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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 2. Exclusions of Section Coverage A Bodily In jury 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 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 or damage. b. Any loss cost or expenses arising out of the abating testing for monitoring clean ing up removing containing treating de toxifying neutralizing remediating or dis posing 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. 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 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 detoxify ing neutralizing remediating or disposing of or in any way responding to or assess ing 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 m
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COMMERCIAL GENERAL LIABILITY CG21710115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF OTHER ACTS OF TERRORISM COMMITTED OUTSIDE THE UNITED STATES 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. The following exclusion is added This insurance does not apply to TERRORISM Any injury or damage arising directly or indirectly out of an other act of terrorism that is committed outside of the United States including its territories and possessions and Puerto Rico but within the coverage territory. However this exclusion applies only when one or more of the following are attributed to such act 1. The total of insured damage to all types of property exceeds 25000000 valued in U.S. dollars. In determining whether the 25000000 threshold is exceeded we will include all insured damage sustained by property of all persons and entities affected by the terrorism and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision insured damage means damage that is covered by any insurance plus damage that would be covered by any insurance but for the application of any terrorism exclusions or 2. Fifty or more persons sustain death or serious physical injury. For the purposes of this provision serious physical injury means a. Physical injury that involves a substantial risk of death or b. Protracted and disfigurement or obvious physical c. Protracted loss of or impairment of the function of a bodily member or organ or 3. The terrorism involves the use release or escape of nuclear materials or directly or indirectly results in nuclear reaction or radiation or radioactive contamination or 4. The terrorism is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemical materials or 5. Pathogenic or poisonous biological or chemical materials are released and it appears that one purpose of the terrorism was to release such materials. With respect to this exclusion Paragraphs 1. and 2. describe the thresholds used to measure the magnitude of an incident of an other act of terrorism and the circumstances in which the threshold will apply for the purpose of determining whether this exclusion will apply to that incident. B. The following definitions are added 1. For the purposes of this endorsement any injury or damage means any injury or damage covered under any Coverage Part to which this endorsement is applicable and includes but is not limited to bodily injury property damage personal and advertising injury injury or environmental damage as may be defined in any applicable Coverage Part. c. Protracted loss of or impairment of the function of a bodily member or organ or 3. The terrorism involves the use release or escape of nuclear materials or directly or indirectly results in nuclear reaction or radiation or radioactive contamination or 4. The terrorism is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemical materials or 5. Pathogenic or poisonous biological or chemical materials are released and it appears that one purpose of the terrorism was to release such materials. With respect to this exclusion Paragraphs 1. and 2. describe the thresholds used to measure the magnitude of an incident of an other act of terrorism and the circumstances in which the threshold will apply for the purpose of determining whether this exclusion will apply to that incident. B. The following definitions are added 1. For the purposes of this endorsement any injury or damage means any injury or damage covered under any Coverage Part to which this endorsement is applicable and includes but is not limited to bodily injury property damage personal and advertising injury injury or environmental damage as may be defined in any applicable Coverage Part. CG21710115 Insurance Services Office Inc. 2015 Page 1 of 2
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2. 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 a. 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 b. The act resulted in damage 1 Within the United States including its territories and possessions and Puerto Rico or 2 Outside of the United States in the case of a An air carrier as defined in Section 40102 of title 49 United States Code or United States flag vessel or a vessel based principally in the United States on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States regardless of where the loss occurs or b The premises of any United States mission and c. 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. 3. Other act of terrorism means a violent act or an act that is dangerous to human life property or infrastructure that is committed by an individual or individuals and that appears to be part of an effort to coerce a civilian population or to influence the policy or affect the conduct of any government by coercion and the act is not a certified act of terrorism. Multiple incidents of an other act of terrorism which occur within a seventy two hour period and appear to be carried out in concert or to have a related purpose or common leadership shall be considered to be one incident. C. 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. D. 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. Page 2 of 2 Insurance Services Office Inc. 2015 CG21710115
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COMMERCIAL GENERAL LIABILITY CG 21 96 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 In jury And Property Damage Lial 3 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 sil ica 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 ftreating detoxifying neutralizing remediating or disposing of or in any way responding 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 Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Silica Or Silica Related Dust 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.. Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing contain ing ftreating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of silica or silica related dust by any in sured or by any other person or entity. C. The following definitions are added to the Defini 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 21 96 03 05 ISO Properties Inc. 2004 Page 1 of 1 m
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COMMERCIAL GENERAL LIABILITY CG22430413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ENGINEERS ARCHITECTS OR SURVEYORS PROFESSIONAL LIABILITY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART 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 arising out of the rendering of or failure to render any professional services by you or any engineer architect or surveyor who is either employed by you or performing work on your behalf in such capacity. Professional services include 1. The preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications and 2. Supervisory inspection architectural or engineering activities. 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 any engineer architect or surveyor who is either employed by you or performing work on your behalf in such capacity. CG22430413 Insurance Services Office Inc. 2012 Page 1 of 1
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POLICY NUMBER GLD5520300 POLICY NUMBER GLD5520300 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 WHERE REQUIRED BY WRITTEN CONTRACT 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. NY PERSON OR ORGANIZATION WHERE REQUIRED BY WRITTEN CONTRACT CG 24 04 05 09 Insurance Services Office Inc. 2008 Page 1 of 1 m
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COMMERCIAL GENERAL LIABILITY CG24100798 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCESS PROVISION VENDORS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART When you are added to a manufacturer s or distributor s policy as an additional insured because you are a vendor for such manufacturer s or distributor s products Paragraph 4. Other Insurance of Conditions Section IV is amended by the addition of the following The coverage afforded the insured under this Coverage Part will be excess over any valid and collectible insurance available to the insured as an additional insured under a policy issued to a manufacturer or distributor for products manufactured sold handled or distributed. Page Lof 1 CG 241007 98 Copyright Insurance Services Office Inc. 1997
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COMMERCIAL GENERAL LIABILITY CG24260413 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 CG24260413 Insurance Services Office Inc. 2012 Page 1 of 1
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MNEMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY GENERAL L POLICY PERIOD FROM NAMED K C CONCRETE PLACEMENT PO BOX 30301 LINCOLN NE 68503 0301 INSUR DIRECT BILL INSURED IS CORPORATION 090115 TO INC. PRIOR POLICY 4D6 31 42 IABILITY DECLARATIONS 090116 31 4 2 16 E D LOCKTON COMPANIES LLC 1015 N 98TH ST STE 101 OMAHA NE 68114 2357 AGENT AB 8210 AGENT PHONE 402 970 6100 JACK H. STRUYK JR BUSINESS DESC CONCRETE PUMPING OPERATN LIMITS OF INSURANCE EACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT 100000 ANY ONE PREMISES MEDICAL EXPENSE LIMIT 5000 ANY ONE PERSON PERSONAL AND ADVERTISING INJURY LIMIT 1000000 ANY ONE PERSON OR ORGANIZATION GENERAL AGGREGATE LIMIT 2000000 PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT 2000000 COVERAGES PROVIDETD PREMIUM PRODUCTS COMPLETED OPERATIONS 3365.00 OTHER THAN PRODUCTS COMPLETED OPERATIONS 4049.00 TOTAL ESTIMATED POLICY PREMIUM 7414.00 SEE ATTACHED SCHEDULE FOR LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED. FORMS APPLICABLE CG00010413 G2034 0413 CG21671204 CG7001A1012 CG7174.31013 CG74281198 CG76440209 G82840914 IL70281005 IL8384A0108 AUDIT PERIOD ANNUAL DATE OF ISSUE 083115 BPP CG04351207 CG20370413 G21700115 G70031013 CG71910814 CG74291198 CG80810406 IL00210502 IL7130A0401 IL85760909 CG04370413 CG21060514 CG21760115 CG71400714 CG75551013 CG82820414 IL02590907 IL7131A0401 CG72531296 G20100413 G21471207 G22741001 CG71410590 CG72761008 CG76270309 G82830414 IL12010199 IL8383.2A0115 FORM CG7000A ED. 08 99 BPP 060215 003 LN 4D63142 1601 GENERAL LIABILTITY D E POLICY PERIOD FROM 090115 TO 090116 PO BOX 30301 1015 N 98TH ST STE 101 LINCOLN NE 68503 0301 OMAHA NE 68114 2357 AGENT AB 8210 AGENT PHONE 402 970 6100 EACH OCCURRENCE LIMIT DAMAGE TO PREMISES RENTED TO YOU LIMIT MEDICAL EXPENSE LIMIT PERSONAL AND ADVERTISING INJURY LIMIT GENERAL AGGREGATE LIMIT 1000 00 100 00 500 1000 00 PRODUCTS COMPLETED OPERATIONS 3365.00 OTHER THAN PRODUCTS COMPLETED OPERATIONS 4049.00 TOTAL ESTIMATED POLICY PREMIUM
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MNEMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 31 42 16 K C CONCRETE PLACEMENT INC. EFF DATE 090115 EXP DATE 090116 GENERATL L Cc ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM CG0001 04 13 COMMERCIAL GEN LIABILITY COV FORM CG0435 12 07 EMPLOYEE BENEFITS LIABILITY COVERAGE EACH EMPLOYEE 1000000 AGGREGATE 2000000 DEDUCTIBLE EACH EMPLOYEE 1000 RETROACTIVE DATE 09012000 CG0437 04 13 ELECTRONIC DATA LIAB ENDORSEMENT LOSS OF ELECTRONIC DATA LIMIT 50000 CG2010 04 13 AI OWNERS LESSEES OR CONTRACTORS.. NAME ANY OR ALL PERSONS OR ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEPT WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY AND NON CONTRIBUTORY. CG2034 04 13 AI LESSOR OF LEASED EQUIPMENT CG2037 04 13 AI OWNERS LESSEES OR CONT COMP OPS NAME ANY OR ALL PERSONS OR ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEPT WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY AND NON CONTRIBUTORY. CG2106 05 14 EXCL ACCESS DISCL OF CONFID PERSONAL CG2147 12 07 EXCL EMPLOYMENT RELATED PRACTICES CG2167 12 04 FUNGI OR BACTERIA EXCLUSION CG2170 01 15 CAP LOSSES FROM CERT ACTS TERRORISM CG2176 01 15 EXCL PUNITIVE DMGS ACTS OF TERRORISM CG2274 10 01 LTD CONTRACTUAL LIAB COV PERS ADV DESIGNATED CONTRACT OR AGREEMENT ANY CONTRACT CG7001A 10 12 GENERAL LIABILITY SCHEDULE CG7003 10 13 GL QUICK REFERENCE OCCURRENCE CG7140 07 14 INJ TO CO EMPL OR O VOLUNTEER WKRS NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. ALL MANAGERIAL SUPERVISORY EMPLOYEES OR EXECUTIVE OFFICERS CG7141 05 90 EXTENDED PROPERTY DAMAGE COVERAGE CG7174.3 10 13 AUTOMATIC AI CONST CONT INCL COMP OP CG7191 08 14 GENERAL LIAB ESSENTIAL EXTENSION DATE OF ISSUE 083115 CONTINUED FORM IL7131A ED. 04 01 003 LN 4D63142 1601 EDITION CG0437 CG2010 CG2034 CG2037 CG2106 CG2147 CG2167 CG2170 CG2176 CG2274 CG7001A CG7003 CG7140 CG7141 CG7174.3 CG7191 04 13 04 13 04 13 04 13 05 14 12 07 12 04 01 15 01 15 10 01 10 12 10 13 07 14 05 90 10 13 08 14 EMPLOYEE BENEFITS LIABILITY COVERAGE EACH EMPLOYEE 1000000 AGGREGATE 2000000 DEDUCTIBLE EACH EMPLOYEE 1000 RETROACTIVE DATE 09012000 ELECTRONIC DATA LIAB ENDORSEMENT LOSS OF ELECTRONIC DATA LIMIT 50000 AI OWNERS LESSEES OR CONTRACTORS.. NAME ANY OR ALL PERSONS OR ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEPT WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY AND NON CONTRIBUTORY. AI LESSOR OF LEASED EQUIPMENT AI OWNERS LESSEES OR CONT COMP OPS NAME ANY OR ALL PERSONS OR ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEPT WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY AND NON CONTRIBUTORY. EXCL ACCESS DISCL OF CONFID PERSONAL EXCL EMPLOYMENT RELATED PRACTICES FUNGI OR BACTERIA EXCLUSION CAP LOSSES FROM CERT ACTS TERRORISM EXCL PUNITIVE DMGS ACTS OF TERRORISM LTD CONTRACTUAL LIAB COV PERS ADV DESIGNATED CONTRACT OR AGREEMENT ANY CONTRACT GENERAL LIABILITY SCHEDULE GL QUICK REFERENCE OCCURRENCE INJ TO CO EMPL OR O VOLUNTEER WKRS NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. ALL MANAGERIAL SUPERVISORY EMPLOYEES OR EXECUTIVE OFFICERS EXTENDED PROPERTY DAMAGE COVERAGE AUTOMATIC AI CONST CONT INCL COMP OP GENERAL LIAB ESSENTIAL EXTENSION
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MNEMC INSURANCE PAGE NO 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 31 42 16 K C CONCRETE PLACEMENT INC. EFF DATE 090115 EXP DATE 090116 GENERATL L Cc ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM CG7253 12 96 CONTRACTORS EXTENDED PROPERTY DAMAGE CG7276 10 08 LIMITED POLLUTION COV WORK SITES 150 CG7428 11 98 AMEND AGGREGATE LIMIT PER LOCATION CG7429 11 98 AMEND AGGREGATE LIMIT PER PROJECT CG7555 10 13 BLKT WAIV SUBRO WRITTEN CONT AGREE CG7627 03 09 AMENDMENT OF EMPL BENEFITS PROGRAM DESCRIPTION OF OTHER SIMILAR BENEFITS NONE CG7644 02 09 CONTRACTORS OCCURRENCE DEFINITION CG8081 04 06 FUNGI BACTERIA NOTICE TO POLICYHOLDR CG8282 04 14 ADVISORY NOTICE TO POLICYHOLDERS CG8283 04 14 ADVISORY NOTICE TO POLICYHOLDERS CG8284 09 14 ADVISORY NOTICE TO POLICYHOLDERS IL0021 05 02 NUCLEAR ENERGY LIAB EXCL BROAD FORM IL0259 09 07 NE CHANGES CANCELLATION NONRENEWAL IL1201 01 99 CHANGE ENDORSEMENT IL7028 10 05 ASBESTOS EXCLUSION IL7130A 04 01 NAMED INSURED ENDORSEMENT IL7131A 04 01 COMML POLICY ENDORSEMENT SCHEDULE IL8383.2A 01 15 DISCL PURSUANT TERRSM RISK INS. ACT 59 IL8384A 01 08 TERRORISM NOTICE IL8576 09 09 MEDICARE IMPT NOTICE TO POLICYHOLDER DATE OF ISSUE 083115 FORM IL7131A ED. 04 01 003 LN 4D63142 1601 EDITION CG7644 CG8081 CG8282 CG8283 CG8284 IL0021 IL0259 IL1201 IL7028 IL7130A IL7131A IL8383.2A IL8384A IL8576 LIMITED POLLUTION COV WORK SITES AMEND AGGREGATE LIMIT PER LOCATION AMEND AGGREGATE LIMIT PER PROJECT BLKT WAIV SUBRO WRITTEN CONT AGREE AMENDMENT OF EMPL BENEFITS PROGRAM DESCRIPTION OF OTHER SIMILAR BENEFITS NONE CONTRACTORS OCCURRENCE DEFINITION FUNGI BACTERIA NOTICE TO POLICYHOLDR ADVISORY NOTICE TO POLICYHOLDERS ADVISORY NOTICE TO POLICYHOLDERS ADVISORY NOTICE TO POLICYHOLDERS NUCLEAR ENERGY LIAB EXCL BROAD FORM NE CHANGES CANCELLATION NONRENEWAL CHANGE ENDORSEMENT ASBESTOS EXCLUSION NAMED INSURED ENDORSEMENT COMML POLICY ENDORSEMENT SCHEDULE DISCL PURSUANT TERRSM RISK INS. ACT TERRORISM NOTICE MEDICARE IMPT NOTICE TO POLICYHOLDER 5
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MNEMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 31 42 16 K C CONCRETE PLACEMENT INC. EFF DATE 090115 EXP DATE 090116 TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent DATE OF ISSUE 083115 FORM IL8384A 01 08 003 LN 4D63142 1601 K C CONCRETE PLACEMENT INC. EFF DATE 090115 EXP DATE 0901 TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent
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NE INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 31 42 16 K C CONCRETE PLACEMENT INC. EFF DATE 090115 EXP DATE 090116 THIS DISCLOSURE IS ATTACHED TO YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS DISLOSURE DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. SCHEDUTLE Terrorism Premium Certified Acts 59.00 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 terrorism acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this disclosure or in the policy Declarations. B. Disclosure Of Federal Participation In Payment Of Terrorism Losses The United States Government Department of the Treasury will pay a share of terrorism losses insured under the federal program. For losses occurring in 2015 the federal share equals 85 of that portion of the amount of such insured losses that exceeds the applicable insurer retention. Beginning on January 1 2016 the federal share will decrease by one percentage point per calendar year until equal to 80 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. 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. The following statement is required to be part of the disclosure notice in MISSOURI The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your policy carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Includes copyrighted material of ISO Properties Inc. with its permission DATE OF ISSUE 083115 FORM IL8383.2A01 15 003 LN 4D63142 1601 THIS DISCLOSURE IS ATTACHED TO YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS DISLOSURE DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. SCHEDUTLE Terrorism Premium Certified Acts 59.00 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 terrorism acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this disclosure or in the policy Declarations. B. Disclosure Of Federal Participation In Payment Of Terrorism Losses The United States Government Department of the Treasury will pay a share of terrorism losses insured under the federal program. For losses occurring in 2015 the federal share equals 85 of that portion of the amount of such insured losses that exceeds the applicable insur retention. Beginning on January 1 2016 the federal share will decrease by one percentage point per calendar year until equal to 80 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 sha not make any payment for any portion of the amount of such losses that exceeds 100 billion. 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 calend 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 Treasur The following statement is required to be part of the disclosure notice in MISSOURI The premium above is for certain losses resulting from certified acts terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your poli carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Includes copyrighted material of ISO Properties Inc. with its permission SCHEDUTLE i m Certified Acts 59.00 th the federal Terrorism Risk Insurance Act we are side you with a notice disclosing the portion of any attributable to coverage for terrorism acts the Terrorism Risk Insurance Act. The portion of ributable to such coverage is shown in the Schedule ire or in the policy Declarations. deral Participation In Payment Of Terrorism Losses s Government Department of the Treasury will pay In Payment Of Terrorism Losses
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MNEMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY NAMED INSURED ENDORSEMENT POLICY PERIOD FROM 090115 TO 090116 POLICY NUMBER 4D6 31 42 16 N NAMED INSURED K C CONCRETE PLACEMENT INC. LOCKTON COMPANIES LLC PO BOX 30301 1015 N 98TH ST STE 101 LINCOLN NE 68503 0301 OMAHA NE 68114 2357 AGENT AB 8210 AGENT PHONE 402 970 6100 DIRECT BILL JACK H. STRUYK JR IT IS HEREBY AGREED AND UNDERSTOOD THAT THE NAMED INSURED IS AMENDED TO READ AS FOLLOWS 1ST NAMED INSURED K C CONCRETE PLACEMENT INC. NO. 02 B A HOLDING COMPANY PLACE OF ISSUE OMAHA NE DATE OF ISSUE 083115 FORM IL7130A ED. 04 01 003 LN 4D63142 1601 NAMED INSURED ENDO POLICY PERIOD FROM 090115 TO 090116 PO BOX 30301 1015 N 98TH ST STE 101 LINCOLN NE 68503 0301 OMAHA NE 68114 2357 AGENT AB 8210 AGENT PHONE 402 970 6100 IT IS HEREBY AGREED AND UNDERSTOOD THAT THE NAMED INSURED IS AMENDED TO READ AS FOLLOWS 1ST NAMED INSURED K C CONCRETE PLACEMENT INC. NO. 02 B A HOLDING COMPANY PLACE OF ISSUE OMAHA NE OLICY.
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MNEMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 31 42 K C CONCRETE PLACEMENT EFF DATE 090115 EXP DATE 090116 GENERAL LIABILITY SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 001 87224 CONTRACTORS EXTENDED PROPERTY DAMAGE ENDORSEMENT SEE FORM CG7253 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87654 COVERAGE FOR INJURY TO CO EMPLOYEES AND OR YOUR OTHER VOLUNTEER WORKERS PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87741 LIMITED POLLUTION COVERAGE WORKSITES PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87747 AMENDMENT AGGREGATE LIMITS OF INSURANCE PER LOCATION PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87748 AMENDMENT AGGREGATE LIMITS OF INSURANCE PER PROJECT PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87780 CONSTRUCTION CONTRACTS INCLUDING COMPLETED OPERATIONS BLANKET ADDL INSUREDS PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 DATE OF ISSUE 083115 BPP CONTINUED FORM CG7001A ED.10 12 BPP 060215 003 LN 4D63142 1601 TENDED PROPERTY MENT 3 S ION COVERAGE GREGATE LIMITS OF. LOCATION S 1 GREGATE LIMITS OF. PROJECT S
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MNEMC INSURANCE PAGE 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 31 42 K C CONCRETE PLACEMENT EFF DATE 090115 EXP DATE 090116 16 SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 87786 BLANKET WAIVER OF SUBROGATION SEE FORM CG7555 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87808 ELECTRONIC DATA LIABILITY PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87825 1132.000 s 132 EMPLOYEE BENEFITS LIABILITY COVERAGE PREMIUM BASIS PER EMP EXPOSURE 9 SUBLINE EBL 1000 DEDUCTIBLE APPLIES EACH EMPLOYEE 87830 CONTRACTORS OCCURRENCE DEFINITION PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 91560 11.141 3365 7.059s 2132 CONCRETE CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 302000 SUBLINE 336334 ADDITIONAL INTEREST 1 334 BLANKET WHERE REQUIRED LESSOR OF LEASED EQUIPMENT CG2034 75 DATE OF ISSUE 083115 BPP CONTINUED FORM CG7001A ED.10 12 BPP 060215 003 LN 4D63142 1601. OF SUBROGATION 5 A LIABILITY sFITS LIABILITY 5IS 9 EBL TIBLE APPLIES
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MNEMC INSURANCE PAGE 3 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 31 42 16 K C CONCRETE PLACEMENT EFF DATE 090115 EXP DATE 090116 SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 91590 CONTRACTORS PERMANENT YARDS MAINT OR STORAGE OF EQUIP OR MATERIAL 4 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 58254 SUBLINE 334 POLICY LEVEL COVERAGES COVERAGES LIMIT OF INSURANCE PREMIUM GENERAL LIABILITY ESSENTIAL EXTENSION 75 PREMIUM FOR CERTIFIED ACTS OF TERRORISM 59.00 TOTAL ESTIMATED POLICY PREMIUM 7414.00 1 OTHER THAN NOT FOR PROFIT 2 NOT FOR PROFIT 3 INCLUDING PRODUCTS AND OR COMPLETED OPERATIONS UNLESS OTHERWISE EXCLUDED 4 PRODUCTS COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT 5 A 250 PD DEDUCTIBLE PER CLAIM APPLIES TO CUSTOMERS AUTOS UNLESS OTHERWISE DESIGNATED BY THIS CLASSIFICATION CODE 6 FOR SPRAY PAINTING OPERATIONS A PD DEDUCTIBLE OF 250 PER CLAIM APPLIES UNLESS A HIGHER DEDUCTIBLE IS OTHERWISE DESIGNATED FOR THIS CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED RATED LOCATIONS LOC 001 2700 MICRON DRIVE LINCOLN NE 68528 ALL OTHER LOCATIONS 10620 CHANDLER ST LAVISTA NE 68128 DATE OF ISSUE 083115 BPP FORM CG7001A ED.10 12 BPP 060215 003 LN 4D63142 1601 CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED RATED LOCATIONS LOC 001 2700 MICRON DRIVE LINCOLN NE 68528 ALL OTHER LOCATIONS 10620 CHANDLER ST LAVISTA NE 68128 ALL OTHER LOCATIONS 10620 CHANDLER ST LAVISTA NE 68128
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MNEMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 31 42 K C CONCRETE PLACEMENT TRANSACTION RENEWAL01 PRIOR POL 4D6 31 42 TRANSACTION INFORMATION POLICY TERM 09012015 TO 09012016 TRANS DATE 09012015 ACCOUNT NAME K C CONCRETE PLACEMENT CO BR AGENT A B8210 ACCOUNT MAILING STATE NE PROGRAM FINANCING N BILLING METHOD D CDB AUDIT FREQUENCY A PROFIT SHARE Y SIC 1771 ACCOUNT ORIGINAL EFF DATE 09012003 TYPE OF POLICY CONTR 38 ACCOUNT FEIN 470734525 TRANS PREMIUM 7414.00 POLICY ID BA COMMISSION 15.0 PREMIUM 7414.00 ACCOUNT DOMICILE STATE NE DATE OF ISSUE 083115 BPP STAT GL BPP 060215 003 LN 4D63142 1601 C CONCRETE PLACEMENT TRANSACTION INFORMATIOI RIOR POL 4D6 31 42 IS DATE 09012015 SR AGENT A B8210 SRAM ING METHOD D CDB IT SHARE Y POLICY TERM 09012015 TO 09012016 ACCOUNT NAME K C CONCRETE PLACEMENT ACCOUNT MAILING STATE NE FINANCING N AUDIT FREQUENCY A SIC 1771 ACCOUNT ORIGINAL EFF DATE 09012003 ACCOUNT FEIN 470734525 POLICY ID BA COMMISSION 15.0 1IUM
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 04351207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYEE BENEFITS LIABILITY COVERAGE THIS ENDORSEMENT PROVIDES CLAIMS MADE COVERAGE. PLEASE READ THE ENTIRE ENDORSEMENT CAREFULLY. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Each Employee Coverage Limit Of Insurance Deductible Premium Employee Benefits each employee Programs aggregate Retroactive Date Information required to complete this Schedule if not shown above will be shown in the Declarations. A. The following is added to Section Coverages No other obligation or liability to pay sums COVERAGE EMPLOYEE BENEFITS or perform acts or services is covered LIABILITY unless explicitly provided for under Sup plementary Payments. b. This insurance applies to damages only if 1 The act error or omission is negligently ages because of any act error or omission Izlromnlmted Ethefadministrtion of your of the insured or of any other person for employee benefit program whose acts the insured is legally liable to 2 The act error or omission did not take 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as dam 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 dam ages to which this insurance does not ap ply. We may at our discretion investigate any report of an act error or omission and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Paragraph D. 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. place before the Retroactive Date if any shown in the Schedule nor after the end of the policy period and A claim for damages because of an act error or omission is first made against any insured in accordance with Paragraph c. below during the policy period or an Extended Reporting Period we provide under Paragraph F. of this endorsement.. A claim seeking damages will be deemed to have been made at the earlier of the fol lowing times 1 When notice of such claim is received and recorded by any insured or by us whichever comes first or 3 CG 04351207 ISO Properties Inc. 2006 Page 1 0of 6 a
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2 When we make settlement in accor dance with Paragraph a. above. A claim received and recorded by the in sured within 60 days after the end of the policy period will be considered to have been received within the policy period if no subsequent policy is available to cover the claim. All claims for damages made by an em ployee because of any act error or omis sion or a series of related acts errors or omissions including damages claimed by such employee s dependents and benefi ciaries will be deemed to have been made at the time the first of those claims is made against any insured.. Exclusions This insurance does not apply to Dishonest Fraudulent Criminal Or Malicious Act Damages arising out of any intentional dis honest fraudulent criminal or malicious act error or omission committed by any in sured including the willful or reckless viola tion of any statute.. Bodily Injury Property Damage Or Personal And Advertising Injury Bodily injury property damage or per sonal and advertising injury.. Failure To Perform A Contract Damages arising out of failure of perform ance of contract by any insurer.. Insufficiency Of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the employee benefit pro gram.. Inadequacy Of Performance Of Investment Advice Given With Respect To Participation Any claim based upon 1 Failure of any investment to perform 2 Errors in providing information on past performance of investment vehicles or 3 Advice given to any person with respect to that person s decision to participate or not to participate in any plan included in the employee benefit program. f. Workers Compensation And Similar Laws Any claim arising out of your failure to comply with the mandatory provisions of any workers compensation unemployment compensation insurance social security or disability benefits law or any similar law. g. ERISA Damages for which any insured is liable because of liability imposed on a fiduciary by the Employee Retirement Income Secu rity Act of 1974 as now or hereafter amended or by any similar federal state or local laws. h. Available Benefits Any claim for benefits to the extent that such benefits are available with reasonable effort and cooperation of the insured from the applicable funds accrued or other col lectible insurance. i. Taxes Fines Or Penalties Taxes fines or penalties including those imposed under the Internal Revenue Code or any similar state or local law. j Employment Related Practices Damages arising out of wrongful termina tion of employment discrimination or other employment related practices. B. For the purposes of the coverage provided by this endorsement 1. All references to Supplementary Payments Coverages A and B are replaced by Supple mentary Payments Coverages A B and Em ployee Benefits Liability. 2. Paragraphs 1.b. and 2. of the Supplementary Payments provision do not apply. C. For the purposes of the coverage provided by this endorsement Paragraphs 2. and 3. of Section Il Who Is An Insured are replaced by the following 2. Each of the following is also an insured a. Each of your employees who is or was authorized to administer your employee benefit program. b. Any persons organizations or employees having proper temporary authorization to administer your employee benefit program if you die but only until your legal represen tative is appointed. Page 2 of 6 ISO Properties Inc. 2006 CG 04351207 o
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c. Your legal representative if you die but only with respect to duties as such. That repre sentative will have all your rights and duties under this Endorsement. 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 no other similar insurance applies 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 pol icy period whichever is earlier. b. Coverage under this provision does not apply to any act error or omission that was committed before you acquired or formed the organization. D. For the purposes of the coverage provided by this endorsement Section Ill Limits Of Insurance is replaced by the following 1. Limits Of Insurance a. The Limits of Insurance shown in the Schedule and the rules below fix the most we will pay regardless of the number of 1 Insureds 2 Claims made or suits brought 3 Persons or organizations making claims or bringing suits 4 Acts errors or omissions or 5 Benefits included in your employee benefit program. b. The Aggregate Limit is the most we will pay for all damages because of acts errors or omissions negligently committed in the administration of your employee benefit program. c. Subject to the Aggregate Limit the Each Employee Limit is the most we will pay for all damages sustained by any one em ployee including damages sustained by such employee s dependents and benefi ciaries as a result of 1 An act error or omission or 2 A series of related acts errors or omis sions negligently committed in the administra tion of your employee benefit program. However the amount paid under this en dorsement shall not exceed and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the employee benefit program. The Limits of Insurance of this endorsement 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 of the policy to which this endorsement is attached unless the policy period is extended after issu ance 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 Insur ance. 2. Deductible a. Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of the deductible amount stated in the Schedule as applica ble to Each Employee. The limits of insur ance shall not be reduced by the amount of this deductible. b. The deductible amount stated in the Sched ule applies to all damages sustained by any one employee including such em ployee s dependents and beneficiaries because of all acts errors or omissions to which this insurance applies. c. The terms of this insurance including those with respect to 1 Our right and duty to defend any suits seeking those damages and 2 Your duties and the duties of any other involved insured in the event of an act error or omission or claim apply irrespective of the application of the deductible amount. d. We may pay any part or all of the deducti ble amount to effect settiement 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 we have paid. E. For the purposes of the coverage provided by this endorsement Conditions 2. and 4. of Section IV Commercial General Liability Conditions are replaced by the following 2. Duties In The Event Of An Act Error Or Omission Or Claim Or Suit a. You must see to it that we are notified as soon as practicable of an act error or omis sion which may result in a claim. To the extent possible notice should include 1 What the act error or omission was and when it occurred and CG 04351207 ISO Properties Inc. 2006 Page 3 of 6 a
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2 The names and addresses of anyone who may suffer damages as a result of the act error or omission. 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 en forcement of any right against any per son or organization which may be liable to the insured because of an act error or omission 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 without our consent.. Other Insurance If other valid and collectible insurance is avail able to the insured for a loss we cover under this endorsement our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insur ance is primary our obligations are not af fected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method de scribed in Paragraph c. below. b. Excess Insurance 1 This insurance is excess over any of the other insurance whether primary ex cess contingent or on any other basis that is effective prior to the beginning of the policy period shown in the Schedule of this insurance and that applies to an act error or omission on other than a claims made basis if a No Retroactive Date is shown in the Schedule of this insurance or b The other insurance has a policy period which continues after the Ret roactive Date shown in the Schedule of this insurance. 2 When this insurance is excess we will have no duty 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 entitled 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 the total amount that all such other insurance would pay for the loss in absence of this insurance and 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 de scribed in this Excess Insurance provi sion and was not bought specifically to apply in excess of the Limits of Insur ance shown in the Schedule of this en dorsement. c. Method Of Sharing If all of the other insurance permits contri bution by equal shares we will follow this method also. Under this approach each in surer 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 per mit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limits of insurance to the total applicable limits of insurance of all insurers. Page 4 of 6 ISO Properties Inc. 2006 CG 04351207 o
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F. For the purposes of the coverage provided by this endorsement the following Extended Reporting Period provisions are added or if this endorse ment is attached to a claims made Coverage Part replaces any similar Section in that Coverage Part EXTENDED REPORTING PERIOD 1. You will have the right to purchase an Ex tended Reporting Period as described below if a. This endorsement is canceled or not re newed or b. We renew or replace this endorsement with insurance that 1 Has a Retroactive Date later than the date shown in the Schedule of this en dorsement or 2 Does not apply to an act error or omis sion on a claims made basis. 2. The Extended Reporting Period does not ex tend the policy period or change the scope of coverage provided. It applies only to claims for acts errors or omissions that were first committed before the end of the policy period but not before the Retroactive Date if any shown in the Schedule. Once in effect the Ex tended Reporting Period may not be canceled. 3. An Extended Reporting Period of five years is available but only by an endorsement and for an extra charge. You must give us a written request for the en dorsement within 60 days after the end of the policy period. The Extended Reporting Period will not go into effect unless you pay the addi tional premium promptly when due. We will determine the additional premium in accordance with our rules and rates. In doing s0 we may take into account the following a. The employee benefit programs insured b. Previous types and amounts of insurance c. Limits of insurance available under this endorsement for future payment of dam ages and d. Other related factors. The additional premium will not exceed 100 of the annual premium for this endorsement. The Extended Reporting Period endorsement applicable to this coverage shall set forth the terms not inconsistent with this Section appli cable to the Extended Reporting Period includ ing a provision to the effect that the insurance afforded for claims first received during such period is excess over any other valid and col lectible insurance available under policies in force after the Extended Reporting Period starts. 4. If the Extended Reporting Period is in effect we will provide an extended reporting period aggregate limit of insurance described below but only for claims first received and recorded during the Extended Reporting Period. The extended reporting period aggregate limit of insurance will be equal to the dollar amount shown in the Schedule of this endorsement under Limits of Insurance. Paragraph D.1.b. of this endorsement will be amended accordingly. The Each Employee Limit shown in the Schedule will then continue to apply as set forth in Paragraph D.1.c. G. For the purposes of the coverage provided by this endorsement the following definitions are added to the D ions Section 1. Administration means a. Providing information to employees in cluding their dependents and beneficiaries with respect to eligibility for or scope of employee benefit programs b. Handling records in connection with the employee benefit program or c. Effecting continuing or terminating any employee s participation in any benefit in cluded in the employee benefit program. However administration does not include handling payroll deductions. 2. Cafeteria plans means plans authorized by applicable law to allow employees to elect to pay for certain benefits with pre tax dollars. 3. Claim means any demand or suit made by an employee or an employee s dependents and beneficiaries for damages as the result of an act error or omission. CG 04351207 ISO Properties Inc. 2006 Page 5 of 6 a
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4. Employee benefit program means a program providing some or all of the following benefits to employees whether provided through a cafeteria plan or otherwise a. Group life insurance group accident or health insurance dental vision and hearing plans and flexible spending accounts pro vided that no one other than an employee may subscribe to such benefits and such benefits are made generally available to those employees who satisfy the plan s eligibility requirements b. Profit sharing plans employee savings plans employee stock ownership plans pension plans and stock subscription plans provided that no one other than an em ployee may subscribe to such benefits and such benefits are made generally available to all employees who are eligible under the plan for such benefits c. Unemployment insurance social security benefits workers compensation and dis ability benefits d. Vacation plans including buy and sell pro grams leave of absence programs includ ing military maternity family and civil leave tuition assistance plans transporta tion and health club subsidies and e. Any other similar benefits designated in the Schedule or added thereto by endorse ment. H. For the purposes of the coverage provided by this endorsement Definitions 5. and 18. in the Def tions Section are replaced by the following 5. 18. Employee means a person actively em ployed formerly employed on leave of ab sence or disabled or retired. Employee in cludes a leased worker. Employee does not include a temporary worker. Suit means a civil proceeding in which dam ages because of an act error or omission to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the in sured 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. Page 6 of 6 ISO Properties Inc. 2006 CG 04351207 o
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POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 04370413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ELECTRONIC DATA LIABILITY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Loss Of Electronic Data Limit Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Exclusion 2.p. of Coverage A Bodily Injury And Property Damage Liability in Section Coverages is replaced by the following 2. Exclusions This insurance does not apply to p 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 that does not result from physical injury to tangible property. However this exclusion does not apply to liability for damages because of bodily injury. B. The following paragraph is added to Section Ill Limits Of Insurance Subject to 5. above the Loss of Electronic Data Limit shown in the Schedule above is the most we will pay under Coverage A for property damage because of all loss of electronic data arising out of any one occurrence. C. The following definition is added to the Defi section 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. ons D. For the purposes of the coverage provided by this endorsement the definition of property damage in the Definitions section is replaced by the following 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 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 or c. Loss of loss of use of damage to corruption of inability to access or inability to properly manipulate electronic data resulting from physical injury to tangible property. All such loss of electronic data 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 04370413 Insurance Services Office Inc. 2012 Page 1 0of 1
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POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Locations Of Covered Operations 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 1. Your acts or omissions or 2. The acts or omissions of those acting on your behalf in the performance of your ongoing operations for the additional insureds at the locations designated above. 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 additional exclusions apply This insurance does not apply to bodily injury or property damage occurring after 1. Al work including materials parts or equipment furnished in connection with such work on the project other than service maintenance or repairs to be performed by or on behalf of the additional insureds at the location of the covered operations has been completed or 2. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20100413 Insurance Services Office Inc. 2012 Page 1 of 2
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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. Page 2 of 2 Insurance Services Office Inc. 2012 CG201004 13
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COMMERCIAL GENERAL LIABILITY CG 20340413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED LESSOR OF LEASED EQUIPMENT AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU COMMERCIAL GENERAL LIABILITY COVERAGE PART. Section Il Who Is An Insured is amended to include as an additional insured any persons or organizations from whom you lease equipment when you and such persons or organizations have agreed in writing in a contract or agreement that such persons or organizations be added as an additional insured on your policy. Such persons or organizations is an insured 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 the insurance afforded to such additional insured 1. Only applies to the extent permitted by law and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. This endorsement modifies insurance provided under the following A person s or organization s status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends.. 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.. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance The most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement you have entered into with the additional insured 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. CG 20340413 Insurance Services Office Inc. 2012 Page 1 of 1
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POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 20370413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS COMPLETED OPERATIONS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Location And Description Of Completed Operations 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 or property damage caused in whole or in part by your work at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the products completed operations hazard. 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. CG 20370413 Insurance Services Office Inc. 2012 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 2106 0514 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA RELATED LIABILITY WITH LIMITED BODILY INJURY EXCEPTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.p. of Section Coverage A As used in this exclusion electronic data 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. However unless Paragraph 1 above applies this exclusion does not apply to damages because of bodily injury. 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. B. The following is added to Paragraph 2. 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 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. B. The following is added to Paragraph 2. 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 21060514 Insurance Services Office Inc. 2013 Page 1 of 1
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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
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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 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 or damage. b. Any loss cost or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxify ing neutralizing remediating or disposing of or in any way responding to or assess ing 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 in sured 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
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COMMERCIAL GENERAL LIABILITY 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 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. 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. 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. 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 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21760115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF PUNITIVE DAMAGES RELATED TO A CERTIFIED ACT 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. The following exclusion is added This insurance does not apply to TERRORISM PUNITIVE DAMAGES Damages arising directly or indirectly out of a certified act of terrorism that are awarded as punitive damages. B. The following definition is added 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.. 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. 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. C. 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 21760115 Insurance Services Office Inc. 2015 Page 1 of 1
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POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 22741001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED CONTRACTUAL LIABILITY COVERAGE FOR PERSONAL AND ADVERTISING INJURY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Contract Or Agreement If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. A. With respect to the contract or agreement desig nated in the Schedule above Subparagraph e. of Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability is replaced by the following 2. Exclusions This insurance does not apply to e. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a con tract or agreement. This exclusion does not apply to 1 Liability for damages that the insured would have in the absence of the contract or agreement or 2 Liability for personal and advertising injury if a The liability pertains to your busi ness and is assumed in the des ignated contract or agreement shown in the Schedule in which you assume the tort liability of an other. Tort liability means a liabil ity that would be imposed by law in the absence of any contract or agreement b The personal and advertising injury occurs subsequent to the execution of the designated con tract or agreement shown in the Schedule and c The personal and advertising 2 Liability for personal and advertising injury if a The liability pertains to your busi ness and is assumed in the des ignated contract or agreement shown in the Schedule in which you assume the tort liability of an other. Tort liability means a liabil ity that would be imposed by law in the absence of any contract or agreement b The personal and advertising injury occurs subsequent to the execution of the designated con tract or agreement shown in the Schedule and c The personal and advertising injury arises out of the offenses of false arrest detention or im prisonment. CG 22741001 ISO Properties Inc. 2001 Page 1 of 2 o
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Solely for the purposes of liability so as sumed in such designated contract or agreement reasonable attorney fees and necessary litigation expenses in curred by or for a party other than an in sured are deemed to be damages be cause of personal injury described in Paragraph A.2.e.2c above provided i Liability to such party for or for the cost of that party s defense has also been assumed in the same designated contract or agreement and ii Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this in surance applies are alleged. B. With respect to the contract or agreement desig nated in the Schedule above the following is added to Section Supplementary Payments Coverages A And B If we defend an insured against a suit and an in demnitee 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 1. The suit against the indemnitee seeks dam ages for which the insured has assumed tort li ability of the indemnitee in a designated con tract or agreement shown in the Schedule if such liability pertains to your business. Tort li ability means a liability that would be imposed by law in the absence of any contract or agreement 2. This insurance applies to such liability assumed by the insured 3. The obligation to defend or the cost of the defense of that indemnitee has also been as sumed by the insured in the same designated contract or agreement 4. The allegations in the suit and the information we know about the offense are such that no conflict appears to exist between the interests of the insured and the interests of the indem nitee 5. The indemnitee and the insured ask us to con duct and control the defense of that indemnitee against such suit and agree that we can as sign the same counsel to defend the insured and the indemnitee and 6. The indemnitee a. Agrees in writing to 1 Cooperate with us in the investigation settlement or defense of the suit Immediately send us copies of any de mands notices summonses or legal papers received in connection with the suit Notify any other insurer whose coverage is available to the indemnitee and 4 Cooperate with us with respect to coor dinating other applicable insurance available to the indemnitee and b. Provides us with written authorization to 1 Obtain records and other information related to the suit and 2 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 indem nitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supple mentary Payments. Notwithstanding the provisions of Paragraph A.2.e.2 of this endorsement such payments will not be deemed to be damages for personal and advertising injury as described in Paragraph A.2.e.2c above and will not reduce the limits of insurance. Our obligation to defend an insured s indemnitee and to pay for attorneys fees and necessary litiga tion expenses as Supplementary Payments ends when 1. We have used up the applicable limit of insur ance in the payment of judgments or settle ments or 2. The conditions set forth above or the terms of the agreement described in Paragraph 6. above are no longer met. 2 3 Page 2 of 2 ISO Properties Inc. 2001 CG 22741001 o
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COMMERCIAL GENERAL LIABILITY QUICK REFERENCE COMMERCIAL GENERAL LIABILITY COVERAGE FORM OCCURRENCE COVERAGE READ YOUR POLICY CAREFULLY DECLARATIONS PAGES Named Insured And Mailing Address Policy Period Description Of Business And Location Coverages And Limits Of Insurance SECTION COVERAGES Coverage A Bodily Injury And Property Damage Liability Coverage B Personal And Advertising Injury Liability Coverage C Medical Payments Supplementary Payments..................... SECTION Il WHO ISAN INSURED............ SECTION Il LIMITS OF INSURANCE................ it Insuring Agreement. Exclusions Insuring Agreement.............. Exclusions Insuring Agreement. Exclusions SECTION IV COMMERCIAL GENERAL LIABILITYCONDITIONS........................... Bankruptcy Duties In The Event Of Occurrence Offense Claim Or Suit Legal Action Against Us Other Insurance.. Premium Audit. Representations Separation Of Insureds..................... Transfer Of Rights Of Recovery Against Others To Us When We Do Not Renew... SECTIONV DEFINITIONS.................. COMMON POLICY CONDITIONS Cancellation Changes Examination Of Your Books And Records Inspections And Surveys Premiums Transfer Of Your Rights And Duties Under This Policy ENDORSEMENTS If Any Beginning on Page CG700310 13 Page 10f 1
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COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COVERAGE FOR INJURY TO CO EMPLOYEES AND OR YOUR OTHER VOLUNTEER WORKERS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Designated Specific Employees Volunteer Workers Or Specific Job Titles Information required to complete this Schedule if not shown above will be shown in the Declarations. A The following is added to Paragraph 2.a.1 of Section Il Who Is An Insured Paragraphs a b and c above do not apply to the specific employees or volunteer workers or any employees or volunteer workers holding the specific job titles designated in the Schedule of this endorsement with respect to bodily injury to a coemployee or other volunteer worker. B. The following is added to Paragraph 4. Other Insurance Condition under Section IV Commercial General Liability Conditions The coverage provided by this endorsement is excess over any other valid and collectible insurance that covers the liability of the designated employees or volunteer workers or an employee or volunteer worker holding a job title designated in the Schedule of this endorsement. CGT1407 14 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1
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Commercial General Liability THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXTENDED PROPERTY DAMAGE COVERAGE Schedule Limits of Insurance Deductible 5000 Each Occurrence 250 Per Claim 25000 Annual Aggregate Insuring Agreement We will pay for loss to personal property of others including the loss of use of such property while in your care custody or control or personal property over which you for any purpose are exercising physical control when 1. loss arises out of operations away from your premises 2. loss is incidental to your normal business operations and 3. you have property damage liability coverage for that business under the coverage form to which this endorse ment is attached. Loss means unintentional damage or destruction but does not include disappearance or obstruction. Exclusions The coverage under this endorsement does not apply to loss to 1. property held by you for servicing repair storage or sale on premises you own rent occupy or otherwise con trol 2. property while being transported by or caused by the ownership maintenance operation use loading or un loading of any automobile watercraft or aircraft 3. property you own rent or occupy 4. real property. Limit of Insurance The limit of insurance stated in the Schedule of Limits as each occurrence is the most we will pay for all damages on account of each claim or suit covered under this endorsement. The limit of insurance stated in the Schedule of Limits as Annual Aggregate is subject to the above provision respecting each claim the total limit of our liability for all damages under this endorsement in any one policy period. Deductible We will not be liable on account of any loss except to the extent such loss is in excess of the deductible amount stated in the Schedule of Limits with the insurance then applying to such excess only subject otherwise to the appli cable limits of insurance. The terms of the policy with respect to your duties in the event of occurrence claim or suit and our right to investi gate negotiate and settle any 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 notification of the action taken you will promptly reimburse us for any part of the deductible amount as has been paid by us. Settlement In the event of loss covered by this endorsement you will if requested by us replace the property or furnish the labor and materials necessary for repairs at actual cost to you excluding prospective profit or overhead charges of any nature. Any property so paid for or replaced at our option becomes our property. Payment will not constitute an admission of any liability on your part. Other Insurance If any other insurance carried by you applies to a loss covered by this endorsement this endorsement will not ap ply. Nothing herein contained will be held to alter vary or waive any of the agreements conditions or declarations of this policy except as herein stated. Form CG7141 Ed. 5 90
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COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION CONTRACT OR AGREEMENT INCLUDING COMPLETED OPERATIONS PRIMARY AND NONCONTRIBUTORY COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section Il Who Is An Insured is amended to include as an additional insured 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. Such persons or organizations is an additional insured only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by a. Your acts or omissions or b. The acts or omissions of those acting on your behalf in the performance of a. your ongoing operations for the additional insured or b. Your work for the additional insured and included in the products completed operations hazard. However the insurance afforded to such additional insured described above a. Only applies to the extent permitted by law and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured.. With respect to the insurance afforded to these additional insureds the exclusion applies This insurance does not apply to bodily injury property damage and personal and advertising injury arising out of the rendering of or the failure to render any professional architectural engineering or surveying services including a. The preparing approving or failing to prepare or approve maps shop drawings opinions reports following additional E. This endorsement modifies the insurance provided under the following surveys field orders change orders or drawings and specifications or b. Supervisory inspection engineering activities. 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 the 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 the failure to render any professional architectural engineering or surveying services. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance The most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or described in Paragraph A.1. 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. The following is added to the Other Insurance Condition and supersedes any provision to the contrary Primary and Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that 1 The additional insured is a Named Insured under such other insurance and 2 You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of this policy remain unchanged. architectural or agreement CG7174.310 13 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1
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COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY ESSENTIAL EXTENSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM The COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to include the following clarifications and extensions of coverage. The provisions of the coverage part apply unless modified by endorsement. A. EXPECTED OR INTENDED INJURY Any payment we make for damages because of Section Coverage A Exclusion a. is amended as follows a. Bodily injury or property damage expected or intended from the standpoint of an insured. This exclusion does not apply to bodily injury or property damage resulting from the use of reasonable force to protect persons or property. NON OWNED WATERCRAFT Section Coverage A Exclusion g.2 is amended as follows 2 A watercraft you do not own that is a Less than 51 feet long and b Not being used to carry persons or property for a charge EXTENDED PROPERTY DAMAGE COVERAGE Section Coverage A Exclusions j.3 and 4 is amended to add the following Paragraphs 3 and 4 of this exclusion do not apply to tools or equipment loaned to you provided they are not being used to perform operations at the time of loss. SCHEDULE Limits Of Insurance Deductible 2500 Each Occurrence 250 Per Claim 5000 Annual Aggregate a. The each occurrence limit listed above is the most we will pay for all damages because of property damage to property in the care custody and control of or property loaned to an insured as the result of any one occurrence regardless of the number of 1 insureds 2 claims made or suits brought 3 persons or organizations making claims or bringing suits. The aggregate limit listed above is the most we will pay for all damages because of property damage to property in the care custody and control of or property loaned to an insured during the policy period. property damage to property in the care custody and control of or property loaned to an insured will apply against the General Aggregate Limit shown in the declarations. b. Our obligation to pay damages on your behalf applies only to the amount of damages in excess of the deductible amount listed above. We may pay any part or all of the deductible amount listed above. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification by us you will promptly reimburse us for that part of the deductible we paid. c. If two or more coverages apply under one occurrence only the highest per claim deductible applicable to these coverages will apply. d. Insurance provided by this provision is excess over any other insurance whether primary excess contingent or any other basis. Since insurance provided by this endorsement is excess we will have no duty to defend any claim or suit to which insurance provided by this endorsement applies if any other insurer has a duty to defend such a claim or suit. If no other insurer defends we will undertake to do so but we will be entitled to the insured s rights against all those other insurers. PROPERTY DAMAGE ELEVATORS Section Coverage A Exclusions paragraphs j3 j4 j.6 and k. do not apply to the use of elevators. The insurance afforded by this provision is excess over any valid and collectible property insurance including any deductible available to the insured and Section IV Commercial General Liability Conditions paragraph 4. Other Insurance is changed accordingly. FIRE LIGHTNING OR EXPLOSION DAMAGE Except where it is used in the term hostile fire the word fire includes fire lightning or explosion wherever it appears in the Coverage Form. Under Section Coverage A the last paragraph after the exclusions is replaced with the following CGT1918 14 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f3
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Exclusions c. through n. do not apply to damage by fire smoke or leakage from automatic fire protection systems 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. MEDICAL PAYMENTS If Section Coverage C. Medical Payments Coverage is not otherwise excluded from this Coverage Form The requirement in the Insuring Agreement of Coverage C. that expenses must be incurred and reported to us within one year of the accident date is changed to three years.. SUPPLEMENTARY PAYMENTS Supplementary Payments Coverages A and B Paragraphs 1.b. and 1.d. are replaced by the following 1.b. Up to 3000 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. 1.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 350 a day because of time off from work.. SUBSIDIARIES AS INSUREDS Section Il Who Is An Insured is amended to add the following 1.f. Any legally incorporated subsidiary in which you own more than 50 of the voting stock on the effective date of this policy. However insured does not include any subsidiary that is an insured under any other general liability policy or would have been an insured under such a policy but for termination of that policy or the exhaustion of that policy s limits of liability. HEALTH CARE SERVICE PROFESSIONALS AS INSUREDS INCIDENTAL MALPRACTICE Section Il Who is an Insured paragraph 2.a. 1 d is amended as follows This provision does not apply to Nurses Emergency Medical Technicians or Paramedics who provide professional health care services on your behalf. However this exception does not apply if you are in the business or occupation of providing any such professional services. NEWLY FORMED OR ACQUIRED ORGANIZATIONS Section Il Who Is An Insured paragraph 3.a. is replaced by the following 3.a. Coverage under this provision is afforded until the end of the policy period. do not apply to damage by om automatic fire protection while rented to you or you with permission of the of insurance applies to this in Section Il Limits of ge C. Medical Payments rwise excluded from this e Insuring Agreement of nses must be incurred and e year of the accident date s. YMENTS nts Coverages A and B 1.d. are replaced by the ost of bail bonds required ts or traffic law violations of any vehicle to which the Coverage applies. We do 1ese bonds. ses incurred by the insured at t us in the investigation or or suit including actual loss 50 a day because of time off UREDS Insured is amended to add ated subsidiary in which you of the voting stock on the s policy. However insured any subsidiary that is an ther general liability policy 1 an insured under such a wation of that policy or the olicy s limits of liability. CE PROFESSIONALS AS AL MALPRACTICE Insured paragraph 2.a. 1 S pply to Nurses Emergency Paramedics who provide services on your behalf. does not apply if you are in tion of providing any such QUIRED ORGANIZATIONS Insured paragraph 3.a. is s provision is afforded until y period. Includes copyrighted material of ISO Properties Inc. with its permission. This provision does not apply if newly formed or acquired organizations coverage is excluded either by the provisions of the Coverage Form or by endorsements. K. DAMAGE TO PREMISES RENTED TO YOU Section Ill Limits of Insurance paragraph 6. is replaced by the following Subject to 5.a. above the Damage To Premises Rented To You Limit or 300000 whichever is higher 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 smoke or leakage from automatic protection systems while rented to you or temporarily occupied by you with permission of the owner. L. DUTIES IN THE EVENT OF OCCURRENCE OFFENSE CLAIM OR SUIT Section IV Commercial General Liability Condition paragraph 2. is amended to add the following e. The requirement in Condition 2.a. that 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 applies only when the occurrence or offense is known to 1 You if you are an individual or a limited liability company 2 A partner if you are a partnership 3 A member or manager if you are a limited liability company 4 An executive officer or insurance manager if you are a corporation or 5 Atrustee if you are a trust. f. The requirement in Condition 2.b. that you must see to it that we receive notice of a claim or suit as soon as practicable will not be considered breached unless the breach occurs after such claim or suit is known to 1 You if you are an individual or a limited liability company 2 A partner if you are a partnership 3 A member or manager if you are a limited liability company 4 An executive officer or insurance manager if you are a corporation or 5 Atrustee if you are a trust. M. UNINTENTIONAL FAILURE TO DISCLOSE EXPOSURES Section IV Commercial General Liability Conditions paragraph 6. Representations is amended to add the following If you unintentionally fail to disclose any exposures existing at the inception date of your policy we will not deny coverage under the Coverage Form solely because of such failure to disclose. However this provision does not affect our right to collect additional premium or exercise our right of cancellation or non renewal. Page 2 0f 3 CG71918 14 Page 2 0f 3
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This provision does not apply to any known injury or damage which is excluded under any other provision of this policy. MENTAL ANGUISH Section V Definition 3. is replaced by the following Bodily injury means bodily injury sickness or disease sustained by a person including mental anguish or death resulting from bodily injury sickness or disease. LIBERALIZATION If we revise this endorsement to provide greater coverage without additional premium charge we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. CGT1918 14 Includes copyrighted material of ISO Properties Inc. with its permission. Page 3 0f 3
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS EXTENDED PROPERTY DAMAGE COVERAGE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The COMMERCIAL GENERAL LIABILITY COVERAGE PART is amended to include the following extension of cov erage. The provisions of the Coverage Part apply unless modified by this endorsement. SCHEDULE LIMITS OF INSURANCE DEDUCTIBLE 5000 EACH OCCURRENCE 250 EACH CLAIM 25000 ANNUAL AGGREGATE INSURING AGREEMENT We will pay those sums that an insured becomes legally obligated to pay as damages because of property dam age to real or personal property of others while the property is in the insured s care custody or control or over which the insured is for any reason exercising physical control. EXCLUSIONS a. Coverage A Section I Exclusions j3 and j5 are deleted in their entireties. b. Coverage A Section Exclusion j4 is deleted and replaced with the following 1 Personal property in the care custody and control of an insured which is held for servicing repair stor age or sale at premises owned rented operated or used by the insured. LIMITS OF INSURANCE a. The each occurrence limit listed above is the most we will pay for all damages because of property damage to real and personal property in the care custody and control of an insured as the result of any one occur rence regardless of the number of 1 insureds 2 claims made or suits brought 3 persons or organizations making claims or bringing suits. b. The aggregate limit listed above is the most we will pay for all damages because of property damage to real or personal property in your care custody and control during the policy period. c. Any payments we make for damages because of property damage to real or personal property in your care custody or control will apply against the General Aggregate Limit shown in the declarations. DEDUCTIBLE Our obligation to pay damages on your behalf applies only to the amount of damages in excess of the deductible amount listed above. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification by us you will promptly reimburse us for that part of the deductible we paid. OTHER INSURANCE Insurance provided by this endorsement is excess over any other insurance whether primary excess contingent or any other basis. Since insurance provided by this endorsement applies if any other insurer has a duty to defend such a claim or suit. If no other insurer defends we will undertake to do so but we will be entitled to the in sured s rights against all those other insurers. DEDUCTIBLE 250 EACH CLAIM Form CG7253 Ed. 12 96
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COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED POLLUTION COVERAGE WORK SITES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM With respect to SCHEDULE Each Pollution Incident Limit Pollution Liability Aggregate Limit Property Damage Deductible 100000 100000 1000 Each pollution incident coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by this endorsement. A. Section COVERAGES is amended to include the following LIMITED POLLUTION COVERAGE SITES WORK 1. Insuring Agreement CG727610 08 We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage or clean up costs because of environmental 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 those damages for bodily injury property damage or clean up costs because of environmental damage to which this insurance does not apply. We may at our discretion investigate any pollution incident and settle any claim or suit that may result. But 1 The amount we will pay for damages and clean up costs is limited as described in SECTION C LIMITS OF INSURANCE of this endorsement and Our right and duty to defend end 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 SECTION B SUPPLEMENTARY PAYMENTS of this endorsement. This insurance applies to bodily injury property damage or clean up costs because of environmental damage but only if the bodily injury property damage or environmental damage is caused by a pollution incident 2 Includes copyrighted material of ISO Properties Inc. with its permission. 1 at or from a work site within the coverage territory 2 which first commences during the policy period 3 which ceases within 72 hours after it commences and 4 is reported to us within 30 days of its commencement. This reporting provision is in addition to the notification requirements set out in Section IV CONDITIONS. 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. 2. Exclusions The insurance provided by this endorsement does not apply to Bodily injury property damage or environmental damage expected or intended from the standpoint of the insured. Bodily injury property damage or environmental 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 that the insured would have in the absence of the contract or agreement. Property damage or damage at or from 1 awaste facility 2 property or premises you own rent or environmental occupy 3 premises you sell give away or abandon if the property damage arises out of any part of those premises 4 property loaned to you or 5 personal property in your care custody or control. Page 10f3 Page 10f3
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1 the transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or the use of mobile equipment in or while in practice or preparation for a prearranged racing speed or demolition contest or in any stunt activity or 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. I. Any loss cost or expense arising out of any request demand or order by a governmental authority 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 at any site which is included or proposed for inclusion on a governmental authority s clean up priority list. m. Any injury or damage included in the insurance provided by Section 1 Coverage A of this policy. B. For the purposes of the coverage provided by this endorsement 1. All references to Supplementary Payments Coverages A and B are replaced by Supplementary Payments Coverages A B and Limited Pollution Coverage Work Sites. 2. Paragraphs 1.b. and 2. of the Supplementary Payments provision do not apply. C. Section Il LIMITS OF INSURANCE is deleted in its entirety and replaced with the following For the purposes of the coverage provided by this endorsement. 1. Regardless of the number of insureds claims made or suits brought or persons or organizations making claims or bringing suits our liability under this endorsement is limited as follows a. The Each Pollution Incident Limit shown in the Schedule of Limits of Insurance of this endorsement is the most we will pay for all damages and clean up costs arising out of any one discharge dispersal seepage migration release or escape of pollutants under this endorsement. b. The Pollution Liability Aggregate Limit shown in the Schedule of Limits of Insurance of this endorsement is the most we will pay for the aggregate of all damages covered under this endorsement. 2 3 Clean up costs or any other expense incurred by you or others to test for monitor clean up remove contain treat detoxify or neutralize pollutants at or from 1 awaste facility or 2 premises you own rent or occupy or to any recovery claimed for such cost or expense. Bodily injury property damage or environmental damage included within the products completed operations hazard. Bodily injury property damage or environmental damage arising out of the ownership or operation of any offshore facility as defined in the Outer Continental Shelf Lands Act Amendment of 1978 to the Clean Water Act of 1977 or any deepwater port as defined in the Deepwater Port Act of 1974 as amended or as either Act may be amended. Bodily injury property damage or environmental damage arising out of a pollution incident from a work site or any part of a work site that is or was at any time used by you for the storage disposal processing or treatment of waste materials. Bodily injury property damage or environmental damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto rolling stock or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. Bodily injury property damage or environmental damage arising out of the emission discharge release or escape of drilling fluid oil gas or other fluids from any oil gas mineral water or geothermal well. Bodily injury property damage or environmental damage arising out of a pollution incident which results from or is directly attributable to failure to comply with any applicable statute regulation ordinance directive or order relating to the protection of the environment and promulgated by any governmental body provided that failure to comply is a willful or deliberate act or omission of 1 the insured or 2 you or any of your members partners or executive officers. Bodily injury property damage or environmental damage arising out of CG727610 08 Page 20f3 Includes copyrighted material of ISO Properties Inc. with its permission.
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2. The Limits of Insurance for coverages available within the Commercial General Liability Coverage Form that is part of this policy will be reduced by any damages paid on your behalf under this endorsement. 3. Property Damage Deductible a. Our obligation under this endorsement to pay damages for property damage or clean up costs because of environmental damage on your behalf applies only to the amount of damages or clean up costs in excess of any deductible amount stated in this endorsement as applicable to the Each Pollution Incident Limit. Neither the Each Pollution Incident Limit nor the Pollution Liability Aggregate Limit will be reduced by the application of such deductible amount. b. The terms of this insurance including those with respect to 1 our right and duty to defend any suits seeking those damages and 2 your duties in the event of a pollution incident claim or suit apply irrespective of the application of the deductible amount. c. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification or the action taken you shall promptly reimburse us of such part of the deductible amount as has been paid by us.. For the purposes of the coverage provided by this endorsement Condition 4. of Section IV Commercial Liability Conditions is amended as follows All references to Coverages A or B are amended to read Coverages A B or Limited Pollution Coverage Work Sites.. For the purposes of the coverage provided by this endorsement the following definitions are added to Section V DEFINITIONS. Clean up costs means expenses for and includes any costs for testing performed in connection with the removal remediation neutralization or disposal of pollutants. Environmental damage means the injurious presence in or upon land the atmosphere or any water course or body of water of pollutants which results directly from any physical injury to tangible property. Pollution incident means the actual emission discharge release or escape of pollutants from a work site provided that such emission discharge release or escape results in bodily injury property damage or environmental damage. The entirety of any such emission discharge release or escape will be deemed to be one pollution incident. Waste facility means any site to which waste from the operations or a work site is consigned for delivery or delivered for storage disposal processing or treatment. Work site means any premises site or location on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by you any contractor or subcontractor. Work site does not include any premises site or location which currently is or was at any time owned or occupied by or rented or loaned to you. CGT27610 08 Page 30f3 Includes copyrighted material of ISO Properties Inc. with its permission.
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT AGGREGATE LIMITS OF INSURANCE PER LOCATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The General Aggregate Limit under LIMITS OF INSURANCE Section Ill applies separately to each of your locations owned by or rented to you. 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. Includes copyrighted material of Insurance Services Office Inc. with its permission. Form CG7428 Ed. 11 98 Copyright Insurance Services Office Inc. 1984
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT AGGREGATE LIMITS OF INSURANCE PER PROJECT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The General Aggregate Limit under LIMITS OF INSURANCE Section Ill applies separately to each of your projects away from premises owned by or rented to you. Includes copyrighted material of Insurance Services Office Inc. with its permission. Form CG7429 Ed. 11 98 Copyright Insurance Services Office Inc. 1984
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COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF SUBROGATION WHEN REQUIRED IN A WRITTEN CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM 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 any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement 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. CGT55510 13 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1
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COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF EMPLOYEE BENEFITS PROGRAM DEFINITION This endorsement modifies insurance provided under the following EMPLOYEE BENEFITS LIABILITY COVERAGE ENDORSEMENT SCHEDULE Description of Other Similar Benefits If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. A. Paragraph G.4 of the Employee Benefits Liability b. Coverage Endorsement CG0435 is replaced by the following 4. Employee benefit program means a program providing some or all of the following benefits to employees whether provided through a cafeteria plan or otherwise a. Group life insurance group accident or health insurance dental vision prescription and hearing plans and flexible spending accounts provided that no one other than an employee may subscribe to such benefits and such benefits are made d. generally available to those employees who satisfy the plan s eligibility requirements Profit sharing plans employee savings plans individual retirement account IRA plans employee stock ownership plans pension plans and stock subscription plans provided that no one other than an employee may subscribe to such benefits and such benefits are made generally available to all employees who are eligible under the plan for such benefits Unemployment insurance social security benefits workers compensation and disability benefits Vacation plans including buy and sell programs leave of absence programs including military maternity family and civil leave tuition assistance plans transportation and health club subsidies and Any other similar benefits designated in the Schedule or added thereto by endorsement. CG76273 09 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10of 1
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COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS OCCURRENCE DEFINITION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART For the purposes of the coverage provided by this endorsement Section V DEFINITIONS Paragraph 13. is amended to read Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions and also means accidental property damage but does not include faulty workmanship which is the defective condition of an insured s or subcontractor s work without a change or alteration in your work. CGT6442 09 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10of 1
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COMMERCIAL GENERAL LIABILITY FUNGI OR BACTERIA EXCLUSION NOTICE TO POLICYHOLDERS RESTRICTIONS AND CLARIFICATIONS OF COVERAGE NO COVERAGE IS PROVIDED BY THIS POLICYHOLDER NOTICE NOR CAN IT BE CONSTRUED TO REPLACE ANY PROVISIONS OF YOUR POLICY. YOU SHOULD READ YOUR POLICY ALL ATTACHED ENDORSEMENTS AND THE DECLARATIONS PAGE FOR COMPLETE INFORMATION ON THE COVERAGE YOU ARE PROVIDED. IF THERE IS ANY CONFLICT BETWEEN THE POLICY AND THIS NOTICE THE PROVISIONS OF THE POLICY SHALL PREVAIL. THIS NOTICE HAS BEEN PREPARED IN CONJUNCTION WITH THE IMPLEMENTATION OF CHANGES TO YOUR POLICY. THIS NOTICE PROVIDES INFORMATION CONCERNING FUNGI OR BACTERIA EXCLUSIONS AND YOUR POLICY. PLEASE READ THIS NOTICE CAREFULLY. Please contact your agent to discuss any questions. Your right to cancel remains unchanged. CG2167 Fungi or Bacteria Exclusion Commercial General Liability Coverage Part When this endorsement is attached to your policy coverage is restricted to exclude bodily injury or property damage arising directly or indirectly out of any fungi including but not limited to mold or bacteria on or in a building or structure. coverage is clarified to exclude personal and advertising injury or personal injury or advertising injury if defined as such in your policy arising directly or indirectly out of any fungi including but not limited to mold or bacteria on or in a building or structure. This exclusion applies whether or not any other cause event material or product contributed in any sequence to the injury. coverage is restricted to exclude clean up costs associated with fungi or bacteria. The exclusion does not apply to fungi or bacteria intended for bodily consumption such as mushrooms. CG3131 Fungi or Bacteria Exclusion Owners and Contractors Protective Liability Coverage Part and Products Completed Operations Coverage Part When this endorsement is attached to your policy coverage is restricted to exclude bodily injury or property damage arising directly or indirectly out of any fungi including but not limited to mold or bacteria on or in a building or structure. This exclusion applies whether or not any other cause event material or product contributed in any sequence to the injury or damage. coverage is restricted to exclude clean up costs associated with fungi or bacteria. The exclusion does not apply to fungi or bacteria intended for bodily consumption such as mushrooms. G081 4 06 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1
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COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION EXCLUSIONS ADVISORY NOTICE TO POLICYHOLDERS This Notice does not form part of your policy. No coverage is provided by this Notice nor can it be construed to replace any provision of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. If there is any conflict between the Policy and this Notice THE PROVISIONS OF THE POLICY SHALL PREVAIL. Carefully read your policy including the endorsements attached to your policy. This Notice provides information concerning the following new endorsements which applies to your renewal policy being issued by us CG2106 Exclusion Access Or Disclosure Of Confidential Or Personal Information And Data related Liability With Limited Bodily Injury Exception When this endorsement is attached to your policy e Under Coverage A Bodily Injury And Property Damage Liability coverage is excluded for damages arising out of any access to or disclosure of confidential or personal information. This is a reinforcement of coverage. e Under Coverage B Personal And Advertising Injury Liability coverage is excluded for personal and advertising injury arising out of any access to or disclosure of confidential or personal information. To the extent that any access or disclosure of confidential or personal information results in an oral or written publication that violates a person s right of privacy this may result in a reduction in coverage. CG0437 Electronic Data Liability With respect to damages arising out of access or disclosure of confidential or personal information when this endorsement is attached to your policy e Under Coverage A Bodily Injury And Property Damage Liability coverage is excluded for damages arising out of any access to or disclosure of confidential or personal information. This is a reinforcement of coverage. e Under Coverage B Personal And Advertising Injury Liability coverage is excluded for personal and advertising injury arising out of any access to or disclosure of confidential or personal information. To the extent that any access or disclosure of confidential or personal information results in an oral or written publication that violates a person s right of privacy this may result in a reduction in coverage. CG3353 Exclusion Access Or Disclosure Of Confidential Or Personal Information And Data related Liability With Limited Bodily Injury Exception When this endorsement is attached to your policy coverage is excluded for damages arising out of any access to or disclosure of confidential or personal information. This is a reinforcement of coverage. CG82824 14 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1
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GENERAL LIABILITY MULTISTATE FORMS REVISION ADVISORY NOTICE TO POLICYHOLDERS This Notice does not form part of your policy. No coverage is provided by this summary nor can it be construed to replace any provision of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. If there is any conflict between the Policy and this Notice THE PROVISIONS OF THIS POLICY SHALL PREVAIL. Please contact your agent to discuss any questions. Your right to cancel remains unchanged. This Notice provides information concerning the following endorsements which may apply to your renewal policy being issued by us. EMC MULTISTATE STATE SPECIFIC ENDORSEMENTS A. REDUCTION OF COVERAGE 1. Revised Mobile Equipment Coverage We have withdrawn endorsement CG7584 Mobile Equipment Auto Amendment. It will no longer appear on your policy. The definitions of mobile equipment and auto have been revised. Any land vehicle that was classified as a piece of mobile equipment under your previous policy will now be considered an auto if that vehicle is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. With this change coverage is no longer provided for these types of land vehicles since they are now defined to be autos rather than mobile equipment and subject to the Aircraft Auto and Watercraft exclusion in your policy. However the operation of machinery or equipment that is attached to or part of such a vehicle will still be covered by your policy. If you wish to obtain coverage for land vehicles subject to compulsory or financial responsibility laws or other motor vehicle laws you should consider a Commercial Automobile policy. 2. Other Endorsements impacted by the Mobile Equipment Coverage revision We have amended the following endorsements to remove reference to Section Il Who is An Insured Paragraph 4. This paragraph addresses mobile equipment registered in your name under any motor vehicle registration law and who is an insured. Because we are withdrawing CG7584 this paragraph no longer applies. This may be viewed as a reduction in coverage. However if you wish to obtain coverage for mobile equipment subject to compulsory or financial responsibility laws or other motor vehicle laws you should consider a Commercial Automobile policy. CG7105 Extension of Who Is An Insured CGT7140 Coverage for Injury to Co Employees andor Your Other Volunteer Workers CGT7140.1 Coverage for Injury to Co Employees andor Your Other Volunteer Workers CG7233 Coverage for Injury to Co Employees andor Your Other Volunteer Workers CG7233.1 Coverage for Injury to Co Employees andor Your Other Volunteer Workers CGT7242 Commercial General Liability Amendment Nebraska Schools CG7274 Commercial General Liability Amendment ABC Contractors CGT7311 Extension of Who is an Insured Kansas Schools and Community Colleges CGT7415 lowa Association of Business and Industry Commercial General Liability Amendment CG7455 Commercial General Liability Amendment Printers CG7549.1 Commercial General Liability Amendment Schools CGT7610 Petroleum Marketers Industry Extension CGT7633 Commercial General Liability Amendment Municipalities CG7633.1 Commercial General Liability Amendment Municipalities CG82834 14 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f4
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We have removed an amendment to the definition of mobile equipment from the following endorsement. The amendment no longer applies and the power units that this amendment had applied to will now be autos. This may be viewed as a reduction in coverage. However if you wish to obtain coverage you should consider a Commercial Automobile policy. CG7629 Manufactured Housing Industry Extension We are withdrawing CG7583 Motor Vehicles Laws in all states except New Hampshire. This endorsement was used to satisfy the insured s statutory coverage needs when any motor vehicle financial responsibility law applied to a piece or pieces of insured s mobile equipment. Since this equipment will now be covered by a Commercial Automobile policy the endorsement is no longer needed. However since coverage is no longer provided by the Commercial General Liability policy this may be viewed as a reduction in coverage. B. OTHER CHANGES 1. Exclusion All Hazards in Connection with Designated Garage Operations CG7165 has been amended to better track with the definition of garage operations found in ISO s Garagekeepers endorsement CA9937. This is a clarification of coverage intent. Exclusion All Hazards in Connection with Designated Garage Operations CG7165.1 has been amended to better track with the definition of garage operations found in ISO s Virginia Garagekeepers endorsement CA9971. This is a clarification of coverage intent. Professional Services Exclusion Wording To reinforce the Professional Services exclusion within the following endorsements we are enhancing the exclusion to expressly address in part claims alleging negligence or other wrongdoing in the hiring employment training or supervision or monitoring of others by any insured. This is a reinforcement of coverage intent. However this change may result in a reduction in coverage in states where courts have ruled professional services exclusions to be inapplicable to negligent supervision claims and other similar types of claims. CGT7417 Mobile Home Parks and Dealers Additional Insured Automatic Status When Required in Written Contract With You CG7610 Petroleum Marketers Industry Extension CG7629 Manufactured Housing Industry Extension Manufacturing Housing Industry Extension endorsement CG7629 has been revised to remove bodily injury from Paragraph D. 1. Deductible. The deductible only applies to property damage coverage so reference to bodily injury is not necessary. This is a clarification of underwriting intent. lowa Total Pollution Exclusion Endorsement CG7401 has been withdrawn and will be replaced by Total Pollution Exclusion Endorsement CG2149. The forms are the same except CG7401 has a signature line which is no longer needed due to rescission of lowa subrule IA ADC 191 20.42. There is no coverage impact. lowa Total Pollution Exclusion with a Hostile Fire Exception endorsement CG7402 has been withdrawn and will be replaced by Total Pollution Exclusion with a Hostile Fire Exception endorsement CG2155. The forms are the same except CG7402 has a signature line which is no longer needed due to rescission of lowa subrule IA ADC 191 20.42. There is no coverage impact. Additional Insured Endorsements The following additional insured endorsements are revised to indicate that when these endorsements are attached to a policy if coverage provided to the additional insured is required by contract or agreement coverage to the additional insured will be afforded to the extent permissible by law and to the extent the named insured is required by the contract or agreement to provide insurance for the additional insured. This is a clarification of underwriting intent although some may view it as a reduction in coverage. Additionally if coverage provided to the additional insured is required by contract or agreement the Limits of Insurance of the named insured s policy that are available to an additional insured will be limited to the extent required by the contract or agreement or the amount of insurance available under the applicable Limits of Insurance shown in the Declarations whichever is less. This is a clarification of underwriting intent although some may view it as a reduction in coverage. CG7223 Boat Dealers Liability Extension Endorsement CGT7223.1 Boat Dealers Liability Extension Endorsement CGT7223.2 Boat Dealers Liability Extension Endorsement CG82834 14 Page 2 0f 4 Includes copyrighted material of ISO Properties Inc. with its permission.
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10. 1. 12. CGT7242 Commercial General Liability Amendment Nebraska Schools CGT7255 Commercial General Liability Amendment Schools CGT7417 Mobile Home Parks and Dealers Additional Insured Automatic Status When Required in a Written Agreement With You CGT7549 Commercial General Liability Amendment Schools CG7549.1 Commercial General Liability Amendment Schools CG7578 Liability Extension Endorsement CG7578.1 Liability Extension Endorsement CG7578.2 Liability Extension Endorsement Louisiana CG7578.3 Liability Extension Endorsement CG7610 Petroleum Marketers Industry Extension CGT7629 Manufactured Housing Industry Extension Additional Insured Endorsements The following additional insured endorsement is revised to indicate that when this endorsement is attached to a policy if coverage provided to the additional insured is required by contact or agreement coverage to the additional insured will be afforded to the extent permissible by law. This is a clarification of underwriting intent although some may view it as a reduction in coverage. Additionally if coverage provided to the additional insured is required by contract or agreement the Limits of Insurance of the named insured s policy that are available to an additional insured will be limited to the extent required by the contract or agreement or the amount of insurance available under the applicable Limits of Insurance shown in the Declarations whichever is less. This is a clarification of underwriting intent although some may view it as a reduction in coverage. CGT7274 Commercial General Liability Amendment ABC Contractors Primary and Noncontributory Wording We are replacing the current Primary and Noncontributory wording with the new wording that 1ISO introduced with endorsement Primary and Noncontributory Other Insurance Condition CG2001. The only difference is that 1SO s wording requires that the additional insured be a named insured on another insurance policy available to them and that a written contract or agreement has been entered into by the insured stating that the insured s policy will be primary and will not seek contribution from any other insurance available to the additional insured. This is a clarification of underwriting intent although some may view it as a reduction in coverage. CGT7274 Commercial General Liability Amendment ABC Contractors CGT7417 Mobile Home Parks and Dealers Additional Insured Automatic Status When Required in a Written Agreement With You CG7559.1 Additional Insured Managers or Lessors of Premises Vicarious Liability Primary and Noncontributory CGT7610 Petroleum Marketers Industry Extension CGT7629 Manufactured Housing Industry Extension Non Dealers Garage Operations Extension Endorsement CG7595 has been amended to better track with the definition of customer s autos found in the ISO s Garagekeepers endorsement CA9937. This is a clarification of coverage intent. Non Dealers Garage Operation Extension Endorsement CG7595.1 replaces CG7595 on accounts domiciled in Virginia. The customer s autos and garage operations definitions now track with I1SO s Virginia Garagekeepers endorsement CA9971. This is a clarification of coverage intent. Liquor Liability Changes The Limits of Insurance section of the following endorsements has been changed. The expiring endorsements incorrectly made reference to Liability and Medical Expenses limits of insurance. However these are not limits found within the Commercial General Liability coverage form. To clarify underwriting intent we have replaced these limits of insurance with Each Occurrence Personal and Advertising Injury Medical Expense General Aggregate and Products Completed Aggregate. These limits do not apply to liquor liability claims covered by this endorsement as this endorsement has a separate Each Common Cause Limit and Liquor Liability Aggregate Limit. There is no impact on coverage. CGB2834 14 Page 30f 4 Includes copyrighted material of ISO Properties Inc. with its permission.
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CG7613 Liquor Liability Endorsement CG7613.1 Liquor Liability Endorsement Minnesota CG7613.3 Liquor Liability Endorsement lowa CG7613.5 Liquor Liability Endorsement Michigan We have amended wording throughout the following endorsement in response to Minnesota dram shop liability law requirements and the ruling in Brua v. Minnesota Joint Underwriting Association 778N.W.2d 294 Minn 2010. There is no reduction in coverage only clarification. We have also added a definition for the word injury to clarify underwriting intent. CG7613.1 Liquor Liability Endorsement Minnesota We are simplifying the following endorsements by removing wording that is a duplicate of that already found within the Commercial General Liability coverage form. The changes are intended to simplify readability. CG7613.3 Liquor Liability lowa CG7613.4 Liquor Liability lllinois CG7613.5 Liquor Liability Michigan In the following endorsement we have added a statement that the Commercial General Liability limits of insurance are not impacted by damages arising out of the sales serving or furnishing of liquor and that the Aggregate shown in the endorsement is the most that we will pay for bodily injury and property damage under this endorsement. This is a clarification of underwriting intent. CG7613.4 Liquor Liability Endorsement lllinois In the following endorsement we have revised the Liquor in Effect exclusion to apply if the license is not in effect rather than suspended expired cancelled or revoked. This is a clarification of underwriting intent but may be viewed as a reduction in coverage. CG7613.5 Liquor Liability Endorsement Michigan CG82834 14 Page 4 of 4 Includes copyrighted material of ISO Properties Inc. with its permission.
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COMMERCIAL GENERAL LIABILITY IMPORTANT NOTICE TO POLICYHOLDERS This Notice summarizes coverage changes that may affect your Commercial General Liability Coverage. No coverage is provided by this summary nor does it replace any provision of your policy. You should read your policy including all endorsements and review your declarations page for complete information on the coverage you are provided. If there is any conflict between the policy and this notice THE PROVISIONS OF THE POLICY SHALL PREVAIL. Some of the language of the new policy has been restated and repunctuated for clarity and readability but with no change in the coverage intent. Please contact your agent to discuss any questions. Your right to cancel the policy or remove endorsements remains unchanged. I. At renewal if no change is made your Commercial General Liability Policy will include a revised and enhanced edition of the following endorsement. The areas within the policy that broaden reduce or clarify coverage are highlighted below. GENERAL LIABILITY ESSENTIAL EXTENSION CG7191 REPLACING COMMERCIAL GENERAL LIABILITY AMENDMENT CG7191 BROADENING OF COVERAGE Damage to Premises Rented to You Fire Legal Liability limit is increased from 100000 to 300000 Expected or Intended Injury A new coverage Extended Property Damage for Borrowed Equipment and Customer Goods A new coverage is added at 2500 limit per Occurrence5000 limit per policy. A 250 Deductible applies. Newly Acquired Entities time period increased from 180 Days to Until the end of the policy period Health Care Service Professional as Insureds Incidental Malpractice A new coverage GENERAL LIABILITY ELITE EXTENSION CG7578 REPLACING LIABILITY EXTENSION ENDORSEMENT CG7578 BROADENING OF COVERAGE Additional Insured Primary and Non Contributory Extension A new coverage Included if required by contract Blanket Additional Insured A new coverage Included specified relationships if required by contract Damage to Premises Rented to You Fire Legal Liability limit is increased from 300000 to 500000 Fellow Employee Coverage A new coverage Medical Payments Limit Increased to 10000 Non owned Watercraft coverage Increased from Less than 51 ft. long to Less than 60 ft. long Supplementary Payments Limit Increased from 3000 bail bond limit and 350 loss of earnings to 5000 bail bond limit and 500 loss of earnings Waived Subrogation Transfer of Rights of Recovery Against Others To Us A new coverage If required by contract Health Care Service Professional as Insureds Incidental Malpractice A new coverage CG82849 14 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 2
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II. Atrenewal depending on which form is on the policy you will also have the option to change your policy to remove or add either the CG7191 or the CG7578. If you elect this change the areas within the policy that broaden reduce or clarify coverage are highlighted below. GENERAL LIABILITY ELITE EXTENSION CG7578 REPLACING COMMERCIAL GENERAL LIABILITY AMENDMENT CG7191 BROADENING OF COVERAGE Additional Insured Primary and Non Contributory Extension A new coverage Included if required by contract Blanket Additional Insured A new coverage Included specified relationships if required by contract Damage to Premises Rented to You Fire Legal Liability limit is increased from 100000 to 500000 Expected or Intended Injury A new coverage Extended Property Damage for Borrowed Equipment and Customer Goods A new coverage is added at 5000 limit per Occurrence10000 limit per policy. A 250 Deductible applies. Fellow Employee Coverage A new coverage e Medical Payments Limit Increased to 10000 Newly Acquired Entities Time period increased from 180 Days to Until the end of the policy period Non owned Watercraft coverage Increased from Less than 51 ft. long to Less than 60 ft. long Supplementary Payments Limit Increased from 3000 bail bond limit and 350 loss of earnings to 5000 bail bond limit and 500 loss of earnings Waived Subrogation Transfer of Rights of Recovery Against Others To Us A new coverage If required by contract Health Care Service Professional as Insureds Incidental Malpractice A new coverage GENERAL LIABILITY ESSENTIAL EXTENSION CG7191 REPLACING LIABILITY EXTENSION ENDORSEMENT CG7578 BROADENING OF COVERAGE Health Care Service Professional as Insureds Incidental Malpractice A new coverage POTENTIAL REDUCTION OF COVERAGE The CG7191 does not include or reduces the following coverages Additional Insured Governmental subdivisions Ad nal Insured Lessor of leased equipment Additional Insured Managers of premises Extended Property Damage for Borrowed Equipment and Customer Goods Coverage The CG7191 provides lower limits for this coverage 5000 limit per occurrence10000 limit per policy is changed to 2500 limit per Occurrence5000 limit per policy. CG82849 14 Page 2 0of 2 Includes copyrighted material of ISO Properties Inc. with its permission.
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IL 00 21 05 02 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 PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply A. Under any Liability Coverage to bodily injury or property damage 1 With respect to which an insured under 2 the policy is also an insured under a nu clear energy liability policy issued by Nu clear Energy Liability Insurance Associa tion Mutual Atomic Energy Liability Under writers Nuclear Insurance Association of Canada or any of their successors or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability or Resulting from the hazardous properties of nuclear material and with respect to which a any person or organization is re quired to maintain financial protection pur suant to the Atomic Energy Act of 1954 or any law amendatory thereof or b the in sured is or had this policy not been issued would be entitled to indemnity from the United States of America or any agency thereof under any agreement entered into by the United States of America or any agency thereof with any person or organi zation. B. Under any Medical Payments coverage to expenses incurred with respect to bodily in jury resulting from the hazardous properties 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 nu clear 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 prop erty thereat. 2 3. 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. 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 nu clear 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 prop erty thereat.. 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 05 02 ISO Properties Inc. 2001 Page 1 of 2 a
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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 exposed 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 nu clear facility. Nuclear facility means a Any nuclear reactor b Any equipment or device designed or used for 1 separating the isotopes of uranium or plu tonium 2 processing or utilizing spent fuel or 3 handling processing or packaging waste c Any equipment or device used for the process ing fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 d Any structure basin excavation premises or place prepared or used for the storage or dis posal of waste and includes the site on which any of the forego ing 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 Properties Inc. 2001 IL 00 21 05 02 m
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IL 02 59 09 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEBRASKA CHANGES CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following CAPITAL ASSETS PROGRAM OUTPUT POLICY 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 POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART. Paragraphs 2. and 3. of the Cancellation Com mon Policy Condition are replaced by the follow ing 2. Cancellation Of Policies In Effect a. 60 Days Or Less If this policy has been in effect for 60 days or less we may cancel this policy for any reason. b. More Than 60 Days If this policy has been in effect for more than 60 days or if this is a renewal of a pol icy we issued we may cancel this policy only for one or more of the following rea sons 1 Nonpayment of premium 2 The policy was obtained through mate rial misrepresentation 3 Any insured has submitted a fraudulent claim 4 Any insured has violated the terms and conditions of this policy 5 The risk originally accepted has sub stantially increased 6 Certification to the Director of Insurance of our loss of reinsurance which pro vided coverage to us for all or a sub stantial part of the underlying risk in sured or The determination by the Director of In surance that the continuation of the pol icy could place us in violation of the Ne braska Insurance Laws. c. If we cancel this policy subject to 2.a. or 2.b. above we will mail to the first Named Insured a written notice of cancellation stating the reasons for cancellation at least 1. 10 days before the effective date of can cellation if we cancel for nonpayment of premium or 2. 60 days before the effective date of can cellation if we cancel for any other rea son. 3. We will mail our notice by first class mail to the first Named Insured s last mailing address known to us. A United States Postal Service Certificate of Mailing shall be sufficient proof of receipt of notice on the third calendar day after the date of the certificate of mailing. IL 02 59 09 07 ISO Properties Inc. 2006 Page 1 of 2 a
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B. Paragraph 6. of the Cancellation Common Policy Condition does not apply. C. The following is added and supersedes any provi sions to the contrary NONRENEWAL 1. If we decide not to renew this policy we will mail written notice of nonrenewal stating the reasons for nonrenewal to the first Named In sured at least 60 days prior to the expiration date of this policy. 2. Any notice of nonrenewal will be mailed by first class mail to the first Named Insured s last mailing address known to us. A United States Postal Service Certificate of Mailing shall be sufficient proof of receipt of notice on the third calendar day after the date of the certificate of mailing. Page 2 of 2 ISO Properties Inc. 2006 IL 02 59 09 07 o
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INTERLINE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ASBESTOS EXCLUSION This endorsement modifies insurance provided under the following BUSINESSOWNERS COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART The policy does not apply to bodily injury personal injury or personal and advertising injury if defined as such in your policy or property damage including any associated clean up obligations arising out of the installation existence removal or disposal of asbestos or any substance containing asbestos fibers. 1L702810 05 Page 10f 1
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COMMERCIAL INTERLINE IMPORTANT NOTICE TO POLICYHOLDERS Re New Federal Claim Information Reporting Requirements New federal reporting requirements for claims involving parties potentially eligible for Medicare are now in place. With your continued cooperation EMC Insurance Companies will be able to meet these new reporting responsibilities. To help us comply with the new requirements you simply need to make sure you report all claims to your agent or EMC Insurance Companies. If you choose to pay a claim or attempt to settle a claim on your own you may become responsible for these new reporting requirements. For specific information on Section 111 of the Medicare Medicaid and SCHIP Extension Act of 2007 MMSEA P.L. 110 173 go to www.cms.hhs.govMandatorylnsRep or consult with your attorney. 1L85769 09 Page 1 0f 1
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Z ZURICH Disclosure Statement NOTICE OF DISCLOSURE FOR AGENT BROKER COMPENSATION If you want to learn more about the compensation Zurich pays agents and brokers visit httpwww.zurichnaproducercompensation.com or call the following toll free number 866 903 1192. This Notice is provided on behalf of Zurich American Insurance Company and its underwriting subsidiaries. U GU874 ACW 0611 Page 1 of 1
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COMMERCIAL INSURANCE Policy Number GLO 6555467 04 Named Insured and Mailing Address FIRSTSERVICE CORPORATION 1815 GRIFFIN RD DANIA BEACH FL 33004 Z ZURICH COMMON POLICY DECLARATIONS Renewal of Number GLO 6555467 03 Producer and Mailing Address LOCKTON COMPANIES LLC 444 W 47TH ST STE 900 KANSAS CITY MO 64112 1906 Producer Code 37385 000 Policy Period Coverage begins 10 25 2013 at 1201 AM. Coverageends 10 25 2014 at 1201 A M. The name insured is Individual Partnership X Corporation Other surance is provided by one or more of the stock insurance companies which are members of the Zurich American Insurance Group. The company that s coverage is designated on each Coverage Part. Common Declarations. The company or companies providing this insurance may be referred to in this policy as The Company we us or our. The ad dress of the companies of the Zurich American Insurance Grou p are provided on the next page. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGES GENERAL LIABILITY COVERAGE PREMIUM 163473.00 issued by ZURICH AMERICAN INSURANCE COMPANY FL HURRICANE CATASTROPHE FUND 2100.00 FL FIGA 2012 25.00 THIS PREMIUM MAY BE SUBJECT TO AUDIT. TOTAL 163473.00 This premium does not include Taxes and Surcharges. SEE INSTALLMENT SCHEDULE Taxes and Surcharges TOTAL 2125.00 SEE INSTALLMENT SCHEDULE The Forms and Endorsements made a part of this policy at the time of issue are listed on the SCHEDULE of FORMS and ENDORSEMENTS. Countersigned this day of Authorized Representative THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS COVERAGE PART DECLARATIONS COVERAGE PART FORMS FORMS AND ENDORSEMENTS IF ANY ISSUED TO FORM A PART THEREOF COMPLETE THE ABOVE NUMBERED POLICY. U GU D310 A 0193 Page 1 of 1 LI Partners GENERAL LIABILITY COVERAGE PREMIUM 163473.00 issued by ZURICH AMERICAN INSURANCE COMPANY FL HURRICANE CATASTROPHE FUND 2100.00 FL FIGA 2012 S 25.00
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Z ZURICH Important Notice In Witness Clause In return for the payment of premium and subject to the terms of this policy coverage is provided as stated in this policy. IN WITNESS WHEREOF this Company has executed and attested these presents and where required by law has caused this policy to be countersigned by its duly Authorized Representatives. P Janey DV lles D Sk President Corporate Secretary QUESTIONS ABOUT YOUR INSURANCE Your agent or broker is best equipped to provide information about your insurance. Should you require additional information or assistance in resolving a complaint call or write to the following please have your policy or claim number ready Zurich in North America Customer Inquiry Center 1400 American Lane Schaumburg lllinois 60196 1056 1 800 382 2150 Business Hours 8 am 4 pm CT Email info.sourcezurichna.com 1056 1 4 pm CT U GU319 F 0109 Pagel of 1
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COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS Policy Number GLO 6555467 04 ZURICH AMERICAN INSURANCE COMPANY Named Insured FIRSTSERVICE CORPORATION Policy Period Coverage begins 10 25 2013 at 1201 AMCoverageends 10 25 2014 at 1201 AM. Producer Name LOCKTON COMPANIES LLC Producer No. 37385 000 Item 1. Business Description Item 2. Limits of Insurance GENERAL AGGREGATE LIMIT 5000000 PRODUCTS C OMPLETED OPERATIONS AGGREGATE LIMIT 2000000 EACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT 3.222.222 Any one premises MEDICAL EXPENSE LIMIT 32.222 Any one person PERSONAL AND ADVERTISING INJURY LimiT 1 000000 Any one person or organization Item 3. Retroactive Date CG 00 02 ONLY This insurance does not apply to bodily injury property damage or personal and advertising injury offense which occurs before the Retroactive Date if any shown here NONE Enter Date or None if no Retroactive Date ap plies Item 4. Form of Business and Location Premises Form of Business CORPORATION Location of All Premises You Own Rent or Occupy See Schedule of Locations Item 5. Schedule of Forms and Endorsements Forms and Endorsements made a part of this Policy at time of issue See Schedule of Forms and Endorsements Item 6. Premiums Coverage Part Premium 163473 Other Premium Total Premium 163473 COMMERCIAL GENERAL LIABILITY C ZURICH AMERICAN INSU COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS Policy Number GLO 6555467 04 ZURICH AMERICAN INSURANCE COMPANY Named Insured FIRSTSERVICE CORPORATION ENERAL AGGREGATE LIMIT RODUCTS C OMPLETED OPERATIONS AGGREGATE LIMIT ENERAL AGGREGATE LIMIT 5000000 RODUCTS C OMPLETED OPERATIONS AGGREGATE LIMIT 2000000 ACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT 3.222.222 Any one premises MEDICAL EXPENSE LIMIT 32.222 Any one person ERSONAL AND ADVERTISING INJURY LimiT 1000000 Any one person or organization U GLD1115B CW 904
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Employee Benefits Liability Claims Made Coverage Form This Coverage Form provides claims made coverage. Please read the entire form carefully. 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 Declara tions. The words we us and our refer to the Company providing this insurance. Other words and phrases that appear in quotes have special meaning. Refer to the Definitions Section. Section I. Coverage Employee Benefit Liability 1. Insuring Agreement A. We will pay those sums that the insured becomes B. legally obligated to pay as damages because of an act error or omission in the administration of the insured s employee benefit programs. 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 secking damages for any act error or omission for which this insurance does not apply. We may at our discretion investigate any claim and settle any suit that may result but is limited as of Insurance 1 The amount we pay for damages described in Section II. Limit of this Coverage Part 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 un der this Employee Benefit Liability coverage. No other obligation or liability to pay sums or per form acts or services is covered unless explicitly provided for under Supplementary Payments of this Coverage Part. 1 This insurance applies to an act error or omis sion only if a sing out of the act error or made against any insured during the policy period b. The act error or omission takes place in the coverage territory I The insured had no knowledge of and could not have reasonably foreseen any circumstances which might result in a claim or suit and d. The act error or omission did not occur before the Retroactive Date if any shown in the Declarations or after the end of the policy period. 2 A claim will be deemed to have been made when notice of such claim is received and re corded by any insured or by us whichever comes fi All claims for damages to the same person or organization will be deemed to have been made at the time the first of those claims is made against any insured. 2. Exclusions This insurance does not apply to A. Bodily injury property damage or personal and advertising injury B. Any claim or suit arising out of any dishon est fraudulent criminal or malicious act C. Any claim or suit arising out of discrimina tion or humiliation D. Any claim or suit arising out of an insurer s or other provider s failure to perform its con tract E. Any claim or suit arising out of your failure to comply with any workers compensation un employment insurance social security disabil ity benefits law or similar laws F. Any claim or suit arising out of the failure of any of your employee benefit plans to meet obligations due to insufficient funds G. Anyclaim or suit arising out of 1 Advice given to any person to participate or not participate in a plan or program in cluded in employee benefit programs 2 The appointment of or failure to appoint any investment manager administrator trustee actuary advisor counsel account ant custodian or consultant U GL849 B CW 804 Pagel of 4
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3 Any investment activity including the man agement administration or disposition of assets of your employee benefit pro grams or 4 Failure of any investment to perform as represented by any insured. H. Any claim or suit arising out of an insured s liability as a fiduciary under a. The Employee Retirement Income Secu rity Act of 1974 PL93 406 and its amendments or b. The Internal Revenue Code of 1986 in cluding the Internal Revenue Code of 1954 and its amendments. Supplementary Payments We will pay in addition to the applicable Limits of Insurance with respect to any claim we investi gate or settle or A. All expenses incurred by us all costs taxed against the insured in any suit defended by us and all interest on the full amount of any judgment which accrues after entry of the judgment and before we have paid or tendered or deposited in court that part of the judgment which does not exceed the limit of our insur ance. B. Premiums on appeal bonds required and on bonds to release attachments in any suit. We do not have to furnish these bonds. C. All reasonable expenses incurred by the in sured at our request to us in the investi gation or defense of the claim or suit in cluding actual loss of earnings up to 250 a day because of time off from work. D. Prejudgment interest awarded against the in sured 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 in terest based on that period of time after the of fer. I Limits of Insurance A. B. The Limits of Insurance shown in the Declarations and the rules below establish the most we will pay regardless of the number of 1 Insureds 2 Claims made or suits brought or 3 Employees or dependents or beneficiaries of employees making claims or bringing s The Aggregate Limit is the most we will pay for all damages because of all claims or suits arising from the administration of your employee benefit programs during the policy period. C. Subject to the Aggregate Limit provisions in B. above the Each Claim Limit is the most we will pay for all damages sustained by any one em ployee including the employee s dependents and beneficiaries because of acts errors or omissions committed in the administration of your em ployee benefit programs.. The limits of this Coverage Part apply separately to each consecutive annual period and to any remain ing period of less than 12 months starting with the beginning of the policy period shown in the Decla rations unless the policy period is extended after is suance 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 pur poses of determining the Limits of Insurance. ML Conditions A. Bankruptcy Bankruptey or insolvency of the insured or the in sured s estate will not relieve us of our obligations. Duties in the Event of an Act Error Omission Claim or Suit 1 Regardless of whether the loss exceeds any ap plicable deductible amount you mus that we are notified as soon as practicable of any act error or omi n which may result in aclaim. To the extent possible notice should include a. How when and where the act error or omission took place b. The names and addresses of any injured employee dependents or beneficiaries of any employec and witnes Notice of an act error or omission is not notice of a claim. 2 If a claim is received by any insured you must a. Immediately record the specifics of the claim and the date received and b. Notify us as soon as practicable. You must see to it that we receive written no tice of the claim as soon as practicable. 3 You and any other involved insured must a. Immediately send us copies of any de mands notices summonses or legal papers received in connection with the claim or suit b. Authorize us to obtain records and other information U GL849 B CW 804 Page2of 4
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I Cooperate with us in the investigation set tlement or defense of the claim or suit and d. Assist us upon our request in the en forcement of any right against any person or organization which may be liable to the insured because of injury to which this in surance may also apply. 4 No insureds will except at their own cost vol untarily make a payment assume any obliga tion or incur any expense without our consent. Legal Action Against Us No person or organization has a right 1 To join us as a party or otherwise bring us into a suit asking for damages from an insured or 2 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 obtained after an actual trial 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. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this Cov erage Part our obligations are limited as follows 1 Primary Insurance surance is primary except when 2. below If this insurance is primary our obli s are not affected unless any of the other rance is also primary. Then we will share with all that other insurance by the method de scribed in 3. below. 2 Excess Insurance This insurance is excess over any other insur ance whether primary excess contingent or on any other basis that is effective prior to the be ginning of the policy period shown in the Dec larations of this insurance and applies to an act on on other than a claims made No Retroactive Date is shown in the Dec larations of this insurance or b. The other insurance has a policy period which continues after the Retroactive Date if any shown in the Declarations of this insurance. When this insurance is excess we will have no duty to defend any claim or suit that any other insurer has a duty to defend. If no other insurer defends we will undertake to do so but we will be entitled to the insured s rights against all those other insurers. When this insurance is excess over other insur ance we will pay only our share of the amount of the loss if any that exceeds the sum of i. The total amount that all such other insur ance would pay for the loss in the absence of this insurance and ii. The total of all deductible and self insured amounts under all that other insurance. 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. 3 Method of Sharing If all of the other insurance permits contribu tion by equal shares we will follow this method also. Under this approach each insurer con tributes equal amounts until it has paid its ap plicable limit of insurance or none of the I 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. E. 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 in surance applies 1 As if each Named Insured were the only Named Insured and 2 Separately to cach insured against whom claim is made or suit is brought. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we 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. IV. Definitions U GL849 B CW 804 Page 3of 4
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G. H. 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 1 Notices that are published include material placed on the Internet or on similar electronic means of communication and 2 Regarding web sites only that part of a web site that is about your goods products or ser vices for the purposes of attracting customers or supporters is considered an advertisement. Administration mea 1 Counseling employees including their de pendents and beneficiaries with respect to employee benefit programs 2 Handling recor benefit programs s in connection with employee or 3 Effecting or terminating an employee s par ticipation in a plan included in employee benefit programs. Bodily injury means bodily injury sickness or dis ease sustained by a person including death result ing from any of these at any time. Claim means The receipt by you of a demand for money or ser vices which alleges an act error or omission in the administration of your employee benefit pro grams. Coverage territory means 1 The United States of America including its territories and possessions Puerto Rico and Canada or 2 All parts of the world if the insured s respon sibility to pay ddmdge determined in a suit s in the territory described in E. 1 above or in a settlement to which we agree. Your officers and employees whether actively em ployed disabled or retired. Employee benefit programs mean Group life insurance group accident or health in surance profit sharing plans pension plans em ployee stock subscription plans workers compens tion unemployment insurance salary continuation plans social security disability benefits insurance savings plans vacation plans or any other similar plans or programs. Insured You and any of your partners executive officers di rectors members stockholders or employees provided such employee is authorized to act in the administration of your employee benefit pro grams. Personal and advertising injury means Injury including consequential bodily injury aris ing out of one or more of the following offens 1 False arrest detention or imprisonment 2 Malicious prosecution 3 The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person oc cupies by or on behalf of its owner landlord or lessor 4 Oral or written publication in any manner of material that slanders or libels a person or or ganization or disparages a person s or organi zation s goods products or services or 5 Oral or written publication in any manner of material that violates a person s right of pri vacy 6 The use of another s advertising idea in your advertisement or 7 Infringing upon another s copyright trade dress or slogan in your advertisement. Property damage means 1 Physical injury to tangible property including all resulting loss of use of that property. 2 Loss of use of tangible property that is not physically injured. For the purposes of this insurance electronic data is not tangible property. As used in this definition electronic data means in formation facts or programs stored as or on cre ated or used on or transmitted to or from computer software including systems and applications soft ware hard or floppy disks CD ROMS tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. Suit means A civil proceeding in which damages to which this insurance applies is alleged. Suit includes 1 An arbitration proceeding in which such dam ages are claimed and to which you must submit or do submit with our consent or 2 Any other alternative dispute resolution pro ceeding in which such damages are claimed and to which you submit with our consent. U GL849 B CW 804 Pagedof 4
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EMPLOYEE BENEFIT LIABILITY COVERAGE PART CLAIMS MADE DECLARATIONS Policy Number GLO 6555467 04 Named Insured FIRSTSERVICE CORPORATION Policy Period Coverage begins 10 25 2013 at1201 AM Coverage ends 10 25 2014 at1201 AM Producer Name LOCKTON COMPANIES LLC Producer No. 37385 000 Item 1. Limits of Insurance 1000000 Aggregate Limit 1000000 Each Claim Limit Item 2. Form of Business Individual Parnership Joint Venture X Corporation Other Item 3. Premium Schedule Code No. Premium Basis Rate Advance Premium Estimated Number of Employees Per Employee Flat Charge Total Advance Premium For This Coverage Part Audit Period X Annual Semi annual Quarterly Monthly Forms And Endorsements Applicable To This Coverage Part SEE SCHEDULE OF FORMS AND ENDORSEMENTS Joint Venture X Corporation Advance Premium Retroactive Date 10252002 Enter date or None if no Retroactive Date applies This insurance does not apply to damages caused by an act error or omission which occurred before the Retroac tive Date if any shown above. U GL D849 B CW 904 Page Lof
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Policy Number GLO 6555467 04 SCHEDULE OF FORMS AND ENDORSEMENTS Zurich American Insurance Company Named Insured FIRSTSERVICE CORPORATION Effective Date 10 25 13 1201 A.M. Standard Time Agent Name LOCKTON COMPANIES LLC Agent No. 37385 000 COMMON GENERAL LIABILITY FORMS AND ENDORSEMENTS U GU319 F IMPORTANT NOTICE IN WITNESS CLAUSE U GL D1115 B CW COMMERCIAL GL COVERAGE PART DECLARATIONS U GL849 B CW EMPLOYEE BENEFITS LIABILITY CLAIMS MADE U GL D849 B CW EMPLOYEE BENEFITS LIAB DEC CLAIMS MADE U GU619 A CW SCHEDULE OF FORMS AND ENDORSEMENTS INSTALLMENT PREMIUM SCHEDULE NAMED INSURED BROAD FORM NAMED INSURED POOL CLEANING AND MAINTENANCE COVERAGE DESIGNATED ENTITY EXCLUSION DEDUCTIBLE ENDORSEMENT DISCLOSURE OF IMPORTANT INFO REL TO TRIA COMMERCIAL GENERAL LIABILITY COV FORM LEAD LIABILITY EXCLUSION U GL1055 A CW BODILY INJURY REDEFINED UGL1171ACW FUNGI OR BACTERIA EXCLUSION U GL1177 C CW ADDL INS OWNR LESSE CONTR SCHED PERS ORG U GL1178ACW ASBESTOS EXCLUSION ENDORSEMENT U GL1446 A FL NOTIFICATION TO OTHERS OF CANCELLATION U GL1517 A CW COLLCTN OR DISTRB OF MATRL OR INFO EXCL U GL872 B PREMIUM REPORTS AGREEMENT COMP RATED U GL915 C FELLOW EMPLOYEE COVERAGE ENDORSEMENT U GL920 A NONOWNED WATERCRAFT COVERAGE ENDT U GL921 A AMENDMENT OF REPRESENTATIONS CONDITION U GL922 B NOTICE OF ERROR IN CLAIM REPORTING ENDT U GL923 B SILICA OR SILICA MIXED DUST EXCLUSION U GL925 B WAIVER OF SUBROGATION BLANKET ENDT. U GU1016 A CW KNOWLEDGE BY POSITION OR DEPARTMENT FL CHANGES CANCELLATION NONRENEWAL ELECTRONIC DATA LIABILITY ENDORSEMENT ADDL INSD CONTROLLING INT ADDL INSD OWNERS LESSEES OR ADDL INSD MANAGERS LESSORS OF PREMISES ADDL INSD MORTGAGEE ASSIGNEE OR RECEIVER ADDL INSD OWNERS LESSEES CONTR COMP OPS EMPLOYMENT RELATED PRACTICES EXCLUSION AMEND LIQUOR LIABILITY SCHED ACTIVITY TOTAL POLLUTION EXCL WITH EXCEPTIONS PESTICIDE OR HERBICIDE APPLC COV WAIVER OF TRANSFER RIGHTS OF RECOVERY DESIGNATED CONSTRUCTION PROJECTS GENERAL CALCULATION OF PREMIUM COMMON POLICY CONDITIONS NUCLEAR ENERGY LIABILITY EXCLUSION ENDT FL DISCLOSURE IMPORTANT INFO REL TO TRIA CANCELLATION BY US CAP ON LOSSES FROM CERTIFIED ACTS OF TER U GU619 A CW 10 02 SCHEDULE OF FORMS AND ENDOF Zurich American Insurance GLO 6555467 04 F FORMS AND ENDORSEMENTS ican Insurance Company N Effective Date 10 25 1 1201 A.M. Standard Tin OMMON GRENBRAL LIADBILILY PFPOUORMo AND BNDUROBRMENILIOS GU319 GL D1115 B CW F GL849 B CW GL D849 B CW GU619 A CW GU406 A GL1114 A CW GL1114 A CW GL1114 A CW GL1114 A CW GL1114 A CW GU630 C G 00 01 GL1016 B CW L1055 A CW GL1171ACW GL1177 C CW GL1178ACW GL1446 A FL GL1517 A CW GL872 GL915 GL920 GL921 GL922 GL923 GL925 B C A A B B B GU 1016 A CW 02 frraaoOOOa 0 nne IS o IMPORTANT NOTICE IN WITNESS CLAUSE COMMERCIAL GL COVERAGE PART DECLARATIONS EMPLOYEE BENEFITS LIABILITY CLAIMS MADE EMPLOYEE BENEFITS LIAB DEC CLAIMS MADE SCHEDULE OF FORMS AND ENDORSEMENTS INSTALLMENT PREMIUM SCHEDULE NAMED INSURED BROAD FORM NAMED INSURED POOL CLEANING AND MAINTENANCE COVERAGE DESIGNATED ENTITY EXCLUSION DEDUCTIBLE ENDORSEMENT DISCLOSURE OF IMPORTANT INFO REL TO TRIA COMMERCIAL GENERAL LIABILITY COV FORM LEAD LIABILITY EXCLUSION U BODILY INJURY REDEFINED FUNGI OR BACTERIA EXCLUSION ADDL INS OWNR LESSE CONTR SCHED PERS ORG ASBESTOS EXCLUSION ENDORSEMENT NOTIFICATION TO OTHERS OF CANCELLATION COLLCTN OR DISTRB OF MATRL OR INFO EXCL PREMIUM REPORTS AGREEMENT COMP RATED FELLOW EMPLOYEE COVERAGE ENDORSEMENT NONOWNED WATERCRAFT COVERAGE ENDT AMENDMENT OF REPRESENTATIONS CONDITION NOTICE OF ERROR IN CLAIM REPORTING ENDT SILICA OR SILICA MIXED DUST EXCLUSION WAIVER OF SUBROGATION BLANKET ENDT. KNOWLEDGE BY POSITION OR DEPARTMENT FL CHANGES CANCELLATION NONRENEWAL ELECTRONIC DATA LIABILITY ENDORSEMENT ADDL INSD CONTROLLING INT ADDL INSD OWNERS LESSEES OR ADDL INSD MANAGERS LESSORS OF PREMISES ADDL INSD MORTGAGEE ASSIGNEE OR RECEIVER ADDL INSD OWNERS LESSEES CONTR COMP OPS EMPLOYMENT RELATED PRACTICES EXCLUSION AMEND LIQUOR LIABILITY SCHED ACTIVITY TOTAL POLLUTION EXCL WITH EXCEPTIONS PESTICIDE OR HERBICIDE APPLC COV WAIVER OF TRANSFER RIGHTS OF RECOVERY DESIGNATED CONSTRUCTION PROJECTS GENERAL CALCULATION OF PREMIUM COMMON POLICY CONDITIONS NUCLEAR ENERGY LIABILITY EXCLUSION ENDT FL DISCLOSURE IMPORTANT INFO REL TO TRIA CANCELLATION BY US CAP ON LOSSES FROM CERTIFIED ACTS OF TER
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INSTALLMENT PREMIUM SCHEDULE The total premium shown in the Declarations of this policy is made payable in installments on the dates and in the amount shown below. NAMED INSURED POLICY NUMBER FIRSTSERVICE CORPORATION GLO 6555467 04 PAYMENT STANDARD TAXES TOTAL PREMIUM PREPAID PREMIUM 102513 012514 042514 072514 TOTAL 163473 Failure to pay the Installment Premium by the Date Due shown shall constitute non pay ment of premium for which we may cancel this policy. U GUA406 A 0794 PAGE 1 OF 1 YMENT STANDARD TAXES TOTAL IE PREMIUM PREPAID PREMIUM 2513 B 40869.00 B 2125.00 B 42994.00 12514 B 40868.00 B 40868.00 12514 B 40868.00 B 40868.00 12514 B 40868.00 B 40868.00 DTAL B 163473.00 B 2125.00 B 165598.00 2125.00
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Policy Number GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY Named Insured FIRSTSERVICE CORPORATION Effective Date 10 25 13 1201 A.M Standard Time Agent Name LOCKTON COMPANIES LLC Agent No. 37385 000 NAMED INSURED FIRSTSERVICE CORPORATION GROWERS NOMADS INC FIRSTSERVICE USA INC DELAWARE FIRSTSERVICE CAM HOLDINGS INC DELAWARE FIRSTSERVICE CONTINENTAL HOLDINGS INC FIRSTSERVICE DELAWARE CAM INC DELAWARE FIRSTSERVICE ADMINISTRATION GP FIRSTSERVICE DELAWARE LP FIRSTSERVICE RESIDENTIAL MANAGEMENT INC SERVICE AMERICA ENTERPRISES INC FIRSTSERVICE DELAWARE LLC CONTINENTAL DISTINCTIVE HOSPITALITY LLC FSR DISTINCTIVE LIFESTYLE INC FSR SIMPLIKATE SYSTEMS LLC FIRSTSERVICE RESIDENTIAL TECHNOLOGIES INC THE CONTINENTAL GROUP INC PAUL DAVIS RESTORATION INC HOME INSPECTION SYSTEMS OF GEORGIA INC TENANTACCESS INC WELLINGTON REALTY INC ATTWOOD PHILLIPS INC CHIPCO INC CONTINENTAL PAINTING WATERPROOFING RESTORATION INC EMERALDSHORES SERVICES INC GRANDSHORES MANAGEMENT GROUP INC LUKE BROTHERS INC LUKE S LANDSCAPING INC PRIME MANAGEMENT GROUP LLC PRIME PEST CONTROL INC PRIME REALTY ASSOCIATES INC STERLING FIN MGMT INC VISTA COMMERCIAL PROPERTIES INC VISTA PROPERTIES MANAGEMENT LLC VISTA PROPERTIES RENTALS SALES INC CALIFORNIA CLOSET COMPANY INC CERTAPRO PAINTERS LTD PDRI HOLDINGS INC PILLAR TO POST INC TFC S9 INC THE FRANCHISE COMPANY US INC CAM 1 PARTNERS INC FNA GRS INC API SERVICES BLUE DISTINCTIVE HOSPITALITY DISTINCTIVE LIFESTYLE EUOPEAN DISTINCTIVE HOSPITALITY L L 1 LIFESTYLE LIFESTYLE ONE ALL FLORIDA PEST CONTROL LUKES SAWGRASS LANDSCAPE ALL FLORIDA PEST CONTROL AND FERTILIZATION PAUL DAVIS RESTORATION PAUL DAVIS RESTORATION AND REMODELING PREMIER TNTERIORS U GL1114 A CW 1002 e P GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY FIRSTSERVICE CORPORATION IRSTSERVICE CORPORATION ROWERS NOMADS INC IRSTSERVICE USA INC DELAWARE IRSTSERVICE CAM HOLDINGS INC DELAWARE IRSTSERVICE CONTINENTAL HOLDINGS INC IRSTSERVICE DELAWARE CAM INC DELAWARE IRSTSERVICE ADMINISTRATION GP IRSTSERVICE DELAWARE LP IRSTSERVICE RESIDENTIAL MANAGEMENT INC ERVICE AMERICA ENTERPRISES INC IRSTSERVICE DELAWARE LLC ONTINENTAL DISTINCTIVE HOSPITALITY LLC FSR ISTINCTIVE LIFESTYLE INC FSR IMPLIKATE SYSTEMS LLC IRSTSERVICE RESIDENTIAL TECHNOLOGIES INC HE CONTINENTAL GROUP INC AUL DAVIS RESTORATION INC OME INSPECTION SYSTEMS OF GEORGIA INC ENANTACCESS INC ELLINGTON REALTY INC TTWOOD PHILLIPS INC HIPCO INC ONTINENTAL PAINTING WATERPROOFING RESTORATION MERALDSHORES SERVICES INC RANDSHORES MANAGEMENT GROUP INC UKE BROTHERS INC UKE S LANDSCAPING INC RIME MANAGEMENT GROUP LLC RIME PEST CONTROL INC RIME REALTY ASSOCIATES INC TERLING FIN MGMT INC ISTA COMMERCIAL PROPERTIES INC ISTA PROPERTIES MANAGEMENT LLC ISTA PROPERTIES RENTALS SALES INC ALIFORNIA CLOSET COMPANY INC ERTAPRO PAINTERS LTD DRI HOLDINGS INC ILLAR TO POST INC FC 59 INC HE FRANCHISE COMPANY US INC AM 1 PARTNERS INC FNA GRS INC PI SERVICES LUE DISTINCTIVE HOSPITALITY ISTINCTIVE LIFESTYLE UROPEAN DISTINCTIVE HOSPITALITY 1 1 LIFESTYLE IFESTYLE ONE LL FLORIDA PEST CONTROL UKES SAWGRASS LANDSCAPE LL FLORIDA PEST CONTROL AND FERTILIZATION AUL DAVIS RESTORATION ATIT. DAVTS RFCTORATTON AND REMODFET.TNC INC
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Policy Number GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY Named Insured FIRSTSERVICE CORPORATION Effective Date 10 25 13 1201 A.M. Standard Time Agent Name LOCKTON COMPANIES LLC Agent No. 37385 000 NAMED INSURED SIGNATURE PD PROFESSIONAL CLEANING PRIME MANAGEMENT OF JUPITER PRIME SERVICES CITY WIDE AIR CONDITIONING AND APPLIANCE SERVICE CITY WIDE MECHANICAL SILVER PLUMBING AND SEWER SERVICE STERLING MANAGEMENT SERVICES ARISTA MANAGEMENT GROUP SOUTH PREMIER PROPERTY SERVICES PRIME MANAGEMENT GROUP WELLINGTON MANAGEMENT VISTA PROPERTIES MANAGEMENT VISTA COMMERCIAL PROPERTIES FIRSTSERVICE RESIDENTIAL REALTY FLORIDA CPWR INC GRS INC FIRSTMANAGEMENT PARTNERS INC MCD SPRINKLERS INC CONTINENTAL ASSOCIATION MANAGEMENT INC CONTINENTAL LANDSCAPING LAWN MAINTENANCE INC AQUA SHIELD CORP CITY WIDE AIR CONDITIONING AND APPLIANCE SERVICE INC DICKINSON MANAGEMENT INC PRIME MANAGEMENT INC PRIME SERVICES INC TCG 2002 INC SAWGRASS LANDSCAPE SERVICES LLC PAUL W. DAVIS SYSTEMS INC TFC 1102 INC THE FRANCHISE DEVELOPMENT CENTER INC DONEAGAIN INC DVSS HOLDINGS INC FIRSTSERVICE CONTINENTAL INC FIRSTSERVICE RESIDENTIAL REALTY LLC THE CONTINENTAL GROUP LTD U GL1114 A CW 1002 e P GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY FIRSTSERVICE CORPORATION IGNATURE PD PROFESSIONAL CLEANING RIME MANAGEMENT OF JUPITER RIME SERVICES ITY WIDE AIR CONDITIONING AND APPLIANCE SERVICE ITY WIDE MECHANICAL ILVER PLUMBING AND SEWER SERVICE TERLING MANAGEMENT SERVICES RISTA MANAGEMENT GROUP SOUTH REMIER PROPERTY SERVICES RIME MANAGEMENT GROUP ELLINGTON MANAGEMENT ISTA PROPERTIES MANAGEMENT ISTA COMMERCIAL PROPERTIES IRSTSERVICE RESIDENTIAL REALTY FLORIDA PWR INC RS INC TRSTMANAGEMENT PARTNERS INC CD SPRINKLERS INC ONTINENTAL ASSOCIATION MANAGEMENT INC ONTINENTAL LANDSCAPING LAWN MAINTENANCE INC QUA SHIELD CORP ITY WIDE AIR CONDITIONING AND APPLIANCE SERVICE ICKINSON MANAGEMENT INC RIME MANAGEMENT INC RIME SERVICES INC CG 2002 INC AWGRASS LANDSCAPE SERVICES LLC AUL W. DAVIS SYSTEMS INC FC 1102 INC HE FRANCHISE DEVELOPMENT CENTER INC ONEAGAIN INC VSS HOLDINGS INC IRSTSERVICE CONTINENTAL INC IRSTSERVICE RESIDENTIAL REALTY LLC HE CONTINENTAL GROUP LTD INC
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Policy Number GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY Named Insured FIRSTSERVICE CORPORATION Effective Date 10 25 13 1201 A.M. Standard Time Agent Name LOCKTON COMPANIES LLC Agent No. 37385 000 NAMED INSURED SILVER PLUMBING OOPSA DAISY NURSERY PARADISE LANDSCAPE MAINTENANCE CONCEPT MANAGEMENT SAWGRASS LANDSCAPE SERVICES SHERWOOD FOREST ARBOR CARE SHERWOOD FOREST TREE SERVICE PREMIER LANDSCAPE SERVICES PRIME MANAGEMENT PLUMBING CEDARWOOD LANDCARE CONTINENTAL FRONT DESK SERVICE CONTINENTAL LANDSCAPING AND LAWN MAINTENANCE EAST COAST ORNAMENTAL CARE GLEN MANAGEMENT SERVICES IRRIGATION TECH PRIME PEST CONTROL PRIME PROPERTY SERVICES SOUTH FLORIDA POOL SERVICE SUNSHINE LANDSCAPE SUNSHINE LANDSCAPE GROUP CONTINENTAL BUILDING RENOVATION SERVICES CONTINENTAL PROPERTY SERVICES CONTINENTAL MERIT PROPERTY MANAGEMENT FLOWER POWER NURSERIES SUNSHINE INDUSTRIES OF C.S. CONTINENTAL GROUP BUILDING AND RENOVATION SERVICES DIVISION FLOWER POWER INDUSTRIES PAUL DAVIS SYSTEMS CONTINENTAL PAINTING WATERPROOFING RESTORATION CONTINENTAL PROPERTY SERVICE DINSTINCTIVE LIFESTYLES AQUA TECH MCD SPRINKLERS U GL1114 A CW 1002 e P GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY FIRSTSERVICE CORPORATION ILVER PLUMBING OPSA DAISY NURSERY ARADISE LANDSCAPE MAINTENANCE ONCEPT MANAGEMENT AWGRASS LANDSCAPE SERVICES HERWOOD FOREST ARBOR CARE HERWOOD FOREST TREE SERVICE REMIER LANDSCAPE SERVICES RIME MANAGEMENT PLUMBING EDARWOOD LANDCARE ONTINENTAL FRONT DESK SERVICE ONTINENTAL LANDSCAPING AND LAWN MAINTENANCE AST COAST ORNAMENTAL CARE LEN MANAGEMENT SERVICES RRIGATION TECH RIME PEST CONTROL RIME PROPERTY SERVICES OUTH FLORIDA POOL SERVICE UNSHINE LANDSCAPE UNSHINE LANDSCAPE GROUP ONTINENTAL BUILDING RENOVATION SERVICES ONTINENTAL PROPERTY SERVICES ONTINENTAL MERIT PROPERTY MANAGEMENT LOWER POWER NURSERIES UNSHINE INDUSTRIES OF C.S. ONTINENTAL GROUP BUILDING AND RENOVATION SERVICES DIVISION LOWER POWER INDUSTRIES AUL DAVIS SYSTEMS ONTINENTAL PAINTING WATERPROOFING RESTORATION ONTINENTAL PROPERTY SERVICE INSTINCTIVE LIFESTYLES QUA TECH CD SPRINKLERS
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Policy Number GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY Named Insured FIRSTSERVICE CORPORATION Effective Date 10 25 13 1201 A.M. Standard Time Agent Name LOCKTON COMPANIES LLC Agent No. 37385 000 BROAD FORM NAMED INSURED ANY SUBISIDIARY COMPANY AS NOW FORMED OR CONSTITUTED AND ANY OTHER COMPANY OVER WHICH THE NAMED INSURED HAS ACTIVE CONTROL SO LONG AS THE NAMED INSURED OR ANY SUBSIDIARY COMPAY HAS AN OWNERSHIP INTEREST OF MORE THAN 50 OF SUCH COMPANY. U GL1114 A CW 1002 e P GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY FIRSTSERVICE CORPORATION NY SUBISIDIARY COMPANY AS NOW FORMED OR CONSTITUTED AND ANY OTHER OMPANY OVER WHICH THE NAMED INSURED HAS ACTIVE CONTROL SO LONG AS HE NAMED INSURED OR ANY SUBSIDIARY COMPAY HAS AN OWNERSHIP INTEREST F MORE THAN 50 OF SUCH COMPANY.
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Policy Number GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY Named Insured FIRSTSERVICE CORPORATION Effective Date 10 25 13 1201 A.M. Standard Time Agent Name LOCKTON COMPANIES LLC Agent No. 37385 000 POOL CLEANING AND MAINTENANCE COVERAGE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE COMMERCIAL GENERAL LIABILITY COVERAGE PART A. THE FOLLOWING LANGUAGE IS ADDED TO PARAGRAPH 1 D OF EXCLUSION F. OF SECTION I COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY SOLELY WITH RESPECT TO THIS ENDORSEMENT THE FOLLOWING IS ADDED TO PARAGRAPH 4 B 1 A OF THE OTHER INSURANCE CONDITION OF SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS IF THE LOSS ARISES OUT OF THE CHEMICALS COMMONLY USED IN POOL CLEANING AND MAINTENANCE. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. U GL1114 A CW 1002 e P GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY FIRSTSERVICE CORPORATION HIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE OMMERCIAL GENERAL LIABILITY COVERAGE PART THE FOLLOWING LANGUAGE IS ADDED TO PARAGRAPH 1 D OF EXCLUSION F. OF SECTION I COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY SOLELY WITH RESPECT TO THIS ENDORSEMENT THE FOLLOWING IS ADDED TO PARAGRAPH 4 B 1 A OF THE OTHER INSURANCE CONDITION OF SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS IF THE LOSS ARISES OUT OF THE CHEMICALS COMMONLY USED IN POOL CLEANING AND MAINTENANCE. LL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.
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Policy Number GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY Named Insured FIRSTSERVICE CORPORATION Effective Date 10 25 13 1201 A.M. Standard Time Agent Name LOCKTON COMPANIES LLC Agent No. 37385 000 DESIGNATED ENTITY EXCLUSION THIS INSURANCE DOES NOT APPLY TO BODILY INJURY PROPERTY DAMAGE OR PERSONAL AND ADVERTISING INJURY ARISING OUT OF THE FOLLOWING ENTITIES ANY NAMED INSURED OR ANY SUBSIDIARY COMPANY THAT HAS OWNERSHIP INTEREST OF 50 OR MORE AND COVERED ELSEWHERE WILL NOT BE COVERED UNDER THIS POLICY. REGARDLESS OF OTHER INSURANCE LIMITS AND COVERAGE THIS POLICY WILL NOT BE PRIMARY EXCESS CONTINGENT NOR CONTRIBUTE ON ANY OTHER BASIS. THIS EXCLUSION DOES NOT APPLY FOR NEWLY ACQUIRED ENTITIES UP TO 90 DAYS FOR WHICH THERE IS OWNERSHIP INTEREST OF 50 OR MORE. U GL1114 A CW 1002 e P GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY FIRSTSERVICE CORPORATION HIS INSURANCE DOES NOT APPLY TO BODILY INJURY PROPERTY DAMAGE R PERSONAL AND ADVERTISING INJURY ARISING OUT OF THE FOLLOWING NTITIES NY NAMED INSURED OR ANY SUBSIDIARY COMPANY THAT HAS OWNERSHIP NTEREST OF 50 OR MORE AND COVERED ELSEWHERE WILL NOT BE COVERED NDER THIS POLICY. REGARDLESS OF OTHER INSURANCE LIMITS AND OVERAGE THIS POLICY WILL NOT BE PRIMARY EXCESS CONTINGENT NOR ONTRIBUTE ON ANY OTHER BASIS. HIS EXCLUSION DOES NOT APPLY FOR NEWLY ACQUIRED ENTITIES UP TO 90 AYS FOR WHICH THERE IS OWNERSHIP INTEREST OF 50 OR MORE.
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Policy Number GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY Named Insured FIRSTSERVICE CORPORATION Effective Date102513 1201 A.M. Standard Time Agent Name LOCKTON COMPANIES LLC Agent No.37 385 000 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the COMMERCIAL GENERAL LIABILITY DEDUCTIBLE ENDORSEMENT This endorsement applies between you and us. You will reimburse us for deductible amounts that we pay on your behalf. This endorsement will remain in effect on renewals of this policy unless specifically not made a part of such or replaced by a similar endorsement. This endorsement and its individual sections which include Deductible Amounts How This These Deductibles Apply ies Effect of Deductibles On Limits of Liability Definitions and Conditions apply only with respect to the deductibles which are the subject of this endorsement. SCHEDULE Coverage Deductible Amount Basis Bodily Injury and Property Damage Liability Coverage. All persons or organization 1000000 occurrence Bodily Injury and Property Damage Liability Coverage. Any one person or organization claim Personal and Advertising Injury Liability Coverage 3 By offense Any one person or organization 1000000 claim Coverage 3 Medical Payments 1000000 accident Employee Benefits Liability Coverage Any one person or organization 1000000 claim Other Coverage by FIRE DAMAGE 1000000 FIRE ALLOCATED LOSS ADJUSTMENT EXPENSE ALAE Select one As respects each occurrence each claim or each accident as applicable all ALAE is Option 1. reimbursed in addition to the Deductible Amount. ENDORSEMEN ZURICH AMERICA GLO 6555467 04 ENDORSEMENT ZURICH AMERICAN INSURANCE COMPANY amed Insured FIRSTSERVICE CORPORATION Effective Date102513 1201 A.M. Standard Time gent Name LOCKTON COMPANIES LLC Agent No.37 385 000 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 1is endorsement modifies insurance provided under the COMMERCIAL GENERAL LIABILITY DEDUCTIBLE ENDORSEMENT lis endorsement applies between you and us. You will reimburse us for deductible amounts that we pay on your behalf. This dorsement will remain in effect on renewals of this policy unless specifically not made a part of such or replaced by a similar dorsement. SUULUDIS S W LTS VT Labiiity LeTTItoNS alid LOTIAITVTS apply Ofily Willl Tespetl 10 THe GeuutiivVies Wil ale vle subjett VT ulis dorsement. overage A. overage A. overage B. overage C. verage ther Coverage by lect one ption 1. SCHEDULE Coverage Bodily Injury and Property Damage Liability All persons or organization Bodily Injury and Property Damage Liability Any one person or organization Personal and Advertising Injury Liability By offense Any one person or organization Medical Payments Employee Benefits Liability Any one person or organization FIRE DAMAGE ALLOCATED LOSS ADJUSTMENT EXPENSE ALAE 1000000 1000000 1000000 1000000 1000000 each each each each each each Deductible Amount Basis occurrence claim claim accident claim FIRE As respects each occurrence each claim or each accident as applicable all ALAE is reimbursed in addition to the Deductible Amount. SCHEDULE Deductible Amount Basis each occurrence U GL1114 A CW 1002
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