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COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BROAD NAMED INSURED ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM It is agreed that Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any business entity incorporated or organized under the laws of the United States of America including any State thereof its territories or possessions or Canada including any Province thereof in which the Named Insured shown in the Declarations owns during the policy period an interest of more than 50 percent. If other valid and collectible insurance is available to any business entity covered by this policy solely by reason of ownership by the Named Insured shown in the Declarations in excess of 50 percent this insurance is excess over the other insurance whether primary excess contingent or on any other basis. CGLB307 1109 Insured Copy | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF OCCURRENCE ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. Condition 2. Duties in the Event of Occurrence Offense Claim or Suit of Section IV Conditions is deleted and replaced by the following 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 after the Risk Manager or such person designated as responsible for insurance related matters at the insured s headquarters has knowledge of an occurrence or an offense regardless of the amount 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. Ifaclaim 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 You must notify us and 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. For the purposes of the coverage provided by this endorsement you shall presumed to have knowledge of the occurrence or offense when it has been reported to the Risk Manager or other person designated as responsible for insurance related matters. CGLB308 1109 Insured Copy | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UNINTENTIONAL ERRORS OMISSIONS ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM The following condition is added to SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Unintentional Errors and Omissions Failure by you to disclose to us all hazards existing as of the inception date ofthis policy shall not prejudice us with respect to the coverage afforded by this policy provided such error or omission is not intentional. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. CGLB309 0512 Page 10f 1 Page 1 of 1 Insured Copy | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ASBESTOS ELECTRO MAGNETIC EMISSIONS LEAD AND RADON EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM The following exclusions are added to Paragraph 2. Exclusions of Section ICoverage A Bodily Injury And Property Damage and to Paragraph 2. Exclusions of Section I Coverage B Personal and Advertising Injury This insurance does not apply to Bodily injury property damage or personal and advertising injury arising out of any of the following 1. Asbestos orany asbestos related injury or damage including but not limited to any injury or damage arising out of or alleged to have arisen out of any act error omission failure to warn or failure to disclose the presence of asbestos or other duty involving asbestos its use exposure existence detection removal elimination or avoidance. Electro magnetic emissions or radiation related injury or damageincluding but not limited to any injury or damage arising out of or alleged to have arisen out of any act error omission failure to warn or other duty involving any electro magnetic emissions or radiation from any exposure to or any use existence detection removal elimination or avoidance of electrical energy. Lead orany lead related injury or damage including but not limited to any injury or damage arising out of or alleged to have arisen out of any act error omission failure to warn or other duty involving lead or lead products their use exposure existence detection removal elimination or avoidance. Radon or any other radioactive emissions manmade or natural or any related injury or damage including but not limited to any injury or damage arising out of or alleged to have arisen out of any act error omission failure to warn or other duty involving radon orany other radioactive emissions their use exposure existence detection removal elimination or avoidance. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. CGLB310 0110 Page 1 of 1 Insured Copy Page 1 of 1 Insured Copy | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UNWARRANTED CLAIM OF ANIMAL CRUELTY LIMITED DEFENSE EXPENSE REIMBURSEMENT THIS ENDORSEMENT PROVIDES CLAIMS MADE COVERAGE. PLEASE READ THE ENTIRE ENDORSEMENT CAREFULLY. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM Animal Cruelty Claim Schedule Coverage Description Animal Cruelty Claim Limit of Insurance 20000 Retention 2000 Annual Aggregate Limit Retention is shown in the Schedule The following is added under SUPPLEMENTARY PAYMENTS COVERAGE A AND B 1. ANIMAL CRUELTY CLAIM LIMITED DEFENSE COVERAGE Operation of this Supplementary Payment Coverage. We will provide for reimbursement of certain defense expenses you incur in defending an animal cruelty claim brought against you. No other obligation or liability to pay sums or perform acts or services in defending an animal cruelty claim is covered unless explicitly provided for under this Supplementary Payments Animal Cruelty Claim Limited Defense Coverage. We have no duty to provide you with a defense under the Unwarranted Animal Cruelty Claim Limited Defense coverage. It is your obligation to retain counsel and defend any animal cruelty claim brought against you. We do not provide reimbursement for any settlement damages or other relief that may be awarded against you arising from an animal cruelty claim. This endorsement does not provide reimbursement for any expenses related to any divorce or estate proceedings. Reimbursement for defense expenses is only provided if the insured prevails in the animal cruelty claim and the matter is finally adjudicated without a finding of guilt or liability against you. There will be no reimbursement under this endorsement if the animal cruelty claim is settled for consideration if you admit guilt or wrongdoing or if you are convicted or pleads guilty. If you have already received payment of defense costs under this endorsement you agree to reimburse us for all payments we made before the settlement for consideration admission of guilt or wrongdoing guilty plea or criminal conviction of an animal cruelty claim. CGLB329 0512 Page 10of 3 Copyright 2012 Nationwide Agribusiness Insurance Company Insured Copy | 2 |
COMMERCIAL GENERAL LIABILITY Reimbursement Certain Defense Expenses We will reimburse you for reasonable and necessary defense expenses that you have paid in the defense of a animal cruelty claim brought against you up to the Limit of Insurance shown in the schedule of this endorsement only if the animal cruelty claim is first made against you during the policy period and reported to us in accordance with paragraph 5. We will not reimburse defense expenses paid in any animal cruelty claim until they exceed your Retention shown in the schedule of this endorsement. All similar and related animal cruelty claims that are brought against you will be considered to have been made at the time the first animal cruelty claim is brought against you. Other Insurance If there is any other insurance that provides coverage or defense for any animal cruelty claim to which this endorsement otherwise applies then benefits provided by this endorsement shall be excess over such other insurance whether that other insurance is primary excess contingent or provided on any other basis. Limits of Insurance Annual Aggregate The Limit of Insurance shown in the Schedule of this endorsement is the most we will reimburse you for covered defense expenses for the defense of an animal cruelty claim that exceed your Retention shown in the Schedule. The Limit of Insurance shown in the Schedule of this endorsement is the most we will reimburse you for the defense of an animal cruelty claim regardless of the number of 1 named insureds or 2 persons or organizations who incur expenses This Limit of Insurance is also an Annual Aggregate meaning it is the most we will reimburse you under this endorsement for all defense expenses for the defense of an animal cruelty claim regardless of the number of covered claims made during the policy period. Duties in the Event of Animal Cruelty Claim We have no duty to provide reimbursement under this Endorsement for the defense of an animal cruelty claim unless you comply with the following duties 1 You must provide us with a copy of the written notice of an animal cruelty claim if you reasonably believe you are eligible for the defense expense reimbursement provided by this endorsement. You must give us notice as soon as practicable and either i anytime during the policy period or ii within thirty 30 days after the end of the policy period as long as such claim is reported no later than thirty 30 days after the date such claim is first made against the insured. 2 You must provide us copies of any demands notices summonses or legal papers received in connection with the animal cruelty claim and 3 You must provide us copies of bills and proof of your payment of defense expenses in connection with the animal cruelty claim. CGLB329 0512 Page 2 of 3 Copyright 2012 Nationwide Agribusiness Insurance Company Insured Copy | 2 |
COMMERCIAL GENERAL LIABILITY f. Additional Definitions As used in this Unwarranted Animal Cruelty Claim Limited Defense Coverage Endorsement the following Definitions are added 1 Defense expenses means reasonable and necessary attorney fees and legal costs incurred in defending an animal cruelty claim to which this endorsement applies. 2 Animal cruelty claim means a criminal or civil proceeding that alleges damages or criminal charges due to violations in the treatment or standards of care that cause or is alleged to have caused unwarranted or unnecessary suffering or harm to animals. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. CGLB329 0512 Page 3 of 3 Copyright 2012 Nationwide Agribusiness Insurance Company Insured Copy | 2 |
POLICY NUMBER CPP126376A COMMERCIAL AUTO NATIONWIDE AGRIBUSINESS INSURANCE COMPANY BUSINESS AUTO DECLARATIONS ITEM ONE PRODUCER LOCKTON COMPANIES LLC NAMED INSURED PRAIRIELAND DAIRY LLC SEE NAMED INSURED ENDORSEMENT MAILING ADDRESS 13000 PELLA RD FIRTH NE 68358 POLICY PERIOD From 04 01 2017 to 04 01 2018 at1201 A.M. Standard Time at your mailing address shown above PREVIOUS POLICY NUMBER CPP126376A FORM OF BUSINESS CORPORATION X LIMITED LIABILITY COMPANY INDIVIDUAL PARTNERSHIP OTHER INRETURN 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. Premium shown is payable at incepti AUDIT PERIOD IF APPLICABLE X ANNUALLY SEMI QUARTERLY MONTHLY ANNUALLY ENDORSEMENTS ATTACHED TO THIS POLICY IL 00 17 Common Policy Conditions IL 01 46 in Washington IL 00 21 Broad Form Nuclear Exclusion not Applicable in New York IL 01 98 in Washington SEE SCHEDULE OF FORMS AND ENDORSEMENTS COUNTERSIGNED BY Date Authorized Representative AU DEC C W 1013 Page 1 Insured Copy | 2 |
ITEM TWO Schedule Of Coverages And Covered Autos This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those autos shown as covered autos. Autos are shown as covered autos for a particular coverage by the entry of one or more of the symbols from the Covered Autos section of the Business Auto Coverage Form next to the name of the coverage. COVERED COVERAGES AUTOS LIMIT PREMIUM COVERED AUTOS LIABILITY 1000000 12157 PERSONAL INJURY SEPARATELY STATED IN EACH P.L.P. PROTECTION or equivalent No fault Coverage ADDED PERSONAL INJURY PROTECTION or equivalent Added No fault Coverage SEPARATELY STATED IN THE PROPERTY PROPERTY PROTECTION PROTECTION INSURANCE ENDORSEMENT INSURANCE Michigan only DEDUCTIBLE FOR EACH ACCIDENT. AUTO MEDICAL PAYMENTS 5000 EACH INSURED INCL MEDICAL EXPENSE AND SEPARATELY STATED IN THE MEDICAL INCOME LOSS BENEFITS EXPENSE AND INCOME LOSS BENEFITS Virginia only ENDORSEMENT. UNINSURED MOTORISTS 1000000 INCL UNDERINSURED MOTORISTS When not included in Uninsured Motorists Coverage ACTUAL CASH VALUE OR COST OF REPAIR WHICHEVER IS LESS MINUS SEE SCHEDULE PHYSICAL DAMAGE DEDUCTIBLE FOR EACH COVERED AUTO BUT COMPREHENSIVE NO DEDUCTIBLE APPLIES TO LOSS CAUSED 1713 BY FIRE OR LIGHTNING. See ITEM FOUR For Hired or Borrowed Autos. ACTUAL CASH VALUE OR COST OF REPAIR EEES EIIEIBDAMAGE WHICHEVER IS LESS MINUS CAUSES OF LOSS DEDUCTIBLE FOR EACH COVERED AUTO FOR COVERAGE LOSS CAUSED BY MISCHIEF OR VANDALISM. See ITEM FOUR For Hired Or Borrowed Autos. ACTUAL CASH VALUE OR COST OF REPAIR PHYSICAL DAMAGE WHICHEVER IS LESS MINUS SEE SCHEDULE NCL COLLISION COVERAGE DEDUCTIBLE FOR EACH COVERED AUTO. See ITEM FOUR For Hired Or Borrowed Autos. PHYSICAL DAMAGE FOR EACH DISABLEMENT TOWING AND LABOR OF A PRIVATE PASSENGER AUTO. TAX SURCHARGE FEE PREMIUM FOR ENDORSEMENTS ESTIMATED TOTAL PREMIUM 13870.00 This policy may be subject to final audit. AU DEC C W 1013 Page 2 MAGE SIVE Page 2 Insured Copy | 2 |
ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN DESCRIPTION TERRITORY Year Model Trade Name Body Type Town State Where The Covered Serial Number S Vehicle Identification Covered Auto Will Be. Auto No. Number VIN Prin lly Garaged Original Cost New 1987 50 1B7JW. 1983 FORD 8000 TRUCK LFDYWBO NE2 1996 GOOSENECK TRAILER 1TH3 NE3 NE4 2001 FORD F 350 LFDWF3TEX1EAB6681 EXCEPT For Towing CLASSIFICATION Al Physical Damage Loss Is Payable To You And The Loss Business Use Payee Named Below According To Their Radius s service Interests In The Auto Covered of r retail Age At The Time Of The Auto No. Operation c commercial Group Secondary Rating Classification Code Loss All Others 50 F 12 014690 Others NE2 50 F 12 314690 All Others NE3 50 12 684990 All Others NE4 50 12 1 others 50 s 12 214990 COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES Absence of a deductible or limit entry in any column below means that the limit or deductible entry in the corresponding ITEM TWO column applies instead. COVERED AUTOS PERSONAL INJURY PROPERTY PROTECTION LIABILITY PROTECTION ADDED P.I.P. Michigan Only Limit Stated Limit Stated InEachP.LP. Premium For InP.P.I. Endt. Minus Limit Stated In Endt. Minus Covered Deductible Each Added Deductible Auto No. Limit Premium Shown Below Premium P.LP. Endt. Shown Below Premium NEL NE2 1000 NCL NE4 1000000 NCL 1000000 NCL Total Premium Page 3 AU DEC C W 1013 Insured Copy | 2 |
ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN DESCRIPTION TERRITORY Year Model Trade Name Body Type Town State Where The Covered Serial Number S Vehicle Identification Covered Auto Will Be. Number VIN Principally Garaged Original Cost New WHITE AERO 4VIWDBDEOPN660563 1TH2A2GKB91025095 D COUNTRY NES 2000 WABASH TRAILER 1JJVS02WAY EXCEPT For Towing CLASSIFICATION Al Physical Damage Loss Is Payable To You And The Loss Business Use Payee Named Below According To Their Radius s service Interests In The Auto Covered of r retail Age At The Time Of The Auto No. Operation c commercial Group Secondary Rating Classification Code Loss All Others 50 12 NET 50 9 674990 NES 12 All Others 200 12 50 c 12 334990 COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES Absence of a deductible or limit entry in any column below means that the limit or deductible entry in the corresponding ITEM TWO column applies instead. COVERED AUTOS PERSONAL INJURY PROPERTY PROTECTION LIABILITY PROTECTION ADDED P.I.P. Michigan Only Limit Stated Limit Stated InEachP.LP. Premium For InP.P.I. Endt. Minus Limit Stated In Endt. Minus Covered Deductible Each Added Deductible Auto No. Limit Premium Shown Below Premium P.LP. Endt. Shown Below Premium 10000 10000 1000 NCL NE9 1000000 NCL 1000000 NCL AU DEC C W 1013 Page 4 Insured Copy | 2 |
ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN DESCRIPTION TERRITORY Year Model Trade Name Body Type Town State Where The Serial Number S Vehicle Identification Covered Auto Will Be Number VIN Principally Garaged Original Cost New 1803 2006 GMC CANYON 1GTCS138468172895 1974 WALKER TRATLER 173090 45000 EXCEPT For Towing CLASSIFICATION Al Physical Damage Loss Is Payable To You And The Loss Business Use Payee Named Below According To Their Radius s service Interests In The Auto Covered of r retail Age At The Time Of The Auto No. Operation c commercial Group Secondary Rating Classification Code Loss All Others 50 F 12 234690 Others 50 c 12 034390 All Others 200 12 675990 All Others 200 12 1 others 50 12 404390 COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES Absence of a deductible or limit entry in any column below means that the limit or deductible entry in the corresponding ITEM TWO column applies instead. COVERED AUTOS PERSONAL INJURY PROPERTY PROTECTION LIABILITY PROTECTION ADDED P.I.P. Michigan Only Limit Stated Limit Stated InEachP.LP. Premium For InP.P.I. Endt. Minus Limit Stated In Endt. Minus Covered Deductible Each Added Deductible Auto No. Limit Premium Shown Below Premium P.LP. Endt. Shown Below Premium 10000 10000 1000 NCL 1000000 NCL 1000000 NCL AU DEC C W 1013 Page 5 Insured Copy | 2 |
ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN DESCRIPTION TERRITORY Year Model Trade Name Body Type Town State Where The Serial Number S Vehicle Identification Covered Auto Will Be. Number VIN Principally Garaged Original Cost New 45000 2005 WABASH TRAILER 392 1JJV532W45L919250 EFER SEMI TRALLER 2002 UTILITY TRA 53620676903 EXCEPT For Towing CLASSIFICATION Al Physical Damage Loss Is Payable To You And The Loss Business Use Payee Named Below According To Their Radius s service Interests In The Auto Covered of r retail Age At The Time Of The Auto No. Operation c commercial Group Secondary Rating Classification Code Loss All Others 200 c 10 Others 200 12 675990 All Others 200 12 675990 All Others 50 12 1 others 200 12 COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES Absence of a deductible or limit entry in any column below means that the limit or deductible entry in the corresponding ITEM TWO column applies instead. COVERED AUTOS PERSONAL INJURY PROPERTY PROTECTION LIABILITY PROTECTION ADDED P.I.P. Michigan Only Limit Stated Limit Stated InEachP.LP. Premium For InP.P.I. Endt. Minus Limit Stated In Endt. Minus Covered Deductible Each Added Deductible Auto No. Limit Premium Shown Below Premium P.LP. Endt. Shown Below Premium 10000 10000 1000 NCL 1000000 NCL 1000000 NCL Page 6 AU DEC C W 1013 Insured Copy | 2 |
ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN 1983 MACK DESCRIPTION TERRITORY Year Model Trade Name Body Type Town State Where The Serial Number S Vehicle Identification Covered Auto Will Be Number VIN Principally Garaged FIRE TRUCK 1M2B11 Original Cost New TRUCK R685ST67081 RAIN TRAILER 3604021390 1 112.6 BBC L FG HOOD TRTH NE24 431 EXCEPT For Towing CLASSIFICATION Al Physical Damage Loss Is Payable To You And The Loss Business Use Payee Named Below According To Their Radius s service Interests In The Auto Covered of r retail At The Time Of The Auto No. Operation c commercial Secondary Rating Classification Code Loss All Others 50 s 314390 NE22 200 c All Others 200 675990. All Others COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES Absence of a deductible or limit entry in any column below means that the limit or deductible entry in the corresponding ITEM TWO column applies instead. COVERED AUTOS PERSONAL INJURY PROPERTY PROTECTION LIABILITY PROTECTION ADDED P.I.P. Michigan Only Limit Stated Limit Stated InEachP.LP. Premium For InP.P.I. Endt. Minus Limit Stated In Endt. Minus Covered Deductible Each Added Deductible Auto No. Limit Premium Shown Below Premium P.LP. Endt. Shown Below Premium NE2L 10000 10000 1000 NCL neza 1000000 NeL Total 10215 Premium AU DEC C W 1013 Page 7 Insured Copy | 2 |
ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN Continued Total Premium Covered Auto No. Absence of a deductible or limit entry in any column below means that the limit or deductible entry ALTAOYME ICSAL INCOME LOSS BENEFITS UNDERINSURED Virginia Only UNINSURED MOTORISTS MOTORISTS Limit Stated COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES in the corresponding ITEM TWO column applies instead. MEDICAL EXPENSE AND Absence of a deductible or limit entry in any column below means that the limit or deductible entry In The Medical Expense and Income Loss Benefits Endorsement For Each Person Premium Premium COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES in the corresponding ITEM TWO column applies instead. Premium SPECIFIED CAUSES COMPREHENSIVE OF LOSS COLLISION TOWING LABOR Limit Limit Limit Stated In Stated In Stated In ITEM TWO ITEM TWO ITEM TWO Minus Minus Minus Deductible Deductible Deductible Shown Shown Shown Limit Per Below Premium Below Premium Below Premium Disablement Premium Page 8 AU DEC C W 1013 Insured Copy | 2 |
ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN Continued Total Premium Absence of a deductible or limit entry in any column below means that the limit or deductible entry ALTAOYME ICSAL INCOME LOSS BENEFITS UNDERINSURED Virginia Only UNINSURED MOTORISTS MOTORISTS Limit Stated COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES in the corresponding ITEM TWO column applies instead. MEDICAL EXPENSE AND Absence of a deductible or limit entry in any column below means that the limit or deductible entry In The Medical Expense and Income Loss Benefits Endorsement For Each Person Premium Premium COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES in the corresponding ITEM TWO column applies instead. Premium SPECIFIED CAUSES COMPREHENSIVE OF LOSS COLLISION TOWING LABOR Limit Limit Limit Stated In Stated In Stated In ITEM TWO ITEM TWO ITEM TWO Minus Minus Minus Deductible Deductible Deductible Shown Shown Shown Limit Per Below Premium Below Premium Below Premium Disablement Premium Page 9 AU DEC C W 1013 Insured Copy | 2 |
ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN Continued COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES Absence of a deductible or limit entry in any column below means that the limit or deductible entry In The Medical Expense and Income Loss Benefits Endorsement For Each Person Premium Total Premium 1000000 100 COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES in the corresponding ITEM TWO column applies instead. MEDICAL EXPENSE AND ALTAOYME.ICSAL INCOME LOSS BENEFITS UNDERINSURED Virginia Only UNINSURED MOTORISTS MOTORISTS Limit Stated Premium INCL Absence of a deductible or limit entry in any column below means that the limit or deductible entry in the corresponding ITEM TWO column applies instead. Premium INCL SPECIFIED CAUSES COMPREHENSIVE OF LOSS COLLISION TOWING LABOR Limit Limit Limit Stated In Stated In Stated In ITEM TWO ITEM TWO ITEM TWO Minus Minus Minus Deductible Deductible Deductible Covered Shown Shown Shown Limit Per Auto No. Below Premium Below Premium Below Premium Disablement Premium INCL INCL Page 10 AU DEC C W 1013 Insured Copy | 2 |
ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN Continued Total Premium Absence of a deductible or limit entry in any column below means that the limit or deductible entry ALTAOYME ICSAL INCOME LOSS BENEFITS UNDERINSURED Virginia Only UNINSURED MOTORISTS MOTORISTS Limit Stated COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES in the corresponding ITEM TWO column applies instead. MEDICAL EXPENSE AND Absence of a deductible or limit entry in any column below means that the limit or deductible entry In The Medical Expense and Income Loss Benefits Endorsement For Each Person Premium Premium COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES in the corresponding ITEM TWO column applies instead. Premium SPECIFIED CAUSES COMPREHENSIVE OF LOSS COLLISION TOWING LABOR Limit Limit Limit Stated In Stated In Stated In ITEM TWO ITEM TWO ITEM TWO Minus Minus Minus Deductible Deductible Deductible Shown Shown Shown Limit Per Below Premium Below Premium Below Premium Disablement Premium 1 0 INCL 1 0 INCL AU DEC C W 1013 Page 11 Insured Copy | 2 |
ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN Continued Total Premium Absence of a deductible or limit entry in any column below means that the limit or deductible entry COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES in the corresponding ITEM TWO column applies instead. MEDICAL EXPENSE AND ALTAOYME.ICSAL INCOME LOSS BENEFITS UNDERINSURED Virginia Only UNINSURED MOTORISTS MOTORISTS Limit Stated Absence of a deductible or limit entry in any column below means that the limit or deductible entry In The Medical Expense and Income Loss Benefits Endorsement For Each Person Premium COVERAGES PREMIUMS LIMITS AND DEDUCTIBLES in the corresponding ITEM TWO column applies instead. Premium Premium SPECIFIED CAUSES COMPREHENSIVE OF LOSS COLLISION TOWING LABOR Limit Limit Limit Stated In Stated In Stated In ITEM TWO ITEM TWO ITEM TWO Minus Minus Minus Deductible Deductible Deductible Shown Shown Shown Limit Per Below Premium Below Premium Below Premium Disablement Premium INCL INCL Page 12 AU DEC C W 1013 Insured Copy | 2 |
ITEM FOUR SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS COVERED AUTOS LIABILITY COVERAGE Cost Of Hire Rating Basis for Autos Used In Your Motor Carrier Operations Other Than Mobile Or Farm Equipment COVERED AUTOS ESTIMATED ANNUAL LIABILITY COVERAGE COST OF HIRE FOR EACH STATE PREMIUM Primary Coverage Excess Coverage TOTAL HIRED AUTO PREMIUM For autos used in your motor carrier operations cost of hire means 1. Thetotal dollar amount of costs you incurred for the hire of automobiles includes trailers and semitrailers and if not included therein 2. Thetotal remunerations of all operators and drivers helpers of hired automobiles whether hired with a driver by lessor or an employee of the lessee or any other third party and 3. Thetotal dollar amount of any other costs i.e. repair maintenance fuel etc. directly associated with operating the hired automobiles whether such costs are absorbed by the insured paid to the lessor or owner or paid to others. COVERED AUTOS LIABILITY COVERAGE Cost Of Hire Rating Basis for Autos NOT Used In Your Motor Carrier Operations Other Than Mobile Or Farm Equipment COVERED AUTOS ESTIMATED ANNUAL LIABILITY COVERAGE STATE COST OF HIRE FOR EACH STATE PREMIUM Primary Coverage Excess Coverage NE IF ANY 95 TOTAL HIRED AUTO PREMIUM 95 For autos NOT used in your motor carrier operations cost of hire means the total amount you incur for the hire of autos you do nt own not including autos you borrow or rent from your partners or employees or their family members. Cost of hire does not include charges for services performed by motor carriers of property or passengers. biles includes trailers and Page 13 AU DEC C W 1013 Insured Copy | 2 |
ITEM FOUR SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS Contd Physical Damage Coverages Cost Of Hire Rating Basis For All Autos Other Than Mobile or Farm Equipment ESTIMATED ANNUAL COST OF HIRE FOR EACH STATE Excluding Autos Hired With COVERAGE STATE LIMIT OF INSURANCE A Driver PREMIUM ACTUAL CASH VALUE OR COST OF IF ANY s 125 COMPREHENSIVE NE REPAIR WHICHEVER IS LESS MINUS 250 DEDUCTIBLE FOR EACH COVERED AUTO BUT NO DEDUCTIBLE APPLIES TO LOSS CAUSED BY FIRE OR LIGHTNING. ACTUAL CASH VALUE OR COST OF SPECIFIED REPAIR WHICHEVER IS LESS MINUS CAUSES DEDUCTIBLE FOR EACH OF LOSS COVERED AUTO FOR LOSS CAUSED BY MISCHIEF OR VANDALISM. ACTUAL CASH VALUE OR COST OF COLLISION NE REPAIR WHICHEVER IS LESS MINUS T AN s 125 500 DEDUCTIBLE FOR EACH COVERED AUTO. TOTAL HIRED AUTO PREMIUM 250 For Physical Damage Coverages cost of hire means the total amount you incur for the hire of autos you do nt own not including autos you borrow or rent from your partners or employees or their family members. Cost of hire does not include charges for any auto that is leased hired rented or borrowed with a driver. NE OLLISION NE AU DEC C W 1013 Page 14 Insured Copy | 2 |
ITEM FOUR SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS Contd COVERAGE Covered Autos Liability Primary Coverage STATE Cost Of Hire Rating Basis For Mobile Or Farm Equipment Other Than Physical Damage Coverages ESTIMATED ANNUAL COST OF HIRE FOR EACH STATE PREMIUM Mobile Farm Equipment Equipment Mobile Equipment Farm Equipment Covered Autos Liability Excess Coverage Personal Injury Protection Medical Expense Benefits Virginia Only Income Loss Benefits Virginia Only Auto Medical Payments TOTAL HIRED AUTO PREMIUM Cost of hire means the total amount you incur for the hire of autos you do nt own not including autos you borrow or rent from your partners or employees or their family members. Cost of hire does not include charges for services performed by motor carriers of property or passengers. AU DEC C W 1013 Page 15 Insured Copy | 2 |
ITEM FOUR SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS Contd Cost Of Hire Rating Basis For Mobile or Farm Equipment Physical Damage Coverages COVERAGE COMPREHENSIVE STATE LIMIT OF INSURANCE ACTUAL CASH VALUE OR COST OF REPAIR WHICHEVER IS LESS MINUS DEDUCTIBLE FOR EACH COVERED AUTO BUT NO DEDUCTIBLE APPLIES TO LOSS CAUSED BY FIRE OR LIGHTNING. ESTIMATED ANNUAL COST OF HIRE FOR EACH STATE Excluding Autos Hired With A Driver PREMIUM Mobile Farm Equipment Equipment Mobile Farm Equipment Equipment SPECIFIED CAUSES OF LOSS ACTUAL CASH VALUE OR COST OF REPAIR WHICHEVER IS LESS MINUS DEDUCTIBLE FOR EACH COVERED AUTO FORLOSS CAUSED BY MISCHIEF OR VANDAL ISM. COLLISION ACTUAL CASH VALUE OR COST OF REPAIR WHICHEVER IS LESS MINUS DEDUCTIBLE FOR EACH COVERED AUTO. TOTAL HIRED AUTO PREMIUM For Physical Damage Coverages cost of hire means the total amount you incur for the hire of autos you do nt own not including autos you borrow or rent from your partners or employees or their family members. Cost of hire does not include charges for any auto that is leased hired rented or borrowed with a driver. ECIFIED AUSES F LOSS OLLISION Page 16 AU DEC C W 1013 Insured Copy | 2 |
ITEM FOUR SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS Contd Rental Period Rating Basis For Mobile Or Farm Equipment COVERAGE WHERE THE JOB SITE ESTIMATED NUMBER OF DAYS EQUIPMENT WILL TOWN AND STATE BE RENTED PREMIUM Mobile Equipment Farm IS LOCATED Equipment Mobile Equipment Farm Equipment Covered Autos Liability Primary Coverage Covered Autos Liability Excess Coverage Personal Injury Protection Medical Expense Benefits Virginia Only Income Loss Benefits Virginia Only Auto Medical Payments TOTAL HIRED AUTO PREMIUMS ITEM FIVE SCHEDULE FOR NON OWNERSHIP COVERED AUTOS LIABILITY NAMED INSURED S BUSINESS Other Than Garage Service Operations And Other Than Social Service Agencies RATING BASIS NUMBER Number Of Employees 25 PREMIUM 104 Number Of Partners Active and Inactive Garage Service Operations Number Of Employees Whose Principal Duty Involves The Operation Of Autos Number Of Partners Active and Inactive Social Service Agencies Number Of Employees Number Of Volunteers Who Regularly Use Autos To Transport Clients Number Of Partners Active and Inactive TOTAL NON OWNERSHIP COVERED AUTOS LIABILITY PREMIUM 104 AU DEC C W 1013 Page 17 Insured Copy | 2 |
ITEM SIX SCHEDULE FOR GROSS RECEIPTS OR MILEAGE BASIS Type Of Risk Check one Public Autos Leasing Or Rental Concerns Rating Basis Check one Gross Receipts Per 100 Mileage Per Mile Estimated Yearly Check One Gross Receipts Per 100 Mileage Premiums Covered Autos Liability Personal Injury Protection Added Personal Injury Protection Property Protection Insurance Michigan Only Auto Medical Payments Medical Expense And Income Loss Benefits Virginia Only Comprehensive Specified Causes Of Loss Collision Towing And Labor When used as a premium basis FOR PUBLIC AUTOS Gross receipts means the total amount earned by the named insured for transporting passengers mail and merchandise. Gross receipts does not include 1. Amounts paid to air sea or land carriers operating under their own permits. 2. Advertising revenue. 3. Taxes collected as a separate item and paid directly to the government. 4. C.0.D. collections for cost of mail or merchandise including collection fees. Mileage means the total live and dead mileage of all revenue producing autos during the policy period. FOR RENTAL OR LEASING CONCERNS Gross receipts means the total amount earned by the named insured for the leasing or renting of autos to others without drivers. Mileage means the total live and dead mileage of all autos you leased or rented to others without drivers. Page 18 AU DEC C W 1013 Insured Copy | 2 |
POLICY NUMBER CPP126376A POLICY NUMBER CPP126376A COMMERCIAL AUTO CA 20011013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR ADDITIONAL INSURED AND LOSS PAYEE This endorsement modifies insurance provided under the following AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured Endorsement Effective Date SCHEDULE Insurance Company NATIONWIDE AGRIBUSINESS INSURANCE COMPANY Policy Number CPP126376A Effective Date 04 01 2017 Expiration Date 04 01 2018 Named Insured PRAIRIELAND DAIRY LLC Address 13000 PELLA RD FIRTH NE 68358 Additional Insured OMAHA TRUCK CENTER INC Lessor 10550 I ST Address PO BOX 27379 OMAHA NE USA 68127 Designation Or Description Of Leased Autos Any leased auto for which a specific written leasing or rental agreement requires the Additional Insured Lessor shown above to be added as an additional insured and loss payee on your policy. tiva Nata essor ddress nan nan nan nan 68127.0 CA 20011013 Insurance Services Office Inc. 2011 Insured Copy Page 1 of 2 | 2 |
Coverages Limit Of Insurance Covered Autos L 1000000 Each Accident Actual Cash Value Or Cost Of Repair Whichever Is Less Minus Comprehensive 1000 Deductible For Each Covered Leased Auto Collision 1000 Specified Causes Of Loss Actual Cash Value Or Cost Of Repair Whichever Is Less Minus Actual Cash Value Or Cost Of Repair Whichever Is Less Minus Deductible For Each Covered Leased Auto Deductible For Each Covered Leased Auto Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Coverage 1. Any leased auto designated or described in the Schedule will be considered a covered auto you own and not a covered auto you hire or borrow. 2. For a leased auto designated or described in the Schedule the Who Is An Insured provision under Covered Autos Liability Coverage is changed to include as an insured the lessor named in the Schedule. However the lessor is an insured only for bodily injury or property damage resulting from the acts or omissions by a. You b. Any of your employees or agents or c. Any person except the lessor or any employee or agent of the lessor operating a leased auto with the permission of any of the above. 3. The coverages provided under this endorsement apply to any leased auto described in the Schedule until the expiration date shown in the Schedule or when the lessor or his or her agent takes possession of the leased auto whichever occurs first. B. Loss Payable Clause 1. We will pay as interest may appear you and the lessor named in this endorsement for loss to a leased auto. oX D. E. 2. The insurance covers the interest of the lessor unless the loss results from fraudulent acts or omissions on your part. 3. If we make any payment to the lessor we will obtain his or her rights against any other party. Cancellation 1. If we cancel the policy we will mail notice to the lessor in accordance with the Cancellation Common Policy Condition. 2. If you cancel the policy we will mail notice to the lessor. 3. Cancellation ends this agreement. The lessor is not liable for payment of your premiums. Additional Definition As used in this endorsement Leased auto means an auto leased or rented to you including any substitute replacement or extra auto needed to meet seasonal or other needs under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor. ble For Each Covered Leased r ble For Each Covered Leased r Y ole For Each Covered Leased ed auto designated or described in dule will be considered a covered u own and not a covered auto you rrow. ised auto designated or described in C. Page 2 of 2 Insurance Services Office Inc. 2011 Insured Copy CA20011013 | 2 |
POLICY NUMBER CPP126376A POLICY NUMBER CPP126376A COMMERCIAL AUTO CA 20011013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR ADDITIONAL INSURED AND LOSS PAYEE This endorsement modifies insurance provided under the following AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured Endorsement Effective Date SCHEDULE Insurance Company NATIONWIDE AGRIBUSINESS INSURANCE COMPANY Policy Number CPP126376A Effective Date 04 01 2017 Expiration Date 04 01 2018 Named Insured PRAIRIELAND DAIRY LLC Address 13000 PELLA RD FIRTH NE 68358 Additional Insured PENSKE TRUCK LEASING CO LP PENSKE LEASING Lessor RENTAL CO. Address 9401 J STREET OMAHA NE USA 68127 Designation Or Description Of Leased Autos Any leased auto for which a specific written leasing or rental agreement requires the Additional Insured Lessor shown above to be added as an additional insured and loss payee on your policy. tiva Nata essor ddress nan nan nan nan 58127.0 CA 20011013 Insurance Services Office Inc. 2011 Insured Copy Page 1 of 2 | 2 |
Coverages Limit Of Insurance Covered Autos L 1000000 Each Accident Actual Cash Value Or Cost Of Repair Whichever Is Less Minus Comprehensive 1000 Deductible For Each Covered Leased Auto Collision 1000 Specified Causes Of Loss Actual Cash Value Or Cost Of Repair Whichever Is Less Minus Actual Cash Value Or Cost Of Repair Whichever Is Less Minus Deductible For Each Covered Leased Auto Deductible For Each Covered Leased Auto Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Coverage 1. Any leased auto designated or described in the Schedule will be considered a covered auto you own and not a covered auto you hire or borrow. 2. For a leased auto designated or described in the Schedule the Who Is An Insured provision under Covered Autos Liability Coverage is changed to include as an insured the lessor named in the Schedule. However the lessor is an insured only for bodily injury or property damage resulting from the acts or omissions by a. You b. Any of your employees or agents or c. Any person except the lessor or any employee or agent of the lessor operating a leased auto with the permission of any of the above. 3. The coverages provided under this endorsement apply to any leased auto described in the Schedule until the expiration date shown in the Schedule or when the lessor or his or her agent takes possession of the leased auto whichever occurs first. B. Loss Payable Clause 1. We will pay as interest may appear you and the lessor named in this endorsement for loss to a leased auto. oX D. E. 2. The insurance covers the interest of the lessor unless the loss results from fraudulent acts or omissions on your part. 3. If we make any payment to the lessor we will obtain his or her rights against any other party. Cancellation 1. If we cancel the policy we will mail notice to the lessor in accordance with the Cancellation Common Policy Condition. 2. If you cancel the policy we will mail notice to the lessor. 3. Cancellation ends this agreement. The lessor is not liable for payment of your premiums. Additional Definition As used in this endorsement Leased auto means an auto leased or rented to you including any substitute replacement or extra auto needed to meet seasonal or other needs under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor. ble For Each Covered Leased r ble For Each Covered Leased r Y ole For Each Covered Leased ed auto designated or described in dule will be considered a covered u own and not a covered auto you rrow. ised auto designated or described in C. Page 2 of 2 Insurance Services Office Inc. 2011 Insured Copy CA20011013 | 2 |
POLICY NUMBER CPP126376A POLICY NUMBER CPP126376A COMMERCIAL AUTO CA 20011013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR ADDITIONAL INSURED AND LOSS PAYEE This endorsement modifies insurance provided under the following AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured Endorsement Effective Date SCHEDULE Insurance Company NATIONWIDE AGRIBUSINESS INSURANCE COMPANY Policy Number CPP126376A Effective Date 04 01 2017 Expiration Date 04 01 2018 Named Insured PRAIRIELAND DAIRY LLC Address 13000 PELLA RD FIRTH NE 68358 Additional Insured GREAT PLAINS TRUCK LEASING MERCEDES BENZ FINL Lessor SERVICES Address 4522 S 108TH ST OMAHA NE USA 68137 Designation Or Description Of Leased Autos Any leased auto for which a specific written leasing or rental agreement requires the Additional Insured Lessor shown above to be added as an additional insured and loss payee on your policy. tiva Nata essor ddress nan nan nan nan 137.0 CA 20011013 Insurance Services Office Inc. 2011 Insured Copy Page 1 of 2 | 2 |
Coverages Limit Of Insurance Covered Autos L 1000000 Each Accident Actual Cash Value Or Cost Of Repair Whichever Is Less Minus Comprehensive 1000 Deductible For Each Covered Leased Auto Collision 1000 Specified Causes Of Loss Actual Cash Value Or Cost Of Repair Whichever Is Less Minus Actual Cash Value Or Cost Of Repair Whichever Is Less Minus Deductible For Each Covered Leased Auto Deductible For Each Covered Leased Auto Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Coverage 1. Any leased auto designated or described in the Schedule will be considered a covered auto you own and not a covered auto you hire or borrow. 2. For a leased auto designated or described in the Schedule the Who Is An Insured provision under Covered Autos Liability Coverage is changed to include as an insured the lessor named in the Schedule. However the lessor is an insured only for bodily injury or property damage resulting from the acts or omissions by a. You b. Any of your employees or agents or c. Any person except the lessor or any employee or agent of the lessor operating a leased auto with the permission of any of the above. 3. The coverages provided under this endorsement apply to any leased auto described in the Schedule until the expiration date shown in the Schedule or when the lessor or his or her agent takes possession of the leased auto whichever occurs first. B. Loss Payable Clause 1. We will pay as interest may appear you and the lessor named in this endorsement for loss to a leased auto. oX D. E. 2. The insurance covers the interest of the lessor unless the loss results from fraudulent acts or omissions on your part. 3. If we make any payment to the lessor we will obtain his or her rights against any other party. Cancellation 1. If we cancel the policy we will mail notice to the lessor in accordance with the Cancellation Common Policy Condition. 2. If you cancel the policy we will mail notice to the lessor. 3. Cancellation ends this agreement. The lessor is not liable for payment of your premiums. Additional Definition As used in this endorsement Leased auto means an auto leased or rented to you including any substitute replacement or extra auto needed to meet seasonal or other needs under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor. ble For Each Covered Leased r ble For Each Covered Leased r Y ole For Each Covered Leased ed auto designated or described in dule will be considered a covered u own and not a covered auto you rrow. ised auto designated or described in C. Page 2 of 2 Insurance Services Office Inc. 2011 Insured Copy CA20011013 | 2 |
COMMERCIAL AUTO CA00011013 BUSINESS AUTO COVERAGE FORM Various provisions in this policy restrict coverage. SECTION COVERED AUTOS Read the entire policy carefully to determine rights ltem Two of the Declarations shows the autos that duties and what is and is not covered. are covered autos for each of your coverages. The Throughout this policy the words you and your following numerical symbols describe the autos that refer to the Named Insured shown in the Declarations. may be covered autos. The symbols entered next to The words we us and our refer to the company a coverage on the Declarations designate the only providing this insurance. autos that are covered autos. Other words and phrases that appear in quotation A. Description Of Covered Auto Designation marks have special meaning. Refer to Section V Symbols Definitions. Symbol Description Of Covered Auto Designation Symbols 1 Any Auto 2 Owned Autos Only those autos you own and for Covered Autos Liability Coverage any Only trailers you do nt own while attached to power units you own. This includes those autos you acquire ownership of after the policy begins. 3 Owned Private Only the private passenger autos you own. This includes those private Passenger passenger autos you acquire ownership of after the policy begins. Autos Only 4 Owned Only those autos you own that are not of the private passenger type and for Autos Other Covered Autos Liability Coverage any trailers you do nt own while attached to Than Private power units you own. This includes those autos not of the private passenger Passenger type you acquire ownership of after the policy begins. Autos Only 5 Owned Autos Only those autos you own that are required to have no fault benefits in the state Subject To where they are licensed or principally garaged. This includes those autos you No fault acquire ownership of after the policy begins provided they are required to have no fault benefits in the state where they are licensed or principally garaged. 6 Owned Autos Only those autos you own that because of the law in the state where they are Subject To A licensed or principally garaged are required to have and can not reject Uninsured Compulsory Motorists Coverage. This includes those autos you acquire ownership of after the Uninsured policy begins provided they are subject to the same state uninsured motorists Motorists Law requirement. 7 Specifically Only those autos described in Item Three of the Declarations for which a Described premium charge is shown and for Covered Autos Liability Coverage any trailers Autos you do nt own while attached to any power unit described in Item Three. 8 Hired Autos Only those autos you lease hire rent or borrow. This does not include any auto Only you lease hire rent or borrow from any of your employees partners if you are a partnership members if you are a limited liability company or members of their households. 9 Non owned Only those autos you do not own lease hire rent or borrow that are used in Autos Only connection with your business. This includes autos owned by your employees partners if you are a partnership members if you are a limited liability company or members of their households but only while used in your business or your personal affairs. utos Oniy CA00011013 Insurance Services Office Inc. 2011 Insured Copy Page 1 of 12 | 2 |
19 Mobile Equipment Subject To Compulsory Or Financial Responsibility Or Other Motor Vehicle Insurance Law Only Only those autos that are land vehicles and that would qualify under the definition of mobile equipment under this policy if they were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where they are licensed or principally garaged. B. Owned Autos You Acquire After The Policy Begins 1. If Symbols 1 2 3 4 5 6 or 19 are entered next to a coverage in Item Two of the Declarations then you have coverage for autos that you acquire of the type described for the remainder of the policy period. 2. But if Symbol 7 is entered next to a coverage in Item Two of the Declarations an auto you acquire will be a covered auto for that coverage only if a. We already cover all autos that you own for that coverage or it replaces an auto you previously owned that had that coverage and b. You tell us within 30 days after you acquire it that you want us to cover it for that coverage. C. Certain Trailers Mobile Equipment And Temporary Substitute Autos If Covered Autos Liability Coverage is provided by this Coverage Form the following types of vehicles are also covered autos for Covered Autos Liability Coverage 1. Trailers with a load capacity of 2000 pounds or less designed primarily for travel on public roads. 2. Mobile equipment while being carried or towed by a covered auto. 3. Any auto you do not own while used with the permission of its owner as a temporary substitute for a covered auto you own that is out of service because of its a. Breakdown. Repair. Servicing. Loss or. Destruction. o oo 0 SECTION Il COVERED AUTOS LIABILITY COVERAGE A. Coverage We will pay all sums an insured legally must pay as damages because of bodily injury or property damage to which this insurance applies caused by an accident and resulting from the ownership maintenance or use of a covered auto. We will also pay all sums an insured legally must pay as a covered pollution cost or expense to which this insurance applies caused by an accident and resulting from the ownership maintenance or use of covered autos. However we will only pay for the covered pollution cost or expense if there is either bodily injury or property damage to which this insurance applies that is caused by the same accident. We have the right and duty to defend any insured against a suit asking for such damages or a covered pollution cost or expense. However we have no duty to defend any insured against a suit seeking damages for bodily injury or property damage or a covered pollution cost or expense to which this insurance does not apply. We may investigate and settle any claim or suit as we consider appropriate. Our duty to defend or settle ends when the Covered Autos Liability Coverage Limit of Insurance has been exhausted by payment of judgments or settlements. 1. Who Is An Insured The following are insureds a. You for any covered auto. b. Anyone else while using with your permission a covered auto you own hire or borrow except 1 The owner or anyone else from whom you hire or borrow a covered auto. This exception does not apply if the covered auto is a trailer connected to a covered auto you own. Page 2 of 12 Insurance Services Office Inc. 2011 Insured Copy CA00011013 | 2 |
2 Your employee if the covered auto is owned by that employee or a member of his or her household. 3 Someone using a covered auto while he or she is working in a business of selling servicing repairing parking or storing autos unless that business is yours. Anyone other than your employees partners if you are a partnership members if you are a limited liability company or a lessee or borrower or any of their employees while moving property to or from a covered auto. A partner if you are a partnership or a member if you are a limited liability company for a covered auto owned by him or her or a member of his or her household. c. Anyone liable for the conduct of an insured described above but only to the extent of that liability. 2. Coverage Extensions a. Supplementary Payments We will pay for the insured 1 All expenses we incur. 2 Up to 2000 for cost of bail bonds including bonds for related traffic law violations required because of an accident we cover. We do not have to furnish these bonds. The cost of bonds to release attachments in any suit against the insured we defend but only for bond amounts within our Limit of Insurance. All reasonable expenses incurred by the insured at our request including actual loss of earnings up to 250 a day because of time off from work. All court costs taxed against the insured in any suit against the insured we defend. However these payments do not include attorneys fees or attorneys expenses taxed against the insured. All interest on the full amount of any judgment that accrues after entry of the judgment in any suit against the insured we defend but our duty to pay interest ends when we have paid offered to pay or deposited in court the part of the judgment that is within our Limit of Insurance. 4 5 3 4 5 6 These payments will not reduce the Limit of Insurance. b. Out of state Coverage Extensions While a covered auto is away from the state where it is licensed we will 1 Increase the Limit of Insurance for Covered Autos Liability Coverage to meet the limits specified by a compulsory or financial responsibility law of the jurisdiction where the covered auto is being used. This extension does not apply to the limit or limits specified by any law governing motor carriers of passengers or property. Provide the minimum amounts and types of other coverages such as no fault required of out of state vehicles by the jurisdiction where the covered auto is being used. We will not pay anyone more than once for the same elements of loss because of these extensions. B. Exclusions This insurance does not apply to any of the following 1. Expected Or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. 2. Contractual Liability assumed under any contract or agreement. But this exclusion does not apply to liability for damages a. 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 b. That the insured would have in the absence of the contract or agreement. 3. Workers Compensation Any obligation for which the insured or the insured s insurer may be held liable under any workers compensation disability benefits or unemployment compensation law or any similar law. 2 CA00011013 Insurance Services Office Inc. 2011 Insured Copy Page 3 of 12 | 2 |
4. Employee Indemnification And Employer s Liabi Bodily injury to a. An employee of the insured arising out of and in the course of 1 Employment by the insured or 2 Performing the duties related to the conduct of the insured s business or b. The spouse child parent brother or sister of that employee as a consequence of Paragraph a. 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. But this exclusion does not apply to bodily injury to domestic employees not entitied to workers compensation benefits or to liability assumed by the insured under an insured contract. For the purposes of the Coverage Form a domestic employee is a person engaged in household or domestic work performed principally in connection with a residence premises. 5. Fellow Employee Bodily injury to a. Any fellow employee of the insured arising out of and in the course of the fellow employee s employment or while performing duties related to the conduct of your business or b. The spouse child parent brother or sister of that fellow employee as a consequence of Paragraph a. above. 6. Care Custody Or Control Property damage to or covered pollution cost or expense involving property owned or transported by the insured or in the insured s care custody or control. But this exclusion does not apply to liability assumed under a sidetrack agreement. 7. Handling Of Property Bodily injury or property damage resulting from the handling of property a. Before it is moved from the place where it is accepted by the insured for movement into or onto the covered auto or 8. 10. b. After it is moved from the covered auto to the place where it is finally delivered by the insured. Movement Of Property By Mechanical Device Bodily injury or property damage resulting from the movement of property by a mechanical device other than a hand truck unless the device is attached to the covered auto.. Operations Bodily injury or property damage arising out of the operation of a. Any equipment listed in Paragraphs 6.b. and 6.c. of the definiton of mobile equipment or b. Machinery or equipment that is on 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. Completed Operations Bodily injury or property damage arising out of your work after that work has been completed or abandoned. In this exclusion your work means a. Work or operations performed by you or on your behalf and b. Materials parts or equipment furnished in connection with such work or operations. Your work includes warranties or representations made at any time with respect to the fitness quality durability or performance of any of the items included in Paragraph a. or b. above. Your work will be deemed completed at the earliest of the following times 1 When all of the work called for in your contract has been completed 2 When all of the work to be done at the site has been completed if your contract calls for work at more than one site or 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. 3 Page 4 of 12 Insurance Services Office Inc. 2011 Insured Copy CA00011013 | 2 |
1 Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. Pollution Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a. That are or that are contained in any property that is 1 Being transported or towed by handled or handled for movement into onto or from the covered auto 2 Otherwise in the course of transit by or on behalf of the insured or 3 Being stored disposed of treated or processed in or upon the covered auto b. Before the pollutants or any property in which the pollutants are contained are moved from the place where they are accepted by the insured for movement into or onto the covered auto or c. After the pollutants or any property in which the pollutants are contained are moved from the covered auto to the place where they are finally delivered disposed of or abandoned by the insured. Paragraph a. above does not apply to fuels lubricants fluids exhaust gases or other similar pollutants that are needed for or result from the normal electrical hydraulic or mechanical functioning of the covered auto or its parts if 1 The pollutants escape seep migrate or are discharged dispersed or released directly from an auto part designed by its manufacturer to hold store receive or dispose of such pollutants and The bodily injury property damage or covered pollution cost or expense does not arise out of the operation of any equipment listed in Paragraphs 6.b. and 6.c. of the definition of mobile equipment. 2 Paragraphs b. and c. above of this exclusion do not apply to accidents that occur away from premises owned by or rented to an insured with respect to pollutants not in or upon a covered auto if a The pollutants or any property in which the pollutants are contained are upset overturned or damaged as a result of the maintenance or use of a covered auto and b The discharge dispersal seepage migration release or escape of the pollutants is caused directly by such upset overturn or damage. 12. War Bodily injury or property damage arising directly or indirectly out of a. War including undeclared or civil war b. 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 c. Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. 13. Racing Covered autos while used in any professional or organized racing or demolition contest or stunting activity or while practicing for such contest or activity. This insurance also does not apply while that covered auto is being prepared for such a contest or activity. C. Limit Of Insurance Regardless of the number of covered autos insureds premiums paid claims made or vehicles involved in the accident the most we will pay for the total of all damages and covered pollution cost or expense combined resulting from any one accident is the Limit Of Insurance for Covered Autos Liability Coverage shown in the Declarations. CA00011013 Insurance Services Office Inc. 2011 Insured Copy Page 5 of 12 | 2 |
All bodily injury property damage and covered pollution cost or expense resulting from continuous or repeated exposure to substantially the same conditions will be considered as resulting from one accident. No one will be entitled to receive duplicate payments for the same elements of loss under this Coverage Form and any Medical Payments Coverage endorsement Uninsured Motorists Coverage endorsement or Underinsured Motorists Coverage endorsement attached to this Coverage Part. SECTION lll PHYSICAL DAMAGE COVERAGE A. Coverage 1. We will pay for loss to a covered auto or its equipment under a. Comprehensive Coverage From any cause except 1 The covered auto s collision with another object or 2 The covered auto s overturn. b. Specified Causes Of Loss Coverage Caused by 1 Fire lightning or explosion 2 Theft 3 Windstorm hail or earthquake 4 Flood 5 Mischief or vandalism or 6 The sinking burning collision or derailment of any conveyance transporting the covered auto. c. Collision Coverage Caused by 1 The covered auto s collision with another object or 2 The covered auto s overturn. 2. Towing We will pay up to the limit shown in the Declarations for towing and labor costs incurred each time a covered auto of the private passenger type is disabled. However the labor must be performed at the place of disablement. 3. Glass Breakage Hitting A Bird Or Animal Falling Objects Or Missiles If you carry Comprehensive Coverage for the damaged covered auto we will pay for the following under Comprehensive Coverage a. Glass breakage b. Loss caused by hitting a bird or animal and c. Loss caused by falling objects or missiles. However you have the option of having glass breakage caused by a covered auto s collision or overturn considered a loss under Collision Coverage. 4. Coverage Extensions a. Transportation Expenses We will pay up to 20 per day to a maximum of 600 for temporary transportation expense incurred by you because of the total theft of a covered auto of the private passenger type. We will pay only for those covered autos for which you carry either Comprehensive or Specified Causes Of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending regardless of the policy s expiration when the covered auto is returned to use or we pay for its loss. b. Loss Of Use Expenses For Hired Auto Physical Damage we will pay expenses for which an insured becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or agreement. We will pay for loss of use expenses if caused by 1 Other than collision only if the Declarations indicates that Comprehensive Coverage is provided for any covered auto 2 Specified Causes Of Loss only if the Declarations indicates that Specified Causes Of Loss Coverage is provided for any covered auto or Page 6 of 12 Insurance Services Office Inc. 2011 Insured Copy CA00011013 | 2 |
3 Collision only if the Declarations indicates that Collision Coverage is provided for any covered auto. However the most we will pay for any expenses for loss of use is 20 per day to a maximum of 600. B. Exclusions 1. We will not pay for loss caused by or resulting from any of the following. Such loss is excluded regardless of any other cause or event that contributes concurrently or in any sequence to the loss. a. Nuclear Hazard 1 The explosion of any weapon employing atomic fission or fusion or 2 Nuclear reaction or radiation or radioactive contamination however caused. b. War Or ary Action 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. 2. We will not pay for loss to any covered auto while used in any professional or organized racing or demolition contest or stunting activity or while practicing for such contest or activity. We will also not pay for loss to any covered auto while that covered auto is being prepared for such a contest or activity. 3. We will not pay for loss due and confined to a. Wear and tear freezing mechanical or electrical breakdown. b. Blowouts punctures or other road damage to tires. This exclusion does not apply to such loss resulting from the total theft of a covered auto. 4. We will not pay for loss to any of the following a. Tapes records discs or other similar audio visual or data electronic devices designed for use with audio visual or data electronic equipment. 3 b. Any device designed or used to detect speed measuring equipment such as radar or laser detectors and any jamming apparatus intended to elude or disrupt speed measuring equipment. c. Any electronic equipment without regard to whether this equipment is permanently installed that reproduces receives or transmits audio visual or data signals. d. Any accessories used with the electronic equipment described in Paragraph c. above. 5. Exclusions 4.c. and 4.d. do not apply to equipment designed to be operated solely by use of the power from the auto s electrical system that at the time of loss is a. Permanently installed in or upon the covered auto b. Removable from a housing unit which is permanently installed in or upon the covered auto c. An integral part of the same unit housing any electronic equipment described in Paragraphs a. and b. above or d. Necessary for the normal operation of the covered auto or the monitoring of the covered auto s operating system. 6. We will not pay for loss to a covered auto due to diminution in value. C. Limits Of Insurance 1. The most we will pay for a. Loss to any one covered auto is the lesser of 1 The actual cash value of the damaged or stolen property as of the time of the loss or 2 The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. b. All electronic equipment that reproduces receives or transmits audio visual or data signals in any one loss is 1000 if at the time of loss such electronic equipment is 1 Permanently installed in or upon the covered auto in a housing opening or other location that is not normally used by the auto manufacturer for the installation of such equipment CA00011013 Insurance Services Office Inc. 2011 Insured Copy Page 7 of 12 | 2 |
2 Removable from a permanently installed housing unit as described in Paragraph b.1 above or 3 An integral part of such equipment as described in Paragraphs b.1 and b.2 above. 2. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total loss. 3. If a repair or replacement results in better than like kind or quality we will not pay for the amount of the betterment. D. Deductible For each covered auto our obligation to pay for repair return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Declarations. Any Comprehensive Coverage deductible shown in the Declarations does not apply to loss caused by fire or lightning. SECTION IV BUSINESS AUTO CONDITIONS The following conditions apply in addition to the Common Policy Conditions A. Loss Conditions 1. Appraisal For Physical Damage Loss If you and we disagree on the amount of loss either may demand an appraisal of the loss. In this event each party will select a competent appraiser. The two appraisers will select a competent and impartial umpire. The appraisers will state separately the actual cash value and amount of loss. If they fail to agree they will submit their differences to the umpire. A decision agreed to by any two will be binding. Each party will a. Pay its chosen appraiser and b. Bear the other expenses of the appraisal and umpire equally. If we submit to an appraisal we will still retain our right to deny the claim. 2. Duties In The Event Of Accident Claim Suit Or Loss We have no duty to provide coverage under this policy unless there has been full compliance with the following duties a. In the event of accident claim suit or loss you must give us or our authorized representative prompt notice of the accident or loss. Include 1 How when and where the accident or loss occurred 2 The insured s name and address and 3 To the extent possible the names and addresses of any injured persons and witnesses. b. Additionally you and any other involved insured must 1 Assume no obligation make no 2 3 4 5 payment or incur no expense without our consent except at the insured s own cost. Immediately send us copies of any request demand order notice summons or legal paper received concerning the claim or suit. Cooperate with us in the investigation or settlement of the claim or defense against the suit. Authorize us to obtain medical records or other pertinent information. Submit to examination at our expense by physicians of our choice as often as we reasonably require. c. If there is loss to a covered auto or its equipment you must also do the following 1 Promptly notify the police if the covered auto or any of its equipment is stolen. 2 Take all reasonable steps to protect the 3 4 covered auto from further damage. Also keep a record of your expenses for consideration in the settlement of the claim. Permit us to inspect the covered auto and records proving the loss before its repair or disposition. Agree to examinations under oath at our request and give us a signed statement of your answers. 3. Legal Action Against Us No one may bring a legal action against us under this Coverage Form until a. There has been full compliance with all the terms of this Coverage Form and Under Covered Autos Liability Coverage we agree in writing that the insured has an obligation to pay or until the amount of that obligation has finally been determined by judgment after trial. No one has the right under this policy to bring us into an action to determine the insured s liability. b. Page 8 of 12 Insurance Services Office Inc. 2011 Insured Copy CA00011013 | 2 |
4. Loss Payment Physical Damage Coverages At our option we may a. Pay for repair or replace damaged or stolen property b. Return the stolen property at our expense. We will pay for any damage that results to the auto from the theft or c. Take all or any part of the damaged or stolen property at an agreed or appraised value. If we pay for the loss our payment will include the applicable sales tax for the damaged or stolen property. 5. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after accident or loss to impair them. B. General Conditions 1. Bankruptcy Bankruptcy or insolvency of the insured or the insured s estate will not relieve us of any obligations under this Coverage Form. 2. Concealment Misrepresentation Or Fraud This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other insured at any time intentionally conceals or misrepresents a material fact concerning a. This Coverage Form b. The covered auto c. Your interest in the covered auto or d. A claim under this Coverage Form. 3. Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge your policy will automatically provide the additional coverage as of the day the revision is effective in your state. 4. No Benefit To Bailee Physical Damage Coverages We will not recognize any assignment or grant any coverage for the benefit of any person or organization holding storing or transporting property for a fee regardless of any other provision of this Coverage Form. CA00011013 Insurance Servic 5. Other Insurance a. For any covered auto you own this Coverage Form provides primary insurance. For any covered auto you do nt own the insurance provided by this Coverage Form is excess over any other collectible insurance. However while a covered auto which is a trailer is connected to another vehicle the Covered Autos Liability Coverage this Coverage Form provides for the trailer is 1 Excess while it is connected to a motor vehicle you do not own or 2 Primary while it is connected to a covered auto you own. b. For Hired Auto Physical Damage Coverage any covered auto you lease hire rent or borrow is deemed to be a covered auto you own. However any auto that is leased hired rented or borrowed with a driver is not a covered auto. c. Regardless of the provisions of Paragraph a. above this Coverage Form s Covered Autos Liability Coverage is primary for any liability assumed wunder an insured contract. d. When this Coverage Form and any other Coverage Form or policy covers on the same basis either excess or primary we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the limits of all the Coverage Forms and policies covering on the same basis. 6. Premium Audit a. The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy began. We will compute the final premium due when we determine your actual exposures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the balance if any. The due date for the final premium or retrospective premium is the date shown as the due date on the bill. If the estimated total premium exceeds the final premium due the first Named Insured will get a refund. b. If this policy is issued for more than one year the premium for this Coverage Form will be computed annually based on our rates or premiums in effect at the beginning of each year of the policy. Insurance Services Office Inc. 2011 Insured Copy Page 9 of 12 | 2 |
7. Policy Period Coverage Territory Under this Coverage Form we cover accidents and losses occurring a. During the policy period shown in the Declarations and b. Within the coverage territory. The coverage territory is 1 The United States of America 2 The territories and possessions of the United States of America 3 Puerto Rico 4 Canada and 5 Anywhere in the world if a covered auto of the private passenger type is leased hired rented or borrowed without a driver for a period of 30 days or less provided that the insured s responsibility to pay damages is determined in a suit on the merits in the United States of America the territories and possessions of the United States of America Puerto Rico or Canada or in a settlement we agree to. We also cover loss to or accidents involving a covered auto while being transported between any of these places. 8. Two Or More Coverage Forms Or Policies Issued By Us If this Coverage Form and any other Coverage Form or policy issued to you by us or any company affiliated with us applies to the same accident the aggregate maximum Limit of Insurance under all the Coverage Forms or policies shall not exceed the highest applicable Limit of Insurance under any one Coverage Form or policy. This condition does not apply to any Coverage Form or policy issued by us or an affiliated company specifically to apply as excess insurance over this Coverage Form. SECTION V DEFINITIONS A. Accident includes continuous or repeated exposure to the same conditions resulting in bodily injury or property damage.. Auto means 1. A land motor vehicle trailer or semitrailer designed for travel on public roads or 2. 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.. Covered pollution cost or expense means any cost or expense arising out of 1. Any 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. Any 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. Covered pollution cost or expense does not include any cost or expense arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a. That are or that are contained in any property that is 1 Being transported or towed by handled or handled for movement into onto or from the covered auto 2 Otherwise in the course of transit by or on behalf of the insured or 3 Being stored disposed of treated or processed in or upon the covered auto b. Before the pollutants or any property in which the pollutants are contained are moved from the place where they are accepted by the insured for movement into or onto the covered auto or c. After the pollutants or any property in which the pollutants are contained are moved from the covered auto to the place where they are finally delivered disposed of or abandoned by the insured. Page 10 of 12 Insurance Services Office Inc. 2011 Insured Copy CA00011013 | 2 |
Paragraph a. above does not apply to fuels lubricants fluids exhaust gases or other similar pollutants that are needed for or result from the normal electrical hydraulic or mechanical functioning of the covered auto or its parts if 1 The pollutants escape seep migrate or are discharged dispersed or released directly from an auto part designed by its manufacturer to hold store receive or dispose of such pollutants and The bodily injury property damage or covered pollution cost or expense does not arise out of the operation of any equipment listed in Paragraph 6.b. or 6.c. of the definition of mobile equipment. Paragraphs b. and c. above do not apply to accidents that occur away from premises owned by or rented to an insured with respect to pollutants not in or upon a covered auto if 2 a The pollutants or any property in which the pollutants are contained are upset overturned or damaged as a result of the maintenance or use of a covered auto and b The discharge dispersal seepage migration release or escape of the pollutants is caused directly by such upset overturn or damage. Diminution in value means the actual or perceived loss in market value or resale value which results from a direct and accidental loss.. Employee includes a leased worker. Employee does not include a temporary worker.. Insured means any person or organization qualifying as an insured in the Who Is An Insured provision of the applicable coverage. Except with respect to the Limit of Insurance the coverage afforded applies separately to each insured who is seeking coverage or against whom a claim or suit is brought.. Insured contract means 1. Alease of premises 2. A sidetrack agreement 3. Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad 4. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality 5. 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 to pay for bodily injury or property damage to a third party or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement or 6. That part of any contract or agreement entered into as part of your business pertaining to the rental or lease by you or any of your employees of any auto. However such contract or agreement shall not be considered an insured contract to the extent that it obligates you or any of your employees to pay for property damage to any auto rented or leased by you or any of your employees. An insured contract does not include that part of any contract or agreement a. 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 roadbeds tunnel underpass or crossing b. That pertains to the loan lease or rental of an auto to you or any of your employees if the auto is loaned leased or rented with a driver or c. That holds a person or organization engaged in the business of transporting property by auto for hire harmless for your use of a covered auto over a route or territory that person or organization is authorized to serve by public authority. I. 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.. Loss means direct and accidental loss or damage. K. Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment 1. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads 2. Vehicles maintained for use solely on or next to premises you own or rent 3. Vehicles that travel on crawler treads CA00011013 Insurance Services Office Inc. 2011 Insured Copy Page 11 of 12 | 2 |
4. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted a. Power cranes shovels loaders diggers or drills or b. Road construction or resurfacing equipment such as graders scrapers or rollers 5. Vehicles not described in Paragraph 1. 2. 3. or 4. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types a. Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or b. Cherry pickers and similar devices used to raise or lower workers or 6. Vehicles not described in Paragraph 1. 2. 3. or 4. above maintained primarily for purposes other than the transportation of persons or cargo. However self propelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos a. Equipment designed primarily for 1 Snow removal 2 Road maintenance but not construction or resurfacing or 3 Street cleaning b. Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and c. Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting or well servicing equipment. However mobile equipment does not include 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.. Pollutants means 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.. Property damage means damage to or loss of use of tangible property.. Suit means a civil proceeding in which 1. Damages because of bodily injury or property damage or 2. Acovered pollution cost or expense to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages or covered pollution costs or expenses 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 or covered pollution costs or expenses are claimed and to which the insured submits with our consent.. Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions.. Trailer includes semitrailer. Page 12 of 12 Insurance Services Office Inc. 2011 Insured Copy CA00011013 | 2 |
COMMERCIAL AUTO CA01561113 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEBRASKA CHANGES This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. A. Changes In Physical Damage Coverage Paragraph C. Limits Of Insurance is changed by adding the following If a loss to your covered auto is also payable as damages under the liability coverage of another Coverage Form or policy issued by us we will pay for such damage or loss only once either under this Coverage Form or the liability coverage of the other Coverage Form or policy issued by us. B. Changes In Conditions 1. The Appraisal For Physical Damage Loss Condition is replaced by the following Appraisal For Physical Damage Loss If you and we disagree on the amount of loss both parties may agree in writing to an appraisal of the loss and to be bound by the results of that appraisal. If both parties so agree then each party will select a competent and impartial appraiser. The two appraisers will select an umpire. If they can not agree either may request that selection be made by a judge of a court having jurisdiction. The appraisers will state separately the value of the property and amount of loss. If they fail to agree they will submit their differences to the umpire. A decision agreed to by any two will be binding. Each party will a. Pay its chosen appraiser and b. Bear the other expenses of the appraisal and umpire equally. If there is an appraisal we will still retain our right to deny the claim. 2. The Concealment Misrepresentation Or Fraud Condition is replaced by the following Misrepresentation Or Breach Of Condition Or Warranty a. A misrepresentation or warranty made by you or on your behalf in the negotiation of or application for this Coverage Part will void this policy if 1 ltis material 2 Itis made with the intent to deceive 3 Werely on it and 4 We are deceived to our injury. b. A breach of warranty or condition will void the policy if such breach exists at the time of loss and contributes to the loss.. The Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance Primary And Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are revised by the addition of the following When this Coverage Form and any other Coverage Form or policy providing liability andor physical damage insurance apply with respect to an accident or loss involving a loaned vehicle and such Coverage Forms or policies have a mutually repugnant clause regarding primary coverage and a. One provides coverage to a licensed seller or dealer that owns the loaned vehicle and 2. The Concealment Misrepresentation Or Fraud Condition is replaced by the following Misrepresentation Or Breach Of Condition Or Warranty a. A misrepresentation or warranty made by you or on your behalf in the negotiation of or application for this Coverage Part will void this policy if 1 ltis material 2 Itis made with the intent to deceive 3 Werely on it and 4 We are deceived to our injury. b. A breach of warranty or condition will void the policy if such breach exists at the time of loss and contributes to the loss. 3. The Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance Primary And Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are revised by the addition of the following When this Coverage Form and any other Coverage Form or policy providing liability andor physical damage insurance apply with respect to an accident or loss involving a loaned vehicle and such Coverage Forms or policies have a mutually repugnant clause regarding primary coverage and a. One provides coverage to a licensed seller or dealer that owns the loaned vehicle and CA 01561113 Insurance Services Office Inc. 2013 Insured Copy Page 1 of 2 | 2 |
b. The other provides coverage to the operator of the loaned vehicle and At the time of such accident or loss the operator s liability andor physical damage insurance as described in Paragraph b. is primary and the licensed seller or dealer s liability andor physical damage insurance described in Paragraph a. is excess over any insurance available to that operator.. Additional Definitions As used in this endorsement Loaned vehicle means a covered auto which is provided for use as a temporary substitute without a direct charge to an insured operator by a licensed seller or dealer for use while the insured operator s covered auto is being serviced repaired or inspected by such seller or dealer until such auto is returned to the licensed seller or dealer. Page 2 of 2 Insurance Services Office Inc. 2013 Insured Copy CA 01561113 | 2 |
COMMERCIAL AUTO CA02211013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEBRASKA CHANGES CANCELLATION This endorsement modifies insurance provided under the following AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. The following is added to Paragraph 3. of the b. Any reason other than nonpayment of Cancellation Common Policy Condition premium If the policy has been in effect 60 days or notice of cancellation will be sent by more or is a renewal or continuation policy registered or certified mail. and we cancel for a. Nonpayment of premium to a premium finance company or b. Any reason other than nonpayment of premium notice of cancellation will be sent by registered or certified mail. CA02211013 Insurance Services Office Inc. 2012 Insured Copy Page 1 of 1 | 2 |
POLICY NUMBER CPP126376A POLICY NUMBER CPP126376A COMMERCIAL AUTO CA21701013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEBRASKA UNINSURED AND UNDERINSURED MOTORISTS COVERAGE For a covered auto licensed or principally garaged in or auto dealer operations conducted in Nebraska this endorsement modifies insurance provided under the following AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured Endorsement Effective Date SCHEDULE Limit Of Insurance 1000000 Each Accident Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Coverage 1. We will pay all sums the insured is legally 1 Have been given prompt written notice of such tentative settlement and entitled to recover as compensatory damages from the owner or driver of an uninsured motor vehicle or underinsured motor vehicle. The damages must result from bodily injury sustained by the insured caused by an accident. The owner s or driver s liability for these damages must result from the ownership maintenance or use of the uninsured motor vehicle or underinsured motor vehicle. 2. With respect to damages resulting from an accident with an underinsured motor vehicle we will pay under this coverage only if Paragraph a. or b. below applies a. The limits of any applicable liability bonds or policies have been exhausted by payment of judgments or settlements or b. A tentative settlement has been made between an insured and the insurer of the underinsured motor vehicle and we 2 Advance payment to the insured in an amount equal to the tentative settlement within 30 days after receipt of notification. 3. Any judgment for damages arising out of a suit brought against the owner or operator of an uninsured motor vehicle or underinsured motor vehicle without our written consent is not binding on us unless we a. Receive reasonable notice of the pendency of the suit resulting in the judgment and b. Have had a reasonable opportunity to protect our interest in the suit. B. Who Is An Insured If the Named Insured is designated in the Declarations as 1. Anindividual then the following are insureds a. The Named Insured and any family members. tive Data CA21701013 Insurance Services Office Inc. 2012 Insured Copy Page 1 of 4 | 2 |
2. b. Anyone else occupying or using a covered auto or a temporary substitute for a covered auto. The covered auto must be out of service because of its breakdown repair servicing loss or destruction. c. Anyone for damages he or she is entitled to recover because of bodily injury sustained by another insured. A partnership limited liability company corporation or any other form of organization then the following are insureds a. Anyone occupying or using a covered auto or a temporary substitute for a covered auto. The covered auto must be out of service because of its breakdown repair servicing loss or destruction. b. Anyone for damages he or she is entitled to recover because of bodily injury sustained by another insured. C. Exclusions This insurance does not apply to any of the following 1. 4. Any claim settled without our consent. However this exclusion does not apply a. If such settlement does not adversely affect our rights or b. To a settlement made with the insurer of an underinsured motor vehicle in accordance with the procedure described in Paragraph A.2.b. The direct or indirect benefit of any insurer or self insurer under any workers compensation disability benefits or similar law. Bodily injury sustained by a. An individual Named Insured while occupying or when struck by any vehicle owned by that Named Insured that is not a covered auto for Underinsured Motorists Coverage under this Coverage Form b. Any family member while occupying or when struck by any vehicle owned by that family member that is not a covered auto for Underinsured Motorists Coverage under this Coverage Form or c. Any family member while occupying or when struck by any vehicle owned by the Named Insured that is insured for Underinsured Motorists Coverage on a primary basis under any other Coverage Form or policy. Punitive or exemplary damages. 5. Bodily injury arising directly or indirectly out of a. War including undeclared or civil war b. 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 c. Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. D. Limit Of Insurance 1. Regardless of the number of covered autos insureds premiums paid claims made or vehicles involved in the accident the most we will pay for all damages resulting from any one accident is the Limit Of Liability shown in the Schedule or Declarations. The coverage limit for Uninsured and Underinsured Motorists Coverage applies separately to damages caused by an accident with an uninsured motor vehicle and an underinsured motor vehicle. 2. No one will be entitled to receive duplicate payments for the same elements of loss under this Coverage Form and any Liability Coverage form or Uninsured or Underinsured Motorists Coverage endorsement attached to this Coverage Part. We will not make a duplicate payment under this Coverage for any element of loss for which payment has been made by or for anyone who is legally responsible. We will not pay for any element of loss if a person is entitled to receive payment for the same element of loss under any workers compensation disability benefits or similar law. E. Changes In Conditions The Conditions are changed for Underinsured Motorists Coverage as follows 1. With respect to damages caused by an uninsured motor vehicle the reference in Other Insurance in the Auto Dealers and Business Auto Coverage Forms and Other Insurance Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form to other collectible insurance applies only to other collectible uninsured motorists insurance. Page 2 of 4 Insurance Services Office Inc. 2012 Insured Copy CA21701013 | 2 |
3. Duties In The Event Of Accident Claim Suit Or Loss in the Business Auto and Motor Carrier Coverage Forms and Duties In The Event Of Accident Claim Offense Suit Loss Or Acts Errors Or Omissions in the Auto Dealers Coverage Form are changed by adding the following a. Promptly notify the police if a hit and run driver is involved and b. Promptly send us copies of the legal papers if a suit is brought. With respect to an underinsured motor vehicle Duties In The Event Of Accident Claim Suit Or Loss in the Business Auto and Motor Carrier Coverage Forms and Duties In The Event Of Accident Claim Offense Suit Loss Or Acts Errors Or Omissions in the Auto Dealers Coverage Form are also changed by adding the following a. Promptly notify us in writing of a tentative settlement between the insured and the insurer of an underinsured motor vehicle. b. Allow us to advance payment to that insured in an amount equal to the tentative settlement within 30 days after receipt of notification to preserve our rights against the insurer owner or operator of such underinsured motor vehicle. 4. Transfer Of Rights Of Recovery Against Others To Us is changed by adding the following a. If we make any payment and the insured recovers from another party the insured shall hold the proceeds in trust for us and pay us back that amount we have paid. b. For an underinsured motor vehicle the Transfer Of Rights Of Recovery Against Others To Us Condition does not apply if we 1 Have been given prompt written notice of a tentative settlement between an insured and the insurer of an underinsured motor vehicle and Fail to advance payment to the insured in an amount equal to the tentative settlement within 30 days after receipt of written notification. 2 2. With respect to damages caused by an underinsured motor vehicle Other Insurance in the Auto Dealers and Business Auto Coverage Forms and Other Insurance Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form are replaced by the following If there is other applicable insurance available under one or more policies or provisions of coverage The maximum recovery under all Coverage Forms or policies combined may equal but not exceed the highest applicable limit for any one vehicle under any Coverage Form or policy providing coverage on either a primary or excess basis.. Any insurance we provide with respect to a vehicle the Named Insured does not own shall be excess over any other collectible underinsured motorists insurance providing coverage on a primary basis. If the coverage under this Coverage Form is provided 1 On a primary basis we will pay only our share of the loss that must be paid under insurance providing coverage on a primary basis. Our share is the proportion that our limit of liability bears to the total of all applicable limits of liability for coverage on a primary basis. 2 On an excess basis we will pay only our share of the loss that must be paid under insurance providing coverage on an excess basis. Our share is the proportion that our limit of liability bears to the total of all applicable limits of liability for coverage on an excess basis. The following priorities of recovery apply First The Underinsured Motorists Coverage applicable to the Vehicle the insured was occupying at the time of the accident. Second The Underinsured Motorists Coverage applicable to an auto not involved in the accident under which the injured person is an insured. CA21701013 Insurance Services Office Inc. 2012 Insured Copy Page 3 of 4 | 2 |
If we advance payment to the insured in an amount equal to the tentative settlement within 30 days after receipt of notification 1 That payment will be separate from any amount the insured is entitled to recover under the provisions of Underinsured Motorists Coverage and 2 We also have a right to recover the advance payment. 5. The following condition is added 6. Reimbursement And Trust If we make any payment and the insured recovers from another party the insured shall hold the proceeds in trust for us and pay us back the amount we have paid. The following condition is added Arbitration a. If we and an insured disagree whether the insured is legally entitled to recover damages from the owner or driver of an underinsured motor vehicle or do not agree as to the amount of damages that are recoverable by that insured then the matter may be arbitrated. However disputes concerning coverage under this endorsement may not be arbitrated. Both parties must agree to arbitration. If both parties so agree each party will select an arbitrator. The two arbitrators will select a third. If they can not agree within 30 days either may request that selection be made by a judge of a court having jurisdiction. Each party will pay the expenses it incurs and bear the expenses of the third arbitrator equally. b. Unless both parties agree otherwise arbitration will take place in the county in which the insured lives. Local rules of law as to arbitration procedures and evidence will apply. A decision agreed to by two of the arbitrators will be binding. F. Additional Definitions As used in this endorsement 1. Family member means a person related to an individual Named Insured by blood marriage or adoption who is a resident of such Named Insured household including a ward or foster child. Occupying means in upon getting in on out or off. 3. Uninsured motor vehicle means a land motor vehicle or trailer a. For which no liability bond or policy applies at the time of the accident. b. For which an insuring or bonding company denies coverage or is or becomes insolvent or c. Thatis a hit and run vehicle and neither the driver nor owner can be identified. If there is no physical contact with the hit and run vehicle the facts of the accident must be corroborated by competent evidence provided by an independent and disinterested person other than the insured making the claim or any person occupying the covered auto. However uninsured motor vehicle does not include any vehicle a. Owned or operated by a self insurer under any applicable motor vehicle law except a self insurer who is or becomes insolvent and can not provide the amounts required by that motor vehicle law b. Owned by a governmental unit or agency or c. Designed for use mainly off public roads while not on public roads.. Underinsured motor vehicle means a land motor vehicle or trailer to which a bodily injury liability bond or policy applies at the time of an accident but its limit for bodily injury liability is either a. Not enough to pay the full amount the insured is legally entitled to recover as damages or b. Reduced by payments to persons other than an insured injured in the accident to less than the full amount the insured is legally entitled to recover as damages. However underinsured motor vehicle does not include any vehicle c. Owned by or furnished or available for the Named Insured s regular use or that of any family member if the Named Insured is an individual. d. Owned by a governmental unit or agency. e. Designed for use mainly off public roads while not on public roads. f. Owned or operated by a self insurer under any applicable motor vehicle law. g. While located for use as a residence or premises. h. Which is an uninsured motor vehicle. Page 4 of 4 Insurance Services Office Inc. 2012 Insured Copy CA21701013 | 2 |
COMMERCIAL AUTO CA23051013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WRONG DELIVERY OF LIQUID PRODUCTS This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. Covered Autos Liability Coverage is changed by adding the following exclusion This insurance does not apply to Bodily injury or property damage resulting from the delivery of any liquid into the wrong receptacle or to the wrong address or from the delivery of one liquid for another if the bodily injury or property damage occurs after delivery has been completed. Delivery is considered completed even if further service or maintenance work or correction repair or replacement is required because of wrong delivery. Delivery is considered completed even if further service or maintenance work or correction repair or replacement is required because of wrong delivery. CA23051013 Insurance Services Office Inc. 2011 Insured Copy Page 1 of 1 | 2 |
COMMERCIAL AUTO CA 23841013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF TERRORISM This endorsement modifies insurance provided under the following AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM SINGLE INTEREST AUTOMOBILE PHYSICAL DAMAGE INSURANCE POLICY With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. A. The following definitions are added and apply under this endorsement wherever the term terrorism or the phrase any injury damage loss or expense is enclosed in quotation marks 1. Terrorism means activities against persons organizations or property of any nature a. That involve the following or preparation for the following 1 Use or threat of force or violence or 2 Commission or threat of a dangerous act or 3 Commission or threat of an act that interferes with or disrupts an electronic communication information or mechanical system and b. When one or both of the following apply 1 The effect is to intimidate or coerce a government or the civilian population or any segment thereof or to disrupt any segment of the economy or It appears that the intent is to intimidate or coerce a government or to further political ideological religious social or economic objectives or to express or express opposition to a philosophy or ideology. 2 2. Any injury damage loss or expense means any injury damage loss or expense covered under any Coverage Form or Policy to which this endorsement is applicable and includes but is not limited to bodily injury property damage personal and advertising injury loss loss of use rental reimbursement after loss or covered pollution cost or expense as may be defined under this Coverage Form Policy or any applicable endorsement. B. Except with respect to Physical Damage Coverage Trailer Interchange Coverage Garagekeepers Coverage Garagekeepers Coverage Customers Sound Receiving Equipment or the Single Interest Automobile Physical Damage Insurance Policy the following exclusion is added Exclusion Of Terrorism We will not pay for any injury damage loss or expense caused directly or indirectly by terrorism including action in hindering or defending against an actual or expected incident of terrorism. Any injury damage loss or expense is excluded regardless of any other cause or event that contributes concurrently or in any sequence to such injury damage loss or expense. But this exclusion applies only when one or more of the following are attributed to an incident of terrorism 1. The terrorism is carried out by means of the dispersal or application of radioactive material or through the use of a nuclear weapon or device that involves or produces a nuclear reaction nuclear radiation or radioactive contamination or CA23841013 Insurance Services Office Inc. 2013 Insured Copy Page 10f 3 | 2 |
I. Radioactive material is released and it appears that one purpose of the terrorism was to release such material or 3. The terrorism is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemical materials or Pathogenic or poisonous biological or chemical materials are released and it appears that one purpose of the terrorism was to release such materials or 5. The total of insured damage to all types of property exceeds 25000000. In determining whether the 25000000 threshold is exceeded we will include all insured damage sustained by property of all persons and entities affected by the terrorism and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision insured damage means damage that is covered by any insurance plus damage that would be covered by any insurance but for the application of any terrorism exclusions or 6. Fifty or more persons sustain death or serious physical injury. For the purposes of this provision serious physical injury means a. Physical injury that involves a substantial risk of death or b. Protracted and obvious physical disfigurement or c. Protracted loss of or impairment of the function of a bodily member or organ. Multiple incidents of terrorism which occur within a 72 hour period and appear to be carried out in concert or to have a related purpose or common leadership will be deemed to be one incident for the purpose of determining whether the thresholds in Paragraphs B.5. and B.6. are exceeded. With respect to this exclusion Paragraphs B.5. and B.6. describe the thresholds used to measure the magnitude of an incident of terrorism and the circumstances in which the threshold will apply for the purpose of determining whether this exclusion will apply to that incident. When the exclusion applies to an incident of terrorism there is no coverage under this Coverage Form Policy or any applicable endorsement. C. With respect to Physical Damage Coverage Trailer Interchange Coverage Garagekeepers Coverage Garagekeepers Coverage Customers Sound Receiving Equipment or the Single Interest Automobile Physical Damage Insurance Policy the following exclusion is added Exclusion Of Terrorism We will not pay for any loss loss of use or rental reimbursement after loss caused directly or indirectly by terrorism including action in hindering or defending against an actual or expected incident of terrorism. But this exclusion applies only when one or more of the following are attributed to an incident of terrorism 1. The terrorism is carried out by means of the dispersal or application of radioactive material or through the use of a nuclear weapon or device that involves or produces a nuclear reaction nuclear radiation or radioactive contamination or 2. Radioactive material is released and it appears that one purpose of the terrorism was to release such material or 3. The terrorism is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemical materials or 4. Pathogenic or poisonous biological or chemical materials are released and it appears that one purpose of the terrorism was to release such materials or 5. The total of insured damage to all types of property exceeds 25000000. In determining whether the 25000000 threshold is exceeded we will include all insured damage sustained by property of all persons and entities affected by the terrorism and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision insured damage means damage that is covered by any insurance plus damage that would be covered by any insurance but for the application of any terrorism exclusions. Multiple incidents of terrorism which occur within a 72 hour period and appear to be carried out in concert or to have a related purpose or common leadership will be deemed to be one incident for the purpose of determining whether the threshold in Paragraph C.5. is exceeded. Page 2 of 3 Insurance Services Office Inc. 2013 Insured Copy CA 23841013 | 2 |
With respect to this exclusion Paragraph C.5. describes the threshold used to measure the magnitude of an incident of terrorism and the circumstances in which the threshold will apply for the purpose of determining whether this exclusion will apply to that incident. When the exclusion applies to an incident of terrorism there is no coverage under this Coverage Form Policy or any applicable endorsement. D. In the event of any incident of terrorism that is not subject to the exclusion in Paragraph B. or C. coverage does not apply to any injury damage loss or expense that is otherwise excluded under this Coverage Form Policy or any applicable endorsement. CA23841013 Insurance Services Office Inc. 2013 Insured Copy Page 30f 3 | 2 |
COMMERCIAL AUTO CA23941013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SILICA OR SILICA RELATED DUST EXCLUSION FOR COVERED AUTOS EXPOSURE AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM This endorsement modifies insurance provided under the following With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. A. The following exclusion is added to Covered Autos Liability Coverage Silica Or Silica related Dust Exclusion For Covered Autos Exposure This insurance does not apply to 1. Bodily injury arising in whole or in part out of the actual alleged threatened or suspected inhalation of or ingestion of silica or silica related dust. 2. Property damage arising in whole or in part out of the actual alleged threatened or suspected contact with exposure to existence of or presence of silica or silica related dust. 3. Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of silica or silica related dust by any insured or by any other person or entity. B. Additional Definitions As used in this endorsement 1. Silica means silicon dioxide occurring in crystalline amorphous and impure forms silica particles silica dust or silica compounds. 2. Silica related dust means a mixture or combination of silica and other dust or 3. Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of silica or silica related dust by any insured or by any other person or entity. B. Additional Def ons As used in this endorsement 1. Silica means silicon dioxide occurring in crystalline amorphous and impure forms silica particles silica dust or silica compounds. 2. Silica related dust means a mixture or combination of silica and other dust or particles. CA23941013 Insurance Services Office Inc. 2011 Insured Copy Page 1 of 1 | 2 |
COMMERCIAL AUTO CA99351113 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEBRASKA AUTO MEDICAL PAYMENTS COVERAGE This endorsement modifies insurance provided under the following AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. A. Coverage 4. Bodily injury to your employee arising out of We will pay reasonable expenses incurred for necessary medical and funeral services to or for an insured who sustains bodily injury caused by accident. We will pay only those expenses incurred for services rendered within three years from the date of the accident.. Who Is An Insured 1. You while occupying or while a pedestrian when struck by any auto. 2. If you are an individual any family member while occupying or while a pedestrian when struck by any auto. 3. Anyone else occupying a covered auto or a temporary substitute for a covered auto. The covered auto must be out of service because of its breakdown repair servicing loss or destruction.. Exclusions This insurance does not apply to any of the following 1. Bodily injury sustained by an insured while occupying a vehicle located for use as a premises. 2. Bodily injury sustained by you or any family member while occupying or struck by any vehicle other than a covered auto owned by you or furnished or available for your regular use. 3. Bodily injury sustained by any family member while occupying or struck by any vehicle other than a covered auto owned by or furnished or available for the regular use of any family member. and in the course of employment by you. However we will cover bodily injury to your domestic employees if not entitled to workers compensation benefits. For the purposes of this endorsement a domestic employee is a person engaged in household or domestic work performed principally in connection with a residence premises. 5. Bodily injury to an insured while working in a business of selling servicing repairing or parking autos unless that business is yours. 6. Bodily injury arising directly or indirectly out of a. War including undeclared or civil war b. 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 c. Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. 7. Bodily injury to anyone using a vehicle without a reasonable belief that the person is entitled to do so. 8. Bodily injury sustained by an insured while occupying any covered auto while used in any professional racing or demolition contest or stunting activity or while practicing for such contest or activity. This insurance also does not apply to any bodily injury sustained by an insured while the auto is being prepared for such a contest or activity.. Bodily injury to your employee arising out of and in the course of employment by you. However we will cover bodily injury to your domestic employees if not entitled to workers compensation benefits. For the purposes of this endorsement a domestic employee is a person engaged in household or domestic work performed principally in connection with a residence premises.. Bodily injury to an insured while working in a business of selling servicing repairing or parking autos unless that business is yours.. Bodily injury arising directly or indirectly out of a. War including undeclared or civil war b. 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 c. Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these.. Bodily injury to anyone using a vehicle without a reasonable belief that the person is entitled to do so.. Bodily injury sustained by an insured while occupying any covered auto while used in any professional racing or demolition contest or stunting activity or while practicing for such contest or activity. This insurance also does not apply to any bodily injury sustained by an insured while the auto is being prepared for such a contest or activity. CA99351113 Insurance Services Office Inc. 2013 Insured Copy Page 1 of 2 | 2 |
D. Limit Of Insurance Regardless of the number of covered autos insureds premiums paid claims made or vehicles involved in the accident the most we will pay for bodily injury for each insured injured in any one accident is the Limit Of Insurance for Auto Medical Payments Coverage shown in the Declarations. No one will be entitled to receive duplicate payments for the same elements of loss under this coverage and any Liability Coverage Form Uninsured Motorists Coverage Endorsement or Underinsured Motorists Coverage Endorsement attached to this Coverage Part. Changes In Conditions The Conditions are changed for Auto Medical Payments Coverage as follows 1. The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply. 2. The reference in Other Insurance in the Auto Dealers and Business Auto Coverage Forms and Other Insurance Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form to other collectible insurance applies only to other collectible auto medical payments insurance. When this Coverage Form and any other Coverage Form or policy providing Auto Medical Payments Coverage apply with respect to an accident involving a loaned vehicle and such Coverage Forms or policies have a mutually repugnant clause regarding primary coverage and a. One provides coverage to a licensed seller or dealer that owns the loaned vehicle and b. The other provides coverage to the operator of the loaned vehicle and c. At the time of such accident the operator s Auto Medical Payments Coverage as described in Paragraph b. is primary and the licensed seller or dealer s Auto Medical Payments Coverage described in Paragraph a. is excess over any insurance available to that operator. F. Additional Definitions As used in this endorsement 1. Family member means a person related to you by blood marriage or adoption who is a resident of your household including a ward or foster child. 2. Occupying means in upon getting in on out or off. 3. Loaned vehicle means an auto which is provided for use as a temporary substitute without a direct charge to an insured operator by a licensed seller or dealer for use while the insured operator s covered auto is being serviced repaired or inspected by such seller or dealer until such auto is returned to the licensed seller or dealer. Page 2 of 2 Insurance Services Office Inc. 2013 Insured Copy CA99351113 | 2 |
COMMERCIAL AUTO CA 99441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LOSS PAYABLE CLAUSE This endorsement modifies insurance provided under the following AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. A. We will pay as interest may appear you and the loss payee named in the policy for loss to a covered auto. B. The insurance covers the interest of the loss payee unless the loss results from conversion secretion or embezzlement on your part. C. We may cancel the policy as allowed by the Cancellation Common Policy Condition. Cancellation ends this agreement as to the loss payee s interest. If we cancel the policy we will mail you and the loss payee the same advance notice.. If we make any payments to the loss payee we will obtain his or her rights against any other party. Cancellation ends this agreement as to the loss payee s interest. If we cancel the policy we will mail you and the loss payee the same advance notice.. If we make any payments to the loss payee we will obtain his or her rights against any other party. CA99441013 Insurance Services Office Inc. 2011 Insured Copy Page 1 of 1 | 2 |
Policy Number CPP126376A Nationwide SCHEDULE OF LOSS PAYEES NATIONWIDE AGRIBUSINESS INSURANCE COMPANY Named Insured PRAIRIELAND DAIRY LLC Effective Date 04 01 17 1201 A.M. Standard Time AgentName LOCKTON COMPANIES LLC Loss Payee and Mailing Address FIRST STATE BANK CORTLAND BRANCH PO BOX 202 CORTLAND NE USA 68331 Designation or Description of Autos NE 12 2006 GMC CANYON 1GTCS138468172895 NE 13 1974 WALKER TRAILER TT3090 SCHEDULE OF LOSS PAYEES CPP126376A NY Effective Date 04 01 17 1201 A.M. Standard Time e e g AWM ee IRST STATE BANK CORTLAND BRANCH O BOX 202 ORTLAND NE USA 68331 esignation or Description of Autos E 12 2006 GMC CANYON 1GTCS138468172895 E 13 1974 WALKER TRAILER TT3090 LOSS PAYEE 0197 Insured Copy | 2 |
COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO PLUS ENDORSEMENT This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM The BUSINESS AUTO COVERAGE FORM is amended to include the following additions and extensions of CHOPPDOZErAETIOMMPO WD overage NEWLY ACQUIRED OR FORMED ENTITIES TEMPORARY SUBSTITUTE AUTOS PHYSICAL DAMAGE COVERAGE BLANKET ADDITIONAL INSURED REQUIRED BY CONTRACT EMPLOYEES AS INSUREDS NONOWNED AUTOS EMPLOYEE HIRED AUTOS SUPPLEMENTARY PAYMENTS BAIL BONDS SUPPLEMENTARY PAYMENTS LOSS OF EARNINGS FELLOW EMPLOYEE COVERAGE PROPERTY OF OTHERS PERSONAL EFFECTS COVERAGE AUTO MEDICAL PAYMENTS COVERAGE INCREASED LIMITS EXPANDED TOWING COVERAGE. AUTO LOAN OR LEASE COVERAGE RENTAL REIMBURSEMENT COVERAGE EXPANDED TRANSPORTATION EXPENSE EXPENSE YOU INCUR TO RECOVER A STOLEN AUTO ACCIDENTAL AIRBAG DISCHARGE COVERAGE PHYSICAL DAMAGE TWO OR MORE DEDUCTIBLES BLANKET WAIVER OF SUBROGATION AMENDED DUTIES IN THE EVENT OF ACCIDENT CLAIM SUIT OR LOSS UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS A. NEWLY ACQUIRED OR FORMED ENTITIES The Named Insured shown in the Declarations is amended to include 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 more than 50 interest if there is no other similar insurance available to that organization. Coverage under this provision is afforded only until the 90 day after you acquire or form the organization or the end of the policy period whichever comes first. B. TEMPORARY SUBSTITUTE AUTOS PHYSICAL DAMAGE COVERAGE The following is added to Paragraph C. Certain Trailers Mobile Equipment And Temporary Substitute Autos of SECTION COVERED AUTOS If Physical Damage Coverage is provided on a covered auto you own that is out of service because of its breakdown repair servicing loss or destruction then you have coverage for any auto you do not own while used with the permission of its owner as a temporary substitute for the covered out of service auto. The deductible for the temporary substitute auto will be the same as the applicable deductible for the covered auto it replaces. Includes copyrighted material of Insurance Services Office Inc. with its permission. CCAB191 1013 Page 1 of 6 Insured Copy | 2 |
COMMERCIAL AUTO C. BLANKET ADDITIONAL INSURED REQUIRED BY CONTRACT The following is added to Paragraph A.1. Who Is An Insured of SECTION Il COVERED AUTOS LIABILITY COVERAGE Any persons or organizations is an additional insured with whom you have agreed in a valid written contract or agreement executed prior to any accident or loss that such persons or organizations be added as an additional insured on your policy. Such persons or organizations are additional insureds but only with respect to liability for bodily injury or property damage caused by an accident that is in whole or in part caused by your acts or omissions or the acts or omissions of those acting on your behalf and resulting from the ownership maintenance or use of a covered auto. D. EMPLOYEES AS INSUREDS NONOWNED AUTOS The following is added to the SECTION Il COVERED AUTOS LIABILITY COVERAGE Paragraph A.1. Who Is An Insured provision Any employee of yours is an insured while using a covered auto you do nt own hire or borrow in your business or your personal affairs. E. EMPLOYEE HIRED AUTOS 1. Changes In Covered Autos Liability Coverage The following is added to the Who Is An Insured Provision An employee of yours is an insured while operating an auto hired or rented under a contract or agreement in an employee s name with your permission while performing duties related to the conduct of your business. 2. Changes In General Conditions Paragraph 5.b. of the Other Insurance Condition in the BUSINESS AUTO COVERAGE FORM is replaced by the following For Hired Auto Physical Damage Coverage the following are deemed to be covered autos you own a. Any covered auto you lease hire rent or borrow and b. Any covered auto hired or rented by your employee under a contract in an employee s name with your permission while performing duties related to the conduct of your business. However any auto that is leased hired rented or borrowed with a driver is not a covered auto. F. SUPPLEMENTARY PAYMENTS BAIL BONDS The following replaces Paragraph A.2.a. 2 of SECTION Il COVERED AUTOS LIABILITY COVERAGE 2 Up to 5000 for cost of bail bonds including bonds for related traffic law violations required because of an accident we cover. We do not have to furnish these bonds. G. SUPPLEMENTARY PAYMENTS LOSS OF EARNINGS The following replaces Paragraph A.2.a. 4 of SECTION Il COVERED AUTOS LIABILITY COVERAGE Includes copyrighted material of Insurance Services Office Inc. with its permission. CCAB191 1013 Page 2 of 6 Insured Copy | 2 |
COMMERCIAL AUTO 4 All reasonable expenses incurred by the insured at our request including actual loss of earnings up to 500 a day because of time off from work.. FELLOW EMPLOYEE COVERAGE The Fellow Employee Exclusion contained under the COVERED AUTOS LIABILITY COVERAGE does not apply. PROPERTY OF OTHERS The Care Custody Or Control Exclusion in SECTION Il COVERED AUTOS LIABILITY COVERAGE does not apply to property damage to property other than your property up to an amount not exceeding 3000 in any one accident. This coverage applies as a result of a covered loss without applying a deductible. Coverage is excess over any other valid and collectible insurance.. PERSONAL EFFECTS COVERAGE The following is added to Paragraph A.4. Coverage Extensions of SECTION Ill PHYSICAL DAMAGE COVERAGE We will pay up to 1000 for the loss to personal effects which are 1 Owned by an insured and 2 Inoron your covered auto. This coverage applies as a result of a covered loss without applying a deductible. Coverage is excess over any other valid and collectible insurance.. AUTO MEDICAL PAYMENTS COVERAGE INCREASED LIMITS In the event of a covered loss where Auto Medical Payments Coverage applies we will double the Limit Of Insurance for Medical Payments shown in the Declarations for each insured who was wearing a seat belt at the time of the accident. This limit is the most we will pay for all covered medical expenses regardless of the number of covered autos insureds premiums paid claims made or vehicles involved in the accident.. EXPANDED TOWING COVERAGE The following replaces Paragraph A.2. of SECTION Ill PHYSICAL DAMAGE COVERAGE We will pay up to 1. 100 for a covered auto you own of the private passenger type or 2. 500 for a covered auto you own that is not of the private passenger type for towing and labor costs incurred each time the covered auto is disabled. However the labor must be performed at the place of disablement.. AUTO LOAN OR LEASE COVERAGE Physical Damage Coverage is amended by the addition of the following 1. In the event of a total loss to a covered auto we will pay any unpaid amount due on the lease or loan including up to maximum of 500 for early termination fees or penalties for a covered auto less Includes copyrighted material of Insurance Services Office Inc. with its permission. CCAB191 1013 Page 3 of 6 Insured Copy | 2 |
COMMERCIAL AUTO a. The amount paid under the policy s Physical Damage Coverage and b. Any 1 Overdue lease loan payments at the time of the loss 2 Financial penalties imposed under a lease for excessive use abnormal wear and tear or high mileage 3 Security deposits not returned by the lessor 4 Costs of extended warranties Credit Life insurance Health Accident or Disability insurance purchased with the loan or lease and 5 Carry over balances from previous loans or leases. This coverage only applies to a loss which is also covered under this policy for Comprehensive Specified Causes Of Loss or Collision Coverage. Coverage does not apply to any unpaid amount due on a loan for which the covered auto is not the sole collateral. This endorsement does not apply to any covered auto for which broader coverage is provided by any other endorsement form on this policy. N. RENTAL REIMBURSEMENT COVERAGE 1. We will pay for rental reimbursement expenses incurred by you for the rental of an auto because of loss to a covered auto. Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered auto. No deductibles apply to this coverage. This coverage applies only to a covered auto for which Physical Damage Coverage is provided on this policy. We will pay only for those expenses incurred during the policy period beginning 24 hours after the loss and ending regardless of the policy s expiration with the lesser of the following number of days a. The number of days reasonably required to repair or replace the covered auto. If loss is caused by theft this number of days is added to the number of days it takes to locate the covered auto and return it to you. b. 30 days. Our payment is limited to the lesser of the following amounts a. Necessary and actual expenses incurred. b. 75 for any one day or for a maximum of 30 days. This coverage does not apply while there are spare or reserve autos available to you for your operations. If loss results from the total theft of a covered auto of the private passenger type we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Expanded Transportation Expense Coverage Extension in this form. This endorsement does not apply to any covered auto for which broader coverage is provided by any other endorsement form on this policy. 0. EXPANDED TRANSPORTATION EXPENSE Paragraph A.4.a. of SECTION lil PHYSICAL DAMAGE is replaced by the following Includes copyrighted material of Insurance Services Office Inc. with its permission. CCAB191 1013 Page 4 of 6 Insured Copy | 2 |
COMMERCIAL AUTO We will pay up to 50 per day to a maximum of 1500 for temporary transportation expense incurred by you because of the total theft of a covered auto of the private passenger type. We will pay only for those covered autos for which you carry either Comprehensive or Specified Causes Of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending regardless of the policy s expiration when the covered auto is returned to use or we pay for its loss. P. EXPENSE YOU INCUR TO RECOVER A STOLEN AUTO The following is added to Paragraph A.4. of SECTION lll PHYSICAL DAMAGE COVERAGE We will pay up to 5000 for the expense of recovering a stolen covered auto to you. We will pay only for those covered autos for which you carry Comprehensive or Specified Causes Of Loss Coverage. Q. ACCIDENTAL AIRBAG DISCHARGE COVERAGE The following is added to Paragraph B.3.a. of SECTION Ill PHYSICAL DAMAGE COVERAGE Mechanical breakdown does not include the accidental discharge of an airbag. R. PHYSICAL DAMAGE TWO OR MORE DEDUCTIBLES The following is added to Paragraph D. Deductible of SECTION Ill PHYSICAL DAMAGE COVERAGE When two or more covered autos sustain loss in the same collision the loss will be reduced by the largest single deductible that applies. For purposes of this coverage an auto and its attached trailer are two separate autos. S. BLANKET WAIVER OF SUBROGATION The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply but only when the Named Insured agrees that subrogation is waived prior to the accident or the loss under the terms of a written contract entered into between the Named Insured and an entity that is part of that contract. T. AMENDED DUTIES IN THE EVENT OF ACCIDENT CLAIM SUIT OR LOSS The following replaces Paragraph A.2.a. Duties In The Event Of Accident Claim Suit Or Loss of SECTION IV BUSINESS AUTO CONDITIONS We have no duty to provide coverage under this policy unless there has been full compliance with the following duties a. In the event of accident claim suit or loss your insurance manager or any other person you designate as responsible for insurance related matters must notify us promptly of an accident or a loss regardless of the amount which may result in a claim. Include 1 How when and where the accident or loss occurred 2 The insured s name and address and 3 To the extent possible the names and addresses of any injured persons and witnesses. Paragraph A.2.b.2 Duties In The Event Of Accident Claim Suit Or Loss of SECTION IV BUSINESS AUTO CONDITIONS is amended as follows b. Additionally you and any other involved insured must Includes copyrighted material of Insurance Services Office Inc. with its permission. CCAB191 1013 Page 50f 6 CCAB191 1013 Page 5 of 6 Insured Copy | 2 |
COMMERCIAL AUTO 2 Notify us and send us copies of any request demand order notice summons or legal papers received concerning the claim or suit as soon as practicable. For the purposes of this coverage provided you are presumed to have knowledge of the accident or loss when it has been reported to the insurance manager or any other person you designate as responsible for insurance related matters.. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following Condition is added to SECTION IV BUSINESS AUTO CONDITIONS Unintentional Failure To Disclose Hazards Failure by you to disclose to us all hazards existing as of the inception date of this policy shall not prejudice us with respect to the coverage afforded by this policy provided such error or omission is not intentional. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. Includes copyrighted material of Insurance Services Office Inc. with its permission. CCAB191 1013 Page 6 of 6 Insured Copy | 2 |
COMMERCIAL AUTO THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY. COMPOSITE RATE ENDORSEMENT This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. Paragraph 6. Premium Audit under B. General Conditions of Section IV Business Auto Conditions is deleted and replaced by the following 6. PREMIUM AUDIT We will compute the premiums for this coverage part in accordance with the rates shown in the Schedule below. The deposit premium shown in the Schedule below is an estimate based on the number of autos you told us you would have at the beginning of the policy period. At the end of the policy period we will compute the final earned premium for that period and send notice to the first Named Insured. The final premiums will be determined using your average number of autos during the policy period. The average number of autos will be calculated by adding the number of your autos at the beginning of the policy period to the number of your autos at the end of the policy period and dividing that sum by two. Any fractional average number of autos will be rounded up to the nearest whole number. To calculate the final premium your average number of autos will be multiplied by the rates shown in the Schedule below. If the final premiums is more than the estimated premiums you paid to us you must pay us the balance. The due date for the final premium is the date shown as the due date on the bill. If the final premiums is less than the estimated premiums we will refund the balance to you. The first Named Insured must keep records of the information we need for premium computation and make available or send us copies as we may request upon expiration of this policy. SCHEDULE Coverage Description Number of Units Rate Premium Covered Autos Liability POWERED UNITS 13 919.85 11958 Including PIP Med Pay Coverage Description Covered Autos Liability POWERED UNITS Including PIP Med Pay andor UM UIM As shown in the Declarations Page Coverage Description Physical Damage COVERED UNITS As shown in the Declarations Page Premium 11958 Description COVERED UNITS Number of Units Rate 5 292.60 Premium 1463 ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. CCAB192 1013 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 10f 1 Insured Copy | 2 |
COMMERCIAL AUTO THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY. COVERED AUTO DESIGNATION SYMBOL This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. Section Covered Autos is amended by adding the following Item Two of the Declarations shows the autos that are covered autos for each of your coverages. The following numerical symbols may be used in addition to the numerical symbols described in the Coverage Form to describe the autos that may be covered autos. The entry of one of the following symbols described below next to a coverage on the Declarations will designate the only autos that are covered autos. 2006 GMC PICKUP 72895 2006 FREIGHTLINER TRUCK 53925 2008 STERLING TRUCK 78393 2002 ARTEX TRAILER 21390 1993 MACK DIESEL TRUCK 24431 CCAB211 0210 Page 10f 1 Includes copyrighted material of Insurance Services Office Inc. with its permission. Insured Copy | 2 |
THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY. SCHEDULE OF PHYSICAL DAMAGE DEDUCTIBLES This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM The SEE SCHEDULE reference to the Physical Damage deductibles shown for each covered auto in ITEM TWO THE SCHEDULE OF COVERAGES AND COVERED AUTOS are shown in the following deductible schedule SCHEDULE All covered autos defined by Item Two of the Covered Auto Business Auto Declaration for Physical Damage Coverage. Deductible Coverage COMP 1000 COLL 1000 CCAB212 0909 Page 1 of 1 Insured Copy | 2 |
COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GLASS REPAIR WAIVER OF DEDUCTIBLE This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. The following is added to Paragraph D. Deductible of Section Ill PHYSICAL DAMAGE C OVERAGE Any deductible shown in the Declarations for Comprehensive Coverage will not apply to glass breakage if the glass is repaired rather than replaced on covered autos. However the deductible will not be waived for windshield replacement or replacement subsequent to unsuccessful repairs on covered automobile windshields. CCAB222 0210 Page 10f 1 Insured Copy | 2 |
COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO PHYSICAL DAMAGE ENDORSEMENT This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. The following is added to SECTION Il PHYSICAL DAMAGE COVERAGE A. Coverage Hired Auto Physical Damage a. Any auto you lease hire rent or borrow without a driver from someone other than your employees partners if you are a partnership members if you are a limited liability company or members of their households is a covered auto for the Physical Damage Coverages shown in ITEM FOUR of the Declarations. However the most we will pay for loss in any accident to a hired or borrowed auto is the least of the following amounts minus any applicable deductible shown in ITEM FOUR of the Declarations Ms 50000 2 The actual cash value of the damaged or stolen property as of the time of the lossor 3 The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality b. An adjustment for depreciation and physical damage condition will be made in determining actual cash value in the event of a total loss. c. Ifarepair or replacement results in better than like kind or quality we will not pay for the amount of the betterment. d. For each covered auto our obligation to pay for repair or replace damaged or stolen property will be reduced by the applicable deductible shown in the Declarations. However any Comprehensive Coverage Deductible does not apply to loss caused by fire or lightning. Includes copyrighted material of Insurance Services Office Inc. with its permission. CCAB223 0210 Insured Copy | 2 |
COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY NOTICE OF OCCURRENCE ENDORSEMENT This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. The following replaces Paragraph 2. Duties In The Event Of Accident Claim Suit Or Loss under A. Loss Conditions of Section IV Business Auto Conditions We have no duty to provide coverage under this policy unless there has been full compliance with the following duties a. In the event of accident claim suit or loss your insurance manager or any other person you designate as responsible for insurance related matters must notify us promptly of an accident or a loss regardless of the amount which may result in a claim. Include 1 How when and where the accident or loss occurred 2 The insured s name and address and 3 To the extent possible the names and addresses of any injured persons and witnesses. b. Additionally you and any other involved insured must 1 Assume no obligation make no payment or incur no expense without our consent except at the insured s own cost. 2 Notify us and send us copies of any request demand order notice summons or legal paper received concerning the claim or suit as soon as practicable. 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit. 4 Authorize us to obtain medical records or other pertinent information. 5 Submit to examination at our expense by physicians of our choice as often as we reasonably require. c. Ifthereis loss to a covered auto or its equipment you must also do the following 1 Promptly notify the police if the covered auto or any of its equipment is stolen. 2 Take all reasonable steps to protect the covered auto from further damage. Also keep a record of your expenses for consideration in the settlement of the claim. 3 Permit us to inspect the covered auto and records proving the loss before its repair or disposition. 4 Agree to examinations under oath at our request and give us a signed statement of your answers. For the purposes of the coverage provided by this endorsement you are presumed to have knowledge of the accident or loss when it has been reported to your insurance manager or any other person you designate as responsible for insurance related matters. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. CCAB232 1013 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 1 Insured Copy Page 1 of 1 | 2 |
COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM SCHEDULE Number of Days Notice g0 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. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. Includes copyrighted material of Insurance Services Office Inc. with its permission CCAB237 0910 Page 10f 1 Insured Copy | 2 |
COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW VEHICLE REPLACEMENT COST This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indi cated below. Named Insured PRAIRIELAND DAIRY LLC Endorsement Effective Date 04012017 The following is added to paragraph C. Limit Of Insurance of SECTION Il PHYSICAL DAMAGE COVERAGE 1. The provisions of subparagraphs 1. and 3. of paragraph C. Limit Of Insurance do not apply to a covered auto of the private passenger type or a vehicle with a gross vehicle weight of 20000 pounds or less which is a new vehicle. In the event of a total loss to your new vehicle to which this coverage applies we will pay at your option a. The verifiable new vehicle purchase price you paid for your damaged vehicle not including any insurance or warranties purchased b. Ifitis available the purchase price as negotiated by us of a new vehicle of the same make model and equipment or the most similar model available not including any furnishings parts or equipment not installed by the manufacturer or manufacturer s dealership or c. The market value of your damaged vehicle not including any furnishings parts or equipment not installed by the manufacturer or manufacturer s dealership. We will not pay for initiation or set up costs associated with loans or leases. In this endorsement a new vehicle means an auto of which you are the original owner that has not been previously titled and which you purchased less than 365 days before the date of the loss. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. CCAB241 0213 Page 10f 1 Includes copyrighted material of Insurance Services Office Inc. with its permission Insured Copy | 2 |
COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLLUTION MODIFICATION ENDORSEMENT This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM A. POLLUTION CLARIFICATION The following is added to 11. Pollution of Paragraph B. Exclusions under SECTION Il COVERED AUTOS LIABILITY or to any amendment to or replacement thereof This exclusion applies even if the pollutants have a function in your business operations premises site or location. B. The definition of Pollutants under SECTION V DEFINITIONS is deleted and replaced by L. Pollutants mean a. Any organic or inorganic substance or material that is a solid liquid gaseous or thermal irritant or contaminant including but not limited to smoke vapor soot dust fumes acids alkalis chemicals fibers particles sludge by products biofuels herbicides pesticides insecticides fertilizers and all other similar chemicals and waste. b. Waste includes but is not limited to 1 materials that have been or are to be recycled reconditioned or reclaimed or 2 the excrement of livestock poultry or other animals. c. Pollutants also include gasoline diesel fuel all other petroleum products and their derivatives. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. Includes copyrighted material of Insurance Services Office Inc. with its permission CCAB251 1013 Page 1of 1 Insured Copy | 2 |
COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF BODILY INJURY DEFINITION This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM The definition of bodily injury under SECTION V DEFINITIONS is deleted and replaced by C. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time. Bodily injury includes mental anguish or other mental injury resulting from bodily injury. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. Includes copyrighted material of Insurance Services Office Inc. with its permission. CCAB283 0317 Page 1 of 1 Insured Copy | 2 |
ENDORSEMENT FOR Form Approved MOTOR CARRIER POLICIES OF INSURANCE FOR PUBLIC LIABILITY OMB No. 2125 0074 UNDER SECTIONS 29 AND 30 OF THE MOTOR CARRIER ACT OF 1980 lssuedto PRAIRIELAND DAIRY LLC 13000 PELLA RD of FIRTH NE USA 68358 Datedat DES MOINES IOWA this. 01 dayof APRIL 2017 Amending PolicyNo. CPP126376A Effective Date 04 01 17 Name of Insurance Company NATIONWIDE AGRIBUSINESS INSURANCE COMPANY Telephone Number 800 228 6700 Countersigned by 7 uwh 7 W Authorized Company Representative The policy to which this endorsement is attached provides primary or excess insurance as indicated by X for the limits shown X This insurance is primary and the company shall not be liable for amountsinexcessof 1000 000 for each accident This insurance is excess and the company shall not be liable for amounts in excess of for each accident in excess of the underlying limit of for each accident. Whenever required by the Federal Highway Administration FHWA or the Interstate Commerce Commission ICC the company agrees to furnish the FHWA or the ICC a duplicate of said policy an all its endorsements. The company also agrees upon telephone request by an authorized representative of the FHWA or the ICC to verify that the policy is in force as of a particular date. Cancellation of this endorsement may be effected by the company or the insured by giving 1 thirty five 35 days notice in writing to the other party said 35 days notice to commence from the date the notice is mailed proof of mailing shall be sufficient proof of notice and 2 if the insured is subject to the ICC s jurisdiction by providing thirty 30 days notice to the ICC said 30 days notice to commence from the date the notice is received by the ICC atits office in Washington D.C.. DEFINITIONS AS USED IN THIS ENDORSEMENT ACCIDENT includes continuous or repeated exposure to conditions the accidental discharge dispersal release or escape into or upon the land which results in bodily injury property damage or environmental atmosphere watercourse or body of water of any commodity transported by damage which the insured neither expected nor intended. amotor carrier. This shall include the cost of removal and the cost of necessary MOTOR VEHICLE means a land vehicle machine truck tractor trailer measures taken to minimize or mitigate damage to human health the natural or semitrailer propelled or drawn by mechanical power and used ona environment fish shellfish and wildlife. highway for transporting property or any combination thereof. PROPERTY DAMAGE means damage to or loss of use of tangible property. BODILY INJURY means injury to the body sickness or disease toany PUBLIC LIABILITY means liability for bodily injury property damage and person including death resulting from any of these. environmental restoration. ENVIRONMENTAL RESTORATION means restitution for the loss damage or destruction of natural resources arising out of The insurance policy to which this endorsement is attached provides endorsement thereon o violation thereof shall relieve the company from automobile liability insurance and is amended to assure compliance by liability or from the payment of any final judgment within the limits of liability the insured within the limits stated herein as a motor carrier of herein described irrespective of the financial condition insolvency or property with Sections 29 and 30 of the Motor Carrier Act of 1980and bankruptcy of the insured. However all terms conditions and limitations in the the rules and regulations of the Federal Highway Administration policy to which the endorsement s attached shall remain in full force and effect FHWA and the Interstate Commerce Commission ICC. as binding between the insured and the company. The insured agrees to I consideration of the premium stated in the policy to which this reimburs the company for any payment made by the company on account of endorsement s attached the insurer the company agrees to pay any accident claim or suit involving a breach of the terms of the policy and within the limits of liability described herein any final judgment for any payment that the company would not have been obligated to make acovered againgt the insured for public iabilty resulting from under the provisions of the policy except for the agreement contained in this negligence in the operation maintenance or use of motor vehicles endorsement. subject to the financial responsibility requirements of Sections 29 and Itis further understood and agreed that upon failure of the company to pay 30 of the Motor Carrier Act of 1980 regardless of whether or noteach any final judgment recovered against the insured as provided herein the motor vehicle is specifically described in the policy and whether or not judgment creditor may maintain an action in any court of competent such negligence occurs on any route or in any territory authorized to be jurisdiction against the company to compel such payment. served by the insured or elsewhere. Such insurance as is afforded for The limits of the company s liability for the amounts prescribed in this public liability does not apply to injury to or death of the insured s endorsement apply separately to each accident and any payment under the employees while engaged in the course of their employment or policy because of any one accident shall not operate to reduce the liability of property transported by the insured designated as cargo. It is the company for the payment of final judgments resulting from any other understood and agreed that no condition provision stipulation or accident. limitation contained in the policy this endorsement or any other The Motor Carrier Act of 1980 requires limits of financial responsibility according to the type of carriage and commodity transported by the motor carrier. Itis the MOTOR CARRIER S obligation to obtain the required limits of financial responsibility. THE SCHEDULE OF LIMITS SHOWN ON THE NEXT PAGE DOES NOT PROVIDE COVERAGE. The limits shown in the schedule are for information purposes only. Form MCS90 MC 1622k042000 UNIFORM INFORMATION SERVICES INC. MC 1622k042000 UNIFORM INFORMATION SERVICES INC. Insured Copy | 2 |
SCHEDULE OF LIMITS Public Liability Type of Carriage Commodity Transported Minimum Insurance 1 For hire In interstate or foreign Property nonhazardous 750000 commerce. 2 For hire and Private In interstate Hazardous substances as defined in 49 CFR171.8 5000000 foreign or intrastate commerce. transported in cargo tanks portable tanks or hopper type vehicles with capacities in excess of 3500 water gallons For hire and Private In interstate foreign or intrastate commerce. For hire and Private In interstate or foreign commerce in any quantity or In intrastate commerce in bulk only. Hazardous substances as defined in 49 CFR171.8 transported in cargo tanks portable tanks or hopper type vehicles with capacities in excess of 3500 water gallons or in bulk Divisions 1.1 1.2 and 1.3 materials any quantity of Division 2.3 Hazard Zone A or Division 6.1 Packing Group 1 Hazard Zone A material in bulk Division 2.1 or 2.2 or highway route controlled quantities of a Class 7 material as defined in 49 CFR 173.403. Oil listed in 49 CFR 172.101 hazardous materials and hazardous substances defined in 49 CFR 171.8 and listed in 49 CFR 172.101 but not mentioned in 2 above or 4 below. 5000000 1000000 4 For hire and Private Ininterstate or Any quantity of Division 1.1 1.2 or 1.3 material any foreign commerce. quantity of a Division 2.3 Hazard Zone A or Division 6.1 Packing Group 1 Hazard Zone A material or highway route controlled quantities of Class 7 material as defined in 49 CFR 173.403. 5000000 Note The type of carriage listed under 1 2 and 3 applies to vehicles with a gross vehicle weight rating of 10000 pounds or more. The type of carriage listed under number 4 applies to all vehicles with a gross vehicle weight rating of less than 10000 pounds. 5000000 SCHEDULE OF LIMITS Public Liability For hire motor carriers of passengers operating in interstate or foreign commerce Vehicle Seating Capacity Minimum Insurance 1 Any vehicle with a seating capacity of 16 passengers or more. 5000000 2 Any vehicle with a seating capacity of 15 passengers or less. 1500000 MC 1622k042000 UNIFORM INFORMATION SERVICES INC. Form MCS90 Insured Copy | 2 |
MNEMC INSURANCE EMC PROPERTY CASUALTY COMPANY PRIOR POLICY 4N6 19 26 GENERAL LIABILTITY DECLARATIONS POLICY PERIOD FROM 110120 TO 110121 POLICY NUMBER 4N6 19 2 6 21 N NAMED INSURED PRODUCER BOYER YOUNG REAL ESTATE LOCKTON COMPANIES LLC 9719 GILES RD STE 100 13710 FNB PKWY STE 400 LAVISTA NE 68128 3167 OMAHA NE 68154 5298 AGENT HB 8210 AGENCY BILL AGENT PHONE 402970 6100 CLAIM REPORTING 888362 2255 SERVICING CARRIER 402951 8300 INSURED IS CORPORATION BUSINESS DESC CONTRACTORS EACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT 300000 ANY ONE PREMISES MEDICAL EXPENSE LIMIT 5000 ANY ONE PERSON PERSONAL AND ADVERTISING INJURY LIMIT 1000000 ANY ONE PERSON OR ORGANIZATION GENERAL AGGREGATE LIMIT 2000000 PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT 2000000 COVERAGES PROVIDETD PREMIUM PRODUCTS COMPLETED OPERATIONS 704.00 OTHER THAN PRODUCTS COMPLETED OPERATIONS 1831.00 SEE ATTACHED SCHEDULE FOR LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED. FORMS APPLICABLE CG00010413 CG04370514 CG21471207 CG21671204 G21700115 CG21760115 CG22741001 CG7001A1012 G70031013 CG71400714 CG7174.31013 CG71910814 CG72761116 CG74281198 CG75550219 CG76440209 CG7694M0115 CG7695M0115 IL00210502 IL02591217 IL12010199 IL70280515 IL7130A0401 IL7131A0401 118021 0488 IL8383.5A0120 IL8384A0108 IL85761017 AUDIT PERIOD ANNUAL DATE OF ISSUE 102020 BPP FORM CG7000A ED. 08 99 BPP 110120 007 B8 4N61926 2101 GENERAL LIABILTITY D E POLICY PERIOD FROM 110120 TO 110121 9719 GILES RD STE 100 13710 FNB PKWY STE 400 LAVISTA NE 68128 3167 OMAHA NE 68154 5298 AGENT HB 8210 AGENCY BILL AGENT PHONE 402970 6100 CLAIM REPORTING 888362 2255 AGENCY BILL EACH OCCURRENCE LIMIT DAMAGE TO PREMISES RENTED TO YOU LIMIT MEDICAL EXPENSE LIMIT PERSONAL AND ADVERTISING INJURY LIMIT GENERAL AGGREGATE LIMIT 1000 00 300 00 500 1000 00 PRODUCTS COMPLETED OPERATIONS 704.00 OTHER THAN PRODUCTS COMPLETED OPERATIONS 1831.00 TOTAL ESTIMATED POLICY PREMIUM AUDIT PERIOD ANNUAL | 2 |
MNEMC INSURANCE EMC PROPERTY CASUALTY COMPANY POLICY NUMBER 4N6 19 26 21 BOYER YOUNG REAL ESTATE EFF DATE 110120 EXP DATE 110121 GENERATL L Cc ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM CG0001 04 13 COMMERCIAL GEN LIABILITY COV FORM CG0437 05 14 ELECTRONIC DATA LIAB ENDORSEMENT LOSS OF ELECTRONIC DATA LIMIT 50000 CG2147 12 07 EXCL EMPLOYMENT RELATED PRACTICES CG2167 12 04 FUNGI OR BACTERIA EXCLUSION CG2170 01 15 CAP LOSSES FROM CERT ACTS TERRORISM CG2176 01 15 EXCL PUNITIVE DMGS ACTS OF TERRORISM CG2274 10 01 LTD CONTRACTUAL LIAB COV PERS ADV DESIGNATED CONTRACT OR AGREEMENT ANY CONTRACT CG7001A 10 12 GENERAL LIABILITY SCHEDULE CG7003 10 13 GL QUICK REFERENCE OCCURRENCE CG7140 07 14 INJ TO CO EMPL OR O VOLUNTEER WKRS NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. ALL EMPLOYEES CG7174.3 10 13 AUTOMATIC AI CONST CONT INCL COMP OP CG7191 08 14 GENERAL LIAB ESSENTIAL EXTENSION CG7276 11 16 LIMITED POLLUTION COV WORK SITES 150 EACH POLLUTION INCIDENT LIMIT 100000 POLLUTION LIABILITY AGGREGATE LIMIT 100000 PROPERTY DAMAGE DEDUCTIBLE 1000 EACH POLLUTION INCIDENT CG7428 11 98 AMEND AGGREGATE LIMIT PER LOCATION CG7555 02 19 BLKT WAIV SUBRO WRITTEN CONT AGREE CG7644 02 09 CONTRACTORS OCCURRENCE DEFINITION CG7694 M 01 15 AI OWNERS LESSEES CONTR COMPLETED OP CG7695 M 01 15 AI OWNERS LESSEES CONTR SCHEDULED PE IL0021 05 02 NUCLEAR ENERGY LIAB EXCL BROAD FORM IL0259 12 17 NE CHANGES CANCELLATION NONRENEWAL IL1201 01 99 CHANGE ENDORSEMENT IL7028 05 15 ASBESTOS EXCLUSION IL7130A 04 01 NAMED INSURED ENDORSEMENT IL7131A 04 01 COMML POLICY ENDORSEMENT SCHEDULE IL8021 04 88 ASBESTOS NOTICE IL8383.5A 01 20 DISCL PURSUANT TERRSM RISK INS. ACT PREMIUM THROUGH 123120 s 3 PREMIUM BEYOND 123120 17 IL8384A 01 08 TERRORISM NOTICE IL8576 10 17 MEDICARE IMPT NOTICE TO POLICYHOLDER DATE OF ISSUE 102020 FORM IL7131A ED. 04 01 BPP 007 B8 4N61926 2101 EDITION CG2147 CG2167 CG2170 CG2176 CG2274 CG7001A CG7003 CG7140 CG7174.3 CG7191 CG7276 CG7428 CG7555 CG7644 CG7694 M CG7695 M IL0021 IL0259 IL1201 IL7028 IL7130A IL7131A IL8021 IL8383.5A IL8384A IL8576 11 98 02 19 02 09 01 15 01 15 05 02 12 17 01 99 05 15 04 01 04 01 04 88 01 20 01 08 10 17 ELECTRONIC DATA LIAB ENDORSEMENT LOSS OF ELECTRONIC DATA LIMIT 50000 EXCL EMPLOYMENT RELATED PRACTICES FUNGI OR BACTERIA EXCLUSION CAP LOSSES FROM CERT ACTS TERRORISM EXCL PUNITIVE DMGS ACTS OF TERRORISM LTD CONTRACTUAL LIAB COV PERS ADV DESIGNATED CONTRACT OR AGREEMENT ANY CONTRACT GENERAL LIABILITY SCHEDULE GL QUICK REFERENCE OCCURRENCE INJ TO CO EMPL OR O VOLUNTEER WKRS NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. ALL EMPLOYEES AUTOMATIC AI CONST CONT INCL COMP OP GENERAL LIAB ESSENTIAL EXTENSION LIMITED POLLUTION COV WORK SITES 15 EACH POLLUTION INCIDENT LIMIT 100000 POLLUTION LIABILITY AGGREGATE LIMIT 100000 PROPERTY DAMAGE DEDUCTIBLE 1000 EACH POLLUTION INCIDENT AMEND AGGREGATE LIMIT PER LOCATION BLKT WAIV SUBRO WRITTEN CONT AGREE CONTRACTORS OCCURRENCE DEFINITION AI OWNERS LESSEES CONTR COMPLETED OP AI OWNERS LESSEES CONTR SCHEDULED PE NUCLEAR ENERGY LIAB EXCL BROAD FORM NE CHANGES CANCELLATION NONRENEWAL CHANGE ENDORSEMENT ASBESTOS EXCLUSION NAMED INSURED ENDORSEMENT COMML POLICY ENDORSEMENT SCHEDULE ASBESTOS NOTICE DISCL PURSUANT TERRSM RISK INS. ACT PREMIUM THROUGH 123120 PREMIUM BEYOND 123120 TERRORISM NOTICE MEDICARE IMPT NOTICE TO POLICYHOLDER w o w o | 2 |
MNEMC INSURANCE EMC PROPERTY CASUALTY COMPANY POLICY NUMBER 4N6 19 26 21 BOYER YOUNG REAL ESTATE EFF DATE 110120 EXP DATE 110121 TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent DATE OF ISSUE 102020 FORM IL8384A 01 08 BPP 007 B8 4N61926 2101 BOYER YOUNG REAL ESTATE EFF DATE 110120 EXP DATE 1101 TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent | 2 |
MNEMC INSURANCE EMC PROPERTY CASUALTY COMPANY POLICY NUMBER 4N6 19 26 21 BOYER YOUNG REAL ESTATE EFF DATE 110120 EXP DATE 110121 This endorsement is attached to and made part of your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This endorsement does not grant any coverage or change the terms and conditions of any coverage under the policy. SCHEDUTLE Terrorism Premium Certified Acts A. Premium through end of year 123120 3.00 B. Premium beyond the date specified above 17.00 Refer to paragraph D. below A. DISCLOSURE OF PREMIUM In accordance with the Federal Terrorism Risk Insurance Act we are required to provide you with a notice disclosing the portion of your premium if any attributable to coverage for terrorism acts certified under the Terrorism Risk Insurance Act. As defined in section 1021 of the Act the term act of terrorism means any act that is certified by the Secretary of the Treasury in consultation with the Secretary of Homeland Security and the Attorney General of the United States to be an act of terrorism to be a violent act or an act that is dangerous to human life property or infrastructure to have resulted in damage within the United States or outside the United States in the case of certain air carriers or vessels or the premises of a United States mission and 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. The portion of your premium attributable to such coverage is shown in the schedule of this endorsement or in the policy declarations. B. DISCLOSURE OF FEDERAL PARTICIPATION IN PAYMENT OF TERRORISM LOSSES The United States Government Department of the Treasury will pay a share of terrorism losses insured under the federal program. The federal share equals 80 of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. C. CAP ON INSURER PARTICIPATION IN PAYMENT OF TERRORISM LOSSES If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. Includes copyrighted material of ISO Properties Inc. with its permission DATE OF ISSUE 102020 continued FORM IL8383.5A01 20 BPP 007 B8 4N61926 2101 This endorsement is attached to and made part of your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This endorsement does not grant any coverage or change the terms and conditions of any coverage under the policy. SCHEDUTLE Terrorism Premium Certified Acts A. Premium through end of year 123120 3.00 B. Premium beyond the date specified above 17.00 Refer to paragraph D. below A. DISCLOSURE OF PREMIUM In accordance with the Federal Terrorism Risk Insurance Act we are required to provide you with a notice disclosing the portion of your premium if any attributable to coverage for terrorism acts certified under the Terrorism Risk Insurance Act. As defined in section 1021 of the Act the term act of terrorism means any act that is certified by the Secretary of the Treasury in consultation with the Secretary of Homeland Security and the Attorney General of the United States to be an act of terrorism to be a violent act or an act that is dangerous to human life property or infrastructure to have resulted in damage within the United States or outside the United States in the case of certain air carriers or vessels or the premises of a United States mission and 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. The portion of your premium attributable to such coverage is shown in the schedule of this endorsement or in the policy declarations. B. DISCLOSURE OF FEDERAL PARTICIPATION IN PAYMENT OF TERRORISM LOSSES The United States Government Department of the Treasury will pay a share of terrorism losses insured under the federal program. The federal share equals 80 of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. C. CAP ON INSURER PARTICIPATION IN PAYMENT OF TERRORISM LOSSES If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. | 2 |
MNEMC INSURANCE Page 2 EMC PROPERTY CASUALTY COMPANY POLICY NUMBER 4N6 19 26 21 BOYER YOUNG REAL ESTATE EFF DATE 110120 EXP DATE 110121 This endorsement is attached to your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This disclosure does not grant any coverage or change the terms and conditions of any coverage under the policy. D. PREMIUM BEYOND THE YEAR SPECIFIED IN THE SCHEDULE ABOVE The premium for certified acts of terrorism coverage is calculated based in part on the federal participation in payment of terrorism losses as set forth in the Terrorism Risk Insurance Act. The federal program established by the Act is scheduled to terminate at the end of the year specified in the schedule of this endorsement unless extended by the federal government. If the federal program is extended the premium shown in B in the schedule shall be attributable to coverage for terrorism acts certified under the act. If the Federal program terminates your policy will still contain coverage for acts of terrorism unless you have elected to exclude the coverage. The premium shown in B of the schedule shall be attributable to that coverage for terrorism. THE FOLLOWING STATEMENT IS REQUIRED TO BE PART OF THE DISCLOSURE NOTICE IN MISSOURI The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your policy carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. INCLUDES COPYRIGHTED MATERIAL OF ISO PROPERTIES INC. WITH ITS PERMISSION DATE OF ISSUE 102020 FORM IL8383.5A01 20 BPP 007 B8 4N61926 2101 This endorsement is attached to your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This disclosure does not grant any coverage or change the terms and conditions of any coverage under the policy. D. PREMIUM BEYOND THE YEAR SPECIFIED IN THE SCHEDULE ABOVE The premium for certified acts of terrorism coverage is calculated based in part on the federal participation in payment of terrorism losses as set forth in the Terrorism Risk Insurance Act. The federal program established by the Act is scheduled to terminate at the end of the year specified in the schedule of this endorsement unless extended by the federal government. If the federal program is extended the premium shown in B in the schedule shall be attributable to coverage for terrorism acts certified under the act. If the Federal program terminates your policy will still contain coverage for acts of terrorism unless you have elected to exclude the coverage. The premium shown in B of the schedule shall be attributable to that coverage for terrorism. THE FOLLOWING STATEMENT IS REQUIRED TO BE PART OF THE DISCLOSURE NOTICE IN MISSOURI The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your policy carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. INCLUDES COPYRIGHTED MATERIAL OF ISO PROPERTIES INC. WITH ITS PERMISSION nt is attached to your policy in response to the juirements of the Terrorism Risk Insurance Act. e does not grant any coverage or change the terms 5 of any coverage under the policy. fOND THE YEAR SPECIFIED IN THE SCHEDULE ABOVE n for certified acts of terrorism coverage is based in part on the federal participation in payment sm losses as set forth in the Terrorism Risk Insurance deral program established by the Act is scheduled to.t the end of the year specified in the schedule of this unless extended by the federal government. If the sgram is extended the premium shown in B in the 1all be attributable to coverage for terrorism acts inder the act. If the Federal program terminates your still contain coverage for acts of terrorism unless you d to exclude the coverage. The premium shown in B of le shall be attributable to that coverage for terrorism. STATEMENT IS REQUIRED TO BE PART OF THE DISCLOSURE NOTICE | 2 |
MNEMC INSURANCE EMC PROPERTY CASUALTY COMPANY NAMED INSURED POLICY PERIOD FROM 110120 TO 1 NAMED BOYER YOUNG REAL ESTATE 9719 GILES RD STE 100 LAVISTA NE 68128 3167 INSURETD AGENCY BILL IT IS HEREBY AGREED AND UNDE IS AMENDED TO RI 1ST NAMED INSURED BOYER YOUNG REAL ESTATE NO. 02 BOYER YOUNG HOLDINGS NO. MERIDIAN PARK BYEX GLENMOOR MERIDIAN PARK NO. 03 05 TIM W. YOUNG NO. THE NO. 06 HAMPTONS LAND DEVELOPMENT 07 MARK BOYER NO. IRON HORSE RIDGE NO. 08 LLC 09 ENDORSEMENT POLICY NUMBER 19 2 6 21 N 10121 LOCKTON COMPANIES LLC 13710 FNB PKWY STE 400 OMAHA NE 68154 5298 AGENT HB 8210 AGENT PHONE 402970 6100 CLAIM REPORTING 888362 2255 SERVICING CARRIER 402951 8300 RSTOOD THAT THE NAMED INSURED EAD AS FOLLOWS LLC INACTIVE LLC DIANA YOUNG PLACE OF ISSUE OMAHA NE DATE OF ISSUE 102020 CONTINUED FORM IL7130A ED. 04 01 B8 4N61926 2101 NAMED INSURED ENDO POLICY PERIOD FROM 110120 TO 110121 9719 GILES RD STE 100 13710 FNB PKWY STE 400 LAVISTA NE 68128 3167 OMAHA NE 68154 5298 AGENT HB 8210 AGENCY BILL AGENT PHONE 402970 6100 CLAIM REPORTING 888362 2255 AGENCY BILL IT IS HEREBY AGREED AND UNDERSTOOD THAT THE NAMED INSURED IS AMENDED TO READ AS FOLLOWS 1ST NAMED INSURED BOYER YOUNG REAL ESTATE NO. 02 BOYER YOUNG HOLDINGS NO. 03 MERIDIAN PARK BYEX GLENMOOR MERIDIAN PARK LLC INACTIVE NO. 05 TIM W. YOUNG NO. 06 THE HAMPTONS LAND DEVELOPMENT LLC NO. 07 MARK BOYER NO. 08 IRON HORSE RIDGE LLC NO. 09 DIANA YOUNG PLACE OF ISSUE OMAHA NE OLICY. | 2 |
MNEMC INSURANCE PAGE 2 EMC PROPERTY CASUALTY COMPANY POLICY NO 4N6 19 26 21 BOYER YOUNG REAL ESTATE EFF DATE 110120 EXP DATE 110121 NAMED INSURED ENDORSEMENT CONTTINUED NO. 10 RENEE BOYER NO. 11 BOYER YOUNG EQUITIES XI LLC NEBRASKA NO. 12 CENTENNIAL INVESTMENTS LLC NO. 13 IRONHORSE PREMIER PROPERTIES NO. 14 SOUTHBROOK DEVELOPMENT LLC NO. 15 BOYER YOUNG EQUITIES XV HERITAGE LLC NO. 16 MERRITT BEACH RV PARK LLC NO. 17 BYB REALTY NO. 18 BOYER YOUNG EQUITIES XVI BELLE LAGO LLC NO. 19 BOYER YOUNG EQUITIES II PLACE OF ISSUE OMAHA NE DATE OF ISSUE 102020 FORM IL7130A ED. 04 01 007 B8 4N61926 2101 NO. 10 RENEE BOYER NO. 11 BOYER YOUNG EQUITIES XI LLC NEBRASKA NO. 12 CENTENNIAL INVESTMENTS LLC NO. 13 IRONHORSE PREMIER PROPERTIES NO. 14 SOUTHBROOK DEVELOPMENT LLC NO. 15 BOYER YOUNG EQUITIES XV HERITAGE LLC NO. 16 MERRITT BEACH RV PARK LLC NO. 17 BYB REALTY NO. 18 BOYER YOUNG EQUITIES XVI BELLE LAGO LLC NO. 19 BOYER YOUNG EQUITIES II PLACE OF ISSUE OMAHA NE | 2 |
MNEMC INSURANCE EMC PROPERTY CASUALTY COMPANY POLICY NO 4N6 19 26 BOYER YOUNG REAL ESTATE EFF DATE 110120 EXP DATE 110121 GENERAL LIABILITY SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 001 47050 REAL ESTATE AGENTS 4 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 29646 SUBLINE 334 87741 LIMITED POLLUTION COVERAGE WORKSITES PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87747 AMENDMENT AGGREGATE LIMITS OF INSURANCE PER LOCATION PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87780 CONSTRUCTION CONTRACTS INCLUDING COMPLETED OPERATIONS BLANKET ADDL INSUREDS PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87786 BLANKET WAIVER OF SUBROGATION SEE FORM CG7555 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87808 ELECTRONIC DATA LIABILITY PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 DATE OF ISSUE 102020 BPP CONTINUED FORM CG7001A ED.10 12 BPP 110120 007 B8 4N61926 2101 ENTS 4 S PAYROLL ION COVERAGE GREGATE LIMITS OF. LOCATION S. OF SUBROGATION 5 A LIABILITY | 2 |
MNEMC INSURANCE PAGE 2 EMC PROPERTY CASUALTY COMPANY POLICY NO 4N6 19 26 21 BOYER YOUNG REAL ESTATE EFF DATE 110120 EXP DATE 110121 GENERAL LIABILITY SCHEDUTLE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 002 47051 14.092 14 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 1 SUBLINE 334 91585 0.406S 0 0.833 0 CONTRACTORS SUBCONT WORK IN CONNECT WITH CONST RECONST REPAIR OR EREC TION OF BUILDINGS NOC PREMIUM BASIS THOUSANDS OF TOTAL COST EXPOSURE IF ANY SUBLINE 336334 LOCATION 003 68606 25.885 41 VACANT BUILDINGS NOT FACTORIES 1 4 PREMIUM BASIS THOUSANDS OF AREA EXPOSURE 1600 SUBLINE 334 LOCATION 004 47051 14.092 14 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 1 SUBLINE 334 91585 0.406S 0 0.833 0 CONTRACTORS SUBCONT WORK IN CONNECT WITH CONST RECONST REPAIR OR EREC TION OF BUILDINGS NOC PREMIUM BASIS THOUSANDS OF TOTAL COST EXPOSURE IF ANY SUBLINE 336334 DATE OF ISSUE 102020 BPP CONTINUED FORM CG7001A ED.10 12 BPP 110120 007 B8 4N61926 2101 IS IS | 2 |
MNEMC INSURANCE PAGE 3 EMC PROPERTY CASUALTY COMPANY POLICY NO 4N6 19 26 21 BOYER YOUNG REAL ESTATE EFF DATE 110120 EXP DATE 110121 GENERAL LIABILITY SCHEDUTLE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 005 47051 14.092 14 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 1 SUBLINE 334 91585 0.406S 0 0.833 0 CONTRACTORS SUBCONT WORK IN CONNECT WITH CONST RECONST REPAIR OR EREC TION OF BUILDINGS NOC PREMIUM BASIS THOUSANDS OF TOTAL COST EXPOSURE IF ANY SUBLINE 336334 LOCATION 006 47051 14.092 395 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 28 SUBLINE 334 91585 0.406MP 704 0.833 25 CONTRACTORS SUBCONT WORK IN CONNECT WITH CONST RECONST REPAIR OR EREC TION OF BUILDINGS NOC PREMIUM BASIS THOUSANDS OF TOTAL COST EXPOSURE 30000 SUBLINE 336334 DATE OF ISSUE 102020 BPP CONTINUED FORM CG7001A ED.10 12 BPP 110120 007 B8 4N61926 2101 IS IS 28 | 2 |
MNEMC INSURANCE PAGE 4 EMC PROPERTY CASUALTY COMPANY POLICY NO 4N6 19 26 BOYER YOUNG REAL ESTATE EFF DATE 110120 EXP DATE 110121 21 SCHEDUTLE POLICY LEVEL COVERAGES PREMIUM FOR CERTIFIED ACTS OF TERRORISM 20.00 TOTAL ESTIMATED POLICY PREMIUM 2535.00 1 OTHER THAN NOT FOR PROFIT 2 NOT FOR PROFIT 3 INCLUDING PRODUCTS AND OR COMPLETED OPERATIONS UNLESS OTHERWISE EXCLUDED 4 PRODUCTS COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT 5 A 250 PD DEDUCTIBLE PER CLAIM APPLIES TO CUSTOMERS AUTOS UNLESS OTHERWISE DESIGNATED BY THIS CLASSIFICATION CODE 6 FOR SPRAY PAINTING OPERATIONS A PD DEDUCTIBLE OF 250 PER CLAIM APPLIES UNLESS A HIGHER DEDUCTIBLE IS OTHERWISE DESIGNATED FOR THIS CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED RATED LOCATIONS LOC 001 9719 GILES RD STE 100 LAVISTA NE 68128 3167 LOC 002 5120 s 235TH ST ELKHORN NE 68022 3010 LOC 003 HWY IRON HORSE DRIVE ASHLAND NE 68003 6221 LOC 004 108TH SCHRAM PAPILLION NE 68046 LOC DESCRIPTION NW CORNER OF 108TH SCHRAM LOC 005 149TH AT RAINWOOD DR OMAHA NE 68116 LOC 006 US HWY 75 AT BEACH RD PLATTSMOUTH NE 68048 DATE OF ISSUE 102020 BPP FORM CG7001A ED.10 12 BPP 110120 007 B8 4N61926 2101 CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED RATED LOCATIONS Loc Loc Loc Loc Loc Loc 001 002 003 004 005 006 9719 GILES RD STE 100 LAVISTA NE 68128 3167 5120 s 235TH ST ELKHORN NE 68022 3010 HWY IRON HORSE DRIVE ASHLAND NE 68003 6221 108TH SCHRAM PAPILLION NE 68046 LOC DESCRIPTION NW CORNER OF 108TH SCHRAM 149TH AT RAINWOOD DR OMAHA NE 68116 US HWY 75 AT BEACH RD PLATTSMOUTH NE 68048 LOC 002 5120 s 235TH ST ELKHORN NE 68022 3010 LOC 003 HWY IRON HORSE DRIVE ASHLAND NE 68003 6221 LOC 004 108TH SCHRAM PAPILLION NE 68046 LOC DESCRIPTION NW CORNER OF 108TH SCHRAM LOC 005 149TH AT RAINWOOD DR OMAHA NE 68116 LOC 006 US HWY 75 AT BEACH RD PLATTSMOUTH NE 68048 | 2 |
COMMERCIAL GENERAL LIABILITY CG 00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under Section I Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 2 The bodily injury or property damage occurs during the policy period and Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. c. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. d. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim 1 Reports all or any part of the bodily injury or property damage to us or any other insurer Receives a written or verbal demand or claim for damages because of the bodily injury or property damage or 3 Becomes aware by any other means that bodily injury or property damage has occurred or has begun to occur. e. Damages because of bodily injury include damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. 3 2 CG 00010413 Insurance Services Office Inc. 2012 Page 1 0f 16 | 0 |
2. Exclusions This insurance does not apply to a. Expected Or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Contractual Liability Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the absence of the contract or agreement or 2 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorneys fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and Such attorneys fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. b This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in a The supervision hiring employment training or monitoring of others by that insured or b Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol if the occurrence which caused the bodily injury or property damage involved that which is described in Paragraph 1 2 or 3 above. However this exclusion applies only if you are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages. For the purposes of this exclusion permitting a person to bring alcoholic beverages on your premises for consumption on your premises whether or not a fee is charged or a license is required for such activity is not by itself considered the business of selling serving or furnishing alcoholic beverages.. Workers Compensation And Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law.. Employer s Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a Employment by the insured or b Performing duties related to the conduct of the insured s business or 2 The spouse child parent brother or sister of that employee as a consequence of Paragraph 1 above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. Page 2 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a At or from any premises site or location which is or was at any time owned or occupied by or rented or loaned to any insured. However this subparagraph does not apply to i Bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or originating from equipment that is used to heat cool or dehumidify the building or equipment that is used to heat water for personal use by the building s occupants or their guests ii Bodily injury or property damage for which you may be held liable if you are a contractor and the owner or lessee of such premises site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not and never was owned or occupied by or rented or loaned to any insured other than that additional insured or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire b At or from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste c Which are or were at any time transported handled stored treated disposed of or processed as waste by orfor i Any insured or ii Any person or organization for whom you may be legally responsible or d At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by such insured contractor or subcontractor. However this subparagraph does not apply to i Bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or released as part of the operations being performed by such insured contractor or subcontractor ii Bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor or Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the operations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. iii CG 00010413 Insurance Services Office Inc. 2012 Page 3 of 16 | 1 |
2 Any loss cost or expense arising out of any a Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or b Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a governmental authority. g. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed wunder any insured contract for the ownership maintenance or use of aircraft or watercraft or 4 5 Bodily injury or property damage arising out of a The operaton of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definiton of mobile equipment. h. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. i. War Bodily injury or property damage however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. j. Damage To Property Property damage to 1 Property you own rent or occupy including any costs or expenses incurred by you or any other person organization or entity for repair replacement enhancement restoration or maintenance of such property for any reason including prevention of injury to a person or damage to another s property Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you b 3 2 Page 4 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
4 Personal property in the care custody or control of the insured 5 That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the property damage arises out of those operations or That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section Il Limits Of Insurance. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard. 6. Damage To Your Product Property damage to your product arising out of it or any part of it.. Damage To Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor.. Damage To Impaired Property Or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 A defect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use.. Recall Of Products Work Or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it.. Personal And Advertising Injury Bodily injury arising out of personal and advertising injury.. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. However this exclusion does not apply to liability for damages because of bodily injury. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment.. Recording And Distribution Of Material Or Information In Violation Of Law Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or CG 00010413 Insurance Services Office Inc. 2012 Page 5 of 16 | 1 |
4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section Il Limits Of Insurance. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of personal and advertising injury to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for personal and advertising injury to which this insurance does not apply. We may at our discretion investigate any offense and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and 2 Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to personal and advertising injury caused by an offense arising out of your business but only if the offense was committed in the coverage territory during the policy period. 2. Exclusions This insurance does not apply to Knowing Violation Of Rights Of Another Personal and advertising injury caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising injury.. Material Published With Knowledge Of Falsity Personal and advertising injury arising out of oral or written publication in any manner of material if done by or at the direction of the insured with knowledge of its falsity.. Material Published Prior To Policy Period Personal and advertising injury arising out of oral or written publication in any manner of material whose first publication took place before the beginning of the policy period.. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured.. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement.. Breach Of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s advertising idea in your advertisement.. Quality Or Performance Of Goods Failure To Conform To Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your advertisement.. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Page 6 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
i. Infringement Of Copyright Patent Trademark Or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trademark trade secret or other intellectual property rights. Under this exclusion such other intellectual property rights do not include the use of another s advertising idea in your advertisement. However this exclusion does not apply to infringement in your advertisement of copyright trade dress or slogan. j Insureds In Media And Internet Type Businesses Personal and advertising injury committed by an insured whose business is 1 Advertising broadcasting publishing or telecasting 2 Designing or determining content of web sites for others or 3 An Internet search access content or service provider. However this exclusion does not apply to Paragraphs 14.a. b. and c. of personal and advertising injury under the Definitions section. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the insured hosts owns or over which the insured exercises control. I. Unauthorized Use Of Another s Name Or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain name or metatag or any other similar tactics to mislead another s potential customers. m. Pollution Personal and advertising injury arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants at any time. n. Pollution related Any loss cost or expense arising out of any 1 Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. o. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. p. Recording And Distribution Of Material Or Information In Violation Of Law Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or 4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. 3 CG 00010413 Insurance Services Office Inc. 2012 Page 7 of 16 | 1 |
COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that a The accident takes place in the coverage territory and during the policy period b The expenses are incurred and reported to us within one year of the date of the accident and c The injured person submits to examination at our expense by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for 1 First aid administered at the time of an accident 2 Necessary medical surgical X ray and dental services including prosthetic devices and 3 Necessary ambulance hospital professional nursing and funeral services. 2. Exclusions We will not pay expenses for bodily injury a. Any Insured To any insured except volunteer workers. b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d. Workers Compensation And Similar Laws To a person whether or not an employee of any insured if benefits for the bodily injury are payable or must be provided under a workers compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing instructing or participating in any physical exercises or games sports or athletic contests. f. Products Completed Operations Hazard Included within the products completed operations hazard. g. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS COVERAGES A AND B 1. We will pay with respect to any claim we investigate or settle or any suit against an insured we defend a. All expenses we incur. b. Up to 250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. c. The cost of bonds to release attachments but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from work. e. All court costs taxed against the insured in the suit. However these payments do not include attorneys fees or attorneys expenses taxed against the insured. f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment interest based on that period of time after the offer. Page 8 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance.. If we defend an insured against a suit and an indemnitee of the insured is also named as a party to the suit we will defend that indemnitee if all of the following conditions are met a. The suit against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an insured contract b. This insurance applies to such liability assumed by the insured. The obligation to defend or the cost of the defense of that indemnitee has also been assumed by the insured in the same insured contract o. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the insured and the indemnitee and f. The indemnitee 1 Agrees in writing to a Cooperate with us in the investigation settlement or defense of the suit Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit b c Notify any other insurer whose coverage is available to the indemnitee and d Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee and 2 Provides us with written authorization to a Obtain records and other information related to the suit and b Conduct and control the defense of the indemnitee in such suit. So long as the above conditions are met attorneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.2 of Section Coverage A Bodily Injury And Property Damage Liability such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the limits of insurance. Our obligation to defend an insured s indemnitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above or the terms of the agreement described in Paragraph f. above are no longer met. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. c. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. CG 00010413 Insurance Services Office Inc. 2012 Page 9 of 16 | 1 |
2. Each of the following is also an insured a. Your volunteer workers only while performing duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a partnership joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees or volunteer workers are insureds for 1 Bodily injury or personal and advertising injury a To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company to a coemployee while in the course of his or her employment or performing duties related to the conduct of your business or to your other volunteer workers while performing duties related to the conduct of your business To the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of Paragraph 1a above For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph 1a or b above or Arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b Rented to in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees volunteer workers any partner or member if you are a partnership or joint venture or any member if you are a limited liability company. b. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. b c d c. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that property and 2 Until your legal representative has been appointed. d. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION Il LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. Page 10 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
3. The Products Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. 4. Subject to Paragraph 2. above the Personal And Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all personal and advertising injury sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above whichever applies the Each Occurrence Limit is the most we will pay for the sum of a. Damages under Coverage A and b. Medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to Paragraph 5. above the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of property damage to any one premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence Offense Claim Or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or an offense which may result in a claim. To the extent possible notice should include 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured persons and witnesses and 3 The nature and location of any injury or damage arising out of the occurrence or offense. b. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent.. Legal Action Against Us No person or organization has a right under this Coverage Part a. To join us as a party or otherwise bring us into a suit asking for damages from an insured or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us the insured and the claimant or the claimant s legal representative. CG 00010413 Insurance Services Office Inc. 2012 Page 11 of 16 | 1 |
4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance 1 This insurance is excess over a Any of the other insurance whether primary excess contingent or on any other basis i That is Fire Extended Coverage Builder s Risk Installation Risk or similar coverage for your work ii That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner iii That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner or iv If the loss arises out of the maintenance or use of aircraft autos or watercraft to the extent not subject to Exclusion g. of Section I Coverage A Bodily Injury And Property Damage Liability. b Any other primary insurance available to you covering liability for damages arising out of the premises or operations or the products and completed operations for which you have been added as an additional insured. 2 When this insurance is excess we will have no duty under Coverages A or B to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be entitted to the insured s rights against all those other insurers. 3 When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of a The total amount that all such other insurance would pay for the loss in the absence of this insurance and b The total of all deductible and self insured amounts under all that other insurance. 4 We will share the remaining loss if any with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. 6. Representations By accepting this policy you agree a. The statements in the Declarations are accurate and complete Page 12 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
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