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POLICY NUMBER GLL10549 02 COMMERCIAL GENERAL LIABILITY UMR B0356JG135V20A000 CG 210906 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCLUSION UNMANNED AIRCRAFT A. Exclusion 2.g. Aircraft Auto Or Watercraft under Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following 2. Exclusions This insurance does not apply to g. Aircraft Auto Or Watercraft 1 Unmanned Aircraft 2 Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. Use includes operation and loading or unloading. This Paragraph g.1 applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. Aircraft Other Than Unmanned Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft other than unmanned aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This Paragraph g.2 claims against any negligence or other v supervision hiring. training or monitoring insured if the oc caused the bodily in damage involved maintenance use ol others of any airci unmanned aircraft watercraft that is own or rented or loaned to This Paragraph g.2 a A watercraft wt premises you own b A watercraft you d i Less than 26 fe ii Not being used or property for c Parking an auto c next to premises provided the auto or rented or loan insured Liability assume insured contract maintenance or L watercraft or d This Paragraph g.2 applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft other than unmanned aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This Paragraph g.2 does not apply to a A watercraft while ashore on premises you own or rent b A watercraft you do not own that is Less than 26 feet long and ii Not being used to carry persons or property for a charge c Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or d CG 2109 06 15 Insurance Services Office Inc. 2014 Page 1 of 2 | 2 |
e Bodily injury or property damage arising out of i The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or ii The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definition of mobile equipment. B. The following exclusion is added to Paragraph 2. Exclusions of Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Unmanned Aircraft Personal and advertising injury arising out of the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the offense which caused the personal and advertising injury involved the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. This exclusion does not apply to a. The use of another s advertising idea in your advertisement or b. Infringing upon another s copyright trade dress or slogan in your advertisement. C. The following definiton is added to the Definitions section Unmanned aircraft means an aircraft that is not 1. Designed 2. Manufactured or 3. Modified after manufacture to be controlled directly by a person from within or on the aircraft CG 2109 06 15 Insurance Services Office Inc. 2014 Page 2 of 2 | 2 |
POLICY NUMBER GLL10549 02 COMMERCIAL GENERAL LIABILITY UMR B0356JG135V20A000 CG 21471207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY EMPLOYMENT RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided B. The following exclusion is added to Paragraph under the following 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability COMMERCIAL GENERAL LIABILITY This insurance does not apply to COVERAGE PART Personal and advertising injury to A. The following exclusion is added to Paragraph 2. 1 A person arising out of any Exclusions of Section Coverage A Bodily a Refusal to employ that person Injury And Property Damage Liability b Termination of that person s employment This insurance does not apply to or Bodily injury to c Employment related practices policies acts or omissions such as coercion 1 A person arising out of any demotion evaluation reassignment a Refusal to employ that person discipline defamation harassment b Termination of that person s employment humllathn qscrmlnanon or malicious or prosecution directed at that person or c Employment related practices policies 2 The spouse child parent brother ulr sister of acts or omissions such as coercion that person as a consequence of personal demotion evaluation reassignment and advertising injury to that person at whum discipline defamation harassment any 9f the employment related practices humiliation discrimination or malicious described in Paragraphs a b or c above prosecution directed at that person or is directed. 2 The spouse child parent brother or sister of This exclusion applies that person as a consequence of bodily 1 Whether the injury causing event described in injury to that person at whom any of the Paragraphs a b or c above occurs employment related practices described in before employment during employment or Paragraphs a b or c above is directed. after employment of that person This exclusion applies 2 Whether the insured may be liable as an 1 Whether the injury causing event described in employer or in any other capacity and Paragraphs a b or c above occurs 3 To any obligation to share damages with or before employment during employment or repay someone else who must pay damages after employment of that person because of the injury. 2 Whether the insured may be liable as an employer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. CG 21471207 ISO Properties Inc. 2006 Page 10of 1 | 2 |
POLICY NUMBER GLL10549 02 COMMERCIAL GENERAL LIABILITY UMR B0356JG135V20A000 CG 21530196 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION DESIGNATED ONGOING OPERATIONS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description of Designated Ongoing Operations All operations of the insured andor any subcontractor of the insured in Colorado or New York state. Specified Location If Applicable If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. The following exclusion is added to paragraph 2. Exclusions of COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY Section I Coverages This insurance does not apply to bodily injury or property damage arising out of the ongoing opera tions described in the Schedule of this endorsement regardless of whether such operations are conducted by you or on your behalf or whether the operations are conducted for yourself or for others. Unless a location is specified in the Schedule this exclusion applies regardless of where such opera tions are conducted by you or on your behalf. If a specific location is designated in the Schedule of this endorsement this exclusion applies only to the described ongoing operations conducted at that location. For the purpose of this endorsement 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. CG 21530196 Copyright Insurance Services Office Inc. 1994 Page 1 of 1 | 2 |
POLICY NUMBER GLL10549 02 COMMERCIAL GENERAL LIABILITY UMR B0356JG135V20A000 CG 21540196 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION DESIGNATED OPERATIONS COVERED BY A CONSOLIDATED WRAP UP INSURANCE PROGRAM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description and Location of Operations Al locations covered by a Consolidated Wrap Up Insurance Program If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. The following exclusion is added to paragraph 2. Exclusions of COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY Section I Coverages This insurance does not apply to bodily injury or property damage arising out of either your ongoing operations or operations included within the products completed operations hazard at the location described in the Schedule of this endorsement as a consolidated wrap up insurance program has been provided by the prime contractor project manager or owner of the construction project in which you are involved. This exclusion applies whether or not the consolidated wrap up insurance program 1 Provides coverage identical to that provided by this Coverage Part 2 Has limits adequate to cover all claims or 3 Remains in effect. program has been provided by the prime contractor project manager or owner of the construction project in which you are involved. This exclusion applies whether or not the consolidated wrap up insurance program 1 Provides coverage identical to that provided by this Coverage Part 2 Has limits adequate to cover all claims or 3 Remains in effect. CG 2154 01 96 Copyright Insurance Services Office Inc. 1994 Page 1 of 1 | 2 |
POLICY NUMBER GLL10549 02 COMMERCIAL GENERAL LIABILITY UMR B0356JG135V20A000 CG 21651204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION WITH A BUILDING HEATING COOLING AND DEHUMIDIFYING EQUIPMENT EXCEPTION AND A HOSTILE FIRE EXCEPTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion f. under Paragraph 2. Exclusions of ii Atany premises site or location on which Section Coverage A Bodily Injury And Property any insured or any contractors or Damage Liability is replaced by the following subcontractors working directly or indirectly on any insured s behalf are This insurance does not apply to. performing operations to test for monitor f. Pollution clean up remove contain treat detoxify 1 Bodily injury or property damage which neutralize or in any way respond to or would not have occurred in whole or part but for assess the effects of pollutants. the actual alleged or threatened discharge 2 Any loss cost or expense arising out of any dispersal seepage migration release or escape of pollutants at any time. a Request demand order or statutory or regulatory requirement that any insured or This exclusion does not apply to others test for monitor clean up remove a Bodily injury if sustained within a building contain treat detoxify or neutralize or in any which is or was at any time owned or way respond to or assess the effects of occupied by or rented or loaned to any pollutants or insured and caused by smoke fumes vapor b Claim or suit by or on behalf of a or soot produced by or originating from governmental authority for damages equipment that is used to heat cool or because of testing for monitoring cleaning dehumidify the building or equipment that is up removing containing treating used to heat water for personal use by the detoxifying or neutralizing or in any way building s occupants or their guests or responding to or assessing the effects of b Bodily injury or property damage arising pollutants. out of heat smoke or fumes from a hostile fire unless that hostile fire occurred or originated i Atany premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste or ii Atany premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations to test for monitor clean up remove contain treat detoxify neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a b Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. CG 21651204 ISO Properties Inc. 2003 Page 1 of 1 | 2 |
POLICY NUMBER GLL10549 02 UMR B0356JG135V20A000 COMMERCIAL GENERAL LIABILITY CG 21671204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FUNGI OR BACTERIA EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. B. The following exclusion is added to Paragraph Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Bodily injury or property damage which would not have occurred in whole or in part but for the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed concurrently or in any sequence to such injury or damage. b. Any loss cost or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. This exclusion does not apply to any fungi or bacteria that are are on or are contained in a good or product intended for bodily consumption. 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Personal and advertising injury which would not have taken place in whole or in part but for the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed concurrently or in any sequence to such injury. b. Any loss cost or expense arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. C. The following definiton is added to the Definitions Section Fungi means any type or form of fungus including mold or mildew and any mycotoxins spores scents or byproducts produced or released by fungi. CG 21671204 ISO Properties Inc. 2003 Page 1 of 1 | 2 |
POLICY NUMBER GLL10549 02 COMMERCIAL GENERAL LIABILITY UMR B0356JG135V20A000 CG 21700115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk 2.The act is a violent act or an act that is dangerous Insurance Act exceed 100 billion in a calendar to human life property or infrastructure and is year and we have met our insurer deductible committed by an individual or individuals as part of an under the Terrorism Risk Insurance Act we shall effort to coerce the civilian population of the United not be liable for the payment of any portion of the States or to influence the policy or affect the conduct amount of such losses that exceeds 100 billion of the United States Government by coercion. andin SPCh case insured Iusseg up to that amount B. The terms and limitations of any terrorism are subject to pro rata allocation in accordance exclusion or the inapplicability or omission of a with procedures established by the Secretary of terrorism exclusion do not serve to create the Treasury. coverage for injury or damage that is otherwise Certified act of terrorism means an act that is excluded under this Coverage Part. certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following 1. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and 2.The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. B. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. CG 21700115 Insurance Services Office Inc. 2015 Page 10of 1 | 2 |
POLICY NUMBER GLL10549 02 COMMERCIAL GENERAL LIABILITY UMR B0356JG135V20A000 CG 21800115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CERTIFIED ACTS OF TERRORISM AGGREGATE LIMIT CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Certified Acts Of Terrorism Aggregate Limit 2000000. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Coverage provided by this insurance for bodily C. The following definition is added injury property damage or personal and advertising injury arising out of a certified act of terrorism is subject to the Certified Acts Of Terrorism Aggregate Limit as described in Paragraph B. of this endorsement. B. The following provisions are added to Section Ill Limits Of Insurance 1. Subject to Paragraph 2. or 3. of Section Ill Limits Of Insurance whichever applies the Certified Acts Of Terrorism Aggregate Limit shown in the Schedule is the most we will pay for the sum of a. Damages under Coverage A b. Damages under Coverage B and c. Medical expenses under Coverage C because of all bodily injury property damage and personal and advertising injury arising out of all certified acts of terrorism. 2. Paragraph 4. the Personal And Advertising Injury Limit Paragraph 5. the Each Occurrence Limit Paragraph 6. the Damage To Premises Rented To You Limit and Paragraph 7. the Medical Expense Limit of Section Ill Limits Of Insurance continue to apply to bodily injury property damage and personal and advertising injury as applicable arising out of a certified act of terrorism but only if and to the extent that a limit of insurance is available under the Certified Acts Of Terrorism Aggregate Limit. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following 1. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion.. If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. CG 21800115 Insurance Services Office Inc. 2015 Page 1 of 2 | 2 |
E. The terms and limitatons of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. CG 21800115 Insurance Services Office Inc. 2015 Page 2 of 2 | 2 |
POLICY NUMBER GLL10549 02 UMR B0356JG135V20A000 COMMERCIAL GENERAL LIABILITY CG 21861204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION EXTERIOR INSULATION AND FINISH SYSTEMS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. This insurance does not apply to bodily injury property damage or personal and advertising injury arising out of caused by or attributable to whether in whole or in part the following 1. The design manufacture construction fabrication preparation distribution and sale installation application maintenance or repair including remodeling service correction or replacement of any exterior insulation and finish system or any part thereof or any substantially similar system or any part thereof including the application or use of conditioners primers accessories flashings coatings caulking or sealants in connection with such a system or 2. Your product or your work with respect to any exterior component fixture or feature of any structure if an exterior insulation and finish system or any substantially similar system is used on the part of that structure containing that component fixture or feature. B. The following definition is added to the Definitions Section Exterior insulation and finish system means a non load bearing exterior cladding or finish system and all component parts therein used on any part of any structure and consisting of 1. A rigid or semi rigid insulation board made of expanded polystyrene and other materials 2. The adhesive andor mechanical fasteners used to attach the insulation board to the substrate 3. Areinforced or unreinforced base coat 4. Afinish coat providing surface texture to which color may be added and 5. Any flashing caulking or sealant used with the system for any purpose. CG 21861204 ISO Properties Inc. 2003 Page 1 of 1 | 2 |
POLICY NUMBER GLL10549 02 COMMERCIAL GENERAL LIABILITY UMR B0356JG135V20A000 CG 2196 03 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SILICA OR SILICA RELATED DUST EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Silica Or Silica Related Dust a. Personal and advertising injury arising in whole or in part out of the actual alleged threatened or suspected inhalation of ingestion of contact with exposure to existence of or presence of silica or silica related dust. b. Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of silica or silica related dust by any insured or by any other person or entity. C. The following definitions are added to the Definitions Section 1. Silica means silicon dioxide occurring in crystalline amorphous and impure forms silica particles silica dust or silica compounds. 2. Silica related dust means a mixture or combination of silica and other dust or particles. A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Silica Or Silica Related Dust a. Bodily injury arising in whole or in part out of the actual alleged threatened or suspected inhalation of or ingestion of silica or silica related dust. b. Property damage arising in whole or in part out of the actual alleged threatened or suspected contact with exposure to existence of or presence of silica or silica related dust. c. Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of silica or silica related dust by any insured or by any other person or entity. CG 21 96 03 05 ISO Properties Inc. 2004 Page 10of 1 | 2 |
POLICY NUMBER GLL10549 02 UMR B0356JG135V20A000 COMMERCIAL GENERAL LIABILITY CG 22790413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION CONTRACTORS PROFESSIONAL LIABILITY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2. 2. Subject to Paragraph 3. below professional Exclusions of Section Coverage A Bodily services include Injury And Property Damage Liability and i Paragraph 2. Exclusions of Section Coverage B a FEsleng ni ggovggb r ignz pr giirizgnr Personal And Advertising Injury Liability reports surveys field orders change orders 1. This insurance does not apply to bodily injury or drawings and specifications and property damage or personal and advertising injury arising out of the rendering of or failure to render any professional services by you or on your behalf but only with respect to either or both of the following operations a. Providing engineering architectural or surveying services to others in your capacity as an engineer architect or surveyor and b. Providing or hiring independent professionals to provide engineering architectural or surveying services in connection with construction work you perform. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage or the offense which caused the personal and advertising injury involved the rendering of or failure to render any professional services by you or on your behalf with respect to the operations described above. b. Supervisory or inspection activities performed as part of any related architectural or engineering activities.. Professional services do not include services within construction means methods techniques sequences and procedures employed by you in connection with your operations in your capacity as a construction contractor. CG 22790413 Insurance Services Office Inc. 2012 Page 10of 1 | 2 |
POLICY NUMBER GLL10549 02 UMR B0356JG135V20A000 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization Any person or organization whom you are required to waive any right of recovery under a written contract executed prior to the occurrence which results in bodily injury or property damage under Coverage A or the offense which results in personal and advertising injury under coverage B. Information required to complete this Schedule if not shown above will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV Conditions We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. 1y person or organizaiiEn whom you are required to waive any right of recovery under a written contract ecuted prior to the occurrence which results in bodily injury or property damage under Coverage A or the fense which results in personal and advertising injury under coverage B. CG 24 04 05 09 Insurance Services Office Inc. 2008 Page 1of 1 | 2 |
GLOBAL INDEMNITY GROUP INC. PRIVACY NOTICE We at Global Indemnity Group Inc. which includes Diamond State Insurance Company Penn America Insurance Company Penn Patriot Insurance Company Penn Star Insurance Company United National Insurance Company and our affiliated companies and subsidiaries are required to protect our customers nonpublic personal financial information. We collect your nonpublic personal financial information from the following sources Information obtained from you including information from your application such as name address telephone number social security number assets and income. Information about transactions and experiences such as your premium payment and claims history. Information from a consumer reporting agency such as your credit history. WE DO NOT DISCLOSE YOUR NONPUBLIC PERSONAL FINANCIAL INFORMATION EXCEPT AS PERMITTED OR REQUIRED BY LAW. WE RESERVE THE RIGHT HOWEVER TO CHANGE THIS POLICY AT ANY TIME. SHOULD THIS POLICY CHANGE WE WILL GIVE AFFECTED CUSTOMERS AN OPPORTUNITY TO DIRECT THAT THEIR NONPUBLIC PERSONAL FINANCIAL INFORMATION NOT BE DISCLOSED. We maintain electronic physical and procedural safeguards that comply with Federal regulations to protect your nonpublic personal financial information. We limit access to your nonpublic personal financial information to those employees who need to know that information to perform their job responsibilities. We disclose nonpublic personal financial information of former customers to affiliated and nonaffiliated third parties as permitted by law. NAA105 062016 Page 1 of 1 | 2 |
GLOBAL INDEMNITY GROUP INC. Penn America Insurance Company Penn Star Insurance Company Penn Patriot Insurance Gompany United National Insurance Gompany Diamond State Insurance Gompany CLAIMS REPORTING PROCEDURES The Member Companies of Global Indemnity Group Inc. strive to provide quality claims service. In the event of a claim or potential claim please submit information about the claim immediately to us. Claims can be submitted via company web site e mail facsimile phone or mail. Information for submitting Web address httpwww.Unitednat.com Click on Report a Claim. Email address Claimsglobalindemnity.com Fax number 610 660 8885 Phone numbers 800 788 4780 or 610 660 8877 Mailing address Global Indemnity Group Inc. Claims P.O. Box 532 Willow Grove PA 19090 For Emergency Services after normal business hours please call 866 765 0474. NAA169 052017 Page 1 of 1 | 2 |
COMMERCIAL LINES COMMON POLICY DECLARATIONS D INSURANCE IS PROVIDED BY THE COMPANY DESIGNATED BY AN X Stock PENN AMERICA INSURANCE COMPANY Company aroup X PENN STAR INSURANCE COMPANY FAV00 523 PENN PATRIOT INSURANCE COMPANY Renewal of Number Bala Cynwyd Pennsylvania 19004 236 Number Rewrite of Number POLICY NUMBER PAV0005257 1. NAMED INSURED WS DYNOCO PETROLEUM MANAGEMENT DBA LLCPER FORM IL1201 MAILING ADDRESS 4129 W Cheyenne Avenue North Las Vegas NV 89032 2. POLICY PERIOD From October 1 2017 To October 1 2018 at1201 AM. Standard Time at your mailing address shown above. 3. FORM OF BUSINESS Limited Liability Company OTHER DESC 4. BUSINESS DESCRIPTION GAS STATION GROCERY STORE CAR WASH MOTEL RESTAURANT IN RETURN FOR THE PAYMENT OF THE PREMIUM AND SUBJECT TO ALL THE TERMS OF THIS POLICY WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. 5. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. PREMIUM Commercial General Liability Coverage Part 19870.00 Commercial Property Coverage Part NOT COVERED Commercial Crime Coverage Part NOT COVERED Commercial Inland Marine Coverage Part NOT COVERED Professional Liability Coverage Part NOT COVERED Liquor Liability Coverage Part 616.00 Commercial Umbrella Coverage Part NOT COVERED Owners Contractors Protective Coverage Part NOT COVERED TRIA NOT COVERED 6. TOTAL PREMIUM PAYABLE AT INCEPTION 20.456.00 Policy Fee s 225.00 Inspection Fee s 300.00 Surplus Lines Tax s 735.39 Filing Fee 84.04 Other TOTAL 21830.43 7. FORMS AND ENDORSEMENTS MADE A PART OF THIS POLICY AT THE TIME OF ISSUE AS PER FORM 1007 122000 SCHEDULE OF FORMS AND ENDORSEMENTS ATTACHED Omits applicable Forms and Endorsements if shown in specific Coverage Part Coverage Form Declarations. THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS COVERAGE PART DECLARATIONS COVERAGE PART COVERAGE FORMS AND FORMS AND ENDORSEMENTS IF ANY ISSUED TO FORM A PART THEREOF COMPLETE THE ABOVE NUMBERED POLICY. 02505 Worldwide Facilities LLC 725 South Figueroa Street Los Angeles CA 90017 Authonzed Representative 11222017 Agency Code PG 1100092016 Page 10f 1 Satcamrol Number 2305 art Page 1 of 1 | 2 |
COMMERCIAL LINES COMMON POLICY DECLARATIONS SCHEDULE OF FORMS AND ENDORSEMENTS POLICY NUMBER PAV0005257 NAMED INSURED WS Dynoco Petroleum Management LLCPer form IL1201 Form Endorsement No. Edition Date COMMON POLICY S1100 IL0017 IL0021 IL0115 IL1201 EAA230 EAALO00 EAAl46 1003 52002 S2033 IL0003 IL0985 09 16 11 98 09 08 01 10 11 85 02 15 01 12 12 09 08 91 08 02 03 14 09 08 01 15 PENN AMERICA COMMON POLICY DECLARATIONS COMMON POLICY CONDITIONS NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT NV CHANGES DOMESTIC PARTNERSHIP POLICY CHANGES SERVICE OF SUIT IN WITNESS CLAUSE TERRORISM EXCLUSION MINIMUM EARNED PREMIUM COMBINED PROVISIONS ENDORSEMENT LEAD CONTAMINATION EXCLUSION CALCULATION OF PREMIUM DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT COMMERCIAL GENERAL LIABILITY 2000 S2001 CG0001 52045 S2053 CG2008 CG0300 CG2028 S2113 CG2029 CG2101 CG2107 06 01 10 13 04 13 10 14 11 97 04 13 01 96 04 13 10 07 04 13 11 85 05 14 GL COVERAGE PART DECLARATIONS SUPPLEMENTAL GL DEC 1 CGL COVERAGE FORM NON OWNED AND HIRED AUTO LIABILITY EMPLOYEE BENEFITS LIABILITY COVERAGE AI USERS OF GOLFMOBILES DEDUCTIBLE LIABILITY INSURANCE AI LESSOR OF LEASED EQUIPMENT AUTO EXCLUSION AI GRANTOR OF FRANCHISE EXCLUSION ATHLETIC OR SPORTS PARTICIPANTS EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND ABER PENN AMERICA COMMON POLICY DECLARATIONS COMMON POLICY CONDITIONS NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT NV CHANGES DOMESTIC PARTNERSHIP POLICY CHANGES SERVICE OF SUIT IN WITNESS CLAUSE TERRORISM EXCLUSION MINIMUM EARNED PREMIUM COMBINED PROVISIONS ENDORSEMENT LEAD CONTAMINATION EXCLUSION CALCULATION OF PREMIUM DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT GL COVERAGE PART DECLARATIONS SUPPLEMENTAL GL DEC 1 CGL COVERAGE FORM NON OWNED AND HIRED AUTO LIABILITY EMPLOYEE BENEFITS LIABILITY COVERAGE AI USERS OF GOLFMOBILES DEDUCTIBLE LIABILITY INSURANCE AI LESSOR OF LEASED EQUIPMENT AUTO EXCLUSION AI GRANTOR OF FRANCHISE EXCLUSION ATHLETIC OR SPORTS PARTICIPANTS EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA RELATED LIABILITY LIMITED BODILY INJURY EXCEPTION NOT INCLUDED EXCLUSION UNMANNED AIRCRAFT EMPLOYMENT RELATED PRACTICES EXCL AMENDMENT OF LIQUOR LIABILITY EXCLUSION TOTAL POLLUTION EXCLUSION WITH A HOSTILE FIRE EXCEPTION LIMITATION OF COVERAGE TO INSURED PREMISES FOR USE WITH LIQUOR POLICIES FUNGI OR BACTERIA EXCLUSION SILICA OR SILICA RELATED DUST EXCLUSION PRODUCTS COMPLETED OPERATIONS HAZARD REDEFINED CANOES OR ROWBOATS AMENDMENT OF INSURED CONTRACT DEFINITION TOTAL EXCLUSION PROFESSIONAL SERVICES G2109 06 15 cG2147 12 07 G2150 04 13 G2155 09 99 G2806 01 96 G2167 12 04 G2196 03 05 G2407 01 96 cG2416 12 07 cG2426 04 13 EPAL631 08 10 Page 1 of 2 1007 12 2000 | 2 |
COMMERCIAL LINES COMMON POLICY DECLARATIONS SCHEDULE OF FORMS AND ENDORSEMENTS POLICY NUMBER PAV0005257 NAMED INSURED WS Dynoco Petroleum Management LLCPer form IL1201 Form Endorsement No. Edition Date EPA1802 2125 S8000 CG0033 CG0305 S8001 06 17 01 07 11 97 04 13 01 96 06 05 EXCLUSION ELECTRONIC CIGARETTES EXCLUSION FIREARMS AND OTHER WEAPONS LIQUOR LIABILITY COVERAGE FORM DECLARATIONS LIQUOR LIABILITY COVERAGE FORM OCCURRENCE VERSION DEDUCTIBLE LIABILITY INSURANCE FOR USE WITH LIQUOR POLICIES ASSAULT OR BATTERY LIQUOR LIABILITY EXCLUSION ABER Page 2 of 2 1007 12 2000 | 2 |
IL00 17 11 98 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation b. Give you reports on the conditions we find 1. The first Named Insured shown in the Declara tions may cancel this policy by mailing or de livering to us advance written notice of cancel lation. 2. We may cancel this policy by mailing or deliv ering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancel lation if we cancel for nonpayment of pre mium or b. 30 days before the effective date of cancel lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be ef fective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be suf ficient proof of notice.. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declara tions is authorized to make changes in the terms of this policy with our consent. This policy s terms can be amended or waived only by endorsement issued by us and made a part of this policy.. Examination Of Your Books And Records We may examine and audit your books and rec ords as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspections And Surveys 1. We have the right to a. Make inspections and surveys at any time and c. Recommend changes. 2. We are not obligated to make any inspections surveys reports or recommendations and any such actions we do undertake relate only to in surability and the premiums to be charged. We do not make safety inspections. We do not un dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions a. Are safe or healthful or b. Comply with laws regulations codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us but also to any rating advisory rate service or similar organization which makes insurance inspections surveys reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections surveys reports or recom mendations we may make relative to certifica tion under state or municipal statutes ordi nances or regulations of boilers pressure ves sels or elevators.. Premiums The first Named Insured shown in the Declara tions 1. Is responsible for the payment of all premiums and 2. Will be the payee for any return premiums we pay.. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named in sured. If you die your rights and duties will be trans ferred to your legal representative but only while acting within the scope of duties as your legal rep resentative. Until your legal representative is ap pointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. IL00 17 11 98 Copyright Insurance Services Office Inc. 1998 Page 1 of 1 m | 2 |
IL 00 21 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply C. Under any Liability Coverage to bodily injury A. Under any Liability Coverage to bodily injury or property damage resulting fz.hazard or property damage ous properties of nuclear material if 1 With respect to which an insured under 1 The nuclear material a is at any nuclear the policy is also an insured under a nuc facility Wnd by or operated by or on be lear energy liability policy issued by Nuclear half of an insured or b hfS been dis Energy Liability Insurance Association Mu charged or dispersed therefrom tual Atomic Energy Liability Underwriters 2 The nuclear material is contained in Nuclear Insurance Association of Canada spent fuel or waste at any time pos or any of their successors or would be an sessed handled used processed stored insured under any such policy but for its transported or disposed of by or on behalf termination upon exhaustion of its limit of of an insured or liability or 3 The bodily injury or property damage 2 Resulting from the hazardous properties arises out of the furnishing by an insured of nuclear material and with respect to of services materials parts or equipment in which a any person or organization is re connection with the planning construction quired to maintain financial protection pur maintenance operation or use of any nuc suant to the Atomic Energy Act of 1954 or lear facility but if such facility is located any law amendatory thereof or b the in within the United States of America its terri sured is or had this policy not been issued tories or possessions or Canada this ex would be entitled to indemnity from the clusion 3 applies only to property dam United States of America or any agency age to such nuclear facility and any thereof under any agreement entered into property thereat. by the United Stgites of America or any 2. As used in this endorsement agency thereof with any person or organi N... zation. Hazardous properties includes radioactive toxic B. Under any Medical Payments coverage to or explosive prplertles.. expenses incurred with respect to bodily in Nuclear material means source material spe jury resulting from the hazardous properties cial nuclear material or by product material. of nuclear material and arising out of the op eration of a nuclear facility by any person or organization. C. Under any Liability Coverage to bodily injury or property damage resulting from hazard ous properties of nuclear material if 1 The nuclear material a is at any nuclear facility owned by or operated by or on be half of an insured or b has been dis charged or dispersed therefrom The nuclear material is contained in spent fuel or waste at any time pos sessed handled used processed stored transported or disposed of by or on behalf of an insured or The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nuc lear facility but if such facility is located within the United States of America its terri tories or possessions or Canada this ex clusion 3 applies only to property dam age to such nuclear facility and any property thereat. 2. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source material spe cial nuclear material or by product material. 2 3 IL 00 21 09 08 ISO Propetties Inc. 2007 Page 1 of 2 m | 2 |
Source material special nuclear material and by product material have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. Spent fuel means any fuel element or fuel com ponent solid or liquid which has been used or ex posed to radiation in a nuclear reactor. Waste means any waste material a containing by product material other than the tailings or wastes produced by the extraction or concentra tion of uranium or thorium from any ore processed primarily for its source material content and b resulting from the operation by any person or or ganization of any nuclear facility included under the first two paragraphs of the definition of nuc lear facility. Nuclear facility means a Any nuclear reactor b Any equipment or device designed or used for 1 separating the isotopes of uranium or plutonium 2 processing or utilizing spent fuel or 3 handling processing or packag ing waste c Any equipment or device used for the processing fabricating or alloying of spe cial nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of pluto nium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 d Any structure basin excavation premises or place prepared or used for the storage or disposal of waste and includes the site on which any of the foregoing is located all operations conducted on such site and all premises used for such operations. Nuclear reactor means any apparatus designed or used to sustain nuclear fission in a self supporting chain reaction or to contain a critical mass of fissionable material. Property damage includes all forms of radioac tive contamination of property. Page 2 of 2 ISO Propetties Inc. 2007 IL 00 21 09 08 o | 2 |
IL011501 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEVADA CHANGES DOMESTIC PARTNERSHIP This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY. All references to spouse shall include an individual who is in a domestic partnership recognized under Nevada law.. Under the Commercial Auto Coverage Part the term family member is replaced by the following Family member means a person related to the 1. Individual Named Insured by blood adoption marriage or domestic partnership recognized under Nevada law who is a resident of such Named Insured s household including a ward or foster child or 2. Individual named in the Schedule by blood adoption marriage or domestic partnership recognized under Nevada law who is a resi dent of the individual s household including a ward or foster child if the Drive Other Car Coverage Broadened Coverage For Named Individual Endorsement is attached. C. With respect to coverage for the ownership main tenance or use of covered autos provided under the Commercial Liability Umbrella Coverage Part the term family member is replaced by the follow ing Family member means a person related to you by blood adoption marriage or domestic partner ship recognized under Nevada law who is a resi dent of your household including a ward or foster child. C. With respect to coverage for the ownership main tenance or use of covered autos provided under the Commercial Liability Umbrella Coverage Part the term family member is replaced by the follow ing Family member means a person related to you by blood adoption marriage or domestic partner ship recognized under Nevada law who is a resi dent of your household including a ward or foster child. IL011501 10 Insurance Services Office Inc. 2009 Page 1 0of 1 m | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE PAV0005257 10012017 Penn Star Insurance Company NAMED INSURED AUTHORIZED REPRESENTATIVE WS Dynoco Petroleum Management LLCPer form 1L1201 COVERAGE PARTS AFFECTED Commercial General Liability CHANGES NAMED INSUREDS WS Dynoco Petroleum Management LLC Adams Family 1993 Trust WS Dynoco Petroleum Management LLC DBA Wesley s WS Dynoco Il LLC Glendale Gas Management LLC Moapa Town Center surance Company Commercial General Liability NAMED INSUREDS WS Dynoco Petroleum Management LLC Adams Family 1993 Trust WS Dynoco Petroleum Management LLC DBA Wesley s WS Dynoco Il LLC Glendale Gas Management LLC Moapa Town Center Authorized Representative Signature IL12011185 Copyright Insurance Services Office Inc. 1983 Copyright ISO Commercial Risk Services Inc. 1983 Page 1 of 1 m | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SERVICE OF SUIT CLAUSE This endorsement modifies insurance provided under the following ALL COVERAGE PARTS IN THIS POLICY We appoint the highest State official in charge of insurance affairs Commissioner of Insurance Director of Insurance Insurance Commissioner Executive Secretary Superintendent of Insurance or such other official title as designated by the State of the State of Nevada and his successor or successors in office as his and their duly authorized deputies as our true and lawful attorney in and for the aforesaid State upon whom all lawful process may be served in any action suit or proceeding instituted in the said State by or on behalf of any insured or beneficiary against us arising out of this insurance policy provided a copy of any process suit complaint or summons is sent by certified or registered mail to Stephen Ries Esquire Penn Star Insurance Company Three Bala Plaza East Suite 300 Bala Cynwyd PA 19004 EAA230 022015 Page 1 of 1 | 2 |
In Witness Clause In Witness Whereof we have caused this policy to be executed and attested and if required by state law this policy shall not be valid unless countersigned by our authorized representative. SN Secretary Executive Vice President EAA100 012012 Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TERRORISM EXCLUSION This endorsement modifies insurance provided under the following ALL PARTS OF THE POLICY Notwithstanding any other provision of this policy to the contrary this insurance does not apply to any loss cost expense damage injury or economic detriment whether arising by contract operation of law or otherwise whether or not concurrent or in any sequence with any other cause or event that in any way form or manner directly or indirectly arises out of results from or is caused by terrorism and also including any action taken in hindering or defending against terrorism. Terrorism means any act of force or violence or other illegal means whether actual alleged or threatened by any person persons group private or governmental entity or entities or any other type of organization of any nature whatsoever whether the identity of which is known or unknown that appears to be for political religious racial ethnic ideological ecological or social purposes objectives or motives and that causes or appears to be intended to cause 1. alarm fright fear of danger concern or apprehension for public safety 2. the interference or disruption of an electronic communication information or mechanical system 3. the intimidation or coercion of the civilian population or any governmental body or 4. the alteration of the policies foreign or domestic of any governmental body This exclusion does not affect the applicability of and is in addition to any exclusion of war warlike or military action whether or not specifically denominated as such. EAA146 122009 Page 1 of 1 | 2 |
Stock Company Stock COMMERCIAL GENERAL LIABILITY COVERAGE PART P I IDA DECLARATIONS POLICY NUMBERPAV0005257 1. NAMED INSURED WS DYNOCO PETROLEUM MANAGEMENT LLCPER FORM IL1201 2. LIMITS OF INSURANCE INSURANCE APPLIES ONLY FOR COVERAGE FOR WHICH A LIMIT OF INSURANCE IS SHOWN. General Aggregate Limit Other than Products Completed Operations 2000000 Products Completed Operations Aggregate Limit 2000000 Each Occurrence Limit 1000000 Personal Advertising Injury Limit 1000000 Damage to Premises Rented to You Limit 100000 any one premises Medical Expense Limit 5000 any one person 3. LOCATIONS of all premises you Own Rent or Occupy Address City State Zip No. 1 1 3685 N. Moapa Valley Bvd. Logandale NV 89021 PREMIUM BASIS RATES ADVANCE PREMIUM 4 cLAss Code Exposure Prod CO All Other Prod CO AllOther If Classifications are Numbered the coverage applies o the corresponding Location No. No. 1 Bldg 1 13454 0 793707 0.268 3.499 213.00 2777.00 Gasoline Stations self service No. 1 Bldg 1 13673 s 1671176 0.042 2.355 70.00 3936.00 Grocery Stores No. 1 Bldg 1 10368 s 15283 Incl 17.588 Included 269.00 Car Washes self service No. 1 Bldg 1 61217 a 4000 Incl 71.658 Included 287.00 Buildings or Premises bank or office mercantile or manufacturing maintained by the insured lessor s risk onlyOther than Not For Profit No. 1 Bldg 1 e 2 Incl 50.000 Included 100.00 Additional Insured If Classifications are Numbered the coverage applies to the corresponding Location No. TOTAL 19870.00 s gross sales per 1000 c total cost per 1000 m admissions per 1000 e each p payroll per 1000 2 area per 1000 sq. ft. 1 units other 5. Policy may be AUDITABLE t see classification notes in company or ISO Commercial Lines Manual SPECIFIC GENERAL LIABILITY FORMS ENDORSEMENTS As per S1007 12 00 This page alone does not provide coverage and must be attached to a Commercial Lines Common Policy Declarations Common Policy Conditions Coverage Part Coverage Forms and any other applicable forms and endorsements. 52000 0601 Page 1 of 1 | 2 |
Stock Company x COMMERCIAL GENERAL LIABILITY COVERAGE PART I ID SUPPLEMENTAL DECLARATIONS Gr up POLICY NUMBER PAV0005257 NAMED INSURED WS Dynoco Petroleum Management LLCPer form IL1201 NO. LOCATIONS of all premises you Own Rent or Occupy 2 1 2300 E Glendale Blvd Moapa NV 89025 CLASS PREMIUM BASIS. Code Exposure e 1 RATES Prod CO All Other INCL 150.000 ADVANCE PREMIUM Prod CO All Other Included 150.00 CLASS Bldg 1 Non Owned Auto Liability nan nan nan nan 200.0 Bidg 1 Employee Benefits Liability Coverage INCL nan nan nan nan 200.0 Included nan nan nan nan 290.0 Bldg 1 45192 s 42059 Hotels and Motels without pools or beaches less than four stories Incl nan nan nan nan 6.886 Included nan nan nan nan 554.0 Bldg 1 16900 s 51510 0.630 Restaurants with no sale of alcoholic beverages with table service nan nan nan nan 10.75 nan nan nan nan 32.0 4629.00 nan nan nan nan 355.0 nan nan nan nan 3.499 Bldg 1 13454 Gasoline Stations self service nan nan nan nan 1322846.0 nan nan nan nan 0.268 Total Premium This Page See Form 2000 Accumulative Total for Total Premium m admissions per 1000 each u units s gross sales per 1000 c total cost per 1000 m admissions per 1000 each p payroll per 1000 a area per 1000 sq. ft. u units Policy may be AUDITABLE SPECIFIC GENERAL LIABILITY FORMS ENDORSEMENTS This page alone does not provide coverage and must be attached to a Commercial Lines Common Policy Declarations Common Policy Conditions Coverage Part Coverage Forms and any other applicable forms and endorsements. S2001 10 2013 Page 2 of 3 | 2 |
Stock Company x COMMERCIAL GENERAL LIABILITY COVERAGE PART I ID SUPPLEMENTAL DECLARATIONS Group 5 X POLICY NUMBER PAV0005257 NAMED INSURED WS Dynoco Petroleum Management LLCPer form IL1201 NO. LOCATIONS of all premises you Own Rent or Occupy CLASS Bldg 1 13673 Grocery Stores PREMIUM BASIS. Code Exposure s 2506764 RATES Prod CO All Other 0.042 2.355 ADVANCE PREMIUM Prod CO All Other 105.00 5903.00 Total Premium This Page See Form 2000 Accumulative Total for Total Premium m admissions per 1000 each u units s gross sales per 1000 c total cost per 1000 m admissions per 1000 each p payroll per 1000 a area per 1000 sq. ft. u units Policy may be AUDITABLE SPECIFIC GENERAL LIABILITY FORMS ENDORSEMENTS This page alone does not provide coverage and must be attached to a Commercial Lines Common Policy Declarations Common Policy Conditions Coverage Part Coverage Forms and any other applicable forms and endorsements. S2001 10 2013 Page 3 of 3 | 2 |
COMMERCIAL GENERAL LIABILITY CG 00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under Section I Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 2 The bodily injury or property damage occurs during the policy period and Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. c. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. d. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim 1 Reports all or any part of the bodily injury or property damage to us or any other insurer Receives a written or verbal demand or claim for damages because of the bodily injury or property damage or 3 Becomes aware by any other means that bodily injury or property damage has occurred or has begun to occur. e. Damages because of bodily injury include damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. 3 2 CG 00010413 Insurance Services Office Inc. 2012 Page 1 0f 16 | 0 |
2. Exclusions This insurance does not apply to a. Expected Or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Contractual Liability Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the absence of the contract or agreement or 2 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorneys fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and Such attorneys fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. b This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in a The supervision hiring employment training or monitoring of others by that insured or b Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol if the occurrence which caused the bodily injury or property damage involved that which is described in Paragraph 1 2 or 3 above. However this exclusion applies only if you are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages. For the purposes of this exclusion permitting a person to bring alcoholic beverages on your premises for consumption on your premises whether or not a fee is charged or a license is required for such activity is not by itself considered the business of selling serving or furnishing alcoholic beverages.. Workers Compensation And Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law.. Employer s Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a Employment by the insured or b Performing duties related to the conduct of the insured s business or 2 The spouse child parent brother or sister of that employee as a consequence of Paragraph 1 above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. Page 2 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a At or from any premises site or location which is or was at any time owned or occupied by or rented or loaned to any insured. However this subparagraph does not apply to i Bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or originating from equipment that is used to heat cool or dehumidify the building or equipment that is used to heat water for personal use by the building s occupants or their guests ii Bodily injury or property damage for which you may be held liable if you are a contractor and the owner or lessee of such premises site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not and never was owned or occupied by or rented or loaned to any insured other than that additional insured or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire b At or from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste c Which are or were at any time transported handled stored treated disposed of or processed as waste by orfor i Any insured or ii Any person or organization for whom you may be legally responsible or d At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by such insured contractor or subcontractor. However this subparagraph does not apply to i Bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or released as part of the operations being performed by such insured contractor or subcontractor ii Bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor or Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the operations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. iii CG 00010413 Insurance Services Office Inc. 2012 Page 3 of 16 | 1 |
2 Any loss cost or expense arising out of any a Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or b Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a governmental authority. g. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed wunder any insured contract for the ownership maintenance or use of aircraft or watercraft or 4 5 Bodily injury or property damage arising out of a The operaton of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definiton of mobile equipment. h. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. i. War Bodily injury or property damage however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. j. Damage To Property Property damage to 1 Property you own rent or occupy including any costs or expenses incurred by you or any other person organization or entity for repair replacement enhancement restoration or maintenance of such property for any reason including prevention of injury to a person or damage to another s property Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you b 3 2 Page 4 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
4 Personal property in the care custody or control of the insured 5 That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the property damage arises out of those operations or That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section Il Limits Of Insurance. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard. 6. Damage To Your Product Property damage to your product arising out of it or any part of it.. Damage To Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor.. Damage To Impaired Property Or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 A defect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use.. Recall Of Products Work Or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it.. Personal And Advertising Injury Bodily injury arising out of personal and advertising injury.. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. However this exclusion does not apply to liability for damages because of bodily injury. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment.. Recording And Distribution Of Material Or Information In Violation Of Law Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or CG 00010413 Insurance Services Office Inc. 2012 Page 5 of 16 | 1 |
4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section Il Limits Of Insurance. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of personal and advertising injury to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for personal and advertising injury to which this insurance does not apply. We may at our discretion investigate any offense and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and 2 Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to personal and advertising injury caused by an offense arising out of your business but only if the offense was committed in the coverage territory during the policy period. 2. Exclusions This insurance does not apply to Knowing Violation Of Rights Of Another Personal and advertising injury caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising injury.. Material Published With Knowledge Of Falsity Personal and advertising injury arising out of oral or written publication in any manner of material if done by or at the direction of the insured with knowledge of its falsity.. Material Published Prior To Policy Period Personal and advertising injury arising out of oral or written publication in any manner of material whose first publication took place before the beginning of the policy period.. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured.. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement.. Breach Of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s advertising idea in your advertisement.. Quality Or Performance Of Goods Failure To Conform To Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your advertisement.. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Page 6 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
i. Infringement Of Copyright Patent Trademark Or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trademark trade secret or other intellectual property rights. Under this exclusion such other intellectual property rights do not include the use of another s advertising idea in your advertisement. However this exclusion does not apply to infringement in your advertisement of copyright trade dress or slogan. j Insureds In Media And Internet Type Businesses Personal and advertising injury committed by an insured whose business is 1 Advertising broadcasting publishing or telecasting 2 Designing or determining content of web sites for others or 3 An Internet search access content or service provider. However this exclusion does not apply to Paragraphs 14.a. b. and c. of personal and advertising injury under the Definitions section. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the insured hosts owns or over which the insured exercises control. I. Unauthorized Use Of Another s Name Or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain name or metatag or any other similar tactics to mislead another s potential customers. m. Pollution Personal and advertising injury arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants at any time. n. Pollution related Any loss cost or expense arising out of any 1 Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. o. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. p. Recording And Distribution Of Material Or Information In Violation Of Law Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or 4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. 3 CG 00010413 Insurance Services Office Inc. 2012 Page 7 of 16 | 1 |
COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that a The accident takes place in the coverage territory and during the policy period b The expenses are incurred and reported to us within one year of the date of the accident and c The injured person submits to examination at our expense by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for 1 First aid administered at the time of an accident 2 Necessary medical surgical X ray and dental services including prosthetic devices and 3 Necessary ambulance hospital professional nursing and funeral services. 2. Exclusions We will not pay expenses for bodily injury a. Any Insured To any insured except volunteer workers. b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d. Workers Compensation And Similar Laws To a person whether or not an employee of any insured if benefits for the bodily injury are payable or must be provided under a workers compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing instructing or participating in any physical exercises or games sports or athletic contests. f. Products Completed Operations Hazard Included within the products completed operations hazard. g. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS COVERAGES A AND B 1. We will pay with respect to any claim we investigate or settle or any suit against an insured we defend a. All expenses we incur. b. Up to 250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. c. The cost of bonds to release attachments but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from work. e. All court costs taxed against the insured in the suit. However these payments do not include attorneys fees or attorneys expenses taxed against the insured. f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment interest based on that period of time after the offer. Page 8 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance.. If we defend an insured against a suit and an indemnitee of the insured is also named as a party to the suit we will defend that indemnitee if all of the following conditions are met a. The suit against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an insured contract b. This insurance applies to such liability assumed by the insured. The obligation to defend or the cost of the defense of that indemnitee has also been assumed by the insured in the same insured contract o. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the insured and the indemnitee and f. The indemnitee 1 Agrees in writing to a Cooperate with us in the investigation settlement or defense of the suit Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit b c Notify any other insurer whose coverage is available to the indemnitee and d Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee and 2 Provides us with written authorization to a Obtain records and other information related to the suit and b Conduct and control the defense of the indemnitee in such suit. So long as the above conditions are met attorneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.2 of Section Coverage A Bodily Injury And Property Damage Liability such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the limits of insurance. Our obligation to defend an insured s indemnitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above or the terms of the agreement described in Paragraph f. above are no longer met. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. c. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. CG 00010413 Insurance Services Office Inc. 2012 Page 9 of 16 | 1 |
2. Each of the following is also an insured a. Your volunteer workers only while performing duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a partnership joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees or volunteer workers are insureds for 1 Bodily injury or personal and advertising injury a To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company to a coemployee while in the course of his or her employment or performing duties related to the conduct of your business or to your other volunteer workers while performing duties related to the conduct of your business To the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of Paragraph 1a above For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph 1a or b above or Arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b Rented to in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees volunteer workers any partner or member if you are a partnership or joint venture or any member if you are a limited liability company. b. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. b c d c. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that property and 2 Until your legal representative has been appointed. d. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION Il LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. Page 10 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
3. The Products Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. 4. Subject to Paragraph 2. above the Personal And Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all personal and advertising injury sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above whichever applies the Each Occurrence Limit is the most we will pay for the sum of a. Damages under Coverage A and b. Medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to Paragraph 5. above the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of property damage to any one premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence Offense Claim Or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or an offense which may result in a claim. To the extent possible notice should include 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured persons and witnesses and 3 The nature and location of any injury or damage arising out of the occurrence or offense. b. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent.. Legal Action Against Us No person or organization has a right under this Coverage Part a. To join us as a party or otherwise bring us into a suit asking for damages from an insured or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us the insured and the claimant or the claimant s legal representative. CG 00010413 Insurance Services Office Inc. 2012 Page 11 of 16 | 1 |
4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance 1 This insurance is excess over a Any of the other insurance whether primary excess contingent or on any other basis i That is Fire Extended Coverage Builder s Risk Installation Risk or similar coverage for your work ii That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner iii That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner or iv If the loss arises out of the maintenance or use of aircraft autos or watercraft to the extent not subject to Exclusion g. of Section I Coverage A Bodily Injury And Property Damage Liability. b Any other primary insurance available to you covering liability for damages arising out of the premises or operations or the products and completed operations for which you have been added as an additional insured. 2 When this insurance is excess we will have no duty under Coverages A or B to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be entitted to the insured s rights against all those other insurers. 3 When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of a The total amount that all such other insurance would pay for the loss in the absence of this insurance and b The total of all deductible and self insured amounts under all that other insurance. 4 We will share the remaining loss if any with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. 6. Representations By accepting this policy you agree a. The statements in the Declarations are accurate and complete Page 12 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
b. Those statements are based upon representations you made to us and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this Coverage Part to the first Named Insured this insurance applies a. As if each Named Insured were the only Named Insured and b. Separately to each insured against whom claim is made or suit is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part those rights are transferred to us. The insured must do nothing after loss to impair them. At our request the insured will bring suit or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. SECTION V DEFINITIONS 1. Advertisement means a notice that is broadcast or published to the general public or specific market segments about your goods products or services for the purpose of attracting customers or supporters. For the purposes of this definition a. Notices that are published include material placed on the Internet or on similar electronic means of communication and b. Regarding web sites only that part of a web site that is about your goods products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. Auto means a. A land motor vehicle trailer or semitrailer designed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However auto does not include mobile equipment.. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time.. Coverage territory means a. The United States of America including its territories and possessions Puerto Rico and Canada b. International waters or airspace but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above or c. All other parts of the world if the injury or damage arises out of 1 Goods or products made or sold by you in the territory described in Paragraph a. above The activities of a person whose home is in the territory described in Paragraph a. above but is away for a short time on your business or Personal and advertising injury offenses that take place through the Internet or similar electronic means of communication provided the insured s responsibility to pay damages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to.. Employee includes a leased worker. Employee does not include a temporary worker.. Executive officer means a person holding any of the officer positions created by your charter constitution bylaws or any other similar governing document.. Hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be.. lmpaired property means tangible property other than your product or your work that can not be used or is less useful because a. It incorporates your product or your work that is known or thought to be defective deficient inadequate or dangerous or b. You have failed to fulfill the terms of a contract or agreement if such property can be restored to use by the repair replacement adjustment or removal of your product or your work or your fulfilling the terms of the contract or agreement. 2 3 CG 00010413 Insurance Services Office Inc. 2012 Page 13 of 16 | 1 |
9. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract b. A sidetrack agreement c. Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality e. An elevator maintenance agreement f. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or 3 Under which the insured if an architect engineer or surveyor assumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. 2 10.Leased worker means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker. 11.Loading or unloading means the handling of property a. After it is moved from the place where it is accepted for movement into or onto an aircraft watercraft or auto b. While it is in or on an aircraft watercraft or auto or c. While it is being moved from an aircraft watercraft or auto to the place where it is finally delivered but loading or unloading does not include the movement of property by means of a mechanical device other than a hand truck that is not attached to the aircraft watercraft or auto. 12.Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment a. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads b. Vehicles maintained for use solely on or next to premises you own or rent c. Vehicles that travel on crawler treads d. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers e. Vehicles not described in Paragraph a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types 1 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers f. Vehicles not described in Paragraph a. b. c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. Page 14 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
However self propelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos 1 Equipment designed primarily for a Snow removal b Road maintenance but not construction or resurfacing or c Street cleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and 3 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered autos. 13.Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. 14.Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution c. The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies committed by or on behalf of its owner landlord or lessor d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services e. Oral or written publication in any manner of material that violates a person s right of privacy f. The use of another s advertising idea in your advertisement or g. Infringing upon another s copyright trade dress or slogan in your advertisement. 15.Pollutants mean any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals and waste. Waste includes materials to be recycled reconditioned or reclaimed. 16.Products completed operations hazard a. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 Products that are still in your physical possession or 2 Work that has not yet been completed or abandoned. However your work will be deemed completed at the earliest of the following times a When all of the work called for in your contract has been completed. b When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. c When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. b. Does not include bodily injury or property damage arising out of 1 The transportation of property unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you and that condition was created by the loading or unloading of that vehicle by any insured 2 The existence of tools uninstalled equipment or abandoned or unused materials or 3 Products or operations for which the classification listed in the Declarations or in a policy Schedule states that products completed operations are subject to the General Aggregate Limit. 17.Property damage means a. Physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance electronic data is not tangible property. CG 00010413 Insurance Services Office Inc. 2012 Page 15 of 16 | 1 |
As used in this definition electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMSs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. 18.Suit means a civil proceeding in which damages because of bodily injury property damage or personal and advertising injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 19.Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. 20.Volunteer worker means a person who is not your employee and who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other compensation by you or anyone else for their work performed for you. 21.Your product a. Means 1 Any goods or products other than real property manufactured sold handled distributed or disposed of by a You b Others trading under your name or c A person or organizaton whose business or assets you have acquired and 2 Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 22.Your work a. Means 1 Work or operations performed by you or on your behalf and 2 Materials parts or equipment furnished in connection with such work or operations. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your work and 2 The providing of or failure to provide warnings or instructions. Page 16 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
A Group 5 X MINIMUM EARNED PREMIUM CANCELLATIONS AND AUDITS It is hereby understood and agreed that in the event of cancellation of coverage by the insured. the minimum earned premium under this policy shall be 25 of the policy premium. It is further understood the minimum earned premium of this policy shall be. 100 of the policy premium if the policy is in effect for the full term and the audit shows a lower exposure than estimated. 1003 891 Page 1 of 1 | 2 |
COMBINED PROVISIONS ENDORSEMENT This endorsement modifies insurance provided under the following Commercial General Liability Coverage Part. Commercial Professional Liability Coverage Part Liquor Liability Coverage Form In consideration of the premium charged it is agreed that the following special provisions apply to this policy. PUNITIVE DAMAGES EXCLUSION It is part of the conditions of this policy that the Company shall not be liable for any damages awarded against an insured as punitive or exemplary damages. ASBESTOS EXCLUSION In consideration of the premium charged it is hereby understood and agreed that this policy will not provide coverage meaning indemnification or defense costs arising out of A Asbestos or any asbestos related bodily injury or property damage or Any alleged act error omission or duty involving asbestos its use exposure presence existence detection removal elimination transportation disposal or avoidance or The use exposure presence existence detection removal elimination or avoidance of asbestos in any environment building or structure. e EARTH MOVEMENT EXCLUSION In consideration of the premium charged it is understood and agreed that this policy specifically excludes and does not extend to or provide coverage or indemnity for any claim of liability for bodily injury or property damage caused by resulting from attributable or contributed to or aggravated by the subsidence or movement of land as a result of earthquake landslide mudflow earth sinking or shifting resulting from aggravated by or contributed to by operations of the named insured or any subcontractor of the named insured. 2002 0802 Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LEAD CONTAMINATION EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL UMBRELLA LIABILITY COVERAGE PART In consideration of the premium charged it is hereby understood and agreed that this policy will not provide coverage meaning indemnification or defense costs arising out of Bodily Injury Property Damage Personal Injury Advertising Injury Medical Payments or any other damages because of liability alleged liability or occurrence resulting from caused by arising out of or in any way connected with The existence of lead the removal of lead the testing for lead or exposure to lead in any form which is or has at any time been present in on or near the insured s premises or at any location at which the insured is working or has worked in connection with such existence. removal or testing. 1 Whether or not caused by at the instigation of or with the direct or indirect involvement of the insured the insured s employees or other persons on the insured s premises or work site or 2 Whether or not caused by or arising out of the insured s failure to properly supervise or keep the work site in a safe condition. S2033 032014 Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO AND NON OWNED AUTO LIABILITY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Insurance is provided only with respect to those coverages for which a specific Limit of Liability and Premium are shown Coverage Limit of Liability Premium Non Owned Auto Liability 1000000 150 Hired Auto Liability NOT COVERED NOT COVERED General Aggregate Limit 1000000 If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. A. HIRED AUTO LIABILITY The insurance provided under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY SECTION I COVERAGES applies to bodily injury or property damage arising out of the maintenance or use of a hired auto by you or your employees in the course of your business. B. NON OWNED AUTO LIABILITY The insurance provided under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY SECTION I COVERAGES applies to bodily injury or property damage arising out of the use of a non owned auto by any person other than you in the course of your business. C. With respect to all Coverages provided by this endorsement 1. Subparagraphs b. c. e. g. h. j. k. I m. and n. of paragraph 2. Exclusions of COVERAGE A BODI LY INJURY AND PROPERTY DAMAGE LIABILITY SECTION I COVERAGES do not apply. 2. The following exclusions are added to paragraph 2. Exclusions of COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY SECTION I COVERAGES This insurance does not apply to a. Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the absence of the contract or agreement or 2 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. b. Bodily injury to 1 An employee of the insured arising out of and in the course of a Employment by the insured or b Performing duties related to the conduct of the insured s business or 2 The spouse child parent brother or sister of that employee as a consequence of paragraph 1 above. This exclusion applies 1 Whether the insured may be liable as an employer or in any other capacity and 2 To any obligation to share damages with or repay someone else who must pay the damages be cause of the injury. lerage 2045 10 2014 Includes copyrighted material of ISO Commercial Risk Services Inc. with its permission. Copyright ISO Commercial Risk Services Inc. Page 1 of 3 | 2 |
This exclusion does not apply to 1 Liability assumed by the insured under an insured contract or 2 Bodily Injury to domestic employees not entitled to workers compensation benefits. c. Property damage to 1 Property owned or being transported by or rented or loaned to the insured or 2 Property in the care custody or control of the insured. D. WHO IS AN INSURED SECTION II WHO IS AN INSURED is deleted with respect to all Coverages provided under this endorsement and replaced by the following 1. Each of the following is an insured under this insurance to the extent set forth below a. You. b. Any other person using a hired auto with your permission. c. With respect to a non owned auto any partner or executive officer of yours but only while such non owned auto is being used in your business. d. Any other person or organization but only with respect to their liability because of acts or omissions of an insured under paragraphs 1. 2. or 3. above. of the following is an insured a. Any person engaged in the business of his or her employer with respect to bodily injury to any co employee of such person injured in the course of employment b. Any partner or executive officer with respect to any auto owned by such partner or officer or a member of his or her household c. Any person while employed in or otherwise engaged in performing duties related to the conduct of an auto business other than an auto business you operate d. The owner or lessee of whom you are a sublessee of a hired auto or the owner of a non owned auto or any agent or employee of any such owner or lessee e. Any person or organization with respect to the conduct of any current or past partnership or joint ven ture that is not shown as a Named Insured in the Declarations. E. For the purposes of this endorsement only the following is added to the definition of Insured Contract in SECTION V DEFINITIONS g. That part of any contract or agreement entered into as part of your business pertaining to the rental or lease by you or any of your employees of any auto. However such contract or agreement shall not be considered an insured contract to the extent that it obligates you or any of your em ployees to pay for property damage to any auto rented or leased by you or any of your employ ees. F. For the purposes of this endorsement only the following definitions are added to the SECTION V DEFINITIONS 1. Auto business means the business or occupation of selling repairing servicing storing or parking au tos. Hired auto means any auto you lease hire rent or borrow. This does not include any auto you lease hire rent or borrow from any of your employees your partners or your executive officers or members of their households. Non owned auto means any auto you do not own lease hire rent or borrow which is used in connec tion with your business. This includes autos owned by your employees your partners or your execu 2045 10 2014 Includes copyrighted material of ISO Commercial Risk Services Inc. with its permission. Copyright ISO Commercial Risk Services Inc. Page 2 of 3 | 2 |
tive officers or members of their households but only while used in your business or your personal af fairs. G. LIMITS OF INSURANCE FOR HIRED AUTO AND NON OWNED AUTO LIABILITY With respect to HIRED AUTO AND NON OWNED AUTO LIABILITY only SECTION Ill LIMITS OF IN SURANCE is deleted and replaced by the following 1. Regardless of the number of hired autos non owned autos insureds premiums paid claims made or vehicles involved in the accident the most we will pay for all damages resulting from any one accident is the General Aggregate Limit shown in this endorsement. 2. Any amount paid by or for anyone legally responsible for an accident will reduce only the amount of damages to be paid and does not reduce our limit of insurance. 3. Any amount paid under this insurance will reduce any amount an insured may be paid under COVER AGE A SECTION COVERAGES. 2045 10 2014 Includes copyrighted material of ISO Commercial Risk Services Inc. with its permission. Copyright ISO Commercial Risk Services Inc. Page 3 of 3 | 2 |
EMPLOYEE BENEFITS LIABILITY COVERAGE This endorsement modifies insurance provided under the following Commercial General Liability Coverage Part In addition to words and phrases contained in the Commercial General Liability Coverage Form other words and phrases that appear in quotation marks have special meaning. Refer to Paragraph E. ADDITIONAL DEFINITIONS of this endorsement. The definitions of words and phrases coverage territory insured and suit contained in Paragraph E. apply in place of their definitions stated elsewhere in the policy but only as respects coverage under this endorsement. The provisions of this endorsement apply only as respects Employee Benefit Liability Coverage afforded hereunder. SCHEDULE COVERAGE ADVANCE PREMIUM Employee Benefits Programs 1000000 each employee 200.00 1000000 aggregate A. COVERAGE 1. Insuring Agreement 2. Exclusions We will pay those sums that the insured becomes legally obligated to This insurance does not apply to pay as damages because of any negligent act error or omission of the insured or of any other person for whose acts the insured is a. Loss arising our of any dishonest fraudulent criminal or legally liable. The negligent act error or omission must be malicious act or omission committed by any insured committed in the administration of your employee benefit program during the policy period. No other obligation or liability to pay sums b. Bodily injury or property damage or personal injury or perform acts or services is covered unless explicitly provided for under SUPPLEMENTARY PAYMENTS of this endorsement. c. Loss arising out of failure of performance of contract by an insurer The negligent act error or omission must take place in the coverage territory. We will have the right and duty to defend any suit d. Loss arising out of an insufficiency of funds to meet any seeking those damages. But obligations under any plan included in the employee benefit program a. The amount we will pay for damages is limited as described in Paragraph C. LIMITS OF INSURANCE. e. Any claim or sit based upon b. We may at our discretion investigate any report of a negligent 1 failure of any investment to perform as represented by act error or omission and settle any claim or suit that may any insured or result and 2 advice given to any person to participate or not to c. Tender of policy limits does not release the company of its duty participate in any plan included in the employee benefit to defend. program. f. Loss arising out of your failure to comply 20531197 Page 10f 3 | 2 |
with the mandatory provisions of any law concerning workers 2. compensation unemployment insurance social security or disability benefits a Loss for which the insured is liable because of liability imposed on a fiduciary by the Employee Retirement Security Act of 1974 as now or hereafter amended or b. Loss or damage for which benefits have accrued under the terms of an employee benefit plan to the extent that such benefits are available from funds accrued by the insured for such benfits or from collectible insurance notwithstanding the insured s act error or 3. omission in administering the plan which precluded the claimant from Each of the following is also an insured Each of your partners executive officers and employees who is authorized to administer your employee benefit program. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this endorsement. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over receiving such benefits. Supplementary Payments We will pay with respect to any claim or suit we defend which you maintain ownership or majority interest will be deemed to be a Named Insured if there is no similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 90 t a. Allexpenses we incur. day after you acquire or form the organization or the end of b. The cost of bonds to release attachments but only for bond the policy period whichever is earlier amounts within the applicable limit of insurance. We do not b. Coverage under this provision does not apply to any have to furnish these bonds. negligent act error or omission that occurred before you c. Allreasonable expensed incurred by the insured at our request acquired or formed the organization. to assist us in the investigation or defense of the claim or suit including actual loss of earnings up to 100 a day because of No person or organization is an insured with respect to the time off from work. conduct of any current or past partnership or joint venture that is d. Al costs taxed against the insured in the suit. not shown as a Named Insured in the Declarations. e. Pre judgment interest awarded against the insured on that part of the judgment we pay. Allinterest on the full amount of any judgement that accrues after entry of the judgment and before we have paid offered to pay or deposited in court the part of the judgment that is within the applicable limit of insurance. B.WHO IS AN INSURED If you are designated in the Declarations as a. Anindividual you and your spouse are insureds but only with respect to the conduct of a business which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. c. Alimited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. Anorganization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. C. LIMITS OF INSURANCE The Limits of Insurance shown in the Schedule and the rules below fix the most we will pay regardless of the number of Insureds Claims made or suits brought Persons or organizations making claims or bringing suits Acts errors or omissions which result in loss or Plans included in your employee benefit program. oo o The Aggregate Limit is the most we will pay for all damages because of acts errors or omissions committed in the administration of your employee benefit program. Subject to the Aggregate Limit the Each Employee Limit is the most we will pay for all damages sustained by any one employee including the employee s dependents and beneficiaries because of acts errors or omissions committed in the administrations of your employee benefit program. If the policy period is for a term in excess of one year the Aggregate Limit of Insurance shall apply separately to each consecutive annual period. y claim or suit we defend ase attachments but only for bond able limit of insurance. We do not ds. incurred by the insured at our request ation or defense of the claim or suit mings up to 100 a day because of insured in the suit. arded against the insured on that part whlch you maint to be a Named that organizatior a. Coverage L day after yc the policy p b. Coverage L negligent a acquired or No person or or conduct of any notshownasal ent that is within Lt antiire unll are an inelired Valir 20531197 Page 2 of 3 | 2 |
D. DEDUCTIBLE Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of 1000 deductible applicable to Each Employee. The limit of insurance applicable to Each Employee will be reduced by the amount of this deductible. The Aggregate Limit shall not be reduced by the application of such deductible amount. The deductible amount applies to all damages sustained by an employee because of an act error or omission covered by this insurance. The terms of this insurance including those with respect to a. Ourrightand duty to defend any suits seeking those damages and b. Your duties in the event of an act error or omission claim or suit apply irrespective of the application of the deductible amount. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon nofification of the action taken you shall promptly reimburse us for such part of the deductible amount as has been paid by us. E. ADDITIONAL DEFINITIONS Administration means a. Counseling employees including their dependents and beneficiaries with respect to the employee benefit program b. Handling records in connection with the employee benefit program or c. Effecting or terminating any employee s participation in a plan included in the employee benefit program. Coverage territory means the United States of America including its territories and possessions Puerto Rico and Canada. Employee benefit program means the following plans a. Group life insurance group accident or health insurance profit sharing plans pension plans and stock subscription plans provided that no one other than an employee may subscribe to such insurance or plans b. Unemployment insurance social security benefits workers compensation and disability benefits c. Any other similar plan designated in the Schedule or added thereto by endorsement. 4. Insured means any person or organization qualifying as such under Paragraph B. WHO IS AN INSURED. 5. Profit sharing plans means only such plans that are equally available to all full time employees. 6. Stock subscription plans means only such plans that are equally available to all full time employees. 7. Suit means a civil proceeding in which damages because of an act error or omission to which this insurance applies are alleged. Suit includes an arbitration proceeding alleging such damages to which you must submit with our consent. F. ADDITIONAL CONDITION Item 2. Duties In The Event of Occurrence Claim or Suit Paragraphs a.and b. of Section IV Commercial General Liability Coverage Form are inapplicable to this endorsement and replaced by the following 2. Duties in the Event of Act Error or Omission Claim or Suit. a. Youmust see to it that we are notified as soon as practicable of an act error or omission which may result in a claim. Notice should include 1 What the act error or omission was and when it occurred 2 The names and addresses of any employees who may suffer damages as a result of the act error or omission. b. Ifaclaimis received by any insured you must 1 Immediately record the specifics of the claim and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim as soon as practicable. 20531197 Page 3 of 3 | 2 |
COMMERCIAL GENERAL LIABILITY CG 200804 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED USERS OF GOLFMOBILES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section Il Who Is An Insured is amended to B. For the purposes of this endorsement golfmobile include as an additional insured any persons means a motorized conveyance that is using or legally responsible for the use of 1. Designed to carry up to four persons on a golf golfmobiles loaned orvrented to others by you or course for the purpose of playing golf and any of your concessionaires but only for their liability arising out of the use of the golfmobiles. 2. Not built or modified after manufacture to exceed a speed of 25 miles per hour on level ground. CG 2008 04 13 Insurance Services Office Inc. 2012 Page 1 0of 1 | 2 |
POLICY NUMBER PAV0005257 POLICY NUMBER PAV0005257 COMMERCIAL GENERAL LIABILITY CG 03 00 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE SCHEDULE Coverage Bodily Injury Liability OR Property Damage Liability OR Bodily Injury Liability andor Property Damage Liability Combined Amount and Basis of Deductible PER CLAIM or PER OCCURRENCE 500 500 If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. APPLICATION OF ENDORSEMENT Enter below any limitations on the application of this endorsement. If no limitation is entered the deductibles apply to damages for all bodily injury and property damage however caused Amount and Basis of Deductible PER CLAIM or PER OCCURRENCE 500 500 A. Our obligation under the Bodily Injury Liability and Property Damage Liability Coverages to pay damages on your behalf applies only to the amount of damages in excess of any deductible amounts stated in the Schedule above as appli cable to such coverages. B. You may select a deductible amount on either a per claim or a per occurrence basis. Your se lected deductible applies to the coverage option and to the basis of the deductible indicated by the placement of the deductible amount in the Schedule above. The deductible amount stated in the Schedule above applies as follows 1. PER CLAIM BASIS. If the deductible amount indicated in the Schedule above is on a per claim basis that deductible applies as follows a. Under Bodily Injury Liability Coverage to all damages sustained by any one person because of bodily injury b. Under Property Damage Liability Cover age to all damages sustained by any one person because of property damage or c. Under Bodily Injury Liability andor Property Damage Liability Coverage Combined to all damages sustained by any one person because of 1 Bodily injury 2 Property damage or 3 Bodily injury and property damage combined as the result of any one occurrence. If damages are claimed for care loss of serv ices or death resulting at any time from bodily injury a separate deductible amount will be applied to each person making a claim for such damages. With respect to property damage person in cludes an organization. CG 03 00 01 96 Copyright Insurance Services Office Inc. 1994 Page 1 of 2 m | 2 |
2. PER OCCURRENCE BASIS. If the deductible amount indicated in the Schedule above is on a per occurrence basis that deductible amount applies as follows a. Under Bodily Injury Liability Coverage to all damages because of bodily injury b. Under Property Damage Liability Cover age to all damages because of property damage or c. Under Bodily Injury Liability andor Property Damage Liability Coverage Combined to all damages because of 1 Bodily injury 2 Property damage or 3 Bodily injury and property damage combined as the result of any one occurrence regard less of the number of persons or organizations who sustain damages because of that occurrence. C. The terms of this insurance including those with respect to 1. Our right and duty to defend the insured against any suits seeking those damages and 2. Your duties in the event of an occurrence claim or suit apply irrespective of the application of the de ductible amount. D. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification of the action taken you shall promptly reimburse us for such part of the deductible amount as has been paid by us. Page 2 of 2 Copyright Insurance Services Office Inc. 1994 CG 03 000196 u | 2 |
POLICY NUMBER PAV0005257 POLICY NUMBER PAV0005257 COMMERCIAL GENERAL LIABILITY CG 20280413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED LESSOR OF LEASED EQUIPMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations IAmerigas Propane 3807 S. 1600 E Circle 7 B Saint George UT 84790 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by your maintenance operation or use of equipment leased to you by such persons or organizations. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds this insurance does not apply to any occurrence which takes place after the equipment lease expires. C. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. nerigas Propane 07 S. 1600 E Circle 7 B Saint George UT 84790 CG 20280413 Insurance Services Office Inc. 2012 Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO EXCLUSION THIS ENDORSEMENT CHANGES THE POLICY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion 2. of SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY Aircraft Auto Or Watercraft is deleted in its entirety and replaced with the following This insurance does not apply to Bodily injury or property damage arising out of the ownership maintenance or use by any person or entrustment to others of any aircraft auto or watercraft. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved an aircraft auto or watercraft. Use includes operation and loading or unloading. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured 4 Bodily injury or property damage arising out of the operation of any of the equipment listed in paragraph f.2 or f.3 of the definition of mobile equipment. 2113 1007 Page 1 of 1 | 2 |
POLICY NUMBER pav0005257 POLICY NUMBER pav0005257 COMMERCIAL GENERAL LIABILITY CG 20290413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED GRANTOR OF FRANCHISE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Persons Or Organizations Treasure Franchise Company LLC Tesoro Refining Marketing Company LLC BP West Coast Products LLC ic o AMCS P.O. Box 129 Conway AR 72033 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to their liability as grantor of a franchise to you. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. AMCS P.O. Box 129 Conway AR 72033 CG 20290413 Insurance Services Office Inc. 2012 Page 1 of 1 | 2 |
POLICY NUMBER PAV0005257 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ATHLETIC OR SPORTS PARTICIPANTS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Description of Operations Gas Station Convenience Store Car Wash Motel Restaurant Lessor s Risk Only If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. With respect to any operations shown in the Schedule this insurance does not apply to bodily injury to any person while practicing for or participating in any sports or athletic contest or exhibition that you sponsor. CG21011185 Copyright Insurance Services Office Inc. 1984 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG 21070514 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA RELATED LIABILITY LIMITED BODILY INJURY EXCEPTION NOT INCLUDED This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.p. of Section Coverage A B. The following is added to Paragraph 2. Bodily Injury And Property Damage Liability is replaced by the following 2. Exclusions This insurance does not apply to p. Access Or Disclosure Of Confidential Or Personal Information And Data related Liability Damages arising out of 1 Any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information or The loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of that which is described in Paragraph 1 or 2 above. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or organization s confidential or personal information. CG 21070514 Insurance Services Office Inc. 2013 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG 210906 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION UNMANNED AIRCRAFT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.g. Aircraft Auto Or Watercraft under This Paragraph g.2 applies even if the Section Coverage A Bodily Injury And claims against any insured allege Property Damage Liability is replaced by the negligence or other wrongdoing in the following supervision hiring employment training 2. Exclusions or monitoring of others by that insured if o the occurrence which caused the This insurance does not apply to bodily injury or property damage g. Aircraft Auto Or Watercraft involved the ownership maintenance use or entrustment to others of any 1 Unmanned Alrcraft aircraft other than unmanned aircraft Bodily injury or property damage auto or watercraft that is owned or arising out of the ownership operated by or rented or loaned to any maintenance use or entrustment to insured. others of any aircraft that is an unmanned aircraft. Use includes This Paragraph g.2 does not apply to operation and loading or unloading. a A watercralt while ashore on This Paragraph g.1 applies even if the premises you own or rent claims against any insured allege b A watercraft you do not own that is negligence or other wrongdoing in the i Less than 26 feet long and supervision hiring employment training or monitoring of others by that insured if ii Not being used to carry persons the occurrence which caused the or property for a charge bodily injury or property damage c Parking an auto on or on the ways involved the ownership maintenance next to premises you own or rent use or entrustment to others of any provided the auto is not owned by aircraft that is an unmanned aircraft. or rented or loaned to you or the 2 Aircraft Other Than Unmanned insured Aircraft Auto Or Watercraft d Liability assumed under any insured contract for the ownership Bodily injury or property damage y iy property 2 maintenance or use of aircraft or arising out of the ownership maintenance use or entrustment to watercraft or others of any aircraft other than unmanned aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This Paragraph g.2 applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft other than unmanned aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This Paragraph g.2 does not apply to a A watercraft while ashore on premises you own or rent b A watercraft you do not own that is i Less than 26 feet long and ii Not being used to carry persons or property for a charge c Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or d CG 2109 06 15 Insurance Services Office Inc. 2014 Page 1 of 2 | 2 |
e Bodily injury or property damage arising out of i The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or ii The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definition of mobile equipment. B. The following exclusion is added to Paragraph 2. Exclusions of Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Unmanned Aircraft Personal and advertising injury arising out of the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the offense which caused the personal and advertising injury involved the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. This exclusion does not apply to a. The use of another s advertising idea in your advertisement or b. Infringing upon another s copyright trade dress or slogan in your advertisement. C. The following definition is added to the Definitions section Unmanned aircraft means an aircraft that is not 1. Designed 2. Manufactured or 3. Modified after manufacture to be controlled directly by a person from within or on the aircraft. Page 2 of 2 Insurance Services Office Inc. 2014 CG 2109 06 15 | 2 |
COMMERCIAL GENERAL LIABILITY CG 21471207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYMENT RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability This insurance does not apply to Bodily injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demo tion evaluation reassignment discipline defamation harassment humiliation dis crimination or malicious prosecution di rected at that person or 2 The spouse child parent brother or sister of that person as a consequence of bodily injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after em ployment of that person Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. 2 B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Per sonal And Advertising Injury Liability This insurance does not apply to Personal and advertising injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demo tion evaluation reassignment discipline defamation harassment humiliation dis crimination or malicious prosecution di rected at that person or 2 The spouse child parent brother or sister of that person as a consequence of personal and advertising injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after em ployment of that person Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. 2 CG 21471207 ISO Properties Inc. 2006 Page 1 of 1 a | 2 |
COMMERCIAL GENERAL LIABILITY CG 21500413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF LIQUOR LIABILITY EXCLUSION COMMERCIAL GENERAL LIABILITY COVERAGE PART The following replaces Exclusion c. under Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person including causing or contributing to the intoxication of any person because alcoholic beverages were permitted to be brought on your premises for consumption on your premises The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in a The supervision hiring employment training or monitoring of others by that insured or 2 3 This endorsement modifies insurance provided under the following b Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol if the occurrence which caused the bodily injury or property damage involved that which is described in Paragraph 1 2 or 3 above. This exclusion applies only if you 1 Manufacture sell or distribute alcoholic beverages 2 Serve or furnish alcoholic beverages for a charge whether or not such activity a Requires a license b Is for the purpose of financial gain or livelihood 3 Serve or furnish alcoholic beverages without a charge if a license is required for such activity or 4 Permit any person to bring any alcoholic beverages on your premises for consumption on your premises. b Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol if the occurrence which caused the bodily injury or property damage involved that which is described in Paragraph 1 2 or 3 above. This exclusion applies only if you 1 Manufacture sell or distribute alcoholic beverages 2 Serve or furnish alcoholic beverages for a charge whether or not such activity a Requires a license b Is for the purpose of financial gain or livelihood 3 Serve or furnish alcoholic beverages without a charge if a license is required for such activity or 4 Permit any person to bring any alcoholic beverages on your premises for consumption on your premises. CG 21500413 Insurance Services Office Inc. 2012 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG 21 55 09 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION WITH A HOSTILE FIRE EXCEPTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion f. under Paragraph 2. Exclusions of Sec tion Coverage A Bodily Injury And Property Damage Liability is replaced by the following This insurance does not apply to f. Pollution 1 Bodily injury or property damage which would not have occurred in whole or part but for the actual alleged or threatened discharge dispersal seepage migration release or es cape of pollutants at any time. This exclusion does not apply to bodily injury or property damage arising out of heat smoke or fumes from a hostile fire unless that hostile fire occurred or originated a At any premises site or location which is or was at any time used by or for any insured or others for the handling storage dis posal processing or treatment of waste or b At any premises site or location on which any insured or any contractors or subcon tractors working directly or indirectly on any insured s behalf are performing operations to test for monitor clean up remove contain treat detoxify neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a Request demand order or statutory or b regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a govern mental authority for damages because of testing for monitoring cleaning up remov ing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. CG 21 55 09 99 Copyright Insurance Services Office Inc. 1998 Page 1 of 1 m | 2 |
POLICY NUMBER PAV0005257 POLICY NUMBER PAV0005257 COMMERCIAL GENERAL LIABILITY CG 28 06 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITATION OF COVERAGE TO INSURED PREMISES This endorsement modifies insurance provided under the following LIQUOR LIABILITY COVERAGE PART SCHEDULE Description and Location of Insured Premises 3685 N. Moapa Valley Blvd. Logandale NV 89021 2300 E. Glendale Blvd. Moapa NV 89025 If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. A. This insurance only applies to damages arising out of your insured premises. B. The following definition is added to the DEFINITIONS Section Insured premises means 1. The premises shown in the Schedule and 2. Any premises you acquire during the policy period for use in manufacturing distributing selling serving or furnishing alcoholic beverages if a. You notify us within 30 days after the acquisition and b. You have no other valid and collectible insurance applicable to the loss. CG 28 06 01 96 Copyright Insurance Services Office Inc. 1994 Page 1 of 1 m | 2 |
COMMERCIAL GENERAL LIABILITY CG 21671204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FUNGI OR BACTERIA EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Bodily injury or property damage which would not have occurred in whole or in part but for the actual alleged or threatened in halation of ingestion of contact with expo sure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed concurrently or in any sequence to such injury or damage. b. Any loss cost or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. This exclusion does not apply to any fungi or bacteria that are are on or are contained in a good or product intended for bodily consump tion. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Per sonal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Personal and advertising injury which would not have taken place in whole or in part but for the actual alleged or threat ened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed con currently or in any sequence to such injury. b. Any loss cost or expense arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. C. The following definition is added to the Definitions Section Fungi means any type or form of fungus includ ing mold or mildew and any mycotoxins spores scents or byproducts produced or released by fungi. CG 21671204 ISO Properties Inc. 2003 Page 1 of 1 a | 2 |
COMMERCIAL GENERAL LIABILITY CG 2196 03 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SILICA OR SILICA RELATED DUST EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Silica Or Silica Related Dust a. Bodily injury arising in whole or in part out of the actual alleged threatened or sus pected inhalation of or ingestion of silica or silica related dust. b. Property damage arising in whole or in part out of the actual alleged threatened or suspected contact with exposure to ex istence of or presence of silica or silica related dust. c. Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing contain ing treating detoxifying neutralizing reme diating or disposing of or in any way re sponding to or assessing the effects of silica or silica related dust by any in sured or by any other person or entity. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Per sonal And Adverti ing Injury Liabil 2. Exclusions C. The following definitions are added to the Defil This insurance does not apply to Silica Or Silica Related Dust a. Personal and advertising injury arising in whole or in part out of the actual alleged threatened or suspected inhalation of in gestion of contact with exposure to exis tence of or presence of silica or silica related dust. b. Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing contain ing treating detoxifying neutralizing reme diating or disposing of or in any way re sponding to or assessing the effects of silica or silica related dust by any in sured or by any other person or entity. tions Section 1. Silica means silicon dioxide occurring in crystalline amorphous and impure forms sil ica particles silica dust or silica compounds.. Silica related dust means a mixture or combi nation of silica and other dust or particles. CG 2196 03 05 1SO Properties Inc. 2004 Page 1 of 1 a | 2 |
POLICY NUMBER PAV0005257 POLICY NUMBER PAV0005257 COMMERCIAL GENERAL LIABILITY CG 24 07 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRODUCTS COMPLETED OPERATIONS HAZARD REDEFINED This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Description of Premises and Operations Restaurant with no sale of alcoholic beverages with table service If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. With respect to bodily injury or property damage arising out of your products manufactured sold handled or distributed 1. On from or in connection with the use of any premises described in the Schedule or 2. In connection with the conduct of any operation described in the Schedule when conducted by you or on your behalf Paragraph a. of the definition of Products completed operations hazard in the DEFINITIONS Section is replaced by the following Products completed operations hazard a. Includes all bodily injury and property dam age that arises out of your products if the bodily injury or property damage occurs after you have relinquished possession of those products. CG 24 07 01 96 Copyright Insurance Services Office Inc. 1994 Page 1 of 1 m | 2 |
COMMERCIAL GENERAL LIABILITY CG 24161207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANOES OR ROWBOATS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Exclusion g. of Section Coverage A Bodily 2. Section Il Who Is An Insured is amended to Injury And Property Damage Liability does not include as an insured any person or organization apply to bodily injury or property damage aris legally responsible for the use of any such canoe ing out of any canoe or rowboat owned or used by or rowboat you own provided the actual use is or rented to the insured. with your permission. CG 24161207 I1SO Properties Inc. 2006 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG 24260413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF INSURED CONTRACT DEFINITION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART The definition of insured contract in the Definitions section is replaced by the following Insured contract means Paragraph f. does not include that part of any contract or agreement a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract b. A sidetrack agreement c. Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality e. An elevator maintenance agreement f. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization provided the bodily injury or property damage is caused in whole or in part by you or by those acting on your behalf. However such part of a contract or agreement shall only be considered an insured contract to the extent your assumption of the tort liability is permitted by law. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or 3 Under which the insured if an architect engineer or surveyor assumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. 2 CG 24260413 Insurance Services Office Inc. 2012 Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL EXCLUSION PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to professional services the following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability This insurance does not apply to bodily injury property damage or personal and advertising injury due to wrongful acts.. As used in this endorsement the following definitions are added to SECTION V DEFINITIONS A. Professional services means any and all services performed for others requiring special skills experience and knowledge. B. Wrongful act means any actual or alleged negligent act error omission misstatement or misleading statement committed by the insured or by any other person or entity for which the insured is legally liable in the performance of or failure to perform professional services. EPA1631082010 Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ELECTRONIC CIGARETTES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. The following is added to Paragraph 2. Exclusions of SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE and to Paragraph 2. Exclusions of SECTION COVERAGES COVERAGE B PERSONAL AND ADVERTISING INJURY This insurance does not apply to Electronic Cigarettes And Substances Used Or Introduced With Them Bodily injury property damage or personal and advertising injury which would not have occurred in whole or in part but for the actual alleged or threatened use of an electronic cigarette any substance designed for use with an electronic cigarette or any substance introduced by the use of any electronic cigarette. This exclusion applies 1. To the actual threatened or alleged a. Furnishing to any person of b. Violation of any statute ordinance or regulation or other rule relating to the sale gift distribution or use of or c. Act error or omission in supervision instructions recommendations warnings representations warranties or advice in connection with any electronic cigarettes or any smoke heat ash vapor fumes glycol glycerol flavorings nicotine or any other substance used or designed for use with or introduced or emitted by electronic cigarettes.. Any obligation to share damages or expenses with or repay someone who must pay damages or expenses because of bodily injury property damage or personal and advertising injury described in Paragraph 1. above. B. The following is added to SECTION V DEFINITIONS Electronic cigarette means a handheld electronic device that creates an aerosol by heating a liquid and includes electronic or battery operated cigarettes cigars pipes personal vaporized or any type of chemical or nicotine delivery system including any component part or accessory of any of these. Includes copyrighted material of Insurance Services Office Inc. used with permission Page 1 of 1 m EPA1802 06 2017 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION FIREARMS AND OTHER WEAPONS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART This insurance does not apply to bodily injury or property damage arising out of firearms or other weapons. 2125 0107 Page 1 of 1 | 2 |
IL 00 03 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALCULATION OF PREMIUM This endorsement modifies insurance provided under the following CAPITAL ASSETS PROGRAM QUTPUT POLICY COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART The following is added The premium shown in the Declarations was com puted based on rates in effect at the time the policy was issued. On each renewal continuation or anni versary of the effective date of this policy we will compute the premium in accordance with our rates and rules then in effect. IL 00 03 09 08 ISO Properties Inc. 2007 Page 1 of 1 a | 2 |
POLICY NUMBER PAV0005257 POLICY NUMBER PAV0005257 IL 09 8501 15 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SCHEDULE SCHEDULE PART Terrorism Premium Certified Acts 1024.00 This premium is the total Certified Acts premium attributable to the following Coverage Parts Coverage Forms andor Policyies Commercial General Liability Additional information if any concerning the terrorism premium SCHEDULE PART Il Federal share of terrorism losses 83 Year20 17 Refer to Paragraph B. in this endorsement. 82 vear20 18 Federal share of terrorism losses Refer to Paragraph B. in this endorsement. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Disclosure Of Premium In accordance with the federal Terrorism Risk Insurance Act we are required to provide you with a notice disclosing the portion of your premium if any attributable to coverage for terrorist acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this endorsement or in the policy Declarations. his premium is the total Certified Acts premium attributable to the following Coverage Parts overage Forms andor Policyies ommercial General Liability dditional information if any concerning the terrorism premium Year 20 17 Year20 18 IL 09 85 01 15 Insurance Services Office Inc. 2015 Page 1 of 2 | 2 |
B. Disclosure Of Federal Parti Of Terrorism Losses The United States Government Department of the Treasury will pay a share of terrorism losses insured under the federal program. The federal share equals a percentage as shown in Part Il of the Schedule of this endorsement or in the policy Declarations of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. pation In Payment C. Cap On Insurer Participation In Payment Of Terrorism Losses If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. Page 2 of 2 Insurance Services Office Inc. 2015 IL 09 8501 15 | 2 |
COMMERCIAL LINES POLICY LIQUOR LIABILITY COVERAGE FORM DECLARATIONS POLICY NUMBER PAV0005257 1. NAMED INSURED WS Dynoco Petroleum Management LLCPer form IL1201 LIMITS OF INSURANCE Aggregate Limit 1000000 Each Common Cause Limit 1000000 J WAL DESCRIPTION AND LOCATIONS of all licensed premises you Own Rent or Occupy 3685 N. Moapa Valley Blvd. Logandale NV 89021 2300 E Glendale Blvd Moapa NV 89025 4. DESCRIPTION OF HAZARDS Liquor Liability CODE 058161 PREM. BASIS 219933 RATES 2.800 ADVANCE PREMIUM 616.00 5. Policy may be AUDITABLE 6. SPECIFIC LIQUOR LIABILITY FORMS ENDORSEMENTS This page alone does not provide coverage and must be attached to a Commercial Lines Common Policy Declarations Page Common Policy Conditions Coverage Part Coverage Forms and any other applicable forms and endorsements. 80001197 | 2 |
COMMERCIAL GENERAL LIABILITY CG 00330413 LIQUOR LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under Section I Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION LIQUOR LIABILITY COVERAGE 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of injury to which this insurance applies if liability for such injury is imposed on the insured by reason of the selling serving or furnishing of any alcoholic beverage. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for injury to which this insurance does not apply. We may at our discretion investigate any injury and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and 2 Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments. b. This insurance applies to injury only if 1 The injury occurs during the policy period in the coverage territory and 2 Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an injury or claim knew that the injury had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the injury occurred then any continuation change or resumption of such injury during or after the policy period will be deemed to have been known prior to the policy period. c. Injury which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an injury or claim includes any continuation change or resumption of that injury after the end of the policy period. d. Injury will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an injury or claim 1 Reports all or any part of the injury to us or any other insurer 2 Receives a written or verbal demand or claim for damages because of the injury or 3 Becomes aware by any other means that injury has occurred or has begun to occur. 2. Exclusions This insurance does not apply to a. Expected Or Intended Injury Injury expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Workers Compensation And Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law. CG 00330413 Insurance Services Office Inc. 2012 Page 10f 6 | 2 |
c. Employer s Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a Employment by the insured or b Performing duties related to the conduct of the insured s business or 2 The spouse child parent brother or sister of that employee as a consequence of Paragraph 1 above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. d. Liquor License Not In Effect Injury arising out of any alcoholic beverage sold served or furnished while any required license is not in effect. e. Your Product Injury arising out of your product. This exclusion does not apply to injury for which the insured or the insured s indemnitees may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. Other Insurance Any injury with respect to which other insurance is afforded or would be afforded but for the exhaustion of the limits of insurance. This exclusion does not apply if the other insurance responds to liability for injury imposed on the insured by reason of the selling serving or furnishing of any alcoholic beverage. g. War Injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or 3 Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. SUPPLEMENTARY PAYMENTS We will pay with respect to any claim we investigate or settle or any suit against an insured we defend 1. All expenses we incur. 2. The cost of bonds to release attachments but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. 3. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from work. 4. All court costs taxed against the insured in the suit. However these payments do not include attorneys fees or attorneys expenses taxed against the insured. 5. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment interest based on that period of time after the offer. 6. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or deposited in court the part of the judgment that is within the applicable limit of insurance. 7. Expenses incurred by the insured for first aid administered to others at the time of an event to which this insurance applies. These payments will not reduce the limits of insurance. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. c. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. Page 2 of 6 Insurance Services Office Inc. 2012 CG 00330413 | 2 |
d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. 2. Each of the following is also an insured a. Your employees other than either your executive officers if you are an organization other than a partnership joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees is an insured for 1 Injury a To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company or to a coemployee while that coemployee is either in the course of his or her employment or performing duties related to the conduct of your business To the spouse child parent brother or sister of that coemployee as a consequence of Paragraph a above or For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph a or b above. 2 Property damage to property a Owned or occupied by or b Rented or loaned to that employee any of your other employees by any of your partners or members if you are a partnership or joint venture or by any of your members if you are a limited liability company. b. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that property and 2 Until your legal representative has been appointed. b c c. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier and b. Coverage does not apply to injury that occurred before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION Il LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The Aggregate Limit is the most we will pay for all injury as the result of the selling serving or furnishing of alcoholic beverages. 3. Subject to the Aggregate Limit the Each Common Cause Limit is the most we will pay for all injury sustained by one or more persons or organizations as the result of the selling serving or furnishing of any alcoholic beverage to any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV LIQUOR LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this Coverage Part. members if int venture re a limited employee either in the ployment or the conduct it brother or yee as a a above or bligation to ay someone s because of graph a or 2 o Ny. CG 00330413 Insurance Services Office Inc. 2012 Page 30f 6 | 2 |
2. Duties In The Event Of Injury Claim Or Suit a. You must see to it that we are notified as soon c. d. 2 3 4 as practicable of an injury which may result in a claim. To the extent possible notice should include 1 How when and where the injury took place 2 The names and addresses of any injured persons and witnesses and 3 The nature and location of any injury. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit Authorize us to obtain records and other information Cooperate with us in the investigation or settlement of the claim or defense against the suit and Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury to which this insurance may also apply. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part b. To join us as a party or otherwise bring us into a suit asking for damages from an insured or To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us the insured and the claimant or the claimant s legal representative. 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary. Our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method described in b. below. b. Method Of Sharing If all of the other insurance permits contribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium we will return the excess to the first Named Insured. Page 4 of 6 Insurance Services Office Inc. 2012 CG 00330413 | 2 |
c. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. 6. Representations By accepting this policy you agree a. The statements in the Declarations are accurate and complete b. Those statements are based upon representations you made to us and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this Coverage Part to the first Named Insured this insurance applies a. As if each Named Insured were the only Named Insured and b. Separately to each insured against whom claim is made or suit is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part those rights are transferred to us. The insured must do nothing after loss to impair them. At our request the insured will bring suit or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. SECTION V DEFINITIONS 1. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time. 2. Coverage territory means a. The United States of America including its territories and possessions Puerto Rico and Canada ternational waters or airspace but only if the jury occurs in the course of travel or transportation between any places included in Paragraph a. above or c. All other parts of the world if the injury arises out of 1 Goods or products made or sold by you in the territory described in Paragraph a. above or 2 The activities of a person whose home is in the territory described in Paragraph a. above but is away for a short time on your business provided the insured s responsibility to pay damages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to.. Employee includes a leased worker. Employee does not include a temporary worker.. Executive officer means a person holding any of the officer positions created by your charter constitution bylaws or any other similar governing document.. Injury means damages because of bodily injury and property damage including damages for care loss of services or loss of support.. Leased worker means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker.. Property damage means a. Physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it.. Suit means a civil proceeding in which damages because of injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent.. Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. CG 00330413 Insurance Services Office Inc. 2012 Page 50f 6 | 2 |
10.Your product a. Means 1 Any goods or products other than real property manufactured sold handled distributed or disposed of by a You b Others trading under your name or c A person or organizaton whose business or assets you have acquired and 2 Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. Page 6 of 6 Insurance Services Office Inc. 2012 CG 00330413 | 2 |
POLICY NUMBER PAV0005257 POLICY NUMBER PAV0005257 COMMERCIAL GENERAL LIABILITY CG 03 05 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE This endorsement modifies insurance provided under the following LIQUOR LIABILITY COVERAGE PART SCHEDULE SCHEDULE Location Coverage Amount and Basis of Deductible PER CLAIM or PER COMMON CAUSE Liquor Liability 500 If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. APPLICATION OF ENDORSEMENT Enter below any limitations on the application of this endorsement. If no limitation is entered the deductibles apply to damages for injury however caused A. Our obligation under the Liquor Liability Coverage to pay damages on your behalf applies only to the amount of damages in excess of any deductible amount stated in the Schedule above. B. You may select a deductible amount on either a per claim or a per common cause basis. Your se lected deductible applies to the Liquor Liability Coverage and to the basis of the deductible indi cated by the placement of the deductible amount in the Schedule above. The deductible amount stated in the Schedule above applies as follows 1. PER CLAIM BASIS. If the deductible amount indicated in the Schedule above is on a per claim basis that deductible applies under Lig uor Liability Coverage to all injuries sus tained by any one person or organization. 2. PER COMMON CAUSE BASIS. If the de ductible amount indicated in the Schedule above is on a per common cause basis that deductible amount applies under Liquor Liabil ity Coverage to all damages because of injury as the result of the selling serving or furnishing of any alcoholic beverage to any one person regardless of the number of per sons or organizations who sustain damages. C. The terms of this insurance including those with respect to 1. Our right and duty to defend the insured against any suit seeking those damages and 2. Your duties in the event of an injury claim or suit apply irrespective of the application of the de ductible amount. D. We may pay any part or all of the deductible amount to effect settlement of any claims or suit and upon notification of the action taken you shall promptly reimburse us for such part of the deductible amount as has been paid by us. CG 03 05 01 96 Copyright Insurance Services Office Inc. 1994 Page 1 of 1 m | 2 |
ASSAULT OR BATTERY LIQUOR LIABILITY EXCLUSION Group X x X THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided under the following LIQUOR LIABILITY COVERAGE FORM COMMERCIAL LIABILITY UMBRELLA ASSAULT OR BATTERY LIQUOR LIABILITY EXCLUSION In consideration of the premium charge it is understood and agreed that this insurance does not apply to liability for damages because of bodily injury property damage personal and advertising injury medical expense arising out of an assault battery or physical altercation that occurs in on near or away from an insured s premises 1 Whether or not caused by at the instigation of or with the direct or indirect involvement of an insured an insured s employees patrons or other persons in on near or away from an insured s premises or 2 Whether or not caused by or arising out of an insured s failure to properly supervise or keep an insured s premises in a safe condition or 3 Whether or not caused by or arising out of any insured s act or omission in connection with the prevention suppression failure to warn of the assault battery or physical altercation including but not limited to negligent hiring training andor supervision. 4 Whether or not caused by or arising out of negligent reckless or wanton conduct by an insured an insured s employees patrons or other persons. DEFINITIONS For purposes of this endorsement Assault means any attempt or threat to inflict injury to another including any conduct that would reasonably place another in apprehension of such injury. Battery means the intentional or reckless physical contact with or any use of force against a person without his or her consent that entails some injury or offensive touching whether or not the actual injury inflicted is intended or expected. The use of force includes but is not limited to the use of a weapon. Physical altercation means a dispute between individuals in which one or more persons sustain bodily injury arising out of the dispute. All other terms conditions and definitions of the Policy otherwise apply. 80010605 Page 1 of 1 | 2 |
CNA 20020000440292172042588 CNA PARAMOUNT Renewal Effective Date 04072016 Insured Name KANSAS STATE OLATHE INNOVATION CAMPUS INC. 22201 W INNOVATION DR OLATHE KS 66061 1304 Policy Number 4029217204 Policy Period 04072016 04072017 Producer s Information LOCKTON COMPANIES LLC Producer Code 060692 444 W. 47TH ST. 900 KANSAS CITY MO 64112 816 960 9000 CNA Branch Number 310 CNA Branch Name and Address KANSAS CITY BRANCH 7400 COLLEGE BLVD. STE. 650 OVERLAND PARK KS 66210 913661 2700 Thank you for choosing CNA With your CNA Paramount package policy you have insurance coverage tailored to meet the needs of your modern business. The international network of insurance professionals and the financial strength of CNA rated A by A.M. Best provide the resources to help you manage the daily risks of your organization so that you may focus on what s most important to you. Claim Services There When You Need Us Claims are reported through a single point of entry available 247 connecting you to the individuals and information to help you resume your business when you need it most. To report a claim please call 877 CNA ASAP fax 800 953 7389 email lossreportcnaasap.com or visit www.cna.comclaim. Risk Control Services Help Avoid A Claim Before It Occurs As a CNA policyholder you have access to certified risk control professionals risk mitigation programs and online resources to help identify and manage exposures that may disrupt your operation. We collaborate with business leaders to develop customized programs to assist you in safeguarding your assets and improving the bottom line. To learn how our award winning Risk Control services can help your business please call 866 262 0540 email us at riskcontrolwebinfocna.com or visit www.cna.comriskcontrol. When it comes to providing the coverage service and resources paramount to your business success... we can show you more. R sured Name ANSAS STATE OLATHE INNOVATION CAMPUS INC. 2201 W INNOVATION DR LATHE KS 66061 1304 olicy Number 4029217204 roducer s Information OCKTON COMPANIES LLC 44 W. 47TH ST. 900 ANSAS CITY MO 64112 816 960 9000 Branch Number 310 Branch Name and Address ANSAS CITY BRANCH 400 COLLEGE BLVD. STE. VERLAND PARK KS 66210 PR Policy Period 04072016 0407201 Producer Code 060692 INSURED Copyright CNA All Rights Reserved | 2 |
cA CNA PARAMOUNT Policy Holder Notice Countrywide IMPORTANT INFORMATION NOTICE OFFER OF TERRORISM COVERAGE CONFIRMATION OF REJECTION OF COVERAGE FIRE FOLLOWING TERRORISM COVERAGE AND DISCLOSURE OF PREMIUM Solely with respect to the following coverage parts General Liability Employee Benefits Liability g THIS NOTICE DOES NOT FORM A PART OF YOUR POLICY GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. The Named Insured is hereby notified that under the Terrorism Risk Insurance Act as extended and reauthorized Act the Named Insured has a right to purchase insurance coverage of losses arising out of acts of terrorism as defined in Section 1021 of the Act subject to all applicable policy provisions. The Terrorism Risk Insurance Act established a federal program within the Department of the Treasury under which the federal government shares with the insurance industry the risk of loss from future terrorist attacks. This Notice is designed to alert the Named Insured to coverage restrictions and to certain terrorism provisions in the policy. If there is any conflict between this Notice and the policy including its endorsements the provisions of the policy including its endorsements apply. CHANGE IN THE DEFINITION OF A CERTIFIED ACT OF TERRORISM The Act applies when the Secretary of the Treasury certifies that an event meets the definition of an act of terrorism. Originally the Act provided that to be certified an act of terrorism must cause losses of at least five million dollars and must have been committed by an individual or individuals acting on behalf of any foreign person or foreign interest to coerce the government or population of the United States. However the 2007 re authorization of the Act removed the requirement that the act of terrorism must be committed by or on behalf of a foreign interest and now certified acts of terrorism may encompass for example a terrorist act committed against the United States government by a United States citizen when the act is determined by the federal government to be a certified act of terrorism. In accordance with the Act the Insurer is required to offer the Named Insured the ability to purchase coverage for losses resulting from an act of terrorism that is certified under the federal program. The other provisions of this policy including nuclear war or military action exclusions will still apply to such an act. DISCLOSURE OF FEDERAL PARTICIPATION IN PAYMENT OF TERRORISM LOSSES CNAB2821XX 02 15 Page 1 of 2 Copyright GNA All Rights Reserved. | 2 |
cA CNA PARAMOUNT Policy Holder Notice Countrywide The Department of the Treasury will pay a share of terrorism losses insured under the federal program. In 2015 the federal share equals 85 of that portion of the amount of such insured losses that exceeds the applicable insurer retention and shall decrease by 1 percentage point per calendar year until equal to 80. LIMITATION ON PAYMENT OF TERRORISM LOSSES If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a Calendar year January 1 through December 31 the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. Further this coverage is subject to a limit on the Insurer s liability pursuant to the federal law where if aggregate insured losses attributable to terrorist acts certified under the Act exceed 100 billion in a Calendar year January 1 through December 31 and the Insurer has met its insurer deductible under the Act the Insurer shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion. In such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. CONFIRMATION OF REJECTION OF COVERAGE In accordance with the Act the Insurer offered the Named Insured the ability to purchase coverage for losses resulting from an act of terrorism that is certified under the federal program. This Notice confirms that the Named Insured has chosen to reject the Insurer s offer of coverage for certified acts of terrorism to the extent possible. Consequently if permitted by state law a terrorism exclusion endorsement is attached to the policy. Certain states may not allow coverage for certified acts of terrorism to be rejected. If state law prohibits the Named Insured from rejecting certain coverage for certified acts of terrorism the premium for such coverage is shown separately on the Declarations. Solely with respect to Property and Inland Marine coverages by statute for risks locations in the states of i CA GA HI 1A IL MA ME MO NC NJ NY OR RI WA WI and WV for Property and i CA ME MO OR and WI for Inland Marine coverage is required to be provided for fire damage that results or follows from any cause of loss even those that are otherwise excluded. As a result if this policy provides Property or Inland Marine coverage and excludes terrorism the Insurer nevertheless is statutorily required with respect to such coverages to insure against fire damage that might result from otherwise excluded acts of terrorism in the referenced states. CNAB2821XX 02 15 Page 2 of 2 Copyright GNA All Rights Reserved. | 2 |
g CNA CNA PARAMOUNT Policy Holder Notice Countrywide Premium Basis Used on Liability Schedules Premium Basis Used on Liability Schedules This policy includes one or more Liability coverages with associated Schedules of locations coverages or classifications. When such Schedules display an Exposure amount used to calculate premium the Exposure amount is often followed by an abbreviation that denotes what the Exposure amount represents Payroll Gross Sales Area etc.. Such abbreviations are described below. A Area Per 1000 Sq. ft. AC Acres Each AD Activity Days Each AN Animals Each AP Airports Each AT Attendants Each AU Audited Premium Last Year of Manufacture B Bodies Each BA Bales Per 1000 Bales BD Beds Each BE Beaches Each BO Boats Each C Total Cost Per 1000 of Total Cost CD Camper Days Each Camper Day CN Contestants Each CU Convention Days Each CW Cost of Work Per 1000 of Total Cost of Work DB Drawbridges Each DM Dams Each DW Dwellings Each E Each Per Entity Described EM Employees Each ES Solar Energy Systems Each ET Turbines Each EX Exhibitions Each F Flat Charge Flat Premium Charge FG Fairgrounds Each FM Faculty Members Each FP Fishing Piers Each G Graduates Each GA Games Each CNA75144XX 04 15 P Payroll PD Passenger Days PG Picnic Grounds PP Parks Playgrounds PR Parades PS Persons PU Pupils R Receipts RG Registrants RN Range RV Revenue Copyright CNA All Rights Reserved OE Operating Expenditures GL Gallons Per 1000 Gallons GS Grandstands Bleacher Each H Number of Golf Holes Each HO Hoists Each HQ Headquarters Each K Kennels Each L Limit Limit of Insurance for Coverage LD Locations Days Each LE Lessees Each LO Locations Each LR Lakes Reservoirs Each LW Lawyers Each M Admissions Per 1000 Admissions ME Members Each MH Model Homes Each Ml Miles Each NB Newsboys Each O Operators Each Per 1000 of Operating Expenditures Per 1000 of Payroll Per 1000 Passenger Days Each Each Each Each Each Per 1000 of Receipts Each Each Per 1000 of Revenue Page 1 of 2 wVA Pollcy Holder No tands Bleacher r of Golf Holes arters 5 1 imit af Inetirance far C 1S bays ons Per 1000 Ad Page 1 of 2 | 2 |
CNA CNA PARAMOUNT Policy Holder Notice Countrywide Premium Basis Used on Liability Schedules S Gross Sales SA Classification SB Sub 336 Premium SC Scouts SD Students SE Seats SG Total GL Premium SH Shows SL 334336 Premium Per 1000 of Gross Sales Total Class Specific Premium Products Completed Operations Premium Each Each Each General Liability Premium Each Premises Operations and Products Completed Operations Premium SP Swimming Pools ST Stations SU Sub 334 Premium TE Teams TO Towers U Unit VE Vehicles VO Volunteers WC WC Premium Z Zoos Each Each Premises Operations Premium Each Each Per Dwelling Unit Per 1000 Vehicles Each Per 1000 of Workers Compensation Premium Each wVA Pollcy Holder No Tof Premium CNA75144XX 04 15 Page 2 of 2 Copyright CNA All Rights Reserved | 2 |
CNA PARAMOUNT CNA Policy Declarations Policy Number 4029217204 Renewal of 4029217204 Policy Name AMERICAN CASUALTY CO OF READING PA Issued by Address 333 S. WABASH CHICAGO IL. 60604 Producer Code 060692. Name LOCKTON COMPANIES LLC Producer s Address 444 W. 47TH ST. 900 Information KANSAS CITY MO 64112 1. Named Insured Name KANSAS STATE OLATHE INNOVATION CAMPUS INC. Address 22201 W INNOVATION DR OLATHE KS 66061 1304 2. Coverage The coverage parts attached to and Parts forming part of this Policy General Liability Employee Benefits Liability 3. Policy Period Effective date from to At1201 A.M. Standard Time at your 04072016 04072017 mailing address shown above 4. Limits of Insurance and Deductibles See Coverage Part Declarations 5. Premium Surcharges See CuveragePPan Declaranns for lloverag fan e remium surcharges taxes and fees Fees at Total Premium and applicable taxes surcharges and fees 3469.00 Issuance Policy Issued by Producer s Information Name Address Parts Total Premium and applicable ta CNA62639XX 09 12 Copyright CNA All Rights Reserved | 2 |
CNA PARAMOUNT CNA Policy Declarations. Forms and Endorsements Attached to this See Schedule of Forms and Endorsements Policy at Issuance These Declarations along with any attached forms and endorsements shall constitute the contract between the Insureds and the Insurer. See Schedule of Forms and Endorsements CNA62639XX 09 12 Copyright CNA All Rights Reserved | 2 |
CNA CNA PARAMOUNT Schedule of Forms and Endorsements Policy Number 4029217204 l. CNA PARAMOUNT A. Policyholder Notices Endmt Form Title Form Number Form Number Edition Policy Holder Notice Countrywide CNA62821XX 02 15 Policy Holder Notice Countrywide Premium Basis CNA75144XX 04 15 Used on Liability Schedules B. Policy Terms Conditions Policy Declarations CNA62639XX 09 12 Schedule of Forms and Endorsements CNA62640XX 09 12 Common Terms and Conditions CNA62642XX 09 12 Il. POLICY COVERAGE PARTS F. General Liability General Liability Coverage Part Declarations CNA75694XX 01 15 Additional Declarations General Liability CNA75126XX 01 15 Schedule of Locations and Coverages Commercial General Liability Coverage Part G0001 04 13 1 Pollution Exclusion Amendatory Endorsement CNA74843XX 01 15 2 Colleges or Schools Limited Form Endorsement CNA75001XX 01 15 3 silica Exclusion Endorsement CNA74687XX 01 15 4 Fungi Mold Mildew Yeast Microbe Exclusion CNA74708XX 01 15 Endorsement 5 Designated Professional Services Exclusion CNA74754XX 01 15 Endorsement 6 Employment Related Practices Exclusion Endorsement CNA74761XX 01 15 7 Corporal Punishment Exclusion Endorsement CNA74773XX 01 15 8 Athletic or Sports Participants Exclusion with CNA74886XX 01 15 Carveback Endorsement CNA62640XX 09 12 Copyright CNA All Rights Reserved | 2 |
CNA CNA PARAMOUNT Schedule of Forms and Endorsements Policy Number 4029217204 Endmt Form Title Form Number Form Number Edition 9 Exclusion Access or Disclosure of Confidential CNA75089XX 01 15 or Personal Information and Data Related Liability with Limited Bodily Injury Exception Endorsement G. Employee Benefits Liability Employee Benefits Liability Coverage Part CNA74693XX 01 15 Declarations Additional Declarations Employee Benefits CNA75133XX 01 15 Liability Schedule of Locations and Coverages Employee Benefits Liability Coverage Part CNA74721XX 01 15 Occurrence lll. POLICY ENDORSEMENTS 10 Bridge Endorsement Kansas CNA62646KS 01 15 11 Cancellation Non Renewal Kansas CNA62814KS 09 12 12 Calculation of Premium Endorsement CNA74726XX 01 15 13 Asbestos Exclusion Endorsement Kansas CNA74719KS 01 15 14 Nuclear Energy Liability Exclusion Endorsement CNA74727XX 01 15 Broad Form 15 Exclusion of Certified Acts of Terrorism CNA74926XX 02 15 Endorsement CNA62640XX 09 12 Copyright CNA All Rights Reserved | 2 |
g cA CNA PARAMOUNT Common Terms and Conditions The Insurer and the Named Insured in consideration of the payment of the premium and in reliance upon all statements made in the application furnished to the Insurer designated in the Policy Declarations a stock insurance corporation hereafter called the Insurer agree as follows. Terms in bold face type have special meaning as set forth in any applicable First Party Glossary of Defined Terms or the applicable coverage parts of this Policy. All headings are also in bold whether or not they contain defined terms. See Section XVI HEADINGS below. ASSIGNMENT OF INTEREST Assignment of interest under this Policy shall not bind the Insurer unless its consent is endorsed to this Policy except in the case of death of a natural person Named Insured. BANKRUPTCY Bankruptcy or insolvency of any Named Insured or of the Named Insured s estate shall not relieve the Insurer of any of its obligations hereunder. CANCELLATION NONRENEWAL A. Insurer s Right to Cancel The Insurer may cancel this policy by providing to the First Named Insured written notice of such cancellation stating when not less than 10 days thereafter such cancellation shall be effective if such cancellation is due to non payment of premium. If cancellation is due to any other reason such notice shall be provided not less than 60 days thereafter. B. Named Insured s Right to Cancel The First Named Insured may cancel this Policy by providing the Insurer written notice stating when thereafter such cancellation shall be effective. The mailing or delivery of such notice shall be sufficient. C. Premium Refund If this policy is cancelled the Insurer will send the First Named Insured any premium refund due. If the Insurer cancels the refund will be pro rata. If the First Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if the Insurer has not made or offered a refund. D. Nonrenewal If the Insurer decides not to offer any renewal terms for this Policy the Insurer shall provide written notice to the Named Insured at least 60 days prior to the Policy expiration date. The notice shall include the reason for such non renewal. E. Notices If any notice required under this Section is mailed proof of mailing will be sufficient proof of notice. IV. CHANGES Notice to or knowledge possessed by any agent or other person acting on behalf of the Insurer shall not effect a waiver or a change in any part of this Policy or stop the Insurer from asserting any right under the provisions of this Policy nor shall the provisions be waived or changed except by written endorsement issued to form a part of this Policy. V. CONFORMITY TO STATUTE Terms of these conditions or any coverage part that are in conflict with the statutes of the state in which this policy is issued are hereby amended to conform to such statutes. N e e o CNAB2642XX 09 12 Page 10f3 Copyright CNA All Rights Reserved | 2 |
cA CNA PARAMOUNT Common Terms and Conditions VL. COORDINATION AMONG COVERAGE PARTS Subject always to the applicable Limit of Liability should two or more coverage parts apply to the same loss the Insurer will not pay more than the Named Insured s actual loss. VIl. COVERAGE PART TERMS AND CONDITIONS The terms and conditions of each coverage part apply only to that coverage part and shall not apply to any other coverage part. If any provision in the Common Terms and Conditions is inconsistent or in conflict with the terms and conditions of any coverage part the terms and conditions of such coverage part shall control for purposes of that coverage part. Viil. CURRENCY All premiums limits deductibles and other amounts stated or payable under this Policy are expressed and payable in the currency of the United States of America. If any payments due under this Policy are stated or incurred in a currency other than United States of America dollars payment under this Policy will be made in United States of America dollars at the rate of exchange published in The Wall Street Journal on the date the Insurer s obligation to pay such amount is established or if not published on such date the next publication date of The Wall Street Journal. IX. ENTIRE AGREEMENT The Named Insureds agree that this Policy constitutes the entire contract existing between them and the Insurer or any of its agents relating to this insurance. X. EXAMINATION OF THE INSURED S BOOKS AND RECORDS The Insurer may examine and audit any Named Insured s books and records as they relate to this Policy at any time during the policy period and up to 3 years afterward. XI. INSPECTIONS AND SURVEYS The Insurer has the right but not the obligation to A. make inspections and surveys at any time B. provide reports on the conditions it finds C. recommend changes or D. conduct loss control and prevention activity. Any inspections surveys reports or recommendations relate only to insurability and the premiums to be charged. The Insurer does not 1. make safety inspections 2. undertake to perform the duty of any entity to provide for the health or safety of workers or the public 3. warrant that conditions are safe or healthful or comply with laws regulations codes or standards. XIl. LIBERALIZATION If the Insurer adopts any revision that would broaden the coverage under this Policy without additional premium within 60 days prior to or during the policy period the broadened coverage will immediately apply to this Policy. N e e o CNAB2642XX 09 12 Page 2 of 3 Copyright CNA All Rights Reserved | 2 |
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