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Extended Reporting Period Amendatory Endorsement Policy No. Exp. Date of Pol. Eff. Date of End Agency No. Addl. Prem. I Return Prem. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the Employee Benefits Liability Coverage Part L The policy is amended to add the following Extended Reporting Period for the reporting of claims 1 We will provide one or more Extended Reporting Periods as described below if a. This Coverage Part is canceled or not re newed or b. We renew or replace this Coverage Part with insurance that 1 Has a Retroactive Date later than the date shown in the Declarations of this Coverage Part or 2 Does not apply to acts errors or omissions from the administration of employee benefit programs on a claims made ba sis. A basic Extended Reporting Period is automati cally provided without additional charge. This pe riod starts with the end of the policy period and lasts for a. One year for claims arising out of an act er ror or omission reported to us not later than 60 days after the end of the policy period in ac cordance with Condition B. paragraph 1 of this Coverage Part or b. 60 days for all other claims. A Supplemental Extended Reporting Period of three years duration is available but only by an endorsement and for an extra charge. This sup plemental period starts a. One year after the end of the policy period for claims arising out of an act error or omission reported to us not later than 60 days after the end of the policy period in accordance with Condition B. paragraph 1 of this Coverage Part or b. 60 days after the end of the policy period for all other claims. You must give us written request for this endorse ment within 60 days after the end of the policy pe riod. The Supplemental Extended Reporting Pe riod will not go into effect unless you pay the addi tional premium promptly when due. The additional premium will not exceed 200 of the annual pre mium for this Coverage Part. The endorsement shall set forth the terms not in consistent with this Section applicable to the Sup plemental Extended Reporting Period including a provision to the effect that the insurance afforded for claims first received during such period is ex cess over any other valid and collectible insurance available under policies in force after the Supple mental Extended Reporting Period starts. Extended Reporting Periods do not extend the pol icy period or change the scope of coverage pro vided. They apply only to claims for act errors or omissions that occur before the end of the policy period but not before the Retroactive Date if any shown in the Declarations. Claims for such injury or damage which are first received and recorded during the basic Extended Reporting Period or during the Supplemental Ex tended Reporting Period if it is in effect will be deemed to have been made on the last day of the policy period. Once in effect Extended Reporting Periods may not be canceled. Extended Reporting Periods do not reinstate or in crease the Limits of Insurance applicable to any claim to which this Coverage Part applies. All other terms and conditions remain unchanged. U GL878 A CW 1296 Page lof
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AIDS Exclusion Policy No. Eff. Date of Pol Exp. Date of Pol. Eff. Date of End. Producer Addl Prem. Return Prem. 06012021 06012022 37385000 S INCL S THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the Commercial General Liability Coverage Part 1. The following exclusion is added to 2. Exclusions of Section I Coverage A Bodily Injury and Property Damage Liability This insurance shall not apply to AIDS Bodily injury or property damage ai g out of any actual alleged latent or threatened infection communication contagion or development of or contamination by AIDS.. The following exclusion is added to 2. Exclusions of Section I Coverage B Personal and Advertising Injury Liability This insurance shall not apply to AIDS Personal and advertising injury arising out of any actual alleged latent or threatened infection communication conta gion or development of or contamination by AIDS.. For purposes of this exclusion the following additional definition applies AIDS means any one or more of the following A. Human T cell Leukemia Virus HTLV B. Human Immunodeficiency Virus HIV C. Acquired Immune Deficiency Syndrome AIDS D. AIDS related complex ARC or any disease or condition arising out of or associated with any of these. U GL908 BCW 804 Page Lof
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Z ZURICH Claim Series Endorsement Policy No. EIf. Date of Pol. Exp. Date of Pol. EIf. Date of End. Producer Addl Prem Return Prem. GLO 4845817 02 06012021 06012022 37385000 INCL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the Commercial General Liability Coverage Part Section L. Coverage A Bodily Injury and Property Damage is amended to include the following All occurrences which result in a series of claims or suits that the insured becomes legally obligated to pay as damages because of bodily injury or property damage due to a common cause or condition of your products or your work shall be deemed to be just one occurrence regardless of the total number of a. insureds b. claims made or suits brought. persons or organizations making claims or bringing suits or d. potential occurrences that might otherwise have applied in the absence of this endorsement. The following additional Definition is added Common Cause or Condition means the same or similar design error omission or defect manufacturing defect or failure by the insured to warn of a potential hazard in or of your products or your work. U GL911 B CW 905 Page I of 1
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Electromagnetic Radiation Exclusion te of Pol. Exp. Date of Po Addl. Prem n Prem. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the Commercial General Liability Coverage Part 1. The following exclusion is added to 2. Exclusions of Section I Coverage A Bodily Injury and Property Damage Liabil ity This insurance shall not apply to Electromagnetic Radiation Any liability for bodily injury or property damage based upon or arising out of electromagnetic fields netic radiation or electromagnetism. electromag 2. The following exclusion is added to 2. Exclusions of Section L Coverage B Personal and Advertising Injury Liability This insurance shall not apply to Electromagnetic Radiation Any liability for personal and advertising injury based upon or arising out of electromagnetic fields electromagnetic radiation or electromagnetism. 3. For purposes of this exclusion the following definitions apply a. Electromagnetic fields means any field or force made up of associated electric and magnetic components b. Electromagnetic radiation means any succession of electromagnetic waves. Electromagnetism means magnetism developed by a current of electricity. U GL914 B CW 804 Page Lof
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Silica or Silica Mixed Dust Exclusion Policy No. EIf. Date of Pol. Exp. Date of Pol. EIf. Date of End. Producer Addl Prem Return Prem. GLO 4845817 02 06012021 06012022 37385000 INCL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the Commercial General Liability Coverage Part Products Completed Operations Liability Coverage Part The following additional exclusion is added to 2. Exclusions of Section I. Coverages 2. Exclusions This insurance does not apply to Silica or Silica Mixed Dust A. Bodily injury property damage or personal and advertising injury caused directly or indirectly in whole or in part by the actual alleged or threatened inhalation ingestion absorption exposure to existence of or presence of silica or L costs or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any manner responding to or assessing the effects of silica by any insured or by any other person or entity. For the purposes of this exclusion the following definition applies Silica means 1 Any form of crystalline or non crystalline amorphous silica silica particles silica compounds silica dust or silica mixed or combined with dust or other particles or 2 Synthetic silica including precipitated silica silica gel pyrogenic or fumed silica or silica flour. U GL923 B CW 604 Page 1 of Includes copyrighted material of Insurance Services Office Inc. with its permission.
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Waiver Of Subrogation Blanket Endorsement Policy No. EIf. Date of Pol. Exp. Date of Pol. EIf. Date of End. Producer Addl Prem Return Prem. GLO 4845817 02 06012021 06012022 37385000 INCL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the Commercial General Liability Coverage Part The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition If you are required by a written contract or agreement which is executed before a loss to waive your rights of recovery from others we agree to waive our rights of recovery. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. U GL925 B CW 1201 Page I of 1
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COMMERCIAL GENERAL LIABILITY CG 01230397 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INDIANA CHANGES POLLUTION EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Subparagraph. Pollution of Paragraph 2. Exclusions of Bodily Injury And Property Damage Liability Coverage Section I Coverages and to Paragraph 2. Exclusions of Personal And Advertising Injury Liability Coverage Section I Coverages or to any amendment to or replacement thereof This Pollution Exclusion applies whether or not such irritant or contaminant has any function in your business operations premises site or location. Page 1of 1 CG 012303 97 Copyright Insurance Services Office Inc. 1996
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COMMERCIAL GENERAL LIABILITY CG 013408 03 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MISSOURI CHANGES POLLUTION EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Subparagraph f. Pollution of Paragraph 2. Exclusions under Section Coverage A Bodily Injury And Property Damage Liability Coverage and to Subparagraph m. Pollution of Paragraph 2. Exclu sions under Section Coverage B Personal And Advertising Injury Liability or to any amendment to or re placement thereof This Pollution Exclusion applies even if such irritant or contaminant has a function in your business operations premises site or location. CG 01340803 ISO Properties Inc. 2003 Page 10f 1 m
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POLICY NUMBER GLO 4845817 02 POLICY NUMBER GLO 4845817 02 COMMERCIAL GENERAL LIABILITY CG01540413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. VERMONT CHANGES POLLUTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM OCCURRENCE VERSION SCHEDULE Pollution Liability Aggregate Limit 1000000 Information required to complete this Schedule if not shown above will be shown in the Declarations. CG01540413 A. The following is added to Section Coverages Coverage D Pollution Bodily Injury And Property Damage 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 included within the pollution liability hazard 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 Il Limits Of Insurance and 2 Our right and duty to defend end when we have used up the Pollution Liability Aggregate Limit in the payment of judgments or settlements. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A B and D. b. This insurance applies to bodily injuryand property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 The bodily injury or property damage occurs during the policy period and 3 A claim for damages because of the bodily injury or property damage is first made against any insured in accordance with Paragraph c. below during the policy period.. A claim by a person or organization seeking damages will be deemed to have been made at the earlier of the following times 1 When notice of such claim is received and recorded by any insured or by us whichever comes first or 2 When we make a settlement in accordance with Paragraph 1.a. above. All claims for damages because of bodily injury to the same person including damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury will be deemed to have been made at the time the first of those claims is made against any insured. All claims for damages because of property damage causing loss to the same person or organizaton as a result of an occurrence will be deemed to have been made at the time the first of those claims is made against any insured. Al claims for injury or damage arising out of a discharge release or escape of pollutants including all injury or damage arising out of all subsequent exposure of persons and property to such pollutants shall be deemed to have been made at the time the first of those claims is made against any insured. Insurance Services Office Inc. 2012 Page 1of 4 Page 1of 4
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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 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 or 2 That the insured would have in the absence of the contract or agreement. Workers Compensation And Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law. d. 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 1 Whether the insured may be liable as an employer or in any other capacity and 2 To any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. 14 e. 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 to claims against any insured that allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which resulted in 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 4 Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or 5 Bodily injury or property damage arising out of a The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definiton 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 b The operation of any of the machinery or equipment listed in Paragraph.2 or f3 of the definition of mobile equipment. Page 2 of 4 Insurance Services Office Inc. 2012 CG 01540413
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f. 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.. War Bodily injury or property damage however caused arising directly or indirectly out of 1 War including undeclared or civil war or 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. 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 2 Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you or 4 Personal property in the care custody or control of the insured. Paragraphs 3 and 4 of this exclusion do not apply to liability assumed under a sidetrack agreement. 3. Products Completed Operations Hazard Bodily injury or property damage included within the products completed operations hazard. j Statutory Or Regulatory Clean up Costs 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 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. k. Bodily Injury Or Property Damage Bodily injury or property damage which are covered under Coverage A Bodily Injury And Property Damage Liability. B. Supplementary Payments Coverages A And B is replaced by the following Supplementary Payments Coverages A B And D We will pay with respect to any claim we investigate or settle or any suit against an insured we defend 1. All expenses we incur. 2. 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. 3. 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. 2 4. 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. CG 01540413 Insurance Services Office Inc. 2012 Page 3 of 4
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5. 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. 6. 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. 7. 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.. The following is added to Section Il Limits Of Insurance The Pollution Liability Aggregate Limit is the most we will pay under Coverage D for all damages because of injury and damage for which claim is first made during the policy period. D. Paragraph 4. Other Insurance of Section IV Conditions is amended as follows All references to Coverage A or B are amended to read Coverage A B or D. E. The following additional definition applies Pollution liability hazard means all bodily injury and property damage arising out of the discharge release or escape of pollutants at or from a. Premises you own rent or occupy or b. Any site or location on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations. Page 4 of 4 Insurance Services Office Inc. 2012 CG 01540413
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COMMERCIAL GENERAL LIABILITY CG 2106 05 14 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. 2 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 2106 05 14 Insurance Services Office Inc. 2013 Page 1 of 1
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POLICY NUMBER GLO 4845817 02 POLICY NUMBER GLO 4845817 02 COMMERCIAL GENERAL LIABILITY CG211604 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION DESIGNATED PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description Of Professional Services 1. ALL PROFESSIONAL SERVICES With respect to any professional services shown in the Schedule the following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability This insurance does not apply to bodily injury property damage or personal and advertising injury due to the rendering of or failure to render any professional service. Information required to complete this Schedule if not shown above will be shown in the Declarations. 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 service. CG 21160413 Insurance Services Office Inc. 2012 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21320509 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMUNICABLE DISEASE 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 Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Communicable Disease Bodily injury or property damage arising out of the actual or alleged transmission of a communicable disease. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the a. Supervising hiring employing training or monitoring of others that may be infected with and spread a communicable disease b. Testing for a communicable disease c. Failure to prevent the spread of the disease or d. Failure to report the disease to authorities. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Communicable Disease Personal and advertising injury arising out of the actual or alleged transmission of a communicable disease. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the a. Supervising hiring employing training or monitoring of others that may be infected with and spread a communicable disease b. Testing for a communicable disease c. Failure to prevent the spread of the disease or d. Failure to report the disease to authorities. CG 21320509 Insurance Services Office Inc. 2008 Page 10f 1 m
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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 In jury 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 demotion evaluation reassignment discipline defa mation harassment humiliation discrimina tion or malicious prosecution directed 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 whomany 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 2 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. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Personal 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 demotion evaluation reassignment discipline defa mation harassment humiliation discrimina tion or malicious prosecution directed 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 2 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. CG 21471207 ISO Properties Inc. 2006 Page 10f 1 m
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COMMERCIAL GENERAL LIABILITY CG 214909 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion. under Paragraph 2. Exclusions of Section I Coverage A Bodily Injury And Property Damage Liability is replaced by the foliowing This insurance does not apply to f. Pollution 1 Bodily injury or property damage which would not have occurred in whole or part but for the actual alleged or threatened discharge dispersal seepage migration release or es cape of pollutants at any time. 2 Any loss cost or expense arising outof 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 b Claim or suit by or on behalf of a govern mental authority for damages because of leslmg for monitoring cleaning up remov ing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. Page 1of 1 CG 214909 99 Copyright. Insurance Services Office Inc. 1998
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COMMERCIAL GENERAL LIABILITY CG 21550999 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION WITH A HOSTILE FIRE EXCEPTION This endorsement modifies surance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion. under Paragraph 2. Exclusions of Section I Coverage A Bodily Injury And Property Damage Liability is replaced by the foliowing This insurance does not apply to f. Pollution 1 Bodily injury or property damage which would not have occurred in whole or part but for the actual alleged or threatened discharge d spersal seepage migration release or es cape of pollutants at any time. This exclusion does not apply tobodily injury or property damage arising out of heat smoke or fumes from ahostile fire unless that hostile fire occurred or originated a At any premises site or location which is or was at any time used by or for any in sured or others for the handling storage disposal processing or treatment of waste or b At any premises site or location on which any insured or any contractors or subcon tractors working directly or indirectly on any insured s behalf are performing opera tions to test for monitor clean up remove contain treat detoxify neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a Request demand order or statutory or 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 govern mental authority for damages because of testing for monitoring cleaning up re moving containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. Page 1of 1 CG 215509 99 Copyright Insurance Services Office Inc. 1998
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COMMERCIAL GENERAL LIABILITY CG21730115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF CERTIFIED ACTS OF TERRORISM COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART This endorsement modifies insurance provided under the following 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. The following exclusion is added This insurance does not apply to TERRORISM Any injury or damage arising directly or indirectly out of a certified act of terrorism. 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. 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 and b. 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. b. 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 21730115 Insurance Services Office Inc. 2014 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 26 880115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ALASKA EXCLUSION OF 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. The following exclusion is added This insurance does not apply to TERRORISM Any injury or damage arising out of a certified act of terrorism.. 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. 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 and b. 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. b. 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 26 880115 Insurance Services Office Inc. 2015 Page 1 of 1
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IL 00 03 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALCULATION OF PREMIUM This endorsement modifies insurance provided under the following CAPITAL ASSETS PROGRAM OUTPUT POLICY COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART The following is added The premium shown in the Declarations was com puted based on rates in effect at the time the policy was issued. On each renewal continuation or anni versary of the effective date of this policy we will compute the premium in accordance with our rates and rules then in effect. IL 00 03 09 08 ISO Properties Inc. 2007 Page 10f 1 m
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IL 00 17 11 98 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. D. Cancellation 1. The first Named Insured shown in the Declara tions may cancel this policy by mailing or de livering to us advance written notice of cancel lation. 2. We may cancel this policy by mailing or deliv ering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancel lation if we cancel for nonpayment of pre mium or b. 30 days before the effective date of cancel lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be suf ficient proof of notice. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy s terms can be amended or waived only by endorsement issued by us and made a part of this policy. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. Inspections And Surveys 1. We have the right to a. Make inspections and surveys at any time E. b. Give you reports on the conditions we find and Recommend changes. 2. We are not obligated to make any inspections surveys reports or recommendations and any such actions we do undertake relate only to in surability and the premiums to be charged. We do not make safety inspections. We do not un dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not war rant that conditions a. Are safe or healthful or b. Comply with laws regulations codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us but also to any rating advisory rate service or similar organization which makes in surance inspections surveys reports or recom mendations. 4. Paragraph 2. of this condition does not apply to any inspections surveys reports or recommen dations we may make relative to certification under state or municipal statutes ordinances or regulations of boilers pressure vessels or ele vators. Premiums The first Named Insured shown in the Declarations 1. Is responsible for the payment of all premiums and 2. Will be the payee for any return premiums we pay. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representa tive. Until your legal representative is appointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. Pagelof1 O IL 00 17 11 98 Copyright Insurance Services Office Inc. 1998
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IL 00 21 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form This endorsement modifies insurance provided under the following 1. COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY The insurance does not apply C. Under any Liability Coverage to bodily injury A. Under any Liability Coverage to bodily injury or p PeY dfmage resunrgfrvom hazardous or property damage properties of nuclear material if 1 With respect to which an insured under 1 The nuclear material a is at any nuclear the policy is also an insured under a nu facility ownd by or operated by or on be clear energy liability policy issued by Nu half of an nsured or b ha been dis clear Energy Liability Insurance Association charged or dispersed therefrom Mutual Atomic Energy Liability Underwrit 2 The nuclear material is contained in spent ers Nuclear Insurance Association of Can fuel or waste at any time possessed han ada or any of their successors or would be dled used processed stored transported an insured under any such policy but for its or disposed of by or on behalf of an in termination upon exhaustion of its limit of li sured or ability or 3 The bodily injury or property damage 2 Resulting from the hazardous properties arises out of the furnishing by an insured of nuclear material and with respect to of services materials parts or equipment in which a any person or organization is re connection with the planning construction quired to maintain financial protection pur maintenance operation or use of any nu suant to the Atomic Energy Act of 1954 or clear facility but if such facility is located any law amendatory thereof or b the in within the United States of America its terri sured is or had this policy not been issued tories or possessions or Canada this ex would be entitled to indemnity from the clusion 3 applies only to property dam United States of America or any agency age to such nuclear facility and any thereof under any agreement entered into property thereat. by the United States of America or any 2 H. As used in this endorsement agency thereof with any person or organi. L... Zzation. Hazardous properties includes radioactive toxic B. Under any Medical Payments coverage to Ior explosive prupemes.. o. expenses incurred with respect to bodily in Nuclear matgrlall means source matgrlal special jury resulting from the hazardous properties nuclear material or by product material. of nuclear material and arising out of the op eration of a nuclear facility by any person or organization. C. Under any Liability Coverage to bodily injury or property damage resulting from hazardous 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 2 The nuclear material is contained in spent fuel or waste at any time possessed han dled used processed stored transported or disposed of by or on behalf of an in sured 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 property thereat. 2. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source material special nuclear material or by product material. 3 IL 00 21 09 08 ISO Properties Inc. 2007 Page 10f 2 m
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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 plutonium 2 processing or utilizing spent fuel or 3 handling processing or packaging waste c d Any equipment or device used for the proc essing 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 pluto nium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 Any structure basin excavation premises or place prepared or used for the storage or disposal of waste and includes the site on which any of the 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 radioactive contamination of property. Page 2 of 2 ISO Properties Inc. 2007 IL 00 21 09 08 o
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NOTICE TO POLICYHOLDER Fungi Or Bacteria Exclusion Endorsements NO COVERAGE IS PROVIDED BY THIS POLICYHOLDER 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 COVERAGE YOU ARE PROVIDED. IF THERE IS ANY CONFLICT BETWEEN THE POLICY AND THIS SUMMARY 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 YOUR INSURANCE COVERAGE WITH RESPECT TO CLAIMS ARISING OUT OF FUNGI OR BACTERIA ADDED TO YOUR POLICY BY SEPARATE ENDORSEMENT. PLEASE READ THIS NOTICE CAREFULLY. Your policy will include a change at renewal or at the next anniversary date as follows One of the following endorsements will be attached to your policy Fungi Or Bacteria Exclusion Endorsement form U GL1171 A Fungi Or Bacteria Exclusion Endorsement form U GL1181 A GL1171 A and U GL1181 A are a from exposure to fungi or bacteria other than The Fungi or Bacteria Exclusion Endorsements form complete exclusion of any injury or damage that may ari fungi or bacteria contained in edible goods or products intended for human or animal consumption. Further these endorsements also exclude any I s or expenses that may arise out of the cleaning up abatement remediating testing for monitoring treating detoxifying removing disposing or containing of fungi or bacteria or otherwise assessing the effects of or responding to fungi or bacteria. U GL1191 A CW 1103
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Z ZURICH Policyholder Notice General Liability Access Or Disclosure Of Confidential Or Personal Information Exclusions 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 a 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 CG 21 06 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information And Data related Liability With Limited Bodily Injury Exception For Use With The Commercial General Liability Coverage Part When this endorsement is attached to your policy Under Coverage A Bodily Injury And Property Damage Liability coverage is excluded for damages arising out of any access to or disclosure of any person s or organization s confidential or personal information. This is a reinforcement of coverage intent. 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 any person s or organization s 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. CG 21 07 05 14 Exclusion Access or Disclosure of Confidential or Personal Information and Data related Liability Limited Bodily Injury Exception Not Included For Use With The Commercial General Liability Coverage Part When this endorsement is attached to your policy Under Coverage A Bodily Injury And Property Damage Liability coverage is excluded for damages arising out of any access to or disclosure of any person s or organization s confidential or personal information. This is a reinforcement of coverage intent. Coverage is also excluded for damages because of bodily injury arising out of loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. This is a reduction of coverage. 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 any person s or organization s 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 of coverage. CG 21 08 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information Coverage B Only For Use With The Commercial General Liability Coverage Part When this endorsement is attached to your policy coverage is excluded for personal and advertising injury arising out of any access to or disclosure of any person s or organization s 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. U GL2110 A CW 0115 Page 10f 2
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CG 04 37 05 14 Electronic Data Liability For Use With The Commercial General Liability Coverage Part With respect to damages arising out of any access to or disclosure of any person s or organization s confidential or personal information when this endorsement is attached to your policy Under Coverage A Bodily Injury And Property Damage Liability coverage is excluded for damages arising out of any access to or disclosure of any person s or organization s confidential or personal information. This is a reinforcement of coverage intent. 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 any person s or organization s 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 of coverage. CG 33 53 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information And Data related Liability With Limited Bodily Injury Exception For Use With The Owners and Contractors Protective Liability Coverage Part and Products Completed Operations Coverage Parts When this endorsement is attached to your policy coverage is excluded for damages arising out of any access to or disclosure of any person s or organization s confidential or personal information. This is a reinforcement of coverage intent. CG 33 59 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information And Data related Liability Limited Bodily Injury Exception Not Included For Use With The Owners And Contractors Protective Liability and Products Completed Operations Liability Coverage Parts When this endorsement is attached to your policy coverage is excluded for damages arising out of any access to or disclosure of any person s or organization s confidential or personal information. This is a reinforcement of coverage intent. Coverage is also excluded for damages because of bodily injury arising out of loss loss of use of damage to corruption of inability to access or inability to manipulate electronic data. This is a reduction of coverage. U GL2110 A CW 0115 Page 2 of 2
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COMMERCIAL INSURANCE CANCELLATION BY US This endorsement changes the policy. Please read it carefully. This endorsement modifies insurance provided by the following BOILER AND MACHINERY COVERAGE FORM BUSINESS AUTO COVERAGE FORM COMMERCIAL CRIME COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL INLAND MARINE COVERAGE FORM COMMERCIAL PROPERTY COVERAGE FORM FARM COVERAGE FORM GARAGE COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM MOTOR CARRIER COVERAGE FORM POLLUTION LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM TRUCKERS COVERAGE FORM SCHEDULE Number of Days Notice 30 If no entry appears above information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement. For any statutorily permitted reason other than nonpayment of premium the number of days required for notice of cancellation as provided in paragraph 2 of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement is increased to the number of days shown in the Schedule above. U GU298 B CW 494 Page 1 of
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Z ZURICH Insured Name SANEXEN WATER INC Policy Number GLO 4845817 02 Effective Date 06012021 THIS DISCLOSURE IS ATTACHED TO AND MADE PART OF YOUR POLICY. DISCLOSURE OF IMPORTANT INFORMATION RELATING TO TERRORISM RISK INSURANCE ACT SCHEDULE Premium attributable to risk of loss from certified acts of terrorism for lines of insurance subject to TRIA General Liability Not Applicable Terrorism Exclusion Any information required to complete this Schedule if not shown above will be shown in the Declarations. A. Disclosure of Premium In accordance with the federal Terrorism Risk Insurance Act TRIA as amended we are required to provide you with a notice disclosing the portion of your premium if any attributable to the risk of loss from terrorist acts certified under that Act for lines subject to TRIA. That portion of premium attributable is shown in the Schedule above. The premium shown in the Schedule above is subject to adjustment upon premium audit if applicable. B. Disclosure of Federal Participation in Payment of Terrorism Losses You should know that where coverage is provided by this policy for losses resulting from certified acts of terrorism the United States Government may pay up to 80 of insured losses exceeding the statutorily established deductible paid by the insurance company providing the coverage. C. Disclosure of 100 Billion Cap on All Insurer and Federal Obligations If aggregate insured losses attributable to terrorist acts certified under TRIA exceed 100 billion in a calendar year January 1 through December 31 and an insurer has met its deductible under the program that insurer 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 Treasury. D. Availability As required by TRIA we have made available to you for lines subject to TRIA coverage for losses resulting from acts of terrorism certified under TRIA with terms amounts and limitations that do not differ materially from those for losses arising from events other than acts of terrorism. E. Definition of Act of Terrorism under TRIA TRIA defines act of terrorism as any act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act TRIA to be an act of terrorism. The Terrorism Risk Insurance Act provides that the Secretary of Treasury shall certify an act of terrorism 1. To be an act of terrorism 2. To be a violent act or an act that is dangerous to human life property or infrastructure 3. To have resulted in damage within the United States or outside of the United States in the case of an air carrier as defined in section 40102 of Title 49 United States Code or a 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 or the premises of a United States mission and U GU630 E CW 0120 Copyright 2020 Zurich American Insurance Company Page 1 of 2 Includes copyrighted material of Insurance Services Office Inc.. with its permission. eneral Liability Not Applicable Terrorism Exclusion
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4. To have been 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. No act may be certified as an act of terrorism if the act is committed as part of the course of a war declared by Congress except for workers compensation or if losses resulting from the act in the aggregate for insurance subject to TRIA do not exceed 5000000. U GU630 E CW 0120 Page 2 0f 2 Copyright 2020 Zurich American Insurance Company Includes copyrighted material of Insurance Services Office Inc.. with its permission.
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Z ZURICH Fungi Or Bacteria Exclusion Endorsement ZURICH THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. GLO 4845817 02 Effective Date 06012021 This endorsement modifies insurance provided under the 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 2. Exclusions This insurance does not apply to Fungi or Bacteria A. Bodily injury property damage or personal and advertising injury caused directly or indirectly by the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of any 1. Fungi or bacteria or 2. Substance vapor or gas produced by or arising out of any fungi or bacteria. B. Loss costs or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. C. For the purposes of this exclusion the following definitions are added 1. Fungi means any type or form of fungus including mold or mildew and any mycotoxins spores scents or by products produced or released by fungi. 2. Spores means reproductive bodies produced by or arising out of fungi. 3. Bacteria means any type or form of bacteria and any materials or substances that are produced or released by bacteria. This exclusion applies to all diseases contracted by contact with fungi or bacteria in water water vapor or water droplets including but not limited to Legionnaire s Disease. This exclusion does not apply to any bodily injury or property damage caused by any fungi or bacteria that are are on or are contained in any other edible good or edible product intended for human or animal consumption. All other terms conditions provisions and exclusions of this policy remain the same. U GL1171 B CW 0719 Page 1 of 1 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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ZURICH Pollution Liability Exclusion Disclosure Notice This insurance policy does not apply to or provides very limited coverage as respects pollution liability. You should refer to the specific pollution liability policy exclusions or pollution liability exclusion endorsements of your policy for determination of specific terms and conditions as respects exclusion of any pollution liability exposures that you may have. The policy exclusions of the Commercial General Liability Coverage Part apply to pollution exposures in the coverage territory unless replaced or modified as indicated in the applicable endorsement by one or more of the following pollution exclusion endorsements. The pollution exclusion endorsements that are checked X apply to pol lution exposures in the indicated areas of the coverage territory X Total Pollution Exclusion Endorsement ISO Form X All states in the coverage territory except CG 2149 HLIL ME MN VT TX XITotal Pollution Exclusion Hostile Fire Exception All states in the coverage territory except ISO Form CG 21 55 Only applicable in the following states IL MN VT. Total Pollution Exclusion with a Building Heating All states in the coverage territory except Equipment Exception and a Hostile Fire Exception ISO Form CG 21 65 Only applicable in the following states XITotal Pollution Exclusion Hostile Fire Exception ISO Form CG 21 55 Total Pollution Exclusion with a Building Heating Equipment Exception and a Hostile Fire Exception 1SO Form CG 21 65 Other State Endorsements XI Indiana Changes Pollution Exclusion ISO Form X Indiana CG 0123 XI Missouri Changes Pollution Exclusion ISO Form X Missouri CG 01 34 or J Missouri Changes Gasoline Risks Pollution Exclu O Missouri sion 1SO Form CG 01 35 X1 Vermont Vt. Changes Pollution ISO form CG 01 54 Applicable in the following states Other Assuming risk does not qualify as a large risk according to Texas law Indiana X Missouri Missouri U GL1203 A CW 404 Page 1 of
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ZURICH IMPORTANT NOTICE TO POLICYHOLDERS Fungi Or Bacteria Exclusion Endorsement U GL1171 B is a summary of the major changes in your Commercial General Liability Coverage Part. No coverage is provided by ummary nor can it be construed to replace any provisions 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 summary THE PROVISIONS OF THIS POLICY SHALL PREVAIL. The material in the notice makes reference to form and endorsement numbers however not all forms and endorsements are included in a particular policy. Please consult with your broker for how the change impacts your individual policy as certain coverages may have previously been extended by endorsement. COVERAGE FORMS CAUSES OF LOSS FORMS AND RELATED ENDORSEMENTS Clarification of Coverage e Fungi Or Bacteria Exclusion Endorsement U GL1171 B n update to the A version of the endorsement. Under U GL1171 B we have clarified o That the exclusion applies to all diseases contracted by contact with fungi or bacteria in water water vapor or water droplets including but not limited to Legionnaire s Discase. o The exception to the Fungi or Bacteria exclusion language by indicating that the exclusion does not apply to any bodily injury or property damage caused by any fungi or bacteria that are are on or are contained in any other edible good or edible product intended for human or animal consumption. The words bodily injury or property damage caused by any have been added to provided clarification. U PHN1037 A CW 0619 Page 1 of 1
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Z ZURICH SANCTIONS EXCLUSION ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY The following exclusion is added to the policy to which it is attached and supersedes any existing sanctions language in the policy whether included in an Exclusion Section or otherwise SANCTIONS EXCLUSION Notwithstanding any other terms under this policy we shall not provide coverage nor will we make any payments or provide any service or benefit to any insured beneficiary or third party who may have any rights under this policy to the extent that such cover payment service benefit or any business or activity of the insured would violate any applicable trade or economic sanctions law or regulation. The term policy may be comprised of common policy terms and conditions the declarations notices schedule coverage parts insuring agreement application enrollment form and endorsements or riders if any for each coverage provided. Policy may also be referred to as contract or agreement. We may be referred to as insurer underwriter we us and our or as otherwise defined in the policy and shall mean the company providing the coverage. Insured may be referred to as policyholder named insured covered person additional insured or claimant or as otherwise defined in the policy and shall mean the party person or entity having defined rights under the policy. These definitions may be found in various parts of the policy and any applicable riders or endorsements. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED U GU1191 A CW 0315 Page I of 1
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PHILADELPHIA oal INSURANCE COMPANIES A Member of the Tokio Marine Group One Bala Plaza Suite 100 Bala Cynwyd Pennsylvania 19004 610.617.7900 Fax 610.617.7940 PHLY.com 01092014 JOHNSON COUNTY MENTAL HEALTH CENTER 111 S Cherry St Ste 2400 C O RISK MANAGEMENT Olathe KS 66061 3451 Re PHPK1111221 Dear Valued Customer Thank you very much for choosing Philadelphia In for your insurance needs. Our first class customer service national presence and A Superior A.M. Best financial strength rating have made us the selection by over 150000 policyholders nationwide. I realize you have a choice in insurance companies and truly appreciate your business. I wish you much success this year and look forward to building a mutually beneficial business partnership which will prosper for years to come. Welcome to PHLY and please visit PHLY.com to learn more about our Company Sincerely st Robert D. OLeary Jr. President CEO Philadelphia Insurance Companies RDO sm Philadelphia Consolidated Holding Corp. Philadelphia Indemnity Insurance Company Tokio Marine Specialty Insurance Co Maguire Insurance Agency Inc.
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Receive Invoices Electronically Pay Your Bills Online Set Up Recurring Payments Available 247 Safe and Secure NO FEE Environmentally Friendly Avallable 24 Safe and Secure Enroll Today 7.. Pay Your Bill Online To pay your bills online you will need a User ID and Password to access our website. If you do nt have a User ID please create one by visifing htipswww.PHLY.commyphlynewuser.aspx. If you have a User ID please login and click on Online Bl Pay and enter the necessary information to pay your bills. Philadelphia Insurance Companies accepts electronic checks a debit from your checking or savings account as a method of payment. Please allow 2 to 3 business days for your payment to post fo your account. This service is offered free of charge. Please note that credit card payments can not be made online. Recurring Payment Customers that receive their bill directly and not from their agent can sign up for recurring payment via automatic withdrawals from a checking savings or money market account for direct bill policies. If you do not already have an account on PHLY.com you will need to create one by visiting httpswww.PHLY.commyphlynewuser.aspx. Once logged in please refer to Links for You and click the Recurring Payment Instructions to learn how to enroll. You can also click the Online Bill Pay tab on the left hand side to enroll in Recurring Payment. How to Create an Account on PHLY.com 1. Go to httpswww.PHLY.commyphlynewuser.aspx 2. Select the applicable BUTTON insured or producer. 3. Complete the information on the page You will CREATE your own USER NAME and PASSWORD. The password must be at least 7 characters and contain one number one lower case letter and one capital letter. 4. Click CONTINUE when done. 5. On the next page complete the PASSWORD RESET QUESTION. If you ever forget your password we will ask you this security question and you will enter the answer you have selected. 6. Once you have received the page that states CONTINUE TO MY PHLY then you have successfully created the account. PHILADELPHIA INSURANCE COMPANIES A Member of the Tokio Marine Group Focus on the Things that Matter We ll Handle the Risk 10Uu R ASSWORD RESET ur password we will you will enter the PHILADELPHIA INSURANCE COMPANIES AMember of the Tokio Ma
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PHILADELPHIA RANCE COMPANI A Member of the Tokio Marine Group Making Things Easier for You PHLY CUSTOMER SERVICE Did you know... PHLY has a dedicated Nafional Processing Center fo efficiently and effectively process endorsements The loss Assistance Hofline provides Management Professional Liability policyholders with 2 FREE HOURS of legal consuliation with knowledgeable atiormeys on any matter that could potentially result in a claim under a PHIY policy You can review biling and payment history online For example Payment verifications go fo My PHLY on PHLY.com You can pull up and print your invoices and policy documents online You can update your profile online For example Billing address changes and confact information We offer live help within seconds No complicated phone systems 97.3 of our policyholders would refer us to prospective customers 48 hour turmaround fime on small business quotes and policy issuance in less than 10 doys We provide inferest free installments for accounts that generate af least 2000 in premium Frequently Asked Questions How can I get information about my insurance There are 5 different ways to contact Customer Service Customer Service 877.438.7459 Customer Service Fax 866.847.4046 Cuslomer Service Email custservphlyins.com Cusfomer Service Online chat PHLY.com Contact Us When can I contact Customer Service Customer Service Is available Monday Friday 830 am 800 pm EST What forms of payment does PHLY accept PHLY accepts 3 forms of payment Checks sent o the lock box o Check by phone payments through our VR 877.438 7459 Option 1 web site or contact center representatives Credit card payments through our live confact center representatives Visa MasterCard and American Express A Passion for Service Claims Average policyholder first party automobile losses setfled in 10 days or less Same or next business day acknowledgements of newly reported and opened claims Claims representation nationally with Commercial Liability Claims Examiner Niche experlise 247 Claims Senvice. Staff efficiencies with paperless and industry leading systems Staff of Subrogation and Recovery Examiners exclusively dedicated to recovery efforts for policyholder paid losses Experienced consistent staff and department structure Loss Control Product specific webbased loss control solutions through PHLY.com Free online interactive Defensive Driver Training course and examination Regular eflyer communications on current Loss Control issues and Large Loss Lessons Learned Strategic partnership with best in class vendor for discounted background motor vehicle record MVR checks Automatically included on most accounts PHLY Bell endorsement Includes 50000 limits each for Business Travel Accident Benefit Donation Assurance Emergency Real Estate Consulting Fee Identity Theft Expense Image Resforation and Counseling Key Individual Replacement Expenses Kidnap Expense Terrorism Travel Reimbursement Workplace Violence Counseling. 25000 limits for each Conference Cancellation Fundraising Event Blackout Political Unrest 5000 per employee Temporary Meefing Space Reimbursement and 1500 Travel Delay Reimbursement. Honors Awards and Ratings Nationally recognized as a member of Ward s Top 50 Benchmark group of ProperlyCasudlly Insurance companies for outstanding achievement in the areas of financial strength claims performance and consistently favorable underwriting results Forbes Magazine has recognized Philadelphia Insurance Cornpanies as one of the 400 Best Big Companies in America A Superior rated by A.M. Best Company A rated by Standard Poor s for counterparty credit and financial strength Business Insurance s Best Places to Work in Insurance program identifies and recognizes Philadelphia Insurance Companies as a high quality workplaces in the commercial insurance industry. TOKIO MARINE icated National Processing Center fo efficiently process endorsements ince Holline provides Management Professional olders with 2 FREE HOURS of legal consuliation with atfiorneys on any matter that could potentially result in PHLY policy billng and payment history online Payment verifications go fo My PHLY on PHLY.com and print your invoices and policy documents online. your profile online Billing address changes and contact information
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PHILADELPHIA INSURANCE COMPANIES A Member of the Tokio Marine Bell Endorsement Crisis Management PHLY HAS INCREASED LIMITS... PHLY has increased limits on Bell Endorsement and created a Crisis Management Endorsement that will be attached to our policies. Bell Endorsement 50000 Identity Theft Expense coverage which reimburses the expenses of any director or officer who becomes a victim of an incident of identity theft. 50000 Terrorism Travel Reimbursement which covers any director or officer for emergency travel expenses that he or she incurs in the event of a certified act of terrorism 50000 Emergency Real Estate Consulfing Fee coverage for realior s fee o real estate consuliant s fee necessilated by the Insured s need fo relocate due to the Unforeseeable destruction of the Insured s principal location 25000 Temporary Meefing Space Reimbursement coverage for rental of meefing space which is necessitated by the temporary unavailability of the Insured s primary office space due to the failure of a climate confrol system or leakage of a hot water heater. 50000 Workplace Violence Counseling in the event that violent incident occurs at any of the Insured s premises. 50000 Kidnap Expense coverage for reasonable fees incurred as a result of the kidnapping of a Director or Officer or their spouse domestic partner parent or child 50000 Key Individual Replacement Expenses coverage for the Chief Executive Officer or Execulive Director who suffers an injury which results in the loss of life. No deductible applies o this coverage. 50000 Image Restoration and Counseling coverage for image restoration and counseling arising out of Improper Acts. Crisis Management 50000 Donation Assurance coverage for Failed Donation Claimls. 50000 Business Travel coverage for Business Travel Accidental Death Benefit to the Named Insured if a Director or Officer suffers an injury while iaveling on a common carrier for business 25000 Conference Cancellation coverage for any business related conference expenses paid by the insured and not ofherwise reimbursed for a canceled conference that an employee was scheduled fo attend. The cancellation must be due directly to a natural catastrophe or a communicable disease outbreak that forces the cancellation of the conference. 25000 Fundraising Event Blackout coverage for expenses that are incurred due to the cancellation of a fundraising event caused by the lack of electric supply resulting in a power outage provided the fundraising event is not rescheduled. The fundraising event must have been planned at least thirty 30 days prior to the power outage 5000 per employee 25000 policy limit Political Unrest coverage fo reimburse any present director officer employee or volunteer of the named insured while traveling outside the United States of America for emergency evacuation expenses that are incurred as a result of an incident of political unrest. 1500 Travel Delay Reimbursement coverage o reimburse any present director or officer of the named insured for any non reimbursable expenses they incur as a result of the cancellation of any reqularly scheduled business travel on a common carier. 25000 Crisis Management coverage for crisis management emergency response expenses incurred because of an incident giving rise fo a crisis. sement coverage ible fees incurred o1 or their spouse TOKIO MARINE Grour policy ers de Jokes prececience. AN Coverages are nci avaliotie in afl sioies Gue 1o siake insurancs reguialions. Lerkain coverogeis may be provided Dy O SWIpiUs Enes. Insu ly pariicipate in siate guaranty funds and insureds are therefore nol protected by such funds. 2011 2012 Philadelphia Insurance Companies Al Righ s
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b PHILADELPHIA il INSURANCE COMPANI A Member of the Tokio Marine G LOSS CONTROL PHLY LOSS CONTROL SERVICES Welcome to PHLY Loss Control Services PHLY is familiar with the unique Loss Control programming needs of you organization and has achieved superior results in this area. We are committed to delivering quality and timely loss prevention services and risk control products to your organization. Customer satisfaction through the delivery of these professional products to achieve measurable risk improvement results is our goal. We know the fulfillment of our Loss Control commitment is not complete until we deliver upon our promises. OUR MISSION We welcome the opportunity fo demonsirate how we can tailor a risk management program suitable o our customer s needs. We are committed fo providing our customers with improved communications quicker implementation of loss control servicing initiafives and specific benchmarking goals that help us quantify the true value of our services. OUR MOTTO Innovative Services Producing Optimum Results This mantra reflects our commitment to utilize innovative products and solutions to help our customers achieve measurable results. Customer safisfaction through the delivery of these quality professional products is our goal. We know the fulfillment of our loss control commitment is not complete until we deliver upon our promises. In order to gain full access to these resources and others please take a moment fo register on our website. If you already have an i d to PHLY.com please login to access loss control resources. Risk Management Resources AbusePrevention Systems Minisiry Safe Human Services Abuse Prevention Trainin Home Health Aides Abuse Prevention Training PHLY loss Control Services e trainin PureSafely online driver training course PureSafely online safety training software for incident injury and illness management Nonprofit Risk Management Center IntelliCorp Records Inc SafetyFirst fleet monitoring program WWEMED loss Assistance Hofline in2vate Webenabled EPLI employment practices liability insurance Risk Management Services afeWise Youth Services Organizations Aquatics Proprietary Risk Management Services PHLY loss Control Eflyers large Account Service Capabilities o Loss Trend Analysis Risk Management Information System Responding to loss Control Recommendations Qutside the Box ePIC loss Control Services unbundled for fee Risk Management Services Available Contact For more information please contact Cusfomer Service 800.873.4552 IMPORTANT NOTICE TOKIO MARINE DLILY A
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e PHILADELPHIA One Bala Plaza Suite 100 Y Bala Cynwyd Pennsylvania 19004 hadl INSURANCE COMPANIES 610.617.7900 Fax 610.617.7940 A Member of the Tokio Marine Group PHLY.com Philadelphia Indemnity Insurance Company Commercial Lines Policy THIS POLICY CONSISTS OF DECLARATIONS COMMON POLICY CONDITIONS ONE OR MORE COVERAGE PARTS. A COVERAGE PART CONSISTS OF ONE OR MORE COVERAGE FORMS e APPLICABLE FORMS AND ENDORSEMENTS BJP190 1 12 98
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IN WITNESS WHEREOF we have caused this policy to be executed and attested and if required by state law this policy shall not be valid unless signed by our authorized representative. M President CEO e Secretary BJP190 1 12 98
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PP 07 13 0713 PRIVACY POLICY NOTICE Philadelphia Indemnity Insurance Company The Philadelphia Indemnity Insurance Company or We values your privacy and we are committed to protecting personal information that we collect during the course of our business relationship with you. The collection use and disclosure of certain nonpublic personal information are regulated by law. This notice is for your information only and requires no action on your part. It will inform you about the types of information that we collect and how it may be disclosed. This does not reflect a change in the way we do business or handle your information. Information We Collect We collect personal information about you from the following sources. Applications or other forms such as claims forms or underwriting questionnaires completed by you. Information about your transactions with us our affiliates or others and. Depending on the type of transaction you are conducting with us information may be collected from consumer reporting agencies health care providers employers and other third parties. Information We Disclose We will only disclose the information described above to our affiliates and non affiliated third parties as permitted by law and when necessary to conduct our normal business activities. For example we may make disclosures to the following types of third parties. Your agent or broker producer. Parties who perform a business professional or insurance functions for our company including our reinsurance. companies. Independent claims adjusters investigators attorneys other insurers or medical care providers who need information to investigate defend or settle a claim involving you. Regulatory agencies in connection with the regulation of our business and. Lienholders mortgagees lessors or other persons shown on our records as having a legal or beneficial interest in your policy. We do not sell your information to others for marketing purposes. We do not disclose the personal information of persons who have ceased to be our customers. Protection of Information Philadelphia Indemnity Insurance Company maintains physical electronic and procedural safeguards that comply with state and federal regulations to protect the confidentiality of your personal information. We also limit employee access to personally identifiable information to those with a business reason for knowing such information. Use of Cookies We may place electronic cookies in the browser files of your computer when you access this website. Cookies are text files placed on your computer to enable our systems to recognize your browser and to tailor the information on our website to your interests. We or our third party service providers or business partners may place cookies on your computer s hard drive to enable us to match personal information that we maintain about you so that we are able to pre populate on line forms with your information. We also use cookies to help us analyze use of our website to understand which areas of our site are most useful to you. You may refuse the use of cookies by selecting the appropriate settings on your browser. Please note that if you do this you may not be able to use the full functionality of the website. How to Contact Us Philadelphia Indemnity Insurance Company One Bala Plaza Suite 100 Bala Cynwyd PA 19004 Attention Chief Privacy Officer 07192013
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i PHILADELPHIA One Bala Ploza Suite 100 Bala Cynwyd Pennsylvania 19004 e 610.617.7900 Fax 610.617.7940 A Member of the Tokio Marine Group PHLY.com Philadelphia Indemnity Insurance Company COMMON POLICY DECLARATIONS Policy Number PHPK1111221 Named Insured and Mailing Address Producer 2017 JOHNSON COUNTY MENTAL LOCKTON COMPANIES LLC HEALTH CENTER 444 W. 47th St. Suite 900 111 S Cherry St Ste 2400 SUITE 900 C O RISK MANAGEMENT KANSAS CITY MO 64112 Olathe KS 66061 3451 Policy Period From 01012014 To 01012015 at 1201 AM. Standard Time at your mailing address shown above. Business Description Mental Health Organization Non Profit Producer 2017 LOCKTON COMPANIES LLC 444 W. 47th St. Suite 900 SUITE 900 KANSAS CITY MO 64112 IN RETURN FOR THE PAYMENT OF THE PREMIUM AND SUBJECT TO ALL THE TERMS OF THIS POLICY WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. PREMIUM Commercial Property Coverage Part Commercial General Liability Coverage Part 7277.00 Commercial Crime Coverage Part Commercial Inland Marine Coverage Part Commercial Auto Coverage Part Businessowners Workers Compensation Professional Liability Sexual Physical Abuse 64314.00 INCLUDED Total 71591.00 Federal Terrorism Risk Insurance Act Coverage Total Includes Professional Liability Assessments See Schedule Attached 10158.00 FORM S AND ENDORSEMENT S MADE A PART OF THIS POLICY AT THE TIME OF ISSUE Refer To Forms Schedule Omits applicable Forms and Endorsements if shown in specific Coverage Part Coverage Form Declarations P 9 eg Countersignature Date Authorized Representative CPD PIIC 0107 CPD PIIC 0107
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Philadelphia Indemnity Insurance Company Form Schedule Policy Policy Number PHPK1111221 Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue Form Edition Description Recurring Payment Flyer 1212 Recurring Payment Flyer CSNotice1 1011 Making Things Easier BJP190 1 1298 Commercial Lines Policy Jacket PPO713 0713 Privacy Policy Notice CPD PIIC 0107 Common Policy Declarations Location Schedule 0100 Location Schedule Named Insured Sched 0100 Named Insured Schedule PI BELL1 1109 Bell Endorsement PI CME1 1009 Crisis Management Enhancement Endorsement 1L0017 1198 Common Policy Conditions 1L0021 0908 Nuclear Energy Liability Exclusion Endorsement 1L0261 0907 Kansas Changes Cancellation and Nonrenewal Page
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Philadelphia Indemnity Insurance Company Locations Schedule Policy Number PHPK1111221 Prems. Bldg. No. No. Address 0001 0002 0003 0004 0005 0001 0001 0001 0001 0001 6000 Lamar Ave Mission KS 66202 3234 1125 W Spruce St Olathe KS 66061 3123 6440 Nieman Rd Shawnee KS 66203 3326 8901 W 50th Ter Merriam KS 66203 1721 11120 W 65th St Shawnee KS 66203 5504 Page
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Philadelphia Indemnity Insurance Company Named Insured Schedule Policy Number PHPK1111221 JOHNSON COUNTY MENTAL HEALTH CENTER BOARD BOARD OF COUNTY COMMISSIONERS JOHNSON COUNTY KANSAS Page
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COMMERCIAL GENERAL LIABILITY CG P 0110509 RECORDING AND DISTRIBUTION OF MATERIAL OR INFORMATION IN VIOLATION OF LAW EXCLUSION ENDORSEMENT ADVISORY NOTICE TO POLICYHOLDERS This Notice does not form a part of your insurance contract. No coverage is provided by this Notice nor can it be construed to replace any provisions of your policy including its endorsements. If there is any conflict between this Notice and the policy including its endorsements the provisions of the policy including its endorse ments shall prevail. Carefully read your policy including the endorsements attached to your policy. This Notice provides information concerning the following new endorsement which applies to your renewal policy being issued by us Recording And Distribution Of Material Or Information In Violation Of Law Exclusion Endorsement CG 00 68 05 09 This endorsement replaces the current Distribution Of Material In Violation Of Statutes Exclusion in your policy with a revised exclusion newly titled Recording And Distribution Of Material Or Information In Violation Of Law Exclusion. The revised exclusion contains language that elaborates on the intent of the Distribution Of Material In Violation Of Statutes Exclusion to reflect that in addition to the TCPA and CAN SPAM Act of 2003 the exclusion will more explicitly exclude liability coverage for bodily injury property damage or personal and advertising injury arising out of any action or omission that violates or is alleged to violate the Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA and any other similar federal state or local statute ordinance or regulation concerning disposal and dissemination of personal information. CG P 0110509 Insurance Services Office Inc. 2008 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CGP0150413 2012 GENERAL LIABILITY MULTISTATE FORMS REVISION ADVISORY NOTICE TO POLICYHOLDERS This is a summary of the major changes in 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 summary THE PROVISIONS OF THE POLICY SHALL PREVAIL. The major areas within the policy that broaden or reduce coverage and other changes are highlighted below. This notice does not reference every editorial change made in your policy. We have followed the policy sequence of provisions in setting out this material. COMMERCIAL GENERAL LIABILITY COVERAGE FORMS CG 000104 13 AND CG 00 02 04 13 I. EXCLUSIONS A. BROADENING OF COVERAGE 1. 2. Coverage A Exclusion 2.c. Liquor Liability is revised to provide an exception with respect to allowing a person to bring alcoholic beverages onto the named insured s premises for consumption on the named insured s premises. Coverage A Exclusion 2.p. Electronic Data is revised to introduce an exception for liability for damages because of bodily injury. OTHER CHANGES 1. Coverage A Exclusion 2.c. Liquor Liability is revised to reinforce that the exclusion applies even if claims against an insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others or providing or failing to provide transportation with respect to any person that may be under the influence of alcohol.. Coverage A Exclusion 2.g. Aircraft Auto Or Watercraft is revised to delete reference to in the state.. Coverage A Exclusion 2.q. and Coverage B Exclusion 2.p. Recording And Distribution Of Material Or Information In Violation Of Law were previously added to your policy via mandatory endorsement. The endorsement contained an exclusion addressing injury or damage arising out of any action or omission that violates or is alleged to violate certain statutes ordinances and regulations. This exclusion has been incorporated directly into your policy.. Coverage B Exclusions 2.b. and 2.c. Material Published With Knowledge Of Falsity and Material Published Prior To Policy Period are revised to reference in any manner with respect to oral or written publication for consistency with the definition of personal and advertising injury. Il. CONDITIONS OTHER CHANGES Condition 4. Other Insurance is generally revised so that the insurance provided is excess over any for which the named insured has been added as an additional insured whether by endorsement or any other means. CGP0150413 Insurance Services Office Inc. 2012 Page 10f7
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Ill. DEFINITIONS OTHER CHANGES 1. Definition 2. Auto is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged. 2. Definition 12. Mobile Equipment is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged. OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM COVERAGE FOR OPERATIONS OF DESIGNATED CONTRACTOR CG 000904 13 I. EXCLUSIONS BROADENING OF COVERAGE Exclusion 2.I. Electronic Data is revised to introduce an exception for liability for damages because of bodily injury. Il. DEFINITIONS OTHER CHANGES 1. Definition 1. Auto is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged. 2. Definition 10. Mobile Equipment is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged. LIQUOR LIABILITY COVERAGE FORMS CG 0033 04 13 AND CG 00 3404 13 WHO IS AN INSURED BROADENING OF COVERAGE We have included trusts as Named Insureds. In addition trustees have been included as insureds but only with respect to their duties as trustees. CG 00 35 04 13 RAILROAD PROTECTIVE LIABILITY COVERAGE FORM EXCLUSIONS BROADENING OF COVERAGE Exclusion 2.. 3a Pollution is amended to expand the exception to the exclusion with respect to bodily injury or property damage arising out of fuel or lubricants for equipment used at the job location not just when they escape from such equipment. Page 2 0of 7 Insurance Services Office Inc. 2012 CGP0150413
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PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM CG 0037 04 13 AND CG 00 38 04 13 I. EXCLUSIONS BROADENING OF COVERAGE 1. Exclusion 2.c. Liquor Liability is revised to provide an exception with respect to allowing a person to bring alcoholic beverages onto the named insured s premises for consumption on the named insured s premises. 2. Exclusion 2.1. Electronic Data is revised to introduce an exception for liability for damages because of bodily injury. Il. DEFINITIONS OTHER CHANGES 1. Exclusion 2.c. Liquor Liability is revised to reinforce that the exclusion applies even if claims against an insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others or providing or failing to provide transportation with respect to any person that may be under the influence of alcohol. 2. Definition 1. Auto is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged. 3. Definition 10. Mobile Equipment is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged. CG 00 39 04 13 POLLUTION LIABILITY COVERAGE FORM DESIGNATED SITES CG 00 40 04 13 POLLUTION LIABILITY LIMITED COVERAGE FORM DESIGNATED SITES I. EXCLUSIONS A. BROADENING OF COVERAGE Exclusion 2.p. Electronic Data is revised to introduce an exception for liability for damages because of bodily injury. B. OTHER CHANGES Exclusion Aircraft Auto Rolling Stock Or Watercraft is generally revised to reinforce that the 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. The exclusion is also revised to express that a land motor vehicle subject to compulsory or financial responsibility laws or other motor vehicle insurance laws will not be covered with respect to its over the road exposures. Il. DEFINITIONS OTHER CHANGES 1. Exclusion 2.j. Aircraft Auto Rolling Stock Or Watercraft is revised to delete reference to in the state. CG 00 40 only 2. Definition 1. Auto is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged. 3. Definition Mobile Equipment is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged. CGP0150413 Insurance Services Office Inc. 2012 Page 30of 7
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CG 00 42 04 13 UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS EXCLUSIONS BROADENING OF COVERAGE Exclusion 2.i. Electronic Data is revised to introduce an exception for liability for damages because of bodily injury. CG 00 65 04 13 ELECTRONIC DATA LIABILITY COVERAGE FORM EXCLUSIONS OTHER CHANGES Exclusion 2.g. Infringement Of Intellectual Property Rights is revised to delete the exception pertaining to the use of another s advertising idea. MULTISTATE ENDORSEMENTS A. BROADENING OF COVERAGE 1. Electronic Data Liability Endorsement CG 04 37 is revised to introduce an exception to the electronic data exclusion in order to provide that the exclusion does not apply to liability for damages because of bodily injury.. Additional Insured Owners Lessees Or Contractors Automatic Status For Other Parties When Required In Written Construction Agreement Endorsement CG 20 38 is introduced to provide additional insured status to those parties whom the named insured is obligated in writing in a contract or agreement to name as an additional insured.. Druggists Endorsement CG 22 69 is revised to introduce an exception for the administering of vaccinations.. Liquor Liability Bring Your Own Alcohol Establishments Endorsement CG 24 06 is introduced to provide coverage to insureds who permit any person to bring any alcoholic beverage on an insured s premises for consumption on the insured s premises. B. REDUCTIONS OF COVERAGE 1. 2. Additional Insured Users Of Golfmobiles Endorsement CG 20 08 is revised to include a definition of the term golfmobile. Liquor Liability Exclusion Endorsements The following endorsements are revised to indicate that the liquor liability exclusion will apply if a named insured permits any person to bring any alcoholic beverages on the named insured s premises for consumption on the named insured s premises L CG 21 50 Amendment Of Liquor Liability Exclusion for use with Commercial General Liability Coverage Part L CG 21 51 Amendment Of Liquor Liability Exclusion Exception For Scheduled Premises Or Activities for use with Commercial General Liability Coverage Part L CG 29 52 Amendment Of Liquor Liability Exclusion for use with Products Completed Operations Liability Coverage Part L CG 29 53 Amendment Of Liquor Liability Exclusion Exception For Scheduled Premises Or Activities for use with Products Completed Operations Liability Coverage Part Page 4 of 7 Insurance Services Office Inc. 2012 CGP0150413
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3. Total Pollution Exclusion For Designated Products Or Work Endorsement CG 21 99 is introduced to exclude coverage with respect to bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants which arises out of the product or work scheduled in the endorsement. 4. Amendment Of Personal And Advertising Injury Definition Endorsement CG 24 13 is introduced to remove from the definition of personal and advertising injury the offense of oral and written publication in any manner of material that violates a person s right of privacy. C. OTHER CHANGES 1. Limited Product Withdrawal Expense Endorsement CG 04 36 is revised in part to reinforce that the Participation Percentage is indicated in the Schedule and to reflect that the cost of the insured s participation in each product withdrawal will be borne by the named insured when due. 2. Primary And Noncontributory Other Insurance Condition Endorsement CG 20 01 is introduced to revise the Other Insurance Condition to indicated that coverage is provided to an additional insured on a primary and noncontributory basis provided that certain requirements are met. 3. 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. 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 L CG 20 03 Additional Insured Concessionaires Trading Under Your Name L CG 20 05 Additional Insured Controlling Interest L CG 20 07 Additional Insured Engineers Architects Or Surveyors. CG 20 10 Additional Insured Owners Lessees Or Contractors Scheduled Person Or Organization L CG 20 11 Additional Insured Managers Or Lessors Of Premises L CG 20 12 Additional Insured State Or Governmental Agency Or Subdivision Or Political Subdivision Permits Or Authorizations L CG 20 13 Additional Insured State Or Governmental Agency Or Subdivision Or Political Subdivision Permits Or Authorizations Relating To Premises.o CG 20 15 Additional Insured Vendors L CG 20 18 Additional Insured Mortgagee Assignee Or Receiver CG 20 23 Additional Insured Executors Administrators Trustees Or Beneficiaries. CG 20 24 Additional Insured Owners Or Other Interest From Whom Land Has Been Leased L CG 20 26 Additional Insured Designated Person Or Organization. CG 20 27 Additional Insured Co owner Of Insured Premises L CG 20 28 Additional Insured Lessor Of Leased Equipment L CG 20 29 Additional Insured Grantor Of Franchise L CG 20 30 Oil Or Gas Operations Nonoperating Working Interests L CG 20 31 Additional Insured Engineers Architects Or Surveyors L ICG 20d32 Additional Insured Engineers Architects Or Surveyors Not Engaged By The Named nsure CG 20 33 Additional Insured Owners Lessees Or Contractors Automatic Status When Required In Construction Agreement With You CGP0150413 Insurance Services Office Inc. 2012 Page50f 7
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L CG 20 34 Additional Insured Lessor Of Leased Equipment Automatic Status When Required In Lease Agreement With You L CG 20 35 Additional Insured Grantor Of Licenses Automatic Status When Required By Licensor L CG 20 36 Additional Insured Grantor Of Licenses L CG 20 37 Additional Insured Owners Lessees Or Contractors Completed Operations L CG 29 35 Additional Insured State Or Governmental Agency Or Subdivision Or Political Subdivision Permits Or Authorizations. Professional Services Endorsements The following endorsements are revised to expressly address in part claims alleging negligence or other wrongdoing in the hiring employment training supervision or monitoring of others by any insured L CG 21 16 Exclusion Designated Professional Services.o CG 21 52 Exclusion Financial Services.o CG 21 56 Exclusion Funeral Services L CG 21 57 Exclusion Counseling Services.o CG 21 58 Exclusion Professional Veterinarian Services L CG 21 59 Exclusion Diagnostic Testing Laboratories L CG 22 24 Exclusion Inspection Appraisal And Survey Companies.o CG 22 32 Exclusion Professional Services Blood Banks L CG 22 33 Exclusion Testing Or Consulting Errors And Omissions L CG 22 34 Exclusion Construction Management Errors And Omissions L CG 22 36 Exclusion Products And Professional Services Druggists L CG 22 37 Exclusion Products And Professional Services Optical And Hearing Aid Establishments L CG 22 39 Exclusion Camps Or Campgrounds L CG 22 43 Exclusion Engineers Architects Or Surveyors Professional Liability L CG 22 44 Exclusion Services Furnished By Health Care Providers L CG 22 45 Exclusion Specified Therapeutic Or Cosmetic Services L CG 22 48 Exclusion Insurance And Related Operations L CG 22 69 Druggists L CG 22 71 Colleges Or Schools Limited Form L CG 22 72 Colleges Or Schools L CG 22 75 Professional Liability Exclusion Computer Software L CG 22 76 Professional Liability Exclusion Health Or Exercise Clubs Or Commercially Operated Health Or Exercise Facilities L CG 22 77 Professional Liability Exclusion Computer Data Processing L CG 22 79 Exclusion Contractors Professional Liability L CG 22 80 Limited Exclusion Contractors Professional Liability L CG 22 87 Exclusion Adult Day Care Centers L CG 22 88 Professional Liability Exclusion Electronic Data Processing Services And Computer Consulting Or Programming Services L CG 22 90 Professional Liability Exclusion Spas or Personal Enhancement Facilities L CG 22 91 Exclusion Telecommunication Equipment Or Service Providers Errors And Omissions L CG 22 96 Limited Exclusion Personal And Advertising Injury Lawyers Page 6 of 7 Insurance Services Office Inc. 2012 CGP0150413
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10. 11. 12 13. 14. 15. L CG 22 98 Exclusion Internet Service Providers And Internet Access Providers Errors And Omissions L CG 22 99 Professional Liability Exclusion Web Site Designers L CG 23 01 Exclusion Real Estate Agents Or Brokers Errors Or Omissions L CG 31 15 Construction Project Management Protective Liability Coverage. Exclusion Volunteer Workers Endorsement CG 21 66 is revised to delete reference to in the state from Exclusion 2.g. Aircraft Auto Or Watercraft.. Exclusion Failure To Supply Endorsement CG 22 50 is revised to expressly state that the exclusion also applies to the failure of any insured to adequately supply biofuel.. Pesticide Or Herbicide Applicator Coverage Endorsements CG 22 64 and CG 28 12 and Lawn Care Services Coverage Endorsement CG 22 93 are revised to reflect a change in titles to Herbicide Applicator Limited Pollution Coverage endorsements and Lawn Care Services Limited Pollution Coverage.. Real Estate Property Managed Endorsement CG 22 70 is revised to reinforce that the insurance provided is excess over any other insurance available whether such insurance is primary or excess.. Colleges Or Schools Endorsements CG 22 71 and CG 22 72 are revised to expressly address in part claims alleging negligence or other wrongdoing in the hiring employment training supervision or monitoring of others by any insured. Waiver Of Governmental Immunity Endorsement CG 24 14 is revised to reference that the endorsement also applies to the Owners And Contractors Protective Liability Coverage Part and the Railroad Protective Liability Coverage Part. Amendment Of Insured Contract Definition Endorsement CG 24 26 and Limited Contractual Liability Railroads Endorsement CG 24 27 are revised to reflect that the defined term insured contract addresses certain liability assumed by the named insured with respect to the tort liability of another party to the extent the assumption of the tort liability is permitted by law. Designated Locationss Aggregate Limit Endorsement CG 25 14 is introduced to make a separate Designated Location Aggregate Limit available for each location of the insured listed in the Schedule of the endorsement. Supplemental Extended Reporting Period Endorsement CG 27 10 and Supplemental Extended Reporting Period Endorsement For Specific Accidents Products Work Or Locations Endorsement CG 27 11 are revised to amend Condition 4. Other Insurance so that the insurance provided is excess over any for which the named insured has been added as an additional insured whether by endorsement or any other means. Principals Protective Liability Coverage Endorsement CG 28 07 is revised to delete reference to in the state from Exclusion 2.c.1ei. Liquor Liability Exclusion Endorsements The following endorsements are revised to reinforce that the exclusion applies even if claims against an insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others or providing or failing to provide transportation with respect to any person that may be under the influence of alcohol L CG 21 50 Amendment Of Liquor Liability Exclusion for use with Commercial General Liability Coverage Part L CG 21 51 Amendment Of Liquor Liability Exclusion Exception For Scheduled Premises Or Activities for use with Commercial General Liability Coverage Part L CG 29 52 Amendment Of Liquor Liability Exclusion for use with Products Completed Operations Liability Coverage Part L CG 29 53 Amendment Of Liquor Liability Exclusion Exception For Scheduled Premises Or Activities for use with Products Completed Operations Liability Coverage Part CGP0150413 Insurance Services Office Inc. 2012 Page 7 of 7
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Philadelphia Indemnity Insurance Company COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS Policy Number PHPK1111221 Agent 2017 X See Supplemental Schedule LIMITS OF INSURANCE 2000000 General Aggregate Limit Other Than Products Completed Operations 2000000 Products Completed Operations Aggregate Limit Any One Person Or Organization 1000000 Personal and Advertising Injury Limit 1000000 Each Occurrence Limit 100000 Rented To You Limit 5000 Medical Expense Limit Any One Person FORM OF BUSINESS CORPORATION Business Description Mental Health Organization Non Profit Location of All Premises You Own Rent or Occupy SEE SCHEDULE ATTACHED AUDIT PERIOD ANNUAL UNLESS OTHERWISE STATED This policy is not subject to premium audit. Rates Advance Premiums Premium Prem. Prod. Prem. Prod. Classifications Code No. Basis Ops. Comp. Ops Ops. Comp. Ops. SEE SCHEDULE ATTACHED TOTAL PREMIUM FOR THIS COVERAGE PART 7277.00 RETROACTIVE DATE CG 00 02 ONLY This insurance does not apply to Bodily Injury Property Damage or Personal and Advertising Injury which occurs before the retroactive date if any shown below. Retroactive Date FORM S AND ENDORSEMENT S APPLICABLE TO THIS COVERAGE PART Refer To Forms Schedule Countersignature Date Authorized Representative remium SEE SCHEDULE ATTACHED
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Philadelphia Indemnity Insurance Company Form Schedule General Liability Policy Number PHPK1111221 Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue Form Edition Description CGPO11 0509 Recording and Distribution of Material or Information CGPO15 0413 2012 GL Multistate Forms Revision Advisory Notice Gen Liab Dec 1004 Commercial General Liability Coverage Part Declaration Gen Liab Schedule 0100 General Liability Schedule CG0001 0413 Commercial General Liability Coverage Form CG0109 1185 Kansas and Oklahoma Transfer of Rights CG2146 0798 Abuse Or Molestation Exclusion CG2147 1207 Employment Related Practices Exclusion CG2157 0413 Exclusion Counseling Services CG2167 1204 Fungi or Bacteria Exclusion CG2173 0108 Exclusion of Certified Acts of Terrorism CG2642 0105 Kansas Changes Binding Arbitration PI GLD HS 1011 General Liability Deluxe Endorsement Human Services PI HS005 0704 Exclusion Professional Liability Coverage PI MANU1 0100 KANSAS STATUTORY DAMAGES PI MANU2 0100 FELLOW EMPLOYEE EXCLUSION PI SE001 1205 Fund Raising Events Endorsement Page
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Philadelphia Indemnity Insurance Company COMMERCIAL GENERAL LIABILITY COVERAGE PART SUPPLEMENTAL SCHEDULE Policy Number PHPK1111221 Agent 2017 Classifications Code No. Premium Basis Rates Prem. Ops. Prod. Comp. Ops. Advance Premiums Prem. Ops. Prod. Comp. Ops. KS PREM NO. 001 BLDG PREMS OFF ICE NOC NFP PROD COMP OP SUBJ TO GEN AGG LIMIT KS PREM NO. 001 HEALTH CARE FACIL OUTPATNT NEP PROD COMP OP SUBJ TO GEN AGG LIMIT KS PREM NO. 002 HEALTH CARE FACIL OUTPATNT NEP PROD COMP OP SUBJ TO GEN AGG LIMIT KS PREM NO. 003 HEALTH CARE FACIL OUTPATNT NEP PROD COMP OP SUBJ TO GEN AGG LIMIT KS PREM NO. 004 SHELTER MISSION STTLMNT HALF H PROD COMP OP SUBJ TO GEN AGG LIMIT KS PREM NO. 004 WAREHOUSE PRIVATE NFP PROD COMP OP SUBJ TO GEN AGG LIMIT KS PREM NO. 005 HEALTH CARE FACIL ALCOHOL NFP PROD COMP OP SUBJ TO GEN AGG LIMIT 61227 44440 44440 44440 67017 68707 44428 AREA AREA AREA AREA AREA AREA AREA 1000 7843 32310 27180 3000 816 17902 98.782 65.685 100.488 65.685 72.509 26.274 79.845 INCL INCL INCL INCL INCL INCL INCL 99 515 3247 1785 218 21 631 INCL INCL INCL INCL INCL INCL INCL REA REA REA REA REA REA REA 1000 7843 32310 27180 3000 816 17902 INCI INCI INCI INCI INCI INCI INCI KS PREM NO. 001 HEALTH CARE FACIL OUTPATNT NEP PROD COMP OP SUBJ TO GEN AGG LIMIT INCL KS PREM NO. 002 HEALTH CARE FACIL OUTPATNT NEP PROD COMP OP SUBJ TO GEN AGG LIMIT INCL KS PREM NO. 003 HEALTH CARE FACIL OUTPATNT NEP PROD COMP OP SUBJ TO GEN AGG LIMIT INCL KS PREM NO. 004 SHELTER MISSION STTLMNT HALF H PROD COMP OP SUBJ TO GEN AGG LIMIT INCL KS PREM NO. 004 WAREHOUSE PRIVATE NFP PROD COMP OP SUBJ TO GEN AGG LIMIT INCL KS PREM NO. 005 HEALTH CARE FACIL ALCOHOL NFP PROD COMP OP SUBJ TO GEN AGG LIMIT INCL
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Philadelphia Indemnity Insurance Company COMMERCIAL GENERAL LIABILITY COVERAGE PART SUPPLEMENTAL SCHEDULE Policy Number PHPK1111221 Agent 2017 Classifications Code No. Premium Basis Rates Prem. Prod. Ops. Comp. Ops. Advance Premiums Prem. Prod. Ops. Comp. Ops. KS PREM NO. 005 BLDG PREMS OFF ICE NOC NFP PROD COMP OP SUBJ TO GEN AGG LIMIT KS LIABILITY DELUXE 61227 44444 AREA 1000 98.782 INCL 99 INCL 662 REA 1000 INCI KS LIABILITY DELUXE
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P1 603 KS 0203 Philadelphia Indemnity Insurance Company MENTAL HEALTH CENTER PROFESSIONAL LIABILITY PROGRAM Declarations Claims Made Item1. NAMED INSURED and Address No. Street City County State Zip Code Policy Number PHPK1111221 The Named Insured is a JOHNSON COUNTY MENTAL Mental Health Center HEALTH CENTER 111 S Cherry St Ste 2400 C O RISK MANAGEMENT Agent Name Address LOCKTON COMPANIES LLC 444 W. 47th St. Suite 900 SUITE 900 KANSAS CITY MO 64112 Item 2. Policy Period From 01012014 to 01012015 1201 A.M. standard time at the address of the Named Insured as stated herein. Item 3. The Insurance afforded is only respect to such of the following Coverage Parts and Coverage s as are indicated by specific premium charge or charges. The limit of the Company s liability against each such Coverage shall be as stated herein subject to all the terms of this policy having reference thereto. COVERAGE PARTS COVERAGES LIMITS OF LIABILITY ADVANCE PREMIUMS Retroactive Date 200000 Mental Health Center Professional 08141977 Liability Insurance 600000 annual aggregate 25396 A Bodily Injury or each occurrence Property Damage Liability Not Covered Commercial General B Personal Injury Advertis Not Covered annual aggregate Ing Injury Coverage Not Covered Fire Legal Liability Not Covered each occurrence Umbrella Liability Retroactive Date Not Covered Not Covered Not Covered Annual aggregate Excess Liability Retroactive Date Not Covered Not Covered Not Covered annual aggregate Endorsement Nos. Additional Insured Endorsement See Forms Schedule Total Deposit Premium 64314 Kansas Health Care Stabilization Fund Surcharge 10158 Commercial General Excess Liability Retroactive Date Countersigned by Authorized Representative
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Philadelphia Indemnity Insurance Company Form Schedule Professional Liability Policy Number PHPK1111221 Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue Form Edition Description PI603 KS 0203 Mental Health Center Prof Liab Program Dec Claims Made PI600 KS 0203 Specialized Allied Health Care Providers Prof Liab Cov PI600A KS 0203 Additional Insureds Endorsement PI604 KS 0203 Mental Health Center Prof Liab Insurance Claims Made PI ARB1 KS 0503 Binding Arbitration PI PPL001 HS 0803 Prior Pending Litigation and Known Circumstances Excl Page
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Philadelphia Indemnity Insurance Company Professional Liability Assessment Schedule Policy Number PHPK1111221 Kansas Healthcare Stabilization Fund 10158.00 Page
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PI SO008D 11 98 POLICY DECLARATIONS PAGE SEXUAL OR PHYSICAL ABUSE OR MOLESTATION VICARIOUS LIABILITY COVERAGE FORM PLEASE READ THIS POLICY CAREFULLY. POLICY NO. PHPK1111221 POLICY NO. PHPK1111221 Effective date 01012014 1201 A.M. Standard Time LIMIT OF INSURANCE AGGREGATE LIMIT 100000 EACH ABUSIVE CONDUCT LIMIT 100000 BUSINESS DESCRIPTION Form of Business CORPORATION Business Description Mental Health Organization Non Profit FORMS AND ENDORSEMENTS Other than Applicable Forms and Endorsements Shown Elsewhere in the Policy Forms and Endorsements Applying to this Coverage Part and Made Part of this Policy at Time of Issue SEE SCHEDULE THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD. UCT LIMIT Organization Non Profit 1y B e LUVETdYE T alt dlid IVidus T ait VUi e T Uliby at i Page 1 of 1 Includes copyright material of the Insurance Services Office Inc. used with its permission.
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Philadelphia Indemnity Insurance Company Form Schedule Sexual or Physical Abuse or Molestation Policy Number PHPK1111221 Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue Form Edition Description PI SO008D 1198 Policy Dec Sexual or Physical Abuse or Molestation PI ARB1 KS 0503 Binding Arbitration PI SO008 0199 Sexual or Physical Abuse or Molest Liab Occurrence PI SO013 0205 Employee Defense Coverage Page
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PI BELL1 1109 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BELL ENDORSEMENT PHILADELPHIA INSURANCE COMPANIES A Member of the Tokio Marine Group One Bala Plaza Suite 100 Bala Cynwyd Pennsylvania 1900. 610.617.7900 Fax 610.617.79 PHLY.com PHILADELPHIA INSURANCE COMPANIES A Member of the Tokio Marine Group One Bala Plaza Suite 100 Bala Cynwyd Pennsylvania 19004 610.617.7900 Fax 610.617.7940 PHLY.com Unless otherwise stated herein the terms conditions exclusions and other limitations set forth in this endorsement are solely applicable to coverage afforded by this endorsement and the policy is amended as follows SCHEDULE OF ADDITIONAL COVERAGES AND LIMITS The following is a summary of Limits of Liability or Limits of Insurance andor additional coverages provided by this endorsement. This endorsement is subject to the provisions of the policy to which it is attached. COVERAGE Business Travel Accident Benefit Conference Cancellation Donation Assurance Emergency Real Estate Consulting Fee Fundraising Event Blackout Identity Theft Expense Image Restoration and Counseling Key Individual Replacement Expenses Kidnap Expense Political Unrest LIMITS OF INSURANCE 50000 25000 50000 50000 25000 50000 50000 50000 50000 5000 per employee 25 000 policy limit LIMITS OF INSURANCE 50000 25000 50000 50000 25000 50000 50000 50000 50000 5000 per employee 25000 policy limit 25000 50000 1500 50000 Temporary Meeting Space Reimbursement Terrorism Travel Reimbursement Travel Delay Reimbursement Workplace Violence Counseling Page 1 of 8 2009 Philadelphia Insurance Companies
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PI BELL1 1109 CONDITIONS A. Applicability of Coverage Coverage provided by your policy and any endorsements attached thereto is amended by this endorsement where applicable. Limits of Liability or Limits of Insurance 1. When coverage is provided by this endorsement and another coverage form or endorsement attached to this policy the greater limits of liability or limits of insurance will apply. In no instance will multiple limits apply to coverages which may be duplicated within this policy. Additionally if this policy and any other coverage part or policy issued to you by us or any company affiliated with us apply to the same occurrence offense wrongful act accident or loss the maximum limits of liability or limits of insurance under all such coverage parts or policies combined shall not exceed the highest applicable limits of liability or limits of insurance under any one coverage part or policy. 2. Limits of liability or limits of insurance identified in Section I. SCHEDULE OF ADDITIONAL COVERAGES AND LIMITS above are not excess of but are in addition to the applicable Limits of Liability or Limits of Insurance stated in the Declarations.. Claim Expenses Coverages provided herein are not applicable to the generation of claim adjustment costs by you such as fees you may incur by retaining a public adjuster or appraiser. ADDITIONAL COVERAGES A. Business Travel Accident Benefit We will pay a Business Travel Accident Benefit to the insured if a director or officer suffers injury or death while traveling on a common carrier for your business during the policy period. For the purpose of Business Travel Accident Benefit coverage injury means 1. Physical damage to the body caused by violence fracture or an accident that results in loss of life not later than one hundred eighty 180 days after the policy expiration the date of cancellation or the date of non renewal 2. Accidental loss of limbs or multiple fingers 3. Total loss of sight speech or hearing. The limit of insurance for this coverage is 50000 per policy period for all insureds combined. No deductible applies to this coverage. The Business Travel Accident Benefit shall not be payable if the cause of the injury was 1. Anintentional act by the insured 2. An act of suicide or attempted suicide 3. Anact of war or 4. Adisease process. Page 2 of 8 2009 Philadelphia Insurance Companies
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PI BELL1 1109 B. Conference Cancellation We will reimburse the insured for any business related conference expenses paid by the insured and not otherwise reimbursed for a canceled conference that an employee was scheduled to attend. The cancellation must be due directly to a natural catastrophe or a communicable disease outbreak that forces the cancellation of the conference. With respect to a conference cancellation claim it is further agreed as follows 1. The insured employee must have registered for the conference at least thirty 30 days prior to the cancellation and 2. The cancellation must be ordered by a local state or federal Board of Health or other governmental authority having jurisdiction over the location of the conference. The limit of insurance for this coverage is 25000 per policy period for all insureds combined. No deductible applies to this coverage. C. Donation Assurance If the insured is a 501c3 status non profit organization as defined in the United States Internal Revenue Code we will reimburse the insured for failed donation claims. With respect to any failed donation claim it is further agreed as follows 1. The donor must not have been in bankruptcy nor have filed for bankruptcy or reorganization in the past seven 7 years prior to the time said pledge was made to the insured 2. For non cash donations our payment of a failed donation claim shall be based on the fair market value of said non cash donation at the time of the failed donation claim 3. In the case of unemployment or incapacitation of a natural person donor and as a condition of payment of the failed donation claim a. Neither the natural person donor nor the insured shall have had reason to believe the donor would become unemployed or incapacitated subsequent to the donation date and b. The donor shall be unemployed for at least sixty 60 days prior to a claim being submitted by the insured 4. No coverage shall be afforded for a written pledge of funds or other measurable tangible property to the insured dated prior to the policy period and 5. A donation amount which is to be collected by the insured over more than a twelve 12 month period shall be deemed a single donation. The limit of insurance for this coverage is 50000 per policy period for all insureds combined. No deductible applies to this coverage. D. Emergency Real Estate Consulting Fee We will reimburse the insured any realtor s fee or real estate consultant s fee necessitated by the insured s need to relocate due to the unforeseeable destruction of the insured s principal location listed in the Declarations during the policy period. The limit of insurance for this Page 3 of 8 2009 Philadelphia Insurance Companies
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PI BELL1 1109 coverage is 50000 per policy period for all insureds combined. No deductible applies to this coverage. Fundraising Event Blackout We will reimburse the insured for fundraising expenses that are incurred due to the cancellation of a fundraising event caused by the lack of electric supply resulting in a power outage provided the fundraising event is not re scheduled. The fundraising event must have been planned at least thirty 30 days prior to the power outage. The limit of insurance for this coverage is 25000 per policy period for all insureds combined. No deductible applies to this coverage. Identity Theft Expense We will reimburse any present director or officer of the named insured for identity theft expenses incurred as the direct result of any identity theft first discovered and reported during the policy period provided that it began to occur subsequent to the effective date of the insured s first policy with us. The limit of insurance for this coverage is 50000 per policy period for all insureds combined. No deductible applies to this coverage.. Image Restoration and Counseling We will reimburse the insured for expenses incurred for image restoration and counseling arising out of improper acts by any natural person. Covered expenses are limited to 1. The costs of rehabilitation and counseling for the accused natural person insured provided the natural person insured is not ultimately found guilty of criminal conduct this reimbursement to occur after acquittal of the natural person insured 2. The costs charged by a recruiter or expended on advertising for replacing an officer as a result of improper acts and 3. The costs of restoring the named insured s reputation and consumer confidence through image consulting. The limit of insurance for this coverage is 50000 per policy period for all insureds combined. No deductible applies to this coverage. Key Individual Replacement Expenses We will pay key individual replacement expenses if the Chief Executive Officer or Executive Director suffers an injury during the policy period which results in the loss of life during the policy period. The limit of insurance for this coverage is the lesser of 50000 or ten 10 times the annual premium paid for this policy. No deductible applies to this coverage. Kidnap Expense We will pay on behalf of any director or officer of the insured reasonable fees incurred as a result of the kidnapping of them or their spouse domestic partner parent or child during the policy period. Coverage will not apply to any kidnapping by or at the direction of any present or former family member of the victim. Reasonable fees will include Page 4 of 8 2009 Philadelphia Insurance Companies
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PI BELL1 1109 1. Fees and costs of independent negotiators 2. Interest costs for any loan from a financial institution taken by you to pay a ransom demand or extortion threat 3. Travel costs and accommodations incurred by the named insured 4. Reward money paid to an informant which leads to the arrest and conviction of parties responsible for loss covered under this insurance and 5. Salary commissions and other financial benefits paid by you to a director or officer. Such compensation applies at the level in effect on the date of the kidnap and ends upon the earliest of a. Up to thirty 30 days after their release if the director or officer has not yet returned to work b. Discovery of their death c. One hundred twenty 120 days after the last credible evidence following abduction that they are still alive or d. Twelve 12 months after the date of the kidnapping. The limit of insurance for this coverage is 50000 each policy period for all insureds combined. No deductible applies to this coverage. Political Unrest Coverage We will reimburse any present director officer employee or volunteer of the named insured while traveling outside the United States of America for emergency evacuation expenses that are incurred as a result of an incident of political unrest. This political unrest must occur during the policy period. No coverage is granted for travel to countries in a state of political unrest at the time of departure of the travel. The limit of insurance for this coverage is 5000 per covered person subject to a maximum of 25000 per policy period for all insureds combined. No deductible applies to this coverage.. Temporary Meeting Space Reimbursement We will reimburse the insured for rental of meeting space which is necessitated by the temporary unavailability of the insured s primary office space due to the failure of a climate control system or leakage of a hot water heater during the policy period. Coverage will exist only for the renting of temporary meeting space required for meeting with parties who are not insured under this policy. The limit of insurance for this coverage is 25000 per policy period for all insureds combined. No deductible applies to this coverage. Terrorism Travel Reimbursement We will reimburse any present director or officer of the named insured in the event of a certified act of terrorism during the policy period which necessitates that he she incurs emergency travel expenses. The limit of insurance for this coverage is 50000 per policy period for all insureds combined. No deductible applies to this coverage. Page 5 of 8 2009 Philadelphia Insurance Companies
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PI BELL1 1109 M. Travel Delay Reimbursement We will reimburse any present director or officer of the named insured for any non reimbursable expenses they incur as a result of the cancellation of any regularly scheduled business travel on a common carrier. The limit of insurance for this coverage is 1500 per policy period for all insureds combined. A seventy two 72 hour waiting period deductible applies to this coverage. N. Workplace Violence Counseling We will reimburse the insured for emotional counseling expenses incurred directly as a result of a workplace violence incident at any of the insured s premises during the policy period. The emotional counseling expenses incurred must have been for 1. Your employees who were victims of or witnesses to the workplace violence 2. The spouse domestic partner parents or children of your employees who were victims of or witnesses to the workplace violence and 3. Any other person or persons who directly witnessed the workplace violence incident. The limit of insurance for this coverage is 50000 per policy period for all insureds combined. No deductible applies to this coverage. DEFINITIONS For the purpose of this endorsement the following definitions apply A. Certified act of terrorism means any act so defined under the Terrorism Risk Insurance Act and its amendments or extensions. B. Communicable disease means an illness sickness condition or an interruption or disorder of body functions systems or organs that is transmissible by an infection or a contagion directly or indirectly through human contact or contact with human fluids waste or similar agent such as but not limited to Meningitis Measles or Legionnaire s Disease. C. Domestic partner means any person who qualifies as a domestic partner under the provisions of any federal state or local statute or regulation or under the terms and provisions of any employee benefit or other program established by the named insured. D. Emergency evacuation expenses mean 1. Additional lodging expenses 2. Additional transportation costs 3. The cost of obtaining replacements of lost or stolen travel documents necessary for evacuation from the area of political unrest and 4. Translation services message transmittals and other communication expenses. provided that these expenses are not otherwise reimbursable. E. Emergency travel expenses mean Page 6 of 8 2009 Philadelphia Insurance Companies
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PI BELL1 1109 1. Hotel expenses incurred which directly result from the cancellation of a scheduled transport by a commercial transportation carrier resulting directly from and within forty eight 48 hours of a certified act of terrorism and 2. The increased amount incurred which may result from re scheduling comparable transport to replace a similarly scheduled transport canceled by a commerecial transportation carrier in direct response to a certified act of terrorism provided that these expenses are not otherwise reimbursable. Failed donation claim means written notice to the insured during the policy period of 1. The bankruptcy or reorganization of any donor whereby such bankruptcy or reorganization prevents the donor from honoring a prior written pledge of funds or other measurable tangible property to the insured or 2. The unemployment or incapacitation of a natural person donor preventing him her from honoring a prior written pledge of funds or other measurable tangible property to the insured.. Fundraising expenses mean deposits forfeited and other charges paid by you for catering services property and equipment rentals and related transport venue rentals accommodations including travel and entertainment expenses less any deposits or other fees refunded or refundable to you. Identity theft means the act of knowingly transferring or using without lawful authority a means of identification of any director or officer or spouse or domestic partner thereof of the named insured with the intent to commit or to aid or abet another to commit any unlawful activity that constitutes a violation of federal law or a felony under any applicable state or local law. Identity theft expenses mean 1. Costs for notarizing affidavits or similar documents attesting to fraud required by financial institutions or similar credit grantors or credit agencies 2. Costs for certified mail to law enforcement agencies credit agencies financial institutions or similar credit grantors and 3. Loan application fees for re applying for a loan or loans when the original application is rejected solely because the lender received incorrect credit information. Improper acts means any actual or alleged act of 1. Sexual abuse 2. Sexual intimacy 3. Sexual molestation or 4. Sexual assault committed by an insured against any natural person who is not an insured. Such improper acts must have been committed by the insured while in his or her capacity as an insured. Injury whenever used in this endorsement other than in Section Ill. A. Business Travel Page 7 of 8 2009 Philadelphia Insurance Companies
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PI BELL1 1109 means any physical damage to the body caused by violence fracture or an accident. Key individual replacement expenses mean the following necessary expenses 1. 2. Costs of advertising the employment position opening Travel lodging meal and entertainment expenses incurred in interviewing job applicants for the employment position opening and Miscellaneous extra expenses incurred in finding interviewing and negotiating with the job applicants including but not limited to overtime pay costs to verify the background and references of the applicants and legal expenses incurred to draw up an employment contract.. Natural catastrophe means hurricane tornado earthquake or flood. Non reimbursable expenses means the following travel related expenses incurred after a seventy two 72 hour waiting period beginning from the time documented on the proof of cancellation and for which your director or officer produces a receipt 1. 2. 3. 4. 1. Meals and lodging Alternative transportation Clothing and necessary toiletries and Emergency prescription and non prescription drug expenses.. Political unrest means A short term condition of disturbance turmoil or agitation within a foreign country that poses imminent risks to the security of citizens of the United States A long term condition of disturbance turmoil or agitation that makes a foreign country dangerous or unstable for citizens of the United States or A condition of disturbance turmoil or agitation in a foreign country that constrains the United States Government s ability to assist citizens of the United States due to the closure or inaccessibility of an embassy or consulate or because of a reduction of its staff for which either an alert or travel warning has been issued by the United States Department of State. Principal location means the headquarters home office or main location where most business is substantially conducted.. Unforeseeable destruction means damage resulting from a certified act of terrorism fire collision or collapse which renders all of the insured s principal locations completely unusable. Workplace violence means any intentional use of or threat to use deadly force by any person with intent to cause harm and that results in bodily injury or death of any person while on the insured s premises. Page 8 of 8 2009 Philadelphia Insurance Companies
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PI CME1 1009 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CRISIS MANAGEMENT ENHANCEMENT ENDORSEMENT Unless otherwise stated herein the terms conditions exclusions and other limitations set forth in this endorsement are solely applicable to coverage afforded by this endorsement and the policy is amended as follows Solely for the purpose of this endorsement 1 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. 2 The words we us and our refer to the company providing this insurance. SCHEDULE OF ADDITIONAL COVERAGE AND LIMITS The following is the Limit of Liability provided by this endorsement. This endorsement is subject to the provisions of the policy to which it is attached. Crisis Management Expense 25000 CONDITIONS A. Applicability of Coverage Coverage provided by your policy and any endorsements attached thereto is amended by this endorsement where applicable. All other terms and conditions of the policy or coverage part to which this endorsement is attached remain unchanged. B. Limits of Liability or Limits of Insurance When coverage is provided by this endorsement and any other coverage form or endorsement attached to this policy we will pay only for the amount of covered loss or damage in excess of the amount due from that other insurance whether you can collect on it or not. But we will not pay more than the applicable Limit of Liability or Limit of Insurance. C. Claim Expenses Coverages provided herein are not applicable to the generation of claim adjustment costs by you such as fees you may incur by retaining a public adjuster or appraiser. ADDITIONAL COVERAGES A. We will reimburse you for crisis management emergency response expenses incurred because of an incident giving rise to a crisis to which this insurance applies. The amount of such reimbursement is limited as described in Section Il. CONDITIONS B. Limits of Liability or Limits of Insurance. No other obligation or liability to pay sums or perform acts or services is covered. B. We will reimburse only those crisis management emergency response expenses which are incurred during the policy period as shown in the Declarations of the policy to which this coverage is attached and reported to us within six 6 months of the date the crisis was initiated. 25000 Page 1 of 2
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PI CME1 1009 DEFINITIONS A. Crisis means the public announcement that an incident occurred on your premises or at an event sponsored by you. Crisis management emergency response expenses mean those expenses incurred for services provided by a crisis management firm. However crisis management emergency response expenses shall not include compensation fees benefits overhead charges or expenses of any insured or any of your employees nor shall crisis management emergency response expenses include any expenses that are payable on your behalf or reimbursable to you under any other valid and collectible insurance. Crisis management firm means any service provider you hire that is acceptable to us. Our consent will not be unreasonably withheld. Incident means an accident or other event including the accidental discharge of pollutants resulting in death or serious bodily injury to three or more persons. Serious bodily injury means any injury to a person that creates a substantial risk of death serious permanent disfigurement or protracted loss or impairment of the function of any bodily member or organ. Page 2 of 2
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IL00 17 11 98 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation b. Give you reports on the conditions we find 1. The first Named Insured shown in the Declara tions may cancel this policy by mailing or de livering to us advance written notice of cancel lation. 2. We may cancel this policy by mailing or deliv ering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancel lation if we cancel for nonpayment of pre mium or b. 30 days before the effective date of cancel lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be ef fective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be suf ficient proof of notice.. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declara tions is authorized to make changes in the terms of this policy with our consent. This policy s terms can be amended or waived only by endorsement issued by us and made a part of this policy.. Examination Of Your Books And Records We may examine and audit your books and rec ords as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspections And Surveys 1. We have the right to a. Make inspections and surveys at any time and c. Recommend changes. 2. We are not obligated to make any inspections surveys reports or recommendations and any such actions we do undertake relate only to in surability and the premiums to be charged. We do not make safety inspections. We do not un dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions a. Are safe or healthful or b. Comply with laws regulations codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us but also to any rating advisory rate service or similar organization which makes insurance inspections surveys reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections surveys reports or recom mendations we may make relative to certifica tion under state or municipal statutes ordi nances or regulations of boilers pressure ves sels or elevators.. Premiums The first Named Insured shown in the Declara tions 1. Is responsible for the payment of all premiums and 2. Will be the payee for any return premiums we pay.. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named in sured. If you die your rights and duties will be trans ferred to your legal representative but only while acting within the scope of duties as your legal rep resentative. Until your legal representative is ap pointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. IL00 17 11 98 Copyright Insurance Services Office Inc. 1998 Page 1 of 1 m
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IL 00 21 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply A. Under any Liability Coverage to bodily injury or property damage 1 With respect to which an insured under the policy is also an insured under a nu clear energy liability policy issued by Nu clear Energy Liability Insurance Associa 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 tion Mutual Atomic Energy Liability 2 The nuclear material is contained in Underwriters Nuclear Insurance Associa spent fuel or waste at any time pos tion of Canada or any of their successors sessed handled used processed stored or would be an insured under any such pol transported or disposed of by or on behalf icy but for its termination upon exhaustion of an insured or of its limit of liability or 3 The bodily injury or property damage 2 Resulting from the hazardous properties arises out of the furnishing by an insured of nuclear material and with respect to 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 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 property thereat.. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. expenses incurred with respect to bodily in Nuclear material means source material spe jury resulting from the hazardous properties cial nuclear material or by product material. of nuclear material and arising out of the op eration of a nuclear facility by any person or organization. C. Under any Liability Coverage to bodily injury or property damage resulting from hazard ous properties of nuclear material if 1 The nuclear material a is at any nuclear facility owned by or operated by or on be half of an insured or b has been dis charged or dispersed therefrom 2 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 property 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. 3 IL 00 21 09 08 ISO Properties Inc. 2007 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 ex posed to radiation in a nuclear reactor. Waste means any waste material a containing by product material other than the tailings or wastes produced by the extraction or concentra tion of uranium or thorium from any ore processed primarily for its source material content and b resulting from the operation by any person or or ganization of any nuclear facility included under the first two paragraphs of the definition of 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 plutonium 2 processing or utilizing spent fuel or 3 handling processing or packag ing waste c Any equipment or device used for the proc essing 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 pluto nium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 d Any structure basin excavation premises or place prepared or used for the storage or disposal of waste and includes the site on which any of the foregoing is located all operations conducted on such site and all premises used for such operations. Nuclear reactor means any apparatus designed or used to sustain nuclear fission in a self supporting chain reaction or to contain a critical mass of fissionable material. Property damage includes all forms of radioac tive contamination of property. Page 2 of 2 ISO Properties Inc. 2007 IL 00 21 09 08 o
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IL 026109 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. KANSAS 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 A. 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 Paragraph 2. of the Cancellation Common Policy Condition is replaced by the following 2.a. We may cancel this policy by mailing or deliv ering to the first Named Insured written notice of cancellation stating the reasons for cancel lation at least 1 10 days before the effective date of cancel lation if we cancel for nonpayment of pre mium. 2 30 days before the effective date of cancel lation if we cancel for any other reason. b. If this policy has been in effect for 90 days or more or if it is a renewal of a policy we issued we may cancel this policy only for one or more of the following reasons 1 Nonpayment of premium 2 This policy was issued because of material misrepresentation 3 You or any other insured violated any of the material terms and conditions of this policy 4 Unfavorable underwriting factors specific to you exist that were not present at the in ception of this policy 5 A determination by the insurance commis sioner that continuation of coverage could place us in a hazardous financial condition or in violation of the laws of Kansas or 6 A determination by the insurance commis sioner that we no longer have adequate re insurance to meet our needs. B. The following is added and supersedes any condi tion to the contrary NONRENEWAL 1. If we decide not to renew this policy we will mail or deliver written notice of nonrenewal stating the reasons for nonrenewal to the first Named Insured at least 60 days prior to the expiration of the policy. 2. Any notice of nonrenewal will be mailed or delivered to the first Named Insured s last mail ing address known to us. If notice is mailed proof of mailing will be sufficient proof of no tice. IL 02 61 09 07 ISO Properties Inc. 2006 Page 1 of 1 a
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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 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 c 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 under 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. 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 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. o b c 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 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 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 ROMs 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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COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. KANSAS AND OKLAHOMA CHANGES TRANSFER OF RIGHTS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART. Condition 8. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Section 1V does not apply to COVERAGE C. MEDICAL PAYMENTS. CG 01091185 Copyright Insurance Services Office Inc. 1984 Page 1 of 1 a
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COMMERCIAL GENERAL LIABILITY CG 21 46 07 98 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ABUSE OR MOLESTATION EXCLUSION 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 Para graph 2. Exclusions of Section Coverage B Personal And Advertising Injury Lial This insurance does not apply to bodily injury property damage or personal and advertising injury arising out of 1. The actual or threatened abuse or molestation by anyone of any person while in the care custody or control of any insured or 2. The negligent a. Employment b. Investigation c. d. Reporting to the proper authorities or failure Supervision to so report or Retention of a person for whom any insured is or ever was legally responsible and whose conduct would be excluded by Paragraph 1. above. CG 21 46 07 98 Copyright Insurance Services Office Inc. 1997 Page 1 of 1 m
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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 21570413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION COUNSELING SERVICES 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 advisory services or counseling with respect to such issues as mental health crisis prevention social services or drug and alcohol rehabilitation or similar subjects. 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 advisory services or counseling described above. CG 21570413 Insurance Services Office Inc. 2012 Page 1 0of 1
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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 21730108 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF 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 indi rectly out of a certified act of terrorism. 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 dam age personal and advertising injury injury or environmental damage as may be defined in any applicable Coverage Part. 2. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in concurrence with the Secretary of State and the Attorney General of the United States to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria con tained 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 Terror ism Risk Insurance Act and b. The act is a violent act or an act that is dangerous to human life property or infra structure and is committed by an individual or individuals as part of an effort to coerce 2. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in concurrence with the Secretary of State and the Attorney General of the United States to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria con tained 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 Terror ism Risk Insurance Act and b. The act is a violent act or an act that is dangerous to human life property or infra structure 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 con duct of the United States Government by coercion. CG 21730108 ISO Properties Inc. 2007 Page 1 of 1 a
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COMMERCIAL GENERAL LIABILITY CG 26 420105 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. KANSAS CHANGES BINDING ARBITRATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY If after a claim has been made a dispute arises be cause we and the insured do not agree whether cov erage is provided under this Coverage Part for a claim made against the insured both parties may by mutual consent agree in writing to arbitration of the disagreement. One party can not force the other party into arbi tration. However if both parties agree to arbitrate by mutual consent each party will select an arbitrator. The two arbitrators will select a third. If they can not agree within 30 days both parties must request that selec tion be made by a judge of a court having jurisdiction. Each party will 1. Pay the expenses it incurs and 2. Bear the expenses of the third arbitrator equally. Unless both parties agree otherwise arbitration will take place in the county in which the address shown in the Declarations is located. Local rules of law as to procedure and evidence will apply. A decision agreed to by two of the arbitrators will be binding. CG 26 42 01 05 ISO Properties Inc. 2005 Page 1 of 1 a
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