary de-
Unlnwrable and excepted property, Ths po'-cy shall not cover 86 lay ototect the properrY fcx• further damage: forthwith tepa-
8 accounts, bills current, deeds evidences of debt, money, or 87 rate the damaged and p undamaged personal property, put it in
9 securities; nor, uttlea specifcaiiv named herein in writing, 88 he besi puts,bir order furnish a complete inventory of the do-
10 bullion or manuscripts 89 strayed. dis-aged and undamaged property, showing in detail
11 Perils not Included. This rompamy s"tall not be liable for loss by 90 quantities, costs- actual cash value and amount of loss claimed,
12 fire or other perils insured aga:ns, ,n this policy caused d,recily 91 and within 60 days after the loss, enless such time is extended
13 or indirectly, by: la) enemy atsack I— armed forces, including 92 i,. wni,ng by this company, the insured shall render to this com-
14 action taken by rnilitary, naval or air forces in resisting an actual 93 pany a proof of lost signed and sworn to by She insured, stating
15 or, an immediately impending enemy attack, ib) invasion: 94 the knowledge and belief of the insured at to the following: fSe
16 (c) •miurrectioo. Id) rebellion, let revolution; If) civil war; 95 time and origin of the toss, the interest of the insured and of aft
17 (gj usurped power; !hl order of any civil authority except acts 96 others in the property, the actual cash value of each item thereof
18 of destruction at the time of and lot the purpose of preventing the 97 and the amount of loss thereto, all encumbrances thereon, all
19 spread of fire, provided ihat such fire did not originate from any 98 other contracts of insurance, whether valid or not, covering any
20 of the perils excluded by this policy. I,) neglect of the insured to 99 of said property, any changes in the title, use, occupation, !oce-
21 use all reasonable means to save and preserve the property at 100 lion, possession or exposures of said property since the issuing of
22 and after 3 loss, or when the property is endangered by fire in 101 this policy, by whom and for what purpose any building herein
23 neighboring premises; (i; nor shall this company be liable for 102 described and 'she several parts thereof were occupied at the
24 loss by theft. 103 time of loss and whether or not it then stood on leased ground,
:5 Cefier Insurance. Other insurance may be prohibited or the 104 and shall furnish a copy Of all the descriptior,s and schedules in
26 amount of insurance i iay be limited by endorsement attached 105 all policies and, if required and obtainable, verified plans and
27 hereto. 106 specifications of any building, fixtures or machinery de-
28 Conditions suspending or restricting Insurance. Unless otherwise 107 stroyed or damaged. The insured, as often as may be reason-
29 provided in writing added hereto this company shall not be liable i08 ably required, shall exhibit to any person designated by this
30 for loss occurring la) while the hazard is increased by any 109 company all that remains. of any property herein described, and
31 means within the control or knowledge of the insured; or )b) 110 subm€t to examinations under oath by any person named by this
32 while a described building, whether intended for occupancy by I it company, and subscribe the same; and, as often as may be ree-
33 owner or tenant, is vacant or unoccupied beyond a period of i 12 sonably required, shall produce for examination all books of
34 60 conspcutiva days; or ic) as a result of explosion or riot, 113 account, bills, invoices and other vouchers, or certified copies
35 unless fire ensue, and in that event for loss by fire only 114 thereof if originals be loit, at such reasonable time and place as
36 Other perils or subjects. Any other peril to be insured against 115 may be designated by this company or its representative, and
37 or subject of insurance to be covered in this policy shall be 116 shall permit extracts and copies thereof to be made.
38 by endorsement in writing hereon or added hereto 1 17 Appraisal. In case the insured and this company shall fail to
39 Addrad provisions, The extent of the application of insurance )10 agree as to the actual cash value or the amount of loss, then, on
40 under this policy and of the contribution to be made by this com- 119 the written dernand of either, each shall select a competent and
41 pan;, in case of loss, and any other provision or agreement not 120 disinterested appraiser and notify the other of the sppra aer
42 inconsistent with the provisions of this policy, may be provided for 121 selected within 20 days of such demand. The appraisers
43 in writing added hereto, but no provision may be waived except 122 shall first select a competent and disinterested umpire; and fail-
44 such as by the terms of this policy or by statute is subject io 123 ing fcr 15 days to agree upon such umpire, then, on request of
45 change. 124 the insured or thi.. company, such umpire shall be selected by a
46 Waiver provisions- No permission affecting this insurance shall 125 judge of a tour', of record in the state in which the property
47 exist, or waiver of any provision be valid, unless granted herein 1'16 cov-red is located. The appraisers shall then appraise the loss,
48 or expressed in writing auded hereto. No prevision, stipuialion 127 staring separately actual cash value and loss to each item; and.
49 or forfeiture shall be held to be wsrved by any requirement or 128 nailing to agree, shall submit their differences, only, to the um-
50 proceeding on the part of this company relating to appraisal or 129 pine An award in writing, so itemized, of any two when filed
51 to any examination provided for herein. 130 with this company shall determine the amount of actual cash
52 Cancellation of policy. This policy shall be canceled at any time 131 value and loss. Each appraiser shall be paid by the party
53 at the request of the insured, in which case this company shall, 132 selecting him and the expenses of appraisal and umpire shall
5d upon demand and surrender of this policy, refund +-. excess of 133 be paid by the parties equally.
55 paid premium above the customary short rates for the expired 134 Company's options. it shall be optional with This company to
96 time. This policy may be canceled at any time by this company 135 take all, or any cart, of the property at the agreed or appraised
57 by giving to the insured a five days' written notice of cancellation 136 value, and also to repair, rebuild or replace the property
5. with or without tender of the excess of paid premium above the 137 destroyed or damaged with other of like kind and quality
59 pro rate premium for the expired time, which excess, if not ten 138 within a reasonable time, on giving notice of its intention so to
60 deeed, shall be refunded on demand. Notice of cancellation 139 do within 30 days after the receipt of the proof of loss herein
61 shall state that said excess premium Jr.' not tendered) will be 140 required.
62 refunded on demand, 141 Abandonment. There can be no abandonment to this com-
63 Mortgagee Interests and obligations. If loss hereunder is made 142 pany of any property.
64 payable, in whole or in part, to a designated mortgagee not 143 When loss payable. The amount of loss for which this com-
65 named herein as the insured, such interest in this policy may be 144 piny may be liable shall be payable 60 days after proof of
66 canceled by giving to such mortgagee a 10 days' written notice 145 loss, as heroin provided, is received by this company and aster-
67 of cancellation. 146 tainment of the less is made either by agreement between the
68 If the insured fails to render proof of luss such mortgagee, upon 147 insured and this company expressed in writing or by the filing
69 notice, shall render proof of lost in the form herein specified 148 with this company of an award as herein provided.
70 within sixty 1601 days thereafter and shall be subject to the pro- 149 Suit. No suit or action on this policy for the recovery of any
71 visions hereof relating to appraisal and time of payment and of 150 claim shall be sustainable in any court of lave or equity unless
72 bringing suit. 1f this company shall claim that no liability existed 151 all the requirements of this policy shell have been complied
73 as to the mortgagor or owner, it shall, to the extent of payment
74 of loss to the mortgagee, be subrogated to all the mortgagee's 152 with, end unless commenced within twelve months next after
75 rights of recovery, host without impairing mortgagee's right to 153 inception of the loss.
76 sue, or it may pay off the mortgage debt and reclwre an assign- 154 Subrogation, This company may require from the insured
77 ment thereof and of the mortgage. Other pro tisions relating to 155 an assignment of all right of recovery egainst any party for
78 the interests and obligations of such mortgagee may be added 156 loss to the extent that payment therefor is made by this
79 hereto by agreement in writing. 157 company.
In WITNESS WHEREOF, the Company exeaited these presents; but this policy shall not be valid unless countersigned on the Declarations page by a duly
authorized representative of the Company.
ott®ta
ET- 08
7TN EDITION
• ADDITIONAL INSURED ENDORSEMENT
Reference is made to the attached Certificate as To Evidence of Insurance.
It is agreed that:
The person or organization to whom the attached Certificate is issued is an additional insured. This applies only with respect
to liability arising out of the acts or omissions of the named insured. It applies only to the coverages indicated on the
Certificate.
This extension of coverage does not apply:
1. To liability arising out of the negligence of the additional insured, its agents or employees, unless the agent or employee
is the named insured.
2. To any defect of material, design or workmanship in any equipment of whi,:h the additional insured is ttie owner, lessor,
manufacturer, mortgagee, or beneficiary.
3. To any vehicle liability when the named insured is not the owner or does not have care, custody, or conhol of the vehicle.
The intent of this endorsement is to provide the coverage as stated above and in the Certificate. If any court shall interpret
this endorsement to provide coverage other than what is stated above then our limits of liability shall be the limits of bodily
injury liability and property damage liability specified by any motor vehicle financial responsibility law of the state, province,
or territory where the named insured resides. If there is no such law, our limit of liability shall be $5,000 on account of
bodily injury sustained by one person in any one occurrence and subject to this provision respecting each person, $10,000
on account of bodily injury sustained by two or more persons in any one occurrence. Our total liability for all damages be-
cause of all property damage sustained by one or more persons or organizations as the result of any one occurrence shall
not exceed $5,000. This endorsement does not increase the coverage limits.
This endorsement becomes part of the policy to which it is attached and supersedes and controls anything in the policy contrary hereto but is otherwise
subject to the Declarations, Insuring Agreements, Exclusions and Conditions thereof.
,ADDITIONAL INSURED END 1
56-0108 7TN EDITION 11.88 H91 20 Swi000 rA