Forma Construction Company 9/20/2017 Amendment 1

PROPEL INSURANCE PAGE 11 OF 16 @1' Coverage Extension Endorsement ZURICH Policy No. Eff. Date of Pd. Exp. Date of Pol. Eff.Date of End. Producer No. Add'I.Prem Return Prem. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who Is An Insured Provision in Section II—Covered Autos Liability Coverage: The following are also"insureds": a. Any "employee"of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any "employee" of yours is also an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or borrow to transport your clients or other persons in activities necessary to your business. c. Anyone else who furnishes an"auto"referenced in Paragraphs A.1.a.and A.1.b. in this endorsement. d. Where and to the extent permitted by law, any person(s)or organization(s)where required by written contract or written agreement with you executed prior to any "accident', including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. 2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance—Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form: Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any"accident', will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured"will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form. B. Amendment—Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II — Covered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident"we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured"at our request, including actual loss of earnings up to $500 a day because of time off from work. U-CA-424-F CW(04-14) Page 1 of 6 Includes copyrighted material of Insurance Services Office,Inc.,with its permission.