HomeMy WebLinkAboutCousins Maine Lobster 2019-41 Southold Town Board - Letter Board Meeting of September 10, 2019
RESOLUTION 2019-802 Item# 5.35
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ADOPTED DOC ID: 15566
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2019-802 WAS
ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON
SEPTEMBER 10, 2019:
RESOLVED that the Town Board of the Town of Southold hereby ratifies the Special Event of
Cousins Maine Lobster to hold a Special Event 2019-41 at 34515 Main Road, Cutchogue,New
York as applied for in Application Pug2a for one (1) event: September 8, from 11:00 AM to
6:00 PM provided they adhere to all conditions on the application and permit and to the Town of
Southold Policy for Special Event
Elizabeth A. Neville
Southold Town Clerk
RESULT: ADOPTED [UNANIMOUS]
MOVER: William P. Ruland, Councilman
SECONDER:Louisa P. Evans, Justice
AYES: Dinizio Jr, Ruland, Doherty, Ghosio, Evans, Russell
Generated September 11, 2019 Page 53
Town of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 09/11/19 Receipt#: 260019
Quantity Transactions Reference Subtotal
1 Event Fee PUG2a $150.00
Total Paid: $150.00
Notes:
Payment Type Amount Paid By
CK#1105 $150.00 Pugliese, Vineyards
Southold Town Clerk's Office
53095 Main Road, PO Box 1179
Southold, NY 11971
Name: Pugliese, Vineyards
34515 Rt 25
Po Box 467
Cutchoque, NY 11935
Clerk ID: LYNDAR Internal ID PUG2a
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TOWN OF SOUTHOLD
Town Code Chapter 205 "Public Entertainment and Special Events"
SPECIAL EVENT PERMIT INSTRUCTIONS AND APPLICATION FORM
Applications for a Special Event Permit are subject to an inter-departmental coordinated review by the
Southold Town Board,Town Attorney,Town Assessors,Land Preservation,Building,Planning,Zoning
Board of Appeals and Police Departments, and the Suffolk County Planning Commission.
Application fee: $150.00 per application. Up to six (6) multiple events of the same type, occurring over
a period of three months,may be pennitted on one(1) application for a fee of$150.00. However, specific
details of each event must be included with this application.
All applications must be submitted at least 60 business days before the event. Applicants
are encouraged to submit applications as early as possible.
Any completed application that is not submitted 60 or more business days prior to the scheduled
event may be rejected or subject to a late processing fee of$250.00 by the Office of the Town Clerk,
unless a waiver is obtained. Requesting an expedited review must be submitted in writing to the Town
Clerk. The Town Clerk will forward all applications to the Special Events Committee for processing.
The Committee will obtain comments on all applications from relevant Town, County and/or State
agencies and will forward completed applications to the Town Board with a recommendation as to
whether to grant or deny the application.
The Town reserves the right to request additional information from an applicant to address issues related
to the health, safety, and welfare of the community.
When is a Permit Required?
All Special Events,per Southold Town Code Article I, Section 205-2(Definitions)must obtain a permit.
Occasional events on private residential properties hosted by the owner thereof that are by invitation such
as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits.
Any use of residential property for profit such as a venue for weddings or other events is prohibited.
This application is deemed complete once all the following requirements are submitted to the Town
Clerk Please indicate submission of the following by checking off the boxes and signing below.
ElA completed application form signed by the owner and the event manager. Applications without
property owner's signature/approval will be rejected.
FEE: Is the application being submitted at least 60 days before the event[ ] Yes [ ]No
If Yes,Fee of$ 150.00 has been submitted
El If No,Fee of$ has been submitted
Updated 8/7/2018
The applicant/owner of the property where the special event is proposed to take place must provide a
certificate of insurance not less than 2 million dollars naming the Town of Southold as an additional
insured
A Parking/Event Plan: consisting of a survey, site plan and/or aerial view of the subject property that
includes the locations of on-site parking, sanitary facilities, and tents or other temporary structure(s).
(See application form for details)
Events for three hundred (300) or more people require submission and approval of a traffic control
plan acceptable to the Town of Southold AND a qualified traffic controller must be provided at the
event. (See application form for details)
ElSignature of Property Owner on the application authorizing Code Enforcement Personnel of the Town
of Southold to enter the subject premises during the hours of the event to ensure compliance with any
and all special event permit conditions.
My signature below affirms that I have submitted all the information required above in connection
with my application.
09/05/2019
_z
Dated Signature
Activities associated with outdoor public events are strictly prohibited from taking place on land
preserved through the sale of development rights to the Town of Southold, and can only take place on
land preserved through the sale of development rights to the County of Suffolk with a permit issued by
the Suffolk County Farmland Committee.
If food is to be served, it must be catered and prepared off-site by food vendors who hold a permit to
operate issued by the Suffolk County Bureau of Public Health Food Protection Unit.
Updated 8/7/2018
APPLICATION FOR A PERMIT TO HOLD A
SPECIAL EVENT
Please provide ALL of the information requested below.Incomplete applications WILL NOT be
reviewed.
Special Event Permit
A name: M Y Shahul Hameed
# Pp licant(s)
Date of Submission 09/05/2019 Name of Event Cousins Maine Lobster at Pugliese Vineyards
SCTM#'s 1000-Section Block- Lot(s)
Dates of Each Event: 09/08/2019
If Multiple Dates are requested, applicant must give all information for all dates.
Nature of Event: Cousins Maine Lobster at Pugliese Vineyards
(Please attach a detailed description of EACH event to this application)
Time Period(Hours)of Event. From 11 am to 6pm
Town Services requested: ( )Yes (X)No If yes,Describe Police Dept._Highway Dept.
Describe Services
Maximum Number of Persons Attending At One Time: 100 Number of cars expected 20
Is a Tent or other temporary structure being used? [ X]Yes [ ]No If yes provide size(s)
Food truck
22x8 ft
Will food be served? [X]Yes [ ]No If yes provide number and name(s)of food vendor(s)
One
Updated 8/7/2018
Suffolk County permit#(s)
Will other vendors be on the premises during the event? [ ]Yes [)Q No If yes how many? Describe
Type of vendor(s)
Property Owner(name/address): Pugliese Vineyards,34515 Main Rd, Cutchogue, NY 11935
Contact Person and Contact Tel.# Penny Pugliese (631) 734-4057
e-mail address pugliesepenny2@yahoo.com
Event Location: Street-Hamlet Address: 34515 Main Rd, Cutchogue, NY 11935
CTM
Mailing Address to Send Event Permit to: 77 Lexington Avenue, New York, NY 10010
Have any of the development rights been sold to the Town of Southold [ ] Yes [XI No and/or Suffolk
County Agricultural Program? [ ] Yes DQ No If yes to either or both also indicate on the
attached plan the boundaries of the reserved area upon which the event will take place.
YOU MUST ATTACH A PARKING/EVENT PLAN TO THIS APPLICATION IF THE
EXPECTED ATTENDANCE IS 300 OR MORE PEOPLE YOU MUST ALSO ATTACH A
TRAFFIC CONTROL PLAN (see next page)
A Parking/Event Plan may be a survey., site Plan and/or aerial view (for example Google Earth) of
the subject property INDICATE ON THE PLAN ALL of the following information:
A parking/event plan showing:
(1) The size of the property and its location in relation to abutting streets or highways.
(2) The size and location of any existing building(s) or structure(s) that will be in operation
during the course of the event and any proposed building, structure, or signs to be erected
temporarily for the event.
(3) The location of the stage or tents, if any.
(4) The designated areas of use for spectators,exhibitors,vendors, employees and
organizers.
(5) Location of all entries and exits.
(6) The location of all fire extinguishers and other fire safety equipment.
(7) The location of all temporary utilities to be installed for the event, if any.
(8) The layout of any parking area for automobiles and other vehicles and the means of
ingress and egress for such parking areas. The parking spaces must allow for 300 sq. ft.
per car.
(9) A traffic control plan for vehicles entering and leaving the site for the proposed event.
(10) Plan for the use of live outdoor music, loudspeakers and other sounds which will be used,
if any, and the type and location of speakers and other audio equipment.
(11) A description of emergency access and facilities related to the event.
(12) Provisions to dispose of any garbage,trash,rubbish or other refuse.
(13) Location and description of any additional lighting to be utilized in conjunction with the
event.
Updated 8/7/2018
(14) Location of sanitary facilities on site.
Traffic Control Plan
Events for three hundred(300)or more people also require submission and approval of a traffic control
plan,acceptable to the Town of Southold,AND a qualified traffic controller must be provided.Please
attached a written description and/or notate on the parking event plan the following: 1)Who will be
conducting traffic, 2)Where they will be stationed on site, 3)How they will direct the entrance,
circulation,parking, and exiting of cars on site, and 4)Contact information for use by Southold Town
Police.
OWNER'S SIGNATURE:
I ant the Owner of the Property where this event is to be held and I agree to comply with the laws,
rules, regulations, conditions, and requirements of the Code of the Town of Southold, including but
not lintited to the conditions listed below, as well as all other applicable agency rules and regulations
pertaining to the activities under this event. Furthermore,I hereby swear or affirm that the
information contained herein and attachments hereto are trite and correct to the best of►ny knowledge,
and agree to provide notice to the Town immediately should there be any material changes regarding
to this application. .
Furthermore,I hereby authorize Code Enforcement Personnel of the Town of Southold to enter the
property during the hours of the permitted special event to make any and all inspections necessary in
connection with this Special Event.
Print name of Owner Signature of Owner
Print naive of Authorized Person/Representative Signature of Authorized Person/Representative
PERMISSION IS HEREBY GRANTED SUBJECT TO THE FOLLOWING CONDITIONS:
1. By acceptance of this permit, applicant agrees to adequately supervise and direct all parking to be on
the premises or at another site, and to provide parking assistants and any additional traffic controls
necessary for this event. Parking is strictly prohibited on ANY Town County or State Roads or Rights of
Way.
2. Traffic control at events for three hundred(300) or more people shall be provided by a qualified traffic
controller in accordance with the attached,approved traffic control plan.
3. One "on-premises" sign not larger than six (6) square feet in size may be displayed not longer than
thirty (30) days before this event, and removed immediately after the event. Directional parking signs
shall be adequately displayed.
4. Applicant indemnifies and holds harmless the Town of Southold from all claims, damages, expenses,
suits and losses including but not limited to attorney's fees arising from activities under this permit.
5. Tent proposals must receive permit approval from the Southold Town Building Inspector before
placement on the property and must meet all fire and safety codes.
6. This permit is valid only for the time, date, place and use specified above, and for the designated
event. Each additional day will require a separate permit application, fee, and related documents for
review,etc. at least 60 business days prior to the scheduled event.
7. Adequate temporary sanitary facilities must be provided by applicant for this event and applicant
agrees to remove the temporary facilities from the premises within 48 hours after the day of the event.
Updated 8/7/2018
8. On-site food preparation is NOT permitted, although food may be catered subject to all Suffolk
County Department of Health regulations.
9. NO activities associated with this event. including but not limited to parking ingress/egress/access,
tents or temporary structured or temporary sanitary facilities shall be conducted on Town of Southold
Purchase of Development Rights land.
10. NO activities associated with this event including but not limited to parking ingress/egress/access
tent(s) or temporary structure(s), or tempore sanitary facilities shall be conducted on Suffolk County
Purchase of Development Rights land without a permit issued by the Suffolk County Farmland
Committee,
11. Issuance of this permit does not authorize in any manner the occupancy of any building exceeding the
legal limitations under the fire code or other codes which would prohibit such increased occupancy.
12. Access shall be provided for emergency vehicles, to all public assembly areas, all buildings, all work
areas and any additional area where emergencies may occur. Two emergency-fire exits and exit paths
from the building(s) on the property, to a public way or remote safe area, shall remain open and
unobstructed at all times.
13. Owner assures full compliance with all fire, safety,building, and other Town laws.
14. Music,when outdoors, is required to stop at the time specified in the permit. Placement of the
speakers must be in a location that affords the greatest protection from noise intrusion upon adjacent
properties.
15. Owner will allow access to Code Enforcement Personnel of the Town of Southold during the
hours of the special event to stake any and all inspections necessary in connection with this
Special Event.
16. ADDITIONAL CONDITIONS:
ANY VIOLATIONS IN CONNECTION WITH THE CONDITIONS LISTED HEREIN WILL
TERMINATE THIS PERMIT.
APPROVED Town of Southold
Resolution Number: Date Issued:
Updated 8/7/2018
(14) Location of sanitary facilities on site.
Trafflg.Control PI J(300)or more people also require submission and approval of a traffic Control
Events for three hundred Please
plan,acceptable to the Town of Southold,AND
d/or notate on the parking event plan the following: 1)Who will be
attached a written description an ti
on site,3)How they will direct the entrance,
conducting traffic.2)Where they will be stationed Contact information for use by Southold Town
circulation,parking,and exiting Of cars On site,and 4)Co
Police.
1��amdre�Tvner of V0110 P%erty where this event is to be held and I agree to comply with the taws,
Cade of the Town of Southold,including but
rules,regulations,conditions,and requirements of the CO
listed below,as well as all other applicable agency rules and regulations
not limited to tile conditions . Fu?thermore,I hereby swear or affirm that the
pertaild,tig to the activities under this event ct to the best of my knowledge,
information contained herein and attachments hereto are true and corre regarding
to the Town immediately should there be any material changes
and agree to provide notice
to this application,. Personnel of the Town of Southold to enter the
Furthermore,I hereby authorize Code Enforcement I to make any and all inspections necessary in
property during the hours of the permitted special even
connection wirl,this Special Event.
hamm of owner
d
a
Print name of Owner Owner I&
Signature of Authorized Person/Representative
Print name of Authorized Person/Representative
PERMISSION 13 IM Y
1. By acceptance of this permit, applicant agrees to adequately supervise and direct all parking to be on
rovide parking assistants and any additional traffic controls
the premises or at another site, and to p
necessary for this event tl on
WM
2. Traffic control at events for three hundred(300)or more people shall be provided by a qualified traffic
controller in accordance with the attached,approved traffic control plan.
3. One "on-premises" sign not larger than six(6) square feet in size may be displayed not longer than
thirty (30) days before this event, and removed immediately after the event. Directional parking signs
shall be adequately displayed.
4. Applicant indemnifies and holds harmless the Town of Southold from all claims, damages, expenses,
suits and losses including but not limited to attorney's fees arising from activities under this permit.
S. Tent proposals must receive permit approval from the Southold Town Building Inspector before
placement on the property and must meet all fire and safety codes.
6. This permit is valid only for the time, date, place and use specified above, and for tile designatcd
event. Each additional day will require a separate permit application, fee, and related documents for
review,etc.at IQ the &dWeel event.
7. Adequate temporary sanitary facilities must be provided by applicant for this event and applic.axit.
agrees to remove the temporary facilities from the premises within 48 bouts after the dav Of the event.
Ut)daU,
Event Description
Cousins Maine Lobster at Pugliese Vineyards
On September 08, 2019 Cousins Maine Lobster food truck will park in an allotted space on the
Pugliese Vineyards property from 11am to 6pm.The purpose is to vend food to Pugliese's
visitors. No additional guests aside from these visitors are expected, thus the approximation for
number of attendees at one given time is around 100.
ATE
��®® CERTIFICATE OF LIABILITY INSURANCE D09/03I2019Y)
09/03/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
CONTACT Jacll n Scurtl
PRODUCER Gaspar Insurance Services, Inc. NAME y FAX
PHONE 818.3023060 (AIC,No• 818.436.6122
23161 Ventura Blvd.Suite 100 ('C.IL Ext .
Woodland Hills,CA 91364
AooRESS• jacilyn.scurti@gasparinsurance.com
License#: OG66626 INSURERS AFFORDING COVERAGE NAIC#
INSURERA Technology Insurance Company
INSURED INSURER Wesco Insurance Company
Cousins Maine Lobster SO Connecticut&New York Truck Inc INSURER C: Chubb
DBA Cousins Maine Lobster
280 Park Avenue S#12A INSURER D
New York,NY 10010 INSURER E
INSURER F.
COVERAGES CERTIFICATE NUMBER: 00000000-0 REVISION NUMBER: 98
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
FN_SR ADDL SUER POLICY EFF POLICY EXP LIMITS
LTR TYPE OF INSURANCE POLICY NUMBER MM/DDIYYYY MMIDD
A X COMMERCIAL GENERAL LIABILITY TPP1061030 09/07/2018 10/10/2020 EACH OCCUGE TORRENCE $ 1,000,000
CLAIMS-MADE FRJ OCCUR PREMISES Ea occurrence S 100,000
MED EXP(Any one person) $ 5,000
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
X PRO LOC PRODUCTS-COMP/OP AGG $ 2,000,000
POLICY[:]
OTHER COMBINED SINGLE LIMIT $ 1,000,000
B AUTOMOBILE LIABILITY WPP1628089 09/07/2018 10/10/2020 Ea accident
BODILY INJURY(Per person) S
ANY AUTO
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY X AUTOS PROPERTY DAMAGE $
HIRED NON-OWNED Per accident
X AUTOS ONLY X AUTOS ONLY $
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
AGGREGATE $
EXCESS LIAB CLAIMS-MADE
DED RETENTIONS
G. WORKERS COMPENSATION (19)7177-07-02 10/04/2018 10/10/2020 7ELDIS
TUTE ERH
AND EMPLOYERS'LIABILITY Y/N H ACCIDENT $ 1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A
OFFICER/MEMBER EXCLUDED? EASE-EA EMPLOYE $ 1,000,000
(Mandatory in NH) 1,000,000 OOO
If yes,describe under EASE-POLICY LIMIT $ , ,
DESCRIPTION OF OPERATIONS below _E
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required)
Policy includes Blanket Additional Insured-
Town of Southhold,NY and
Pugliese Vineyards are included as additional insured with respects to General Liability arising out of the activities of
the insured at 09/08/2019 event.
Date:September 08,2019
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town of Southhold, NY THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Pugliese Vineyards AUTHORIZED REPRESENT IPjVE
34515 Main Rd, Cutchogue, NY 2t9:_�(JXJ'rlSG�7\�1193588-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORDPrintedby JMS on July 25,2019 at 02 19PM
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
33-0729NY 08 14
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
COMMERCIAL GENERAL LIABILITY COVERAGE
EXPANSION ENDORSEMENT - NEW YORK
(NON-CONTRACTORS),
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART—CG 00 01
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by
the endorsement.
Additional Premium $
SECTION I —COVERAGES
COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE LIABILITY
2. Exclusions
g. Aircraft,Auto Or Watercraft
Paragraph (2) is replaced by the following:
(2) A watercraft you do not own that is:
(a) Less than 51 feet long; and
(b) Not being used to carry persons or property for a charge.
This provision applies to any person, who with your consent, either uses or is responsible for the use of
a watercraft. This insurance is excess over any other valid and collectible insurance available to the
insured whether primary, excess, or contingent.
j. Damage To Property
Paragraph (2) is not applicable.
(2) This paragraph is deleted.
Paragraph (4) replaced with the following:
(4) Personal property in the care, custody or control of the insured which exceeds $50,000 regardless of
the number of:
(a) Insureds
(b) Claims made; or
(c) Persons or organizations making"claims
The most we will pay under this coverage is $50,000. Our duty to pay and defend ends under this
coverage when the coverage limit has been exhausted.
n. Recall Of Products,Work Or Impaired Property
Replace with the following:
Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall,
inspection, repair, replacement, adjustment, removal or disposal of:
33-0729NY 08 14 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 6
Used with permission
(1) "Your product";
(2) "Your work"; or
(3) "Impaired property";
if such product, work, or property is withdrawn or recalled from the market or from use by any person or
organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it, but
this exclusion does not apply to "product recall expenses" that you incur for the "covered recall" of "your
product".
This insurance does not apply to"Product Recall Expense" arising out of or resulting from:
a. Any product withdrawal initiated due to:
(1) The failure of "your products" to accomplish their intended purpose, including any breach of
warranty of fitness, whether written or implied. This exclusion does not apply if such failure has
caused or is reasonably expected to cause"bodily injury" or physical damage to tangible property.
(2) Copyright, patent, trade secret or trademark infringements;
(3) Transformation of a chemical nature, deterioration or decomposition of"your product", except if it is
caused by:
(a) An error in manufacturing, design, processing or transportation of"your product"; or
(b) "Product tampering"
(4) Expiration of the designated shelf life of"your product".
b. A "product withdrawal", initiated because of a "defect" in "your product" known to exist by the Named
Insured or the Named Insured's "executive officers", prior to the inception date of this Coverage Form or
prior to the time"your product" leaves your control or possession.
c. Recall of any specific products for which "bodily injury" or "property damage" is excluded under
COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE LIABILITY by endorsement.
d. Recall of"your products" which have been banned from the market by an authorized government entity
prior to the policy period.
e. The defense of a claim or"suit" against you for"product withdrawal expenses".
f. COVERAGE A does not apply to 'product recall expense" arising out of any withdrawal or recall that
occurred before you acquired or formed the organization.
We will not pay more than $100,000 annually for "product recall expense" incurred from all "Covered Recall"
events covered during this policy term.
Replace the following paragraph-
Exclusion c. through n. do not apply to damage by "specific perils" to premises while rented to you or temporarily
occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in
Section III—Limits Of Insurance.
COVERAGE B —PERSONAL AND ADVERTISING INJURY LIABILITY
2. Exclusions
Paragraph e. Contractual Liability is amended as follows:
e. Contractual Liability
This paragraph is deleted.
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Used with permission
COVERAGE C—MEDICAL PAYMENTS
Paragraph 1.a. (3)(b) under SECTION I—COVERAGE C—MEDICAL PAYMENTS is replaced with the following:
(b) The expenses are incurred and reported to us within two years of the date of the accident; However,
expenses reported to us after two years of the date of the accident will not be denied solely because of the
late submission unless such late submission operates to prejudice our rights; and
SUPPLEMENTARY PAYMENTS —COVERAGES A AND B
Paragraph 1.b. and 1.d. under SECTION I -SUPPLEMENTARY PAYMENTS —COVERAGE A AND B is replaced with
the following-
b. Up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of
any vehicle to which the Bodily Injury Liability Coverage applies. We do not furnish these bonds.
d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the
claim or"suit", including actual loss of earnings up to $300 a day because of time off from work.
SECTION II —WHO IS AN INSURED
Paragraph 3.a. is amended as follows:
a. Coverage under this provision is afforded only until the 180`h day after you acquire or form the organization or
the end of the policy period,whichever is earlier.
However, provision a. above does not apply if the newly formed or acquired organization is excluded by either a
provision of the Coverage Form or by endorsement.
The following is added under SECTION II—WHO IS AN INSURED:.
4. Organization over which you maintain ownership of more than 50% will be a Named Insured if there is no other
similar insurance available to that organization; however
a. COVERAGE A. does not apply to "bodily injury" or"property damage"that occurred before you acquired
or formed the organization; and
b. COVERAGE B. does not apply to "personal and advertising injury" arising out of an offense committed
before you acquired or formed the organization.
If such organizations are not shown in the DECLARATIONS, you must report them to us within 180 days of
inception date of the policy, unless it can be shown not to be reasonably possible to give such notice. In such
instances, notice will be given as soon as reasonably possible thereafter.
5. Any person or organization with whom you agreed, because of written contract or written agreement to provide
insurance, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are
distributed or sold in the regular course of the vendors business, subject to the following additional exclusions:
The insurance afforded the vendor does not apply to:
a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the
assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that
.the vendor would have in the absence of the contract or agreement;
b. Any express representation unauthorized by you;
c. Any physical or chemical change in the product made intentionally by the vendor;
d. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing or the
substitution of parts under instruction from the manufacturer, and then repackaged in the original container;
e. Any failure to make such inspection, adjustments, tests or servicing as the vendor has agreed to make or
normally undertakes to make in the usual course of business in connection with the sale of the product;
33-0729NY 08 14 Includes copyrighted material of Insurance Services Office, Inc , Page 3 of 6
Used with permission
I
I
f. Demonstration, installation, servicing or repair operations, except such operations performed 4 the vendors
premises in connection with the sale of the product;
g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part
or ingredient of any thing or substance by or for the vendor
This insurance does not apply to any insured person or organization, from whom you have acquired such
products, or any ingredient, part or container, entering into accompanying or containing such products.
6. Any person or organization to whom you are obligated by virtue of a written contract to provide insurance such
as is afforded by this policy, but only with respect to liability arising out of the maintenance or use of that part of
any premises leased to you, including common or public areas about such premises if so required in the
contract. However, no such person or organization is an insured with respect to:
a. Any"occurrence"that takes place after you cease to occupy those premises; or
b. Structural alterations, new construction or demolition operations performed by or on behalf of such insured.
7. Any person or organization granting a license to make, or distribute "your products" including "your products"
which use the name or logo of grantor and to whom you are obligated by virtue of the written contract to provide
insurance such as afforded by this policy, but only with respect to liability arising out of"your products".
SECTION III — LIMITS OF INSURANCE
The following is added to Paragraph 2. of SECTION III—LIMITS OF INSURANCE:
d. The General Aggregate Limit applies separately to each of your"locations".
For the purpose of this provision only, "Location" means premises involving the same or connecting lots, or
premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad.
Paragraph 6. is replaced with the following:
6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is replaced by a "Specific Perils"
Limit which is the greater of:
a. $300,000; or
b. The amount shown in the DECLARATIONS for Damage To Premises Rented To You Limit.
The "Specific Perils" limit is the most we will pay under COVERAGE A for damages because of "property
damage'to any one premises, while rented to you or temporarily occupied by you with permission of the owner.
However, provisions a. and b. above do not apply if any reference in the DECLARATIONS for Damage to
Premises Rented to You is deleted from this policy either by the provisions of the Coverage Form or by
endorsement.
The following is added under SECTION III—LIMITS OF INSURANCE:
7. Product Recall Expense
$100,000 is the most we will pay for all"product recall expenses" arising out of the same defect or deficiency.
8. Professional Services
Subject to provisions in SECTION I — COVERAGES - COVERAGE A — BODILY INJURY AND PROPERTY
DAMAGE LIABILITY — 2. Exclusions r. and COVERAGE B — PERSONAL AND ADVERTISING INJURY
LIABILITY—2. Exclusions q.the most we will pay for Professional Services is$50,000 each annual period.
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SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS
2. Duties In The Event Of Occurrence, Offense, Claim Or Suit
Replace paragraph 2.a. with the following:
a. You must see to it we are notified as soon as practicable of an "occurrence" or an offense, which may result in a
claim. Knowledge of an "occurrence" or an offense by your"employees" shall not, in itself, constitute knowledge
to you unless any one of your partners, "executive officers", directors or insurance managers shall have actually
received notice. To the extent possible, notice should include:
(1) How, when and where the "occurrence"took place;
(2) The names and addresses of any injured persons and witnesses; and,
(3) The nature and location of any injury or damage arising out of the"occurrence" or offense.
The following is added to paragraph 2. under SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS:
f. Your rights afforded under this policy shall not be prejudiced if you fail to give us notice of an "occurrence",
offense, claim or"suit", solely due to your reasonable and documented belief that the "bodily injury' or"property
damage" is not covered under this policy.
g. You must see to it that the following are done in the event of an actual or anticipated "covered recall" that may
result in"product recall expense":
(1) Give us prompt notice of any discovery or notification that "your product" must be withdrawn or recalled.
Include a description of"your product" and the reason for withdrawal or recall.
(2) Cease any further release, shipment, consignment or any other method or distribution of like or similar
products until it has been determined that all such products are free from defects that could be a cause of
loss under this insurance.
4. Other Insurance
The following is added to Other Insurance and supersedes any provision to the contrary with respects to the
Commercial General Liability Coverage Part and Products/Completed Operations Liability Coverage Part.
d. This insurance is primary to and will not seek contribution from any other insurance available to an additional
insured under your policy provided that:
(i) The additional insured is a Named Insured under such other insurance; and
(ii)You have agreed in writing in a contract or agreement that this insurance would be primary and would
not seek contribution from any other insurance available to the additional insured. 2013 REVISION
6. Representations
Replace with the following:
By accepting this policy, you agree:
a. The statements in the Declarations are accurate and complete;
b. Those statements are based upon representations you made to us; and
c. We have issued this policy in reliance upon your representations.
Any knowledge of an error or omission in the description of, or failure to completely describe any premises or
operations intended to be covered by the Coverage Form will not invalidate or affect coverage for these
premises or operations. You must report such error or omission to us as soon as practicable after its discovery.
However, this provision does not affect our right to collect additional premium or exercise our right to
cancellation or non-renewal.
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8. Transfer Of Rights Of Recovery Against Others To Us
Replace with the following:
If the insured has rights to recover all or part of any payment we have made under this Coverage Form, those
rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured
will bring "suit' or transfer those rights to us and help us enforce them. However, if the insured has waived those
rights to recover through a written contract or if "your work" was commenced under a letter of intent or work
order, subject to a subsequent reduction to writing with customers whose customary contracts require a waiver,
we waive any right to recovery we may have under this Coverage Form.
SECTION V— DEFINITIONS
Paragraph 3. of SECTION V—DEFINITIONS is replaced with the following:
3. "Bodily Injury" means injury, sickness or disease sustained by a person. This includes mental anguish, mental
injury, shock, fright or death resulting from "bodily injury', sickness or disease.
The following definitions are added:
23. "Covered recall," means:
a. A product recall made necessary because you determine that the product recall is necessary; or
b. An authorized government entity has ordered you to conduct a product recall.
24. "Product recall expense" means necessary and reasonable expenses for.
a. Costs of notification;
b. Costs of stationery, envelopes, production of announcements and postage or facsimiles;
c. Costs of overtime paid to your regular non-salaried employees and costs incurred by your employees,
including costs of transportation and accommodations;
d. Costs of computer time;
e. Costs of hiring independent contractors and other temporary employees;
f. Costs of transportation, shipping or packaging
g. Costs of warehouse or storage space; or
h. Costs of proper disposal of"your products", or products that contain "your products", that can not be reused,
not exceeding your purchase price or your cost to produce the products;
25. "Specific Peril' means fire, lightning; explosion or leakage from fire sprinkler extinguishing equipment.
26. "Professional services" means:
a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys,
field orders, change orders, or drawings and specifications; and
b. Supervisory or inspection activities performed as part of any related architectural or engineering activities.
All other policy wording not specifically changed, modified, or replaced by this endorsement wording remains in effect.
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