text stringlengths 1 8.07k | labels int64 0 2 |
|---|---|
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF OTHER ACTS OF TERRORISM COMMITTED OUTSIDE THE UNITED STATES EXCLUSION OF PUNITIVE DAMAGES RELATED TO A CERTIFIED ACT OF TERRORISM CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations Additional Premium Return Premium S0 S0 This endorsement modifies insurance provided under the following ALL COVERAGE FORMS A.The following exclusions are added This insurance does not apply to TERRORISM Any injury or damage arising directly or indirectly out of an other act of terrorism that is committed outside of the United States including its territories and possessions and Puerto Rico but within the coverage territory. However this exclusion applies only when one or more of the following are attributed to such act 1. The total of insured damage to all types of property exceeds 25000000 valued in U.S. dollars. In determining whether the 25000000 threshold is exceeded we will include all insured damage sustained by property of all persons and entities affected by the terrorism and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision insured damage means damage that is covered by any insurance plus damage that would be covered by any insurance but for the application of any terrorism exclusions or 2. Fifty or more persons sustain death or serious physical injury. For the purposes of this provision serious physical injury means a. Physical injury that involves a substantial risk of death or b. Protracted and obvious physical disfigurement or c. Protracted loss of or impairment of the function of a bodily member or organ or 3. The terrorism involves the use release or escape of nuclear materials or directly or indirectly results in nuclear reaction or radiation or radioactive contamination or 4. The terrorism is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemical materials or 5. Pathogenic or poisonous biological or chemical materials are released and it appears that one purpose of the terrorism was to release such materials. With respect to this exclusion Paragraphs 1. and 2. describe the thresholds used to measure the magnitude of an incident of an other act of terrorism and the circumstances in which the threshold will apply for the purpose of determining whether this exclusion will apply to that incident. TERRORISM PUNITIVE DAMAGES Damages arising directly or indirectly out of a certified act of terrorism that are awarded as punitive damages. Includes Material Insurance Services Office Inc. 2015 Page 1 of 2 ADF3011 0115 | 2 |
B. The following definitions are added 1. For the purposes of this endorsement any injury or damage means any injury or damage covered under any Policy to which this endorsement is applicable and includes but is not limited to bodily injury property damage personal and advertising injury personal injury injury or environmental damage as may be defined in any applicable Policy. 2. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following a. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act b. The act resulted in damage 1 Within the United States including its territories and possessions and Puerto Rico or 2 Outside of the United States in the case of a An air carrier as defined in Section 40102 of title 49 United States Code or United States flag vessel or a vessel based principally in the United States on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States regardless of where the loss occurs or b The premises of any United States mission and c. Theactis a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. 3. Other act of terrorism means a violent act or an act that is dangerous to human life property or infrastructure that is committed by an individual or individuals and that appears to be part of an effort to coerce a civilian population or to influence the policy or affect the conduct of any government by coercion and the act is not a certified act of terrorism. Multiple incidents of an other act of terrorism which occur within a seventy two hour period and appear to be carried out in concert or to have a related purpose or common leadership shall be considered to be one incident. C. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Policy. D. If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Includes Material Insurance Services Office Inc. 2015 Page 2 of 2 ADF3011 0115 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION EIFS EXTERIOR INSULATION AND FINISH SYSTEMS Named Insured Jared Ware Construction Effective Date of Endorsement 06102019 1201AM at the Named Insured address shown on the Declarations Return Prem 0 Attached To and Forming Part of Policy 01000396483 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE The following exclusion is added to this policy This insurance does not apply to bodily injury property damage or personal and advertising injury arising directly or indirectly out of related to or in any way involving the following 1. The design manufacture construction fabrication preparation distribution and sale installation application maintenance or repair including remodeling service correction or replacement of any exterior insulation and finish system or any part thereof including the application or use of conditioners primers accessories flashings coatings caulking or sealants in connection with such a system or 2. Your product or your work with respect to any exterior component fixture or feature of any structure if an exterior insulation and finish system or any part thereof is used on the part of that structure containing that component fixture or feature. The following definition is added to the DEFINITIONS SECTION Exterior insulation and finish system means a non load bearing exterior cladding or finish system and all component parts therein used on any part of any structure and consisting of. Arigid or semi rigid insulation board made of expanded polystyrene and other materials. The adhesive andor mechanical fasteners used to attach the insulation board to the substrate. A reinforced or unreinforced base coat. Afinish coat providing surface texture to which color may be added and. Any flashing caulking or sealant used with the system for any purpose. T IF NN ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3008 0314 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION MEDICAL PAYMENTS Named Insured Jared Ware Construction Effective Date of Endorsement 06102019 1201AM at the Named Insured address shown on the Declarations Return Prem 0 Attached To and Forming Part of Policy 01000396483 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE SECTION COVERAGES COVERAGE C MEDICAL PAYMENTS and all references to it are deleted in their entirety and not replaced. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3009 0110 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION NEW ENTITIES COMMERCIAL GENERAL LIABILITY Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations nal Premium Return Prem 0 0 Addi This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE SECTION Il WHO IS AN INSURED item 4. Is deleted in its entirety. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3011 0110 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION DEMOLITION Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations Additional Premium Return Premiu 0 0 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE The following exclusion is added to this policy This insurance does not apply to any claim or suit arising directly or indirectly out of related to or in any way involving any 1. Demolition or wrecking of any building or structure in excess of four 4 stories or 2. Use of explosives or ball and chain that results in property damage a. To any abutting wall adjoining wall common or party wall or b. To wires conduits pipes sewer mains tanks tunnels or any other similar property beneath the surface of the ground or water or 3. Collapse of or structural injury to any building or structure due to tunneling pile driving cofferdam work or caisson work or due to moving shoring underpinning or raising of any building or structure or any part of any building or structure. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3014 1016 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION PRIOR WORK COMMERCIAL GENERAL LIABILITY Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations Additional Premium Return Premiu 0 0 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE SCHEDULE Prior Work Date 06102016 at 1201 AM at the address of the Named Insured shown on the Declarations The following exclusions are added to this policy 1. This insurance does not apply to bodily injury property damage or personal and advertising injury arising out of your work performed a. Before the Prior Work Date shown in the above Schedule or b. After the expiration of the policy period or c. Byany person whose business or assets you have acquired. 2. This insurance does not apply to bodily injury property damage or personal and advertising injury arising out of your product that was manufactured sold handled distributed furnished abandoned or disposed of by a. You b. Others trading under your name or c. Any person whose business or assets you have acquired before the Prior Work Date shown in the above Schedule or after the expiration of the policy period. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2 Exclusions Damage To Your Work is deleted and replaced with the following. 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 after the Prior Work Date shown in the above Schedule. SECTION V DEFINITIONS item 16. products completed operations hazard is deleted and replaced with the following Products completed operations hazard a. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 Products that are still in your physical possession or 2 Work that has not yet been completed or abandoned. However your work will be deemed completed at the earliest of the following times i. When all of the work called for in your contract has been completed ii. When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site CAS3022 0217 Page 10f2 Page 1 of 2 | 2 |
iii. 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 iv. The date the first notice of completion was filed on the first unit within a job site or v. The date escrow closed or title transferred on the first unit within a job site. Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. b. Does not include bodily injury or property damage arising out of 1 The transportation of property unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you and that condition was created by the loading or unloading of that vehicle by any insured 2 The existence of tools uninstalled equipment or abandoned or unused materials or 3 Products or operations for which the classification listed in the Declarations or in a policy schedule states that products completed operations are subject to the General Aggregate Limit. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page 2 of 2 CAS3022 0217 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION NEW YORK Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations al Premium Return Premi 0 0 Addi This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE The following exclusion is added to this policy This insurance does not apply to any claim or suit for bodily injury property damage or personal and advertising injury arising directly or indirectly out of related to or in any way involving any work performed in New York state by or on behalf of any insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3042 0110 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL POLICY EXCLUSIONS Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations Additional Premium Return Premiu 0 0 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE LIQUOR LIABILITY COVERAGE The following exclusions are added to this policy LEAD ASBESTOS SILICA ERIONITE EXCLUSION This insurance does not apply to any claim or suit for bodily injury property damage or personal and advertising injury or other injury or damage arising directly or indirectly out of related to or in any way involving the manufacture sale lease distribution transportation storage handling installation repair removal clean up testing inspection degradation detoxifying or neutralizing disposal or other use of ingestion inhalation exposure to or contact with any goods products materials plant life or structures containing lead asbestos silica or erionite in any form including but not limited to claims arising out of continuous intermittent or repeated exposure to or ingestion inhalation or absorption of lead asbestos silica or erionite in any form. This exclusion applies 1. To liability assumed in any contract or agreement 2. Toany obligation to pay or indemnify any person entity organization or governmental agency 3. Toany supervision instructions recommendations requests warnings representations or advice given or which should have been given regarding the existence or control of lead asbestos silica or erionite or 4. Toany costs expenses or damages arising out of any remedial investigation or feasibility studies or medical monitoring. PRIOR INJURY OR DAMAGE EXCLUSION This insurance does not apply to bodily injury property damage or personal and advertising injury which begins or takes place before the inception date of this policy or before the retroactive date of this policy if claims made coverage applies regardless of whether or not such bodily injury property damage or personal and advertising injury is known to any insured. This exclusion shall apply even though the nature and extent of such damage or injury may change and even though the damage or injury may be continuous progressive cumulative changing or evolving and even though the occurrence causing such bodily injury or property damage or the offense causing such personal and advertising injury may be or may involve a continuous or repeated exposure to substantially the same general harm or condition. If you are a contractor builder or developer the following also applies All property damage to units of or within a single project or development and arising from the same general type of harm or condition shall be deemed to occur at the time of damage to the first such unit even though the existence nature and extent of such damage may change and even though the occurrence causing such property damage may be or involve a continuous or repeated exposure to substantially the same general harm or condition which also CAS3043 0817 Page10f3 | 2 |
continues or takes place in the case of repeated exposure to the substantially the same general harm or condition during the policy period of this policy. DISCRIMINATION EXCLUSION This insurance does not apply to any claim or suit for bodily injury property damage or personal and advertising injury or other injury or damage arising directly or indirectly out of related to or in any way involving discrimination of any kind whether actual or alleged nor to any expenses or obligation to share damages with or repay another who must pay damages from discrimination. EMPLOYMENT PRACTICES EXCLUSION This insurance does not apply to liability for employment related practices regardless of allegations nor to any expenses nor to any obligation to share damages with or repay anyone else who must pay damages from same including but not limited to 1. Refusal to employ or termination of employment 2. Discrimination coercion demotion evaluation reassignment discipline defamation harassment in any form humiliation or other employment related practices policies acts or omissions 3. Consequential bodily injury or personal and advertising injury as a result of 1. or 2. above. CLASSIFICATION LIMITATION EXCLUSION This insurance applies only to the operations that are described in the DESCRIPTION OF OPERATIONS shown on the Declarations page of this policy. DUTY TO DEFEND EXCLUSION Where there is no coverage under this policy there is no duty to defend. PROFESSIONAL LIABILITY EXCLUSION This insurance does not apply to professional liability malpractice errors or omissions or acts of any type including rendering or failure to render any type of professional service nor to any expenses or any obligation to share damages with or repay anyone else who must pay damages from same unless such Professional Liability coverage is specifically endorsed onto this policy. FIDUCIARY EXCLUSION This insurance does not apply to any claim or suit arising directly or indirectly out of related to or in any way involving 1. Coercion conversion or misappropriation of the funds or property of others 2. Dishonest fraudulent criminal or malicious acts or omissions of the insured or any partner or employee or any person for whom you are legally responsible or 3. Activities or operations performed in the capacity of a fiduciary. WAR EXCLUSION the War Exclusion in the policy is deleted and replaced with the following This insurance does not apply to any claim or suit for bodily injury property damage or personal and advertising injury or other injury or damage arising directly or indirectly out of related to or in any way involving 1. Hostile or warlike action in time of peace or war including any action in hindering combating or defending against an actual impending or expected attach by a. Any government or sovereign power de jure or de facto or by any authority maintaining or using military naval or air forces b. Military or naval or air forces or Page 2 of 3 CAS3043 0817 | 2 |
c. Anagentofa.orb. above it being understood that any discharge explosion or use of any weapon of war employing nuclear fission or fusion or biological chemical or radiological discharge shall be conclusively presumed to be such hostile or warlike action by such a government power authority or forces. 2. Insurrection rebellion revolution civil war usurped power or action taken by governmental authority in hindering combating or defending against such an event. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page 3 of 3 CAS3043 0817 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION UNDERGROUND FACILITY Named Insured Jared Ware Construction Effective Date of Endorsement 06102019 1201AM at the Named Insured address shown on the Declarations Return Prem 0 Attached To and Forming Part of Policy 01000396483 This endorsement modifies the insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE The following exclusion is added to this policy Fol This insurance does not apply to any claim or suit for bodily injury property damage personal and advertising injury or underground property damage arising directly or indirectly out of related to or in any way involving any failure by you or others working on your behalf to take appropriate steps in advance of any job or work commencing locating identifying or marking the location of any underground facility. purposes of this exclusion the following definitions apply Underground property damage means property damage to an underground facility including any resulting property damage to any other property caused by digging grading land paving excavating drilling borrowing filling back filling horizontal boring or pile driving. Appropriate means actions normally taken or used in the job site jurisdiction to locate identify and mark the location of underground facilities to protect or prevent damage. This includes but is not limited to compliance with all state or local codes or regulations. Underground facility means any item located below ground for use in connection with the storage or conveyance of water sewage electronic telephonic or telegraphic communications television fiber optic digital electric energy petroleum products gas gaseous vapors hazardous liquids or other substances and including but not limited to pipes sewers conduits mains cables valves lines wires tanks tunnels manholes attachments and any other similar property and any apparatus used with them beneath the surface of the ground or water. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3044 0319 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION INJURY TO INDEPENDENT CONTRACTORS Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations al Premium Return Prem 0 S0 Addi This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE The following exclusion is added to this policy This insurance does not apply to any claim or suit for bodily injury property damage or personal and advertising injury sustained by any of your independent contractors or subcontractors or any employee leased worker temporary worker or volunteer help of same. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3060 0110 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION WRAP UPS Named Insured Jared Ware Construction Effective Date of Endorsement 06102019 1201AM at the Named Insured address shown on the Declarations Return Prem 0 Attached To and Forming Part of Policy 01000396483 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE The following exclusion is added to this policy This insurance does not apply to any claim or suit for bodily injury property damage or personal and advertising injury arising directly or indirectly out of related to or in any way involving either your ongoing operations or operations included within the products completed operations hazard at any location or project where a consolidated wrap up insurance program Owner Controlled Insurance Program OCIP or Contractor Controlled Insurance Program CCIP has been provided by the prime contractor project manager or owner of the construction project and in which you are enrolled. This exclusion applies whether or not the consolidated wrap up insurance program 1. Provides coverage identical to that provided by this policy 2. Has limits adequate to cover all claims or 3. Remains in effect. This exclusion does not apply to bodily injury property damage or personal and advertising injury arising directly or indirectly out of related to or in any way involving your ongoing operations for a wrap up project at locations other than the wrap up site if coverage for these operations is not provided in the consolidated wrap up insurance program Owner Controlled Insurance Program OCIP or Contractor Controlled Insurance Program CCIP. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3062 0513 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION COLORADO Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations al Premium Return Prem 0 S0 Addi This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE The following exclusion is added to this policy This insurance does not apply to any claim or suit for bodily injury property damage or personal and advertising injury arising directly or indirectly out of related to or in any way involving any work performed in the state of Colorado by or on behalf of any insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3095 0610 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION NAMED INSURED VS. NAMED INSURED Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations al Premium Return Prem 0 S0 Addi This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE The following exclusion is added to this policy This insurance does not apply to any claim or suit for bodily injury property damage or personal and advertising injury brought by one named insured against any other named insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3098 0110 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION WEST VIRGINIA Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations al Premium Return Prem 0 S0 Addi This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE The following exclusion is added to this policy This insurance does not apply to any claim or suit for bodily injury property damage or personal and advertising injury arising directly or indirectly out of related to or in any way involving any work performed in the state of West Virginia by or on behalf of any insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3104 0912 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA RELATED LIABILITY GENERAL LIABILITY Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations Additional Premium Return Premium 0 S0 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE A.The following is added to Paragraph 2. of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information And Data related Liability Damages arising out of 1 Any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information or 2 The loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of that which is described in Paragraph 1 or 2 above. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. B. The following is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or organization s confidential or personal information. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Includes Material Insurance Services Office Inc. 2013 Page1of 1 CAS3108 0814 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION HIGHWAY OR BRIDGE WORK Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations al Premium. Return Prem 50 0 Addi This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE The following exclusion is added to this policy This insurance does not apply to bodily injury or property damage arising out of any engineering design consultation construction reconstruction maintenance refurbishing improving servicing or repair activities of any type on any limited access highway or on any bridge. For purposes of this endorsement limited access highway means a roadway available to the public where access is limited to a set of controlled locations at entrance and exit ramps. This exclusion applies to the negligent hiring employment training supervision or retention of any insured employee agent or other person with respect to such work and regardless of whether such work is conducted by you on your behalf for yourself or for others. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3118 0316 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION VIOLATION OF STATUTES THAT GOVERN E MAILS FAX PHONE CALLS OR OTHER METHODS OF SENDING MATERIAL OR INFORMATION Attached To and Forming Part of Policy 01000396483 Effective Date of Endorsement 06102019 1201AM at the Named Insured address shown on the Declarations Named Insured Jared Ware Construction Additional Premium S0 Return Premium 0 This endorsement modifies insurance provided under the following ALL COVERAGE FORMS The following exclusion is added to this policy This insurance does not apply to any claim or suit arising directly or indirectly out of any violation or alleged violation of a. The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law or b. The CAN SPAM Act of 2003 including any amendment of or addition to such law or c. Any statute ordinance or regulation other than the TCPA or CAN SPAM Act of 2003 that prohibits or limits the sending transmitting communicating or distribution of material or information. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Uses Material ISO Properties Inc. 2004 Page1of 1 CAS3124 0616 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION TRACT HOUSING OF GREATER THAN TWENTY UNITS ALL RESIDENTIAL CONDOMINIUMS TOWNHOMES TIMESHARES Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations Additional Premium Return Premium S0 0 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE The following exclusion is added to this policy This insurance does not apply to bodily injury or property damage included within the products completed operations hazard arising out of resulting from caused by contributed to by or in any way related to work on any 1. Residential single family house in a project or development in which more than twenty 20 individual residential single family houses have been built by you or on your behalf or are in any stage of development planning or construction by you or on your behalf or 2. Residential condominium or town home projects or developments of any size or 3. Timeshare development. This exclusion shall not apply to maintenance service repairs additions or remodeling for an owner of an individual condominium unit town home or single family house. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS3127 0716 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION MOBILE EQUIPMENT SUBJECT TO MOTOR VEHICLE INSURANCE LAW Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations Additional Premium. Return Premiu 50 0 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2. Exclusions the Aircraft Auto Or Watercraft exclusion is deleted and replaced with the following Aircraft Auto or Absolute Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft or auto 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 or auto that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 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 2 Liability assumed under any insured contract for the ownership maintenance or use of an aircraft or 3 Bodily injury or property damage arising out of the operation of any of the equipment listed in Paragraph.2 or.3 of the definition of mobile equipment. 4 Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or 5 Bodily injury or property damage arising out of a The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the 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 b The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definition of mobile equipment. SECTION Il WHO IS AN INSURED part 3. is deleted in its entirety. SECTION V DEFINITIONS the definition of Auto is deleted and replaced with the following Auto means a. A land motor vehicle trailer or semitrailer designed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However auto does not include mobile equipment. Uses Material ISO Properties Inc. 2004 Page 1 of 2 CAS3139 1118 | 2 |
SECTION V DEFINITIONS the definition of Mobile equipment is deleted and replaced by following Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment a. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads b. Vehicles maintained for use solely on or next to premises you own or rent c. Vehicles that travel on crawler treads d. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers e. Vehicles not described in a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types 1 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers f. Vehicles not described in a. b. c. or d. 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 1 Equipment designed primarily for a Snow removal b Road maintenance but not construction or resurfacing or c Street cleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and 3 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered autos. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Uses Material ISO Properties Inc. 2004 Page 2 of 2 CAS3139 1118 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FUNGI OR BACTERIA EXCLUSION Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations Additional Premium Return Premiuj 50 S0 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury Exclusions of Section Coverage B Personal And And Property Damage Liability Advertising Injury Liability 2. Exclusions 2. Exclusions This insurance does not apply to This insurance does not apply to Fungi Or Bacteria a. Bodily injury or property damage which would not have occurred in whole or in part but for the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed concurrently or in any sequence to such injury or damage. b. Any loss cost or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. Fungi Or Bacteria a. Personal and advertising injury which would not have taken place in whole or in part but for the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed concurrently or in any sequence to such injury. b. Any loss cost or expense arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. This exclusion does not apply to any fungi or C. The following definition is added to the Definitions bacteria that are are on or are contained in a Section good or product intended for bodily consumption. Fungi means any type or form of fungus including mold ar mildew and anv mveataxine cnarec rente ar xclusion is added to Paragraph 2. tion Coverage A Bodily Injury nage Liability does not apply to eria jury or property damage which have occurred in whole or in part the actual alleged or threatened of ingestion of contact with to existence of or presence of any bacteria on or within a building or including its contents regardless of iny other cause event material or ontributed concurrently or in any to such injury or damage. cost or expenses arising out of the esting for monitoring cleaning up containing treating detoxifying g remediating or disposing of or in esponding to or assessing the effects or bacteria by any insured or by any on or entity. 1 does not apply to any fungi or are are on or are contained in a ct intended for bodily consumption. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Personal and advertising injury which would not have taken place in whole or in part but for the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed concurrently or in any sequence to such injury. b. Any loss cost or expense arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. C. The following definition is added to the Definitions Section Fungi means any type or form of fungus including mold or mildew and any mycotoxins spores scents or byproducts produced or released by fungi. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. IS0 Properties Inc. 2003 Page1of 1 CG21671204 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON CONTRIBUTORY ENDORSEMENT Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations Additional Prem Return Pre 0 0 jum. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE ENVIRONMENTAL CONTRACTING AND PROFESSIONAL SERVICES LIABILITY COVERAGE PRODUCTS POLLUTION LIABILITY COVERAGE PREMISES ENVIRONMENTAL LIABILITY INSURANCE COVERAGE The insurance provided to Additional Insureds shall be excess with respect to any other valid and collectible insurance available to the Additional Insured unless the written contract specifically requires that this insurance apply on a primary and non contributory basis in which case this insurance shall be primary and non contributory. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 CAS5003 0717 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION Attached To and Forming Part of Policy 0100039648 3 Effective Date of Endorsement 06102019 1201AM at the Named Insured address shown on the Declarations Named Insured Jared Ware Construction Additional Premium 0 Return Premium S0 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Persons or Organizations Locations of Covered Operations Blanket as required by written contract. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by 1. Your acts or omissions or 2. The acts or omissions of those acting on your behalf in the performance of your ongoing operations for the additional insureds at the locations designated above. Is An Insured is amended to include nal insured the persons or own in the Schedule but only with lity for bodily injury property sonal and advertising injury caused t by missions or omissions of those acting on your ce of your ongoing operations for the ds at the locations designated B. With respect to the insurance afforded to these additional insureds the following additional exclusions apply This insurance does not apply to bodily injury or property damage occurring after 1. All work including materials parts or equipment furnished in connection with such work on the project other than service maintenance or repairs to be performed by or on behalf of the additional insureds at the location of the covered operations has been completed or 2. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. IS0 Properties Inc. 2004 Page1of 1 CG 20100704 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS COMPLETED OPERATIONS Named Insured Jared Ware Construction Attached To and Forming Part of Policy Effective Date of Endorsement 0100039648 3 06102019 1201AM at the Named Insured address shown on the Declarations Additional Premium Return Premium S0 0 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Persons or Organizations Location and Description of Completed Operations Blanket as required by written contract. Information required to complete this Schedule if not shown above will be shown in the Declarations. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury or property damage caused in whole or in part by your work at the location desig nated and described in the schedule of this endorse ment performed for that additional insured and in cluded in the products completed operations hazard. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. IS0 Properties Inc. 2004 Page1of 1 CG 20370704 | 2 |
NOTICE OF TERRORISM INSURANCE COVERAGE You are hereby notified that under the federal Terrorism Risk Insurance Act as amended the Act the Company must make available insurance coverage for losses arising out of acts of terrorism as defined in Section 1021 of the Act. This policy includes such coverage for damages arising out of certified acts of terrorism and is limited by the terms conditions exclusions limits other provisions of the coverage quote or renewal application questionnaire to which this offer is attached and by the policy any endorsements to the policy and generally applicable rules of law. 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 an air carrier or vessel 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 YOU SHOULD KNOW THAT COVERAGE PROVIDED BY THIS POLICY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM SUCH LOSSES MAY BE PARTIALLY REIMBURSED BY THE UNITED STATES GOVERNMENT UNDER A FORMULA ESTABLISHED BY FEDERAL LAW. UNDER THE FORMULA THE UNITED STATES GOVERNMENT GENERALLY REIMBURSES 85 THROUGH 2015 84 BEGINNING ON JANUARY 1 2016 83 BEGINNING ON JANUARY 1 2017 82 BEGINNING ON JANUARY 1 2018 81 BEGINNING ON JANUARY 1 2019 AND 80 BEGINNING ON JANUARY 1 2020 OF COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY ESTABLISHED DEDUCTIBLE PAID BY THE INSURANCE COMPANY PROVIDING THE COVERAGE. NO PREMIUM IS CHARGED FOR THIS COVERAGE NOR IS ANY CHARGE MADE FOR THE PORTION OF LOSS THAT MAY BE COVERED BY THE FEDERAL GOVERNMENT UNDER THE ACT. YOU SHOULD ALSO KNOW THAT THE ACT AS AMENDED CONTAINS A 100 BILLION CAP THAT LIMITS U.S. GOVERNIMIENT REIMBBURSEMENT AS WELL AS INSURERS LIABILITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS 100 BILLION. IF THE AGGREGATE INSURED LOSSES FOR ALL INSURERS EXCEED 100 BILLION YOUR COVERAGE MAY BE REDUCED. CCOVERAGE FOR INSURED LOSSES AS DEFINED IN THE ACT IS SUBJECT TO THE COVERAGE TERMS CONDITIONS AMOUNTS AND LIMITS IN THIS POLICY APPLICABLE TO LOSSES ARISING FROM EVENTS OTHER THAN ACTS OF TERRORISM. Pagelof1 ADF9010 0115 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT BROAD FORM Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations al Premium. Return Prem 50 0 Addi This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply B. Under any Medical Payments coverage to expenses incurred with respect to bodily injury resulting from the hazardous properties of nuclear material and arising out of the operation 1 With respect to which an insured under the of a nuclear facility by any person or policy is also an insured under a nuclear energy organization. liability policy issued by Nuclear Energy Liability Insurance Association Mutual Atomic Energy Liability Underwriters Nuclear Insurance Association of Canada or any of their A. Under any Liability Coverage to bodily injury or property damage C. Under any Liability Coverage to bodily injury or property damage resulting from hazardous properties of nuclear material if successors or would be an insured under any 1 The nuclear material a is at any nuclear such policy but for its termination upon facility owned by or operated by or on behalf exhaustion of its limit of liability or of an insured or b has been discharged or 2 Resulting from the hazardous properties of dispersed therefrom nuclear material and with respect to which 2 The nuclear material is contained in spent a any person or organization is required to fuel or waste at any time possessed maintain financial protection pursuant to the handled used processed stored transported Atomic Energy Act of 1954 or any law or disposed of by or on behalf of an insured amendatory thereof or b the insured is or or had this policy not been issued would be n. T o entitled to indemnity from the United States of B o aob oo arses America or any agency thereof under any services materials parts or equipment in agreement entered into by the United States of connection with the planning construction America or any agency thereof with any maintenance operation or use of any nuclear person or organization. facility but if such facility is located within the Hinitad Statec nf America itc tarritarioc ar B. Under any Medical Payments coverage to expenses incurred with respect to bodily injury il injury or resulting from the hazardous properties of nuclear material and arising out of the operation d under the of a nuclear facility by any person or uclear energy organization. gfgfgty C. Under any Liability Coverage to bodily injury or surance property damage resulting from hazardous heir properties of nuclear material if d under any 1 The nuclear material a is at any nuclear 1 upon facility owned by or operated by or on behalf or of an insured or b has been discharged or operties of dispersed therefrom act to which 2 The nuclear material is contained in spent required to fuel or waste at any time possessed suant to the handled used processed stored transported y law or disposed of by or on behalf of an insured nsured is or or ould be 3 The bodily injury or property damage arises nited States of out of the furnishing by an insured of inder any services materials parts or equipment in nited States of connection with the planning construction with any maintenance operation or use of any nuclear facility but if such facility is located within the United States of America its territories or possessions or Canada this exclusion 3 applies only to property damage to such nuclear facility and any property thereat. IS0 Properties Inc. 2007 Page 1 of 2 1L00 21 09 08 | 2 |
2. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source material special nuclear material or by product material. Source material special nuclear material and by product material have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. Spent fuel means any fuel element or fuel component solid or liquid which has been used or exposed to radiation in a nuclear reactor. Waste means any waste material a containing by product material other than the tailings or wastes produced by the extraction or concentration of uranium or thorium from any ore processed primarily for its source material content and b resulting from the operation by any person or organization of any nuclear facility included under the first two paragraphs of the definition of nuclear facility. Nuclear facility means a Any nuclear reactor forsement rties includes radioactive toxic or ies. means source material special or by product material. special nuclear material and by have the meanings given them in the t of 1954 or in any law amendatory 1s any fuel element or fuel or liquid which has been used or ion in a nuclear reactor. 1y waste material a containing by other than the tailings or wastes xtraction or concentration of m from any ore processed primarily terial content and b resulting n by any person or organization of ty included under the first two definition of nuclear facility. means ar reactor b Any equipment or device designed or used for 1 separating the isotopes of uranium or plutonium 2 processing or utilizing spent fuel or 3 handling processing or packaging waste z Any equipment or device used for the processing fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 d Any structure basin excavation premises or place prepared or used for the storage or disposal of waste and includes the site on which any of the foregoing is located all operations conducted on such site and all premises used for such operations. Nuclear reactor means any apparatus designed or used to sustain nuclear fission in a self supporting chain reaction or to contain a critical mass of fissionable material. Property damage includes all forms of radioactive contamination of property. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. IS0 Properties Inc. 2007 Page 2 of 2 1L00 21 09 08 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT Named Insured Jared Ware Construction Attached To and Forming Part of Policy 01000396483 Effective Date of Endorsement 06102019 1201AM at the Named Insured address shown on the Declarations al Premium Return Premy 0 0 Addi SCHEDULE PART Terrorism Premium Certified Acts S The premium amount shown above is the total Certified Acts premium attributable to this Policy. If no premium amount is shown above no additional premium is attributable to Certified Acts. Additional information if any concerning the terrorism premium is shown in this Policy SCHEDULE PART Il Federal Share of Terrorism Losses 85 Year 2015 Federal Share of Terrorism Losses 84 Year 2016 Federal Share of Terrorism Losses 83 Year 2017 Federal Share of Terrorism Losses 82 Year 2018 Federal Share of Terrorism Losses 81 Year 2019 Federal Share of Terrorism Losses 80 Year 2020 Refer to Paragraph B. in this endorsement. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Disclosure Of Premium In accordance with the federal Terrorism Risk Insurance Act we are required to provide you with a notice disclosing the portion of your premium if any attributable to coverage for terrorist acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this endorsement or in the policy Declarations. 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 a percentage as shown in Part Il of the Schedule of this endorsement or in the policy Declarations of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. 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. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Insurance Services Office Inc. 2015 Page1of 1 1L 09 8501 15 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SIGNATURE ENDORSEMENT Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100039648 3 06102019 1201AM at the Named Insured Jared Ware Construction address shown on the Declarations Additional Premium Return Premiu 0 0 This endorsement modifies insurance provided under the following ALL COVERAGE FORMS By signing and delivering this policy to you we state that it is a valid contract when signed as below by our authorized representatives. Conte il Secretary 4 A President ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. Page1of 1 ADF9004 0110 | 2 |
U.S. TREASURY DEPARTMENT S OFFICE OF FOREIGN ASSETS CONTROL OFAC ADVISORY NOTICE TO POLICYHOLDERS This Notice shall not be construed as part of your policy and no coverage is provided by this Notice nor can it be construed to replace any provisions of your policy. You should read your policy and review your Declarations page for complete information on the coverages your policy provides. This Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC. Please read this Notice carefully. The Office of Foreign Assets Control administers and enforces sanctions policy based on Presidential declarations of national emergency. OFAC has identified and listed numerous Foreign Agents Front Organizations Terrorists Terrorist organizations and Narcotics traffickers as Specially Designated Nationals and Blocked Persons. This list can be located on the United States Treasury s web site httpwww.treas.gov ofac. In accordance with OFAC regulations if it is determined that you or any other insured or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person as identified by OFAC this insurance will be considered a blocked or frozen contract and all provisions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract no payments and no premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. Page 1of 1 ADF9009 0110 | 2 |
SAFETY NATIONAL CASUALTY CORPORATION PRIVACY STATEMENT Our Commitment To Our Customers Safety National Casualty Corporation Safety National is proud to have provided quality products and services to its customers for over 50 years. We greatly appreciate the trust that you and all of our customers place in us. We protect that trust by respecting the privacy of all of our customers both present and past. The following will explain our privacy practices so that you will understand our commitment to your privacy. We Respect Your Privacy When you apply to Safety National for any type of insurance you disclose information about you to us. The collection use and disclosure of such information is regulated by law. Safety National and its affiliates maintain physical electronic and procedural safeguards that comply with state and federal regulations to guard your personal information. Our employees are also advised of the importance of maintaining the confidentiality of your information. Types Of Information We Collect Safety National obtains most of our information directly from you your agent or broker. The application you complete as well as any additional information you provide generally gives us most of the details we need to know. Depending on the nature of your insurance transaction we may need further details about you. We may obtain information from third parties such as other insurance or reinsurance companies medical providers government agencies information clearinghouses and other public records. We may also obtain information about you from your other transactions with us our affiliates or others. non affiliates as described in this notice or as otherwise permitted by law. To Whom Do We Disclose Your Information We will not disclose any non public personal information about our customers or former customers except as permitted by law. That means we may disclose information we have collected about you to the following types of third parties e Our affiliated companies Members and subsidiaries of the Tokio Marine Holdings Inc. group of companies. Your agent or broker. e Parties who perform a business or insurance function for Safety National including reinsurance underwriting claims administration or adjusting investigation loss control and computer systems companies. e Other insurance companies or agents as reasonably necessary concerning your application policy or claim. Insurance statistical agencies. regulatory or reporting e Law enforcement or governmental authorities in connection with suspected fraud or illegal activities. Authorized persons as ordered by subpoena warrant or court order or as required by law. We do not disclose any non public personal information about you to non affiliated companies for marketing purposes or for any other purpose except those specifically allowed by law and described above. What We Do With Your Information Information that has been collected about you will be retained in our files. We will review your information in evaluating your request for insurance coverage determining your rates or underwriting risk servicing your policy or adjusting claims. We may retain information about our former customers and would disclose that information only to affiliates and to Independent Sales Agents or Brokers Your policy may have been placed with us through an independent agent or broker Sales Agent. Your Sales Agent may have gathered information about you. The use and protection of information obtained by your Sales Agent is their responsibility not Safety National s. If you have questions about how your Sales Agent uses or discloses your information please contact them directly. PN 99 02 0209 | 2 |
SAFETY NATIONAL CASUALTY CORPORATION 1832 Schuetz Road St. Louis MO 63146 888 995 5300 A STOCK COMPANY COMMERCIAL POLICY o SECRETARY Q Mif A m. PRESIDENT THESE POLICY PROVISIONS WITH THE DECLARATIONS PAGE COVERAGE FORM AND ENDORSEMENTS IF ANY COMPLETE THIS POLICY. CP 990303 14 | 2 |
COMMERCIAL GENERAL LIABILITY DECLARATIONS SAFETY NATIONAL CASUALTY CORP ggvgAFLOEnNEERtAr gPS ST. LOUIS MO 63146 888 995 5300 Policy Number From Policy Period To GL 4056109 01012019 01012020 1201 AM. Standard Time at the described location Previous Policy Number GL 4056109 Transaction ATLANTA GA 30328 Renewal Named Insured and Address Agent FIRST DATA CORPORATION 58531 5565 GLENRIDGE CONNECTOR NE WILLIS INSURANCE SERVICES OF GEORGIA INC. ATLANTA GA 30342 5 CONCOURSE PARKWAY 18TH FLOOR Telephone Business Description Type of Business COMPUTER PROCESSING AND DATA PREPARATION CORPORATION POLICY WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. IN RETURN FOR THE PAYMENT OF THE PREMIUM AND SUBJECT TO ALL THE TERMS OF THIS LIMITS OF INSURANCE EACH OCCURRENCE LIMIT 1000000 Combined BI PD DAMAGE TO PREMISES RENTED TO YOU LIMIT 1000000 Any one premises MEDICAL EXPENSE LIMIT S 10000 Any one person PERSONAL ADVERTISING INJURY LIMIT 1000000 Any one person or organization GENERAL AGGREGATE LIMIT 3000000 PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT 3000000 DESCRIPTION OF BUSINESS FORM OF BUSINESS O INDIVIDUAL 0O PARTNERSHIP O JOINT VENTURE O TRUST BUSINESS DESCRIPTION COMPUTER PROCESSING AND DATA PREPARATION O LIMITED LIABILITY COMPANY ORGANIZATION INCLUDING A CORPORATION BUT NOT INCLUDING A PARTNERSHIP JOINT VENTURE OR LIMITED LIABILITY COMPANY SAFETY NATIONAL CASUALTY CORP ST. LOUIS MO 63146 888 995 5300 565 GLENRIDGE CONNECTOR NE TLANTA GA 30342 ILLIS INSURANCE SERVICES OF GEORGIA INC. CONCOURSE PARKWAY 18TH FLOOR TLANTA GA 30328 RY LIMIT or organization RUST ION BUT NOT INCLUDING A LIABILITY COMPANY Includes copyrighted material of Insurance Services Office Inc. with its permission. Safety National Casualty Corporation CG 10011109 Page 1 of 2 | 2 |
SAFETY NATIONAL CASUALTY CORP ST.LOUIS MO 63146 888 995 5300 COMMERCIAL GENERAL LIABILITY DECLARATIONS Policy Number GL 4056109 Named Insured FIRST DATA CORPORATION Agent WILLIS INSURANCE SERVICES OF GEORGIA INC. Effective Date 01012019 ALL PREMISES YOU OWN RENT OR OCCUPY LOCATION NUMBER ADDRESS OF ALL PREMISES YOU OWN RENT OR OCCUPY Schedule on File with Company See Schedule on File with Company CLASSIFICATION AND PREMIUM LOCATION CLASSIFICATION CODE PREMIUM RATE ADVANCE PREMIUM NUMBER NO. BASE Prem Prod Comp Prem Prod Comp Ops Ops Ops Ops Schedule Office 98111 us See Composite Rating Plan Premium on file Machines or Employee Endorsement SNGL 045 05 14 Attached with Appliances Headcount Company installation inspection adjustment or repair TOTAL PREMIUM SUBJECT TO AUDIT 44429 STATE SURCHARGES if applicable 9 TOTAL DUE AT INCEPTION 44438 AT EACH ANNIVERSARY IF POLICY PERIOD IS MORE THAN ONE YEAR AND PREMIUM IS PAID IN ANNUAL INSTALLMENTS AUDIT PERIOD IF APPLICABLE ANNUALLY O SEMI O QUARTERLY O MONTHLY ANNUALLY ENDORSEMENTS ENDORSEMENTS ATTACHED TO THIS POLICY See Attached Schedule of Forms and Endorsements THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS AND COVERAGE FORMS AND ANY ENDORSEMENTS COMPLETE THE ABOVE NUMBERED POLICY. Countersigned By Date Authorized Representative Endorsenrlent SNGL 0454 05 14 Attached able licable 9 44438 THAN ONE YEAR AND PREMIUM IS PAID IN Includes copyrighted material of Insurance Services Office Inc. with its permission. Safety National Casualty Corporation CG 10011109 Page 2 of 2 | 2 |
SCHEDULE OF SURCHARGES SAFETY NATIONAL CASUALTY CORP From igflfg GL 4056109 01012019 01012020 888 995 5300 Policy Number Policy PTeoriod 1201 AM. Standard Time at the described location Named Insured and Address Agent FIRST DATA CORPORATION WILLIS INSURANCE SERVICES OF GEORGIA INC. 5565 GLENRIDGE CONNECTOR NE 5 CONCOURSE PARKWAY 18TH FLOOR ATLANTA GA 30342 ATLANTA GA 30328 Telephone State Surcharge Description Surcharge Amount KY General Liability Kentucky Municipal Tax 4.00 KY Kentucky Insurance Premium Surcharge 4.00 sc South Carolina Municipality Tax 1.00 565 GLENRIDGE CONNECTOR NE TLANTA GA 30342 CONCOURSE PARKWAY 18TH FLOOR TLANTA GA 30328 Page 1 of 1 IL10011208 | 2 |
SCHEDULE OF FORMS AND ENDORSEMENTS SAFETY NATIONAL CASUALTY CORP Policy Number Policy Period ST.LOUIS MO 63146 From To 888 995 5300 GL 4056109 01012019 01012020 1201 AM. Standard Time at the described location Named Insured and Address Agent FIRST DATA CORPORATION WILLIS INSURANCE SERVICES OF GEORGIA INC. 5565 GLENRIDGE CONNECTOR NE 5 CONCOURSE PARKWAY 18TH FLOOR ATLANTA GA 30342 ATLANTA GA 30328 Telephone Form Number Form Title PN 99 02 02 09 Privacy Statement CP 99 03 03 14 Commercial Policy Cover CG 10 01 11 09 Commercial General Liability Declarations IL 10 01 12 08 Schedule Of Surcharges IL 10 06 12 08 Schedule Of Forms And Endorsements IL N 001 09 03 Fraud Statement IL P 001 01 04 U.S. Treasury Department s Office Of Foreign Assets Control IL N 013 02 13 Alabama Fraud Statement IL N 012 09 03 Alaska Fraud Statement IL N 014 09 03 Arizona Fraud Statement IL N 016 09 03 Arkansas Fraud Statement SNIL PN 001 03 1109 Arkansas Policyholder Notice IL N 018 09 03 California Fraud Statement IL N 020 09 03 Colorado Fraud Statement SNGL PN 001 06 06 13 Connecticut Advisory Notice to Policyholders IL N 026 06 09 District Of Columbia Fraud Statement SNIL PN 001 08 0609 District Of Columbia Waiver Of Premium Disclosure Notice SNIL PN 001 09 0509 Florida Important Notice IL N 034 08 09 Hawaii Fraud Statement IL N 036 09 03 Idaho Fraud Statement PN 11 99 01 1013 Idaho Policyholder Notice SNGL PN 018A 12 1109 Illinois Acknowledgment By Policyholder IL N 175 11 11 Illinois Notice to Policyholders Regarding the Religious IL N 040 09 03 Indiana Fraud Statement IL N 120 10 05 Indiana Notice To Policyholders Regarding Filing IL N 043 01 16 Kansas Fraud Statement IL N 048 09 03 Louisiana Fraud Statement IL N 050 09 03 Maine Fraud Statement IL N 167 01 13 Maryland Fraud Statement SNIL PN 001 21 0411 Michigan Disclosure Notice For Exempt Commercial Policy IL N 058 09 03 Minnesota Fraud Statement IL N 070 09 03 New Hampshire Fraud Statement IL N 072 03 04 New Jersey Fraud Statement Application IL N 073 03 04 New Jersey Fraud Statement Claim Form IL N 074 09 03 New Mexico Fraud Statement 565 GLENRIDGE CONNECTOR NE TLANTA GA 30342 CONCOURSE PARKWAY 18TH FLOOR TLANTA GA 30328 IL 10 06 12 08 Page 1 0of 6 | 2 |
SAFETY NATIONAL CASUALTY CORP ST. LOUIS MO 63146 888 995 5300 SCHEDULE OF FORMS AND ENDORSEMENTS location Policy Period Policy Number From To GL 4056109 01012019 01012020 1201 AM. Standard Time at the described Named Insured and Address Agent FIRST DATA CORPORATION 5565 GLENRIDGE CONNECTOR NE ATLANTA GA 30342 WILLIS INSURANCE SERVICES OF GEORG 5 CONCOURSE PARKWAY 18TH FLOOR ATLANTA GA 30328 Telephone IA INC. SNGL PN 001 N 01 N N 09 P SNIL IL N SNIL SNIL SNIL IL CG CG CG CG CG CG CG N 20 20 20 20 20 20 20 084 79 085 088 10 006 09 10 02 09 07 11 PN 004 098 09 PN 003 PN 002 PN 001 106 02 05 26 11 37 10 15 SNGL 028 SNGL 004 SNGL 044 CG 24 12 SNGL 048 CG 21 70 SNGL 012 IL 10 05 SNGL 045 CG 21 39 SNGL 018 IL 09 85 SNGL 002 CG 02 24 SNGL 049 CG 04 35 09 11 04 04 04 04 04 04 11 11 05 11 05 01 12 12 05 10 02 01 09 10 05 12 31 03 02 11 03 02 05 42 03 42 42 42 03 85 13 13 13 13 13 13 11 11 14 85 14 15 09 08 14 93 10 15 08 93 14 07 0210 0909 0610 0409 0113 New York Advisory Notice To Policyholders Oklahoma Fraud Statement Oklahoma Notice Oregon Fraud Statement Pennsylvania Fraud Statement Pennsylvania Notice Rhode Island Notice To Policyholders Concerning Availab Special Texas Notice Notification Of The Availability Tennessee Fraud Statement Texas Exclusion Asbestos Advisory Notice Texas Exclusion Lead Contamination Advisory Notice Texas Important Notice Virginia Fraud Statement Additional Insured Club Members Additional Insured Controlling Interest Additional Insured Designated Person or Organization Additional Insured Managers Or Lessors Of Premises Additional Insured Owners Lessees Or Contractors C Additional Insured Owners Lessees Or Contractors S Additional Insured Vendors Alienated Premises Amended Definition Of Bodily Injury Asbestos Exclusion Boats Broadened Named Insured Endorsement Cap On Losses from Certified Acts of Terrorism Co Employee Exclusion Deleted Common Policy Change Endorsement Composite Rating Plan Premium Endorsement Contractual Liability Limitation Deductible Liability Coverage Disclosure Pursuant To Terrorism Risk Insurance Act ERISA Exclusion Earlier Notice Of Cancellation Provided By Us Earlier Notice of Nonrenewal Employee Benefits Liability Coverage ility 565 GLENRIDGE CONNECTOR NE TLANTA GA 30342 CONCOURSE PARKWAY 18TH FLOOR TLANTA GA 30328 IL 10 06 12 08 Page 2 of 6 | 2 |
SCHEDULE OF FORMS AND ENDORSEMENTS SAFETY NATIONAL CASUALTY CORP Policy Number Policy Period ST.LOUIS MO 63146 From To 888 995 5300 GL 4056109 01012019 01012020 location Named Insured and Address Agent FIRST DATA CORPORATION 5565 GLENRIDGE CONNECTOR NE 5 CONCOURSE PARKWAY 18TH FLOOR ATLANTA GA 30342 ATLANTA GA 30328 Telephone CG 21 47 12 07 CG 21 07 05 14 CG 21 16 04 13 CG 22 38 07 98 CG 22 48 04 13 SNGL 030 11 11 SNGL 036 11 11 CG 21 67 12 04 SNGL 032 11 11 SNGL 020 11 11 SNGL 043 05 14 SNGL 046 05 14 IL 00 23 07 02 IL 00 21 07 02 IL 00 21 09 08 IL 00 21 05 02 CG 22 75 04 13 CG 21 96 03 05 CG 21 65 12 04 SNGL 038 11 11 SNGL 021 11 11 CG 24 04 05 09 IL 01 21 09 08 IL 02 80 09 08 CG 26 70 10 01 CG 21 30 04 13 CG 32 73 09 08 CG 26 97 03 06 IL 02 58 12 14 CG 01 42 07 11 IL 02 31 09 08 CG 26 08 04 90 IL 01 99 09 08 IL 02 70 09 12 IL 02 28 09 07 IL 01 25 11 13 Employment Related Practices Exclusion Exclusion Access or Disclosure of Confidential Exclusion Designated Professional Services Exclusion Fiduciary Or Representative Liability Of Financial Exclusion Insurance And Related Operations Expected Or Intended Acts Extended Definition Personal Advertising Injury Fungi Or Bacteria Exclusion Incidental Emergency Medical Malpractice Liability Knowledge Of Occurrence Lead Contamination Exclusion Majority Interest Broadened Named Insured Endorsement Nuclear Energy Liability Exclusion End Broad Form Nuclear Energy Liability Exclusion End Broad Form Nuclear Energy Liability Exclusion End Broad Form Nuclear Energy Liability Exclusion End Broad Form Professional Liability Exclusion Computer Software Silica Or Silica Related Dust Exclusion Total Pollution Exclusion With A Building Heating Cooling Unintended Failure To Provide Notice Of Occurrence Unintentional Failure To Disclose Hazards Or Occurrence Waiver Of Transfer Of Rights Of Recovery Against Others Alaska Changes Attorney s Fees Alaska Changes Cancellation And Nonrenewal Alaska Changes Definition Of Metatag Alaska Recording and Distribution of Material or Information Alaska Silica Or Silica Related Dust Exclusion Alaska War Liability Exclusion Arizona Changes Cancellation and Nonrenewal Arkansas Changes Arkansas Changes Cancellation And Nonrenewal Arkansas Changes Multi Year Policies Arkansas Changes Transfer Of Rights Of Recovery California Changes Cancellation And Nonrenewal Colorado Changes Cancellation And Nonrenewal Colorado Changes Civil Union 1201 AM. Standard Time at the described WILLIS INSURANCE SERVICES OF GEORGIA INC. 565 GLENRIDGE CONNECTOR NE TLANTA GA 30342 CONCOURSE PARKWAY 18TH FLOOR TLANTA GA 30328 IL 10 06 12 08 Page 3 of 6 | 2 |
SCHEDULE OF FORMS AND ENDORSEMENTS ST.LOUIS MO 63146 888 995 5300 SAFETY NATIONAL CASUALTY CORP Policy Number 110 Folicy Period GL 4056109 01012019 01012020 location Named Insured and Address Agent FIRST DATA CORPORATION 5565 GLENRIDGE CONNECTOR NE 5 CONCOURSE PARKWAY 18TH FLOOR ATLANTA GA 30342 ATLANTA GA 30328 Telephone CG 33 78 05 10 IL 02 60 02 10 IL 01 40 09 08 CG 27 21 04 13 IL 01 51 01 12 IL 02 37 04 12 IL 02 78 09 08 CG 02 20 03 12 IL 02 62 02 15 IL 02 65 07 02 IL 01 49 01 12 IL 02 04 09 08 CG 02 00 01 18 IL 01 47 09 11 IL 01 62 10 13 IL 01 58 09 08 IL 02 72 09 07 CG 01 23 03 97 IL 01 17 12 10 IL 09 13 04 98 IL 02 76 09 08 CG 01 09 11 85 IL 02 61 09 07 IL 02 63 09 08 IL 02 77 01 18 CG 32 10 04 05 CG 01 25 03 03 CG 01 18 12 04 CG 26 84 12 04 IL 02 47 02 11 CG 02 01 12 17 CG 26 73 12 04 CG 01 68 10 09 IL 02 86 04 17 CG 26 05 02 07 IL 02 45 09 08 Colorado Changes Employee Benefits Liability Coverage Connecticut Changes Cancellation And Nonrenewal Connecticut Changes Civil Union Connecticut Employee Benefits Liability Coverage Delaware Changes Civil Union Delaware Changes Termination Provisions District Of Columbia Changes Cancellation And Nonrenewal Florida Changes Cancellation And Nonrenewal Georgia Changes Cancellation And Nonrenewal Hawaii Changes Cancellation And Nonrenewal Hawaii Changes Civil Union Idaho Changes Cancellation And Nonrenewal Illinois Changes Cancellation And Nonrenewal Illinois Changes Civil Union Illinois Changes Defense Costs Indiana Changes Indiana Changes Cancellation And Nonrenewal Indiana Changes Pollution Exclusion Indiana Changes Workers Compensation Exclusion Insurance Inspection Services Exemption From Liability Iowa Changes Cancellation And Nonrenewal Kansas And Oklahoma Changes Transfer Of Rights Kansas Changes Cancellation And Nonrenewal Kentucky Changes Cancellation And Nonrenewal Louisiana Changes Cancellation And Nonrenewal Louisiana Changes Fungi Or Bacteria Exclusion Louisiana Changes Insuring Agreement Louisiana Changes Legal Action Against Us Louisiana Changes Transfer Of Rights Of Recovery Maine Changes Cancellation And Nonrenewal Maryland Changes Maryland Changes Premium Audit Condition Michigan Changes Michigan Changes Cancellation And Nonrenewal Minnesota Changes Minnesota Changes Cancellation And Nonrenewal 1201 AM. Standard Time at the described WILLIS INSURANCE SERVICES OF GEORGIA INC. 565 GLENRIDGE CONNECTOR NE TLANTA GA 30342 CONCOURSE PARKWAY 18TH FLOOR TLANTA GA 30328 IL 10 06 12 08 Page 4 of 6 | 2 |
SCHEDULE OF FORMS AND ENDORSEMENTS SAFETY NATIONAL CASUALTY CORP Policy Number 5 Policy Period ST.LOUIS MO 63146 rom iIo 888 995 5300 GL 4056109 01012019 01012020 1201 AM. Standard Time at the described location Named Insured and Address Agent FIRST DATA CORPORATION WILLIS INSURANCE SERVICES OF GEORGIA INC. 5565 GLENRIDGE CONNECTOR NE 5 CONCOURSE PARKWAY 18TH FLOOR ATLANTA GA 30342 ATLANTA GA 30328 Telephone CG 01 22 12 07 Minnesota Changes Contractual Liability Exclusion Supplementary CG 26 81 12 04 Minnesota Changes Duties Condition IL 02 82 09 08 Mississippi Changes Cancellation And Nonrenewal IL 09 90 01 15 Missouri Disclosure Pursuant To Terrorism Risk Insurance IL 02 74 02 13 Missouri Changes Cancellation And Nonrenewal CG 26 25 04 05 Missouri Changes Guaranty Association CG 26 50 04 13 Missouri Changes Medical Payments CG 01 34 08 03 Missouri Changes Pollution Exclusion IL 02 43 09 07 Montana Changes IL 01 67 10 13 Montana Changes Conformity With Statutes CG 26 61 10 01 Montana Changes Medical Payments CG 27 16 12 07 Montana Employee Benefits Liability Coverage IL 02 59 12 17 Nebraska Changes Cancellation And Nonrenewal IL 02 51 09 07 Nevada Changes Cancellation And Nonrenewal IL 01 15 01 10 Nevada Changes Domestic Partnership CG 21 29 04 13 New Hampshire Amendment of Liquor Liability Exclusion CG 01 12 06 15 New Hampshire Changes CG 26 55 11 08 New Hampshire Changes Amendment Of Representations IL 01 35 01 19 New Hampshire Changes Cancellation And Nonrenewal CG 01 52 04 17 New Hampshire Changes Premium Audit CG 27 19 07 09 New Hampshire Employee Benefits Liability Coverage IL 02 08 09 07 New Jersey Changes Cancellation And Nonrenewal IL 01 41 09 08 New Jersey Changes Civil Union CG 26 53 06 99 New Jersey Changes Coverage Exclusion Liability for Hazard CG 26 20 10 93 New Jersey Changes Loss Information IL 02 98 05 15 New Mexico Changes Cancellation And Nonrenewal IL 02 68 01 14 New York Changes Cancellation And Nonrenewal CG 01 63 07 11 New York Changes Commercial General Liability Coverage CG 01 04 12 04 New York Changes Premium Audit CG 26 21 10 91 New York Changes Transfer Of Duties IL 02 69 09 08 North Carolina Changes Cancellation And Nonrenewal IL 02 36 09 07 Oklahoma Changes Cancellation And Nonrenewal IL 02 79 09 08 Oregon Changes Cancellation And Nonrenewal IL 01 42 09 08 Oregon Changes Domestic Partnership IL 02 46 09 07 Pennsylvania Changes Cancellation And Nonrenewal IL 01 20 10 13 Pennsylvania Changes Defense Costs 565 GLENRIDGE CONNECTOR NE TLANTA GA 30342 CONCOURSE PARKWAY 18TH FLOOR TLANTA GA 30328 IL 10 06 12 08 Page 5 of 6 | 2 |
SCHEDULE OF FORMS AND ENDORSEMENTS SAFETY NATIONAL CASUALTY CORP Policy Number 5 Policy PTeriod ST.LOUIS MO 63146 rom o 888 995 5300 GL 4056109 01012019 01012020 1201 AM. Standard Time at the described location Named Insured and Address Agent FIRST DATA CORPORATION 5565 GLENRIDGE CONNECTOR NE ATLANTA GA 30342 5 CONCOURSE PARKWAY 18TH FLOOR ATLANTA GA 30328 Telephone WILLIS INSURANCE SERVICES OF GEORGIA INC. IL 01 97 09 08 IL 02 73 01 10 IL 01 61 03 12 IL 01 28 09 08 IL 02 49 09 08 CG 01 44 10 11 IL 02 32 09 08 IL 02 50 09 08 CG 01 03 06 06 IL 02 75 11 13 IL 01 68 03 12 CG 26 39 12 07 CG 01 86 12 04 IL 02 66 09 08 CG 01 47 11 13 IL 02 19 06 15 IL 01 09 09 08 CG 01 54 04 13 IL 01 26 09 08 CG 01 79 07 10 IL 01 38 10 15 CG 32 98 07 10 IL 02 81 04 89 CG 01 24 01 93 IL 02 83 11 18 IL 00 17 11 98 CG 00 01 04 13 Rhode Rhode Rhode Rhode South South South Texas Island Changes Island Changes Island Changes Island Changes Carolina Changes Cancellation And Nonrenewal Civil Union Prejudgment Interest Dakota Changes Dakota Changes Tennessee Changes Cancellation And Nonrenewal Changes Cancellation And Nonrenewal Texas Changes Cancellation And Nonrenewal Provisions Texas Changes Duties Texas Changes Employment Related Practices Exclusion Utah Changes Utah Changes Cancellation And Nonrenewal Utah Changes Common Interest Associations Vermont Changes Vermont Changes Vermont Changes Vermont Changes Virginia Changes Virginia Changes Cancellation and Nonrenewal Virginia Employee Benefits Liability Coverage West Virginia Changes Cancellation Wisconsin Changes Amendment Of Policy Conditions Wisconsin Changes Cancellation And Nonrenewal Common Policy Conditions Commercial General Liability Coverage Form Cancellation And Nonrenewal Civil Union Pollution Statutory Liability Cancellation And Nonrenewal 565 GLENRIDGE CONNECTOR NE TLANTA GA 30342 CONCOURSE PARKWAY 18TH FLOOR TLANTA GA 30328 IL 10 06 12 08 Page 6 of 6 | 2 |
IL N 001 09 03 FRAUD STATEMENT Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly pre sents false information in an application for insurance is guilty of a crime and may be subject to fines and con finement in prison. 1SO Properties Inc. 2003 Page 1 of 1 IL N 001 09 03 | 2 |
IL P 001 01 04 U.S. TREASURY DEPARTMENT S OFFICE OF FOREIGN ASSETS CONTROL OFAC ADVISORY NOTICE TO POLICYHOLDERS No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. This Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC. Please read this Notice carefully. The Office of Foreign Assets Control OFAC administers and enforces sanctions policy based on Presidential declarations of national emergency. OFAC has identified and listed numerous Foreign agents Front organizations Terrorists Terrorist organizations and Narcotics traffickers as Specially Designated Nationals and Blocked Persons. This list can be located on the United States Treasury s web site httpwww.treas.gov ofac. In accordance with OFAC regulations if it is determined that you or any other insured or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person as identified by OFAC this insurance will be considered a blocked or frozen contract and all pro visions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract no payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. ISO Properties Inc. 2004 Page 1 of 1 IL P 0010104 | 2 |
ILN 0130213 ALABAMA FRAUD STATEMENT Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or who knowingly presents false information in an application for insurance is guilty of a crime and may be subject to restitution fines or confinement in prison or any combination thereof. Insurance Services Office Inc. 2013 Page 1 of 1 ILN 0130213 | 2 |
ILN 01209 03 ALASKA FRAUD STATEMENT A person who knowingly and with intent to injure defraud or deceive an insurance company files a claim contain ing false incomplete or misleading information may be prosecuted under state law. 1SO Properties Inc. 2003 Page 1 of 1 ILN 01209 03 | 2 |
IL N 01409 03 ARIZONA FRAUD STATEMENT For your protection Arizona law requires the following statement to appear on this form. Any person who knowingly presents a false or fraudulent claim for payment of a loss is subject to criminal and civil penalties. 1SO Properties Inc. 2003 Page 1 of 1 IL N 01409 03 | 2 |
IL N 016 09 03 ARKANSAS FRAUD STATEMENT Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and con finement in prison. 1SO Properties Inc. 2003 Page 1 of 1 IL N 016 09 03 | 2 |
SNIL PN 00103 Ed. 11 09 ARKANSAS POLICYHOLDER NOTICE As our Insured your satisfaction is very important to us. If you have a question about your policy or if you need assistance with a problem please contact your insurance agent or us. You may reach your insurance agent or broker at Name of Agent WILLIS INSURANCE SERVICES OF GEORGIA INC. Address 5 CONCOURSE PARKWAY 18TH FLOOR ATLANTA GA 30328 Telephone Number You may reach us at Safety National Casualty Corporation 1832 Schuetz Road St. Louis MO 63146 888 995 5300 You may also contact the Arkansas Insurance Department to obtain information on companies agents rights or other inquires at Arkansas Insurance Department 1200 West Third Street Little Rock Arkansas 72201 501 371 2640 or 800 852 5494 ATTACH THIS NOTICE TO YOUR POLICY This notice is for information only and does not become a part or condition of policy. | 2 |
ILN 018 09 03 CALIFORNIA FRAUD STATEMENT For your protection California law requires that you be made aware of the following Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. 1SO Properties Inc. 2003 Page 1 of 1 ILN 018 09 03 | 2 |
IL N 020 09 03 COLORADO FRAUD STATEMENT It is unlawful to knowingly provide false incomplete or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment fines denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false incomplete or misleading facts or information to a policyholder or claimant for the purpose of de frauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado division of insurance within the department of regulatory agencies. 1SO Properties Inc. 2003 Page 1 of 1 IL N 020 09 03 | 2 |
SNGL PN 001 06 06 13 CONNECTICUT ADVISORY NOTICE TO POLICYHOLDERS This Notice does NOT form a part of your insurance contract. The Notice is designed to alert you to changes due to the inclusion of a Deductible Liability Endorsement on your policy. If there is any conflict between this Notice and the policy including its endorsements the provisions of the policy including its endorsements apply. Please read your policy and the endorsements attached to your policy carefully. If your policy is endorsed with one of the following endorsements please note the following in regard to application of the deductible provisions to Allocated Loss Adjustment Expenses SNGL 018A Deductible Liability Coverage Allocated Loss Adjustment Expenses Within Deductible Paid by You The deductible limit provisions of this endorsement include Allocated Loss Adjustment Expense as a portion of the deductible amount reimbursed by you to us. When the deductible limit has been exceeded by your reimbursement of actual damages and Allocated Loss Adjustment Expense we will pay all additional Allocated Loss Adjustment Expense on a per claim or per occurrence basis. Allocated Loss Adjustment Expenses is defined as those expenses under the Supplementary Payments section of the policy which we directly allocate to a particular claim or suit. The attachment of this endorsement does not affect the policy limit of liability. In connection with any deductible offset by Allocated Loss Adjustment Expense and upon written request by you to us you have the right to an accounting of legal defense costs actually expended. SNGL 019A Deductible Liability Coverage Allocated Loss Adjustment Expenses Shared Proportionally Between You and Us The deductible limit provisions of this endorsement do not include Allocated Loss Adjustment Expense as a portion of the deductible amount reimbursed by you to us. Unless the Deductible Aggregate Limit has been exhausted you will reimburse us for all Allocated Loss Adjustment Expense until the per claim or per occurrence deductible limit has been exceeded by your reimbursement of actual damages and then Allocated Loss Adjustment Expense will be shared by you and us with you reimbursing us for the amount the Allocated Loss Adjustment Expense bears to the ratio of the deductible limit to the actual damages paid by us under the policy in disposition of the claim or suit. The attachment of this endorsement does not affect the policy limit of liability. Allocated Loss Adjustment Expenses is defined as those expenses under the Supplementary Payments section of the policy which we directly allocate to a particular claim or suit. SNGL PN 001 06 06 13 Safety National Casualty Corporation Page 1 of 1 | 2 |
IL N 026 06 09 DISTRICT OF COLUMBIA FRAUD STATEMENT WARNING It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment andor fines. In addition an insurer may deny insur ance benefits if false information materially related to a claim was provided by the applicant. Insurance Services Office Inc. 2009 Page 1 of 1 IL N 026 06 09 | 2 |
SNIL PN 001 08 0609 DISTRICT OF COLUMBIA WAIVER OF PREMIUM DISCLOSURE NOTICE The following paragraph is provided per the District of Columbia Code 31 2406 2. Waiver Of Premium We will waive return premium amounts of 15.00 or less. However any return premium requested by you the insured must be granted by us despite the waiver and will be returned to you. SNIL PN 001 08 0609 Page 1 of 1 | 2 |
SNIL PN 001 09 Ed. 05 09 IMPORTANT NOTICE To obtain general information or for complaint resolution You may call safety National Casualty Corporation s toll free telephone number for general information or to resolve a complaint 1 888 995 5300 You may also write to Safety National Casualty Corporation Safety National Casualty Corporation 1832 Schuetz Road St. Louis MO 63146 ATTACH THIS NOTICE TO YOUR POLICY This notice is for information only and does not become a part or condition of the attached document. Date of Notice 01252019 Policy Period 01012019 to 01012020 Page 1 of 1 Insured FIRST DATA CORPORATION Policy No. GL 4056109 | 2 |
IL N 034 08 09 HAWAII FRAUD STATEMENT Intentionally or knowingly misrepresenting or concealing a material fact opinion or intention to obtain coverage benefits recovery or compensation when presenting an application for the issuance or renewal of an insurance policy or when presenting a claim for the payment of a loss is a criminal offense punishable by fines or imprison ment or both. Insurance Services Office Inc. 2009 Page 1 of 1 IL N 034 08 09 | 2 |
IL N 036 09 03 IDAHO FRAUD STATEMENT Any person who knowingly and with intent to defraud or deceive any insurance company files a statement of claim containing any false incomplete or misleading information is guilty of a felony. 1SO Properties Inc. 2003 Page 1 of 1 IL N 036 09 03 | 2 |
PN 1199 01 Ed. 10 13 IDAHO POLICYHOLDER NOTICE As our Insured your satisfaction is very important to us. If you have a question about your policy or if you need assistance with a problem please contact your insurance agent or us. You may reach your insurance agent or broker at Name of Agent WILLIS INSURANCE SERVICES OF GEORGIA INC. Address 5 CONCOURSE PARKWAY 18TH FLOOR ATLANTA GA 30328 Telephone Number You may reach us at Safety National Casualty Corporation 1832 Schuetz Road St. Louis MO 63146 1888 995 5300 You may also contact the Idaho Department of Insurance to obtain information on companies agents rights or other inquires at Idaho Department of Insurance Consumer Affairs 700 West State Street 3 Floor P. 0. Box 83720 Boise ID 83720 0043 1800721 3272 or 208 334 4250 or www.DOl.ldaho.gov ATTACH THIS NOTICE TO YOUR POLICY This notice is for information only and does not become a part or condition of policy. | 2 |
SNGL PN 018A 12 1109 ILLINOIS ACKNOWLEDGMENT BY POLICYHOLDER RE Policy Number cL 4056109 Named Insured FIRST DATA CORPORATION As an authorized representative of the Insured acknowledge that the attachment of the endorsement tited DEDUCTIBLE LIABILITY COVERAGE Allocated Loss Adjustment Expenses Within Deductible Paid by You to the Commercial General Liability Coverage Form provides that the application of any deductible amount will result in the reduction of the Limits of Insurance set forth in the Declarations applicable to the endorsement and in the reduction of the Aggregate Limits of Insurance stated in the Policy for such coverages. Signature of Named Insured Authorized Officer Typed Printed Name and Title SNGL PN 018A 12 1109 | 2 |
ILN17511 11 ILLINOIS NOTICE TO POLICYHOLDERS REGARDING THE RELIGIOUS FREEDOM PROTECTION AND CIVIL UNION ACT Dear Policyholder This is to provide notice that pursuant to lllinois Department of Insurance Company Bulletin 2011 06 CB 2011 06 this policy is in compliance with the lllinois Religious Freedom Protection and Civil Union Act the Act 750 ILL. COMP. STAT. 751. The Act which became effective on June 1 2011 creates a legal relationship between two persons of either the same or opposite sex who establish a civil union. The Act provides that parties to a civil union are entitled to the same legal obligations responsibilities protections and benefits that are afforded or recognized by the law of lllinois to spouses whether they are derived from statute administrative rule policy common law or any source of civil or criminal law. In addition this law requires recognition of a same sex civil union marriage or other substantially similar legal relationship except for common law marriage legally entered into in other jurisdictions. The Act further provides that party to a civil union shall be included in any definition or use of the terms spouse family immediate family dependent next of kin and other terms descriptive of spousal relationships as those terms are used throughout the law. According to CB 2011 06 this includes the terms marriage or married or any variations thereof. CB 2011 06 also states that if policies of insurance provide coverage for children the children of civil unions must also be provided coverage. Insurance Services Office Inc. 2011 Page 1 of 1 ILN17511 11 | 2 |
IL N 040 09 03 INDIANA FRAUD STATEMENT Any person who knowingly and with intent to defraud an insurer files a statement of claim containing any false incomplete or misleading information commits a felony. 1SO Properties Inc. 2003 Page 1 of 1 IL N 040 09 03 | 2 |
POLICY NUMBER GL 4056109 R GL 4056109 IL N 120 10 05 INDIANA NOTICE TO POLICYHOLDERS REGARDING FILING COMPLAINTS WITH THE DEPARTMENT OF INSURANCE Questions regarding your policy or coverage should be directed to Company Name Safety National Casualty Corporation Contact Number 1 888 995 5300 If you a Need the assistance of the governmental agency that regulates insurance or b Have a complaint you have been unable to resolve with your insurer you may contact the Department of Insurance by mail telephone or E mail State of Indiana Department of Insurance Consumer Services Division 311 West Washington Street Suite 300 Indianapolis Indiana 46204 Consumer Hotline 800 622 4461 317 232 2395 Complaints can be filed electronically at www.in.govidoi. 1SO Properties Inc. 2005 Page 1 of 1 IL N 120 10 05 | 2 |
IL N 043 01 16 KANSAS FRAUD STATEMENT Any person who commits a fraudulent insurance act is guilty of a crime and may be subject to restitution fines and confinement in prison. A fraudulent insurance act means an act committed by any person who knowingly and with intent to defraud presents causes to be presented or prepares with knowledge or belief that it will be presented to or by an insurer purported insurer or insurance agent or broker any written electronic electronic impulse facsimile magnetic oral or telephonic communication or statement as part of or in support of an application for insurance or the rating of an insurance policy or a claim for payment or other benefit under an insurance policy which such person knows to contain materially false information concerning any material fact thereto or conceals for the purpose of misleading information concerning any fact material thereto. Insurance Services Office Inc. 2015 Page 1 of 1 IL N 043 0116 | 2 |
IL N 048 09 03 LOUISIANA FRAUD STATEMENT Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and con finement in prison. 1SO Properties Inc. 2003 Page 1 of 1 IL N 048 09 03 | 2 |
IL N 050 09 03 MAINE FRAUD STATEMENT Itis a crime to knowingly provide false incomplete or misleading information to an insurance company for the pur pose of defrauding the company. Penalties may include imprisonment fines or a denial of insurance benefits. 1SO Properties Inc. 2003 Page 1 of 1 IL N 050 09 03 | 2 |
ILN 167 01 13 MARYLAND FRAUD STATEMENT Any person who knowingly or willfully presents a false or fraudulent claim for payment of a loss or benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. Insurance Services Office Inc. 2012 Page 1 of 1 ILN 167 0113 | 2 |
SNIL PN 001 21 0411 MICHIGAN DISCLOSURE NOTICE FOR EXEMPT COMMERCIAL POLICYHOLDER This policy is exempt from the filing requirements of section 2236 of the insurance code of 1956 1956 PA 218 MCL 500.2236. SNIL PN 001 21 0411 Page 1 of 1 | 2 |
IL N 058 09 03 MINNESOTA FRAUD STATEMENT Any person who files a claim with intent to defraud or helps commit a fraud against an insurer is guilty of a crime. 1SO Properties Inc. 2003 Page 1 of 1 IL N 058 09 03 | 2 |
IL N 070 09 03 NEW HAMPSHIRE FRAUD STATEMENT Any person who with a purpose to injure defraud or deceive any insurance company files a statement of claim containing any false incomplete or misleading information is subject to prosecution and punishment for insurance fraud as provided in RSA 63820. 1SO Properties Inc. 2003 Page 1 of 1 IL N 070 09 03 | 2 |
IL N 072 03 04 NEW JERSEY FRAUD STATEMENT APPLICATION Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties. 1SO Properties Inc. 2004 Page 1 of 1 IL N 072 03 04 | 2 |
IL N 073 03 04 NEW JERSEY FRAUD STATEMENT CLAIM FORM Any person who knowingly files a statement of claim containing any false or misleading information is subject to criminal and civil penalties. 1SO Properties Inc. 2004 Page 1 of 1 IL N 073 03 04 | 2 |
IL N 074 09 03 NEW MEXICO FRAUD STATEMENT ANY PERSON WHO KNOWINGLY PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR BENEFIT OR KNOWINGLY PRESENTS FALSE INFORMATION IN AN APPLICATION FOR INSUR ANCE IS GUILTY OF A CRIME AND MAY BE SUBJECT TO CIVIL FINES AND CRIMINAL PENALTIES. 1SO Properties Inc. 2003 Page 1 of 1 IL N 074 09 03 | 2 |
SNGL PN 001 31 0210 NEW YORK ADVISORY NOTICE TO POLICYHOLDERS If your policy is endorsed with the following endorsement please note the following in regard to application of the deductible provisions to Allocated Loss Adjustment Expenses SNGL 018B 31 1209 New York Deductible Liability Coverage Allocated Loss Adjustment Expenses Within Deductible Paid by You The deductible limit provisions of this endorsement include Allocated Loss Adjustment Expense as a portion of the deductible amount reimbursed by you to us. When the deductible limit has been exceeded by your reimbursement of actual damages and Allocated Loss Adjustment Expense we will pay all additional Allocated Loss Adjustment Expense on a per claim or per occurrence basis. Allocated Loss Adjustment Expenses is defined as those expenses under the Supplementary Payments section of the policy excluding post judgment interest which we directly allocate to a particu lar claim or suit. The attachment of this endorsement reduces the policy limit of liability for actual damages paid and reim bursed within the deductible amount. In connection with any deductible offset by Allocated Loss Adjustment Expense and upon written request by you to us you have the right to an accounting of legal defense costs actually expended. NOTE THIS ADVISORY NOTICE TO POLICYHOLDERS IS PAGE ONE OF YOUR POLICY. SNGL PN 001 31 0210 | 2 |
IL N 084 09 03 OKLAHOMA FRAUD STATEMENT WARNING Any person who knowingly and with intent to injure defraud or deceive any insurer makes any claim for the proceeds of an insurance policy containing any false incomplete or misleading information is guilty of a felony. 1SO Properties Inc. 2003 Page 1 of 1 IL N 084 09 03 | 2 |
IL 0179 10 02 OKLAHOMA NOTICE The following statement is added to the policy WARNING Any person who knowingly and with intent to injure defraud or deceive any insurer makes any claim for the proceeds of an insurance policy containing any false incomplete or misleading information is guilty of a felony. 1SO Properties Inc. 2002 Page 1 of 1 IL 01791002 | 2 |
IL N 08502 11 OREGON FRAUD STATEMENT Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents materially false information in an application for insurance may be guilty of a crime and may be subject to fines and confinement in prison. In order for us to deny a claim on the basis of misstatements misrepresentations omissions or concealments on your part we must show that A. The misinformation is material to the content of the policy B. We relied upon the misinformation and C. The information was either 1. Material to the risk assumed by us or 2. Provided fraudulently. For remedies other than the denial of a claim misstatements misrepresentations omissions or concealments on your part must either be fraudulent or material to our interests. With regard to fire insurance in order to trigger the right to remedy material misrepresentations must be willful or intentional. Misstatements misrepresentations omissions or concealments on your part are not fraudulent unless they are made with the intent to knowingly defraud. Insurance Services Office Inc. 2010 Page 1 of 1 ILN 0850211 | 2 |
IL N 088 09 03 PENNSYLVANIA FRAUD STATEMENT Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading information concerning any fact material thereto commits a fraudulent insurance act which is a crime and subjects such person to criminal and civil penalties. 1SO Properties Inc. 2003 Page 1 of 1 IL N 088 09 03 | 2 |
IL 09 10 07 02 ILU9 1007 02 PENNSYLVANIA NOTICE An Insurance Company its agents employees or service contractors acting on its behalf may provide services to reduce the likelihood of injury death or loss. These services may include any of the following or related services incident to the ap plication for issuance renewal or continuation of a policy of insurance 1. Surveys 2. Consultation or advice or 3. Inspections. The Insurance Consultation Services Exemption Act of Pennsylvania provides that the Insurance Company its agents employees or service con tractors acting on its behalf is not liable for dam ages from injury death or loss occurring as a res ult of any act or omission by any person in the fur nishing of or the failure to furnish these services. The Act does not apply 1. If the injury death or loss occurred during the ac tual performance of the services and was caused by the negligence of the Insurance Company its agents employees or service contractors 2. To consultation services required to be per formed under a written service contract not re lated to a policy of insurance or 3. If any acts or omissions of the Insurance Company its agents employees or service con tractors are judicially determined to constitute a crime actual malice or gross negligence. Instruction to Policy Writers Attach the Pennsylvania Notice to all new and renewal certificates insuring risks located in Pennsylvania. 1SO Properties Inc. 2001 Page 1 of 1 IL 09 10 07 02 | 2 |
IL P 006 11 05 RHODE ISLAND NOTICE TO POLICYHOLDERS CONCERNING AVAILABILITY OF LEAD LIABILITY COVERAGE This policy does not provide lead liability coverage. You may be eli gible for lead liability coverage through the FAIR Plan. The FAIR Plan s address and telephone numbers are FAIR Plan Two Center Place Boston MA 02108 1904 800 851 8978. 1SO Properties Inc. 2005 Page 1 of 1 IL P 006 11 05 | 2 |
SNIL PN 004 42 Ed. 09 09 IMPORTANT NOTICE TO POLICYHOLDER. PLEASE READ IT CAREFULLY. SPECIAL TEXAS NOTICE NOTIFICATION OF THE AVAILABILITY OF LOSS CONTROL INFORMATION SERVICES In an effort to help prevent and reduce potential claims and losses Safety National is committed to providing loss control information and services at no charge to its Texas commercial automobile liability and general liability policyholders. For more information or to request services please call our Loss Control Department at the following toll free number 1 888 995 5300 You may also write to our Loss Control Department at Loss Control Department Safety National Casualty Corporation 1832 Schuetz Road St. Louis MO 63146 ATTACH THIS NOTICE TO YOUR POLICY This notice is for information only and does not become a part or condition of the attached document. Date of Notice 01252019 Policy Period 01012019 To 01012020 Page 1 of 1 Insured FIRST DATA CORPORATION Policy No. GL 4056109 | 2 |
IL N 098 09 03 TENNESSEE FRAUD STATEMENT Itis a crime to knowingly provide false incomplete or misleading information to an insurance company for the pur pose of defrauding the company. Penalties include imprisonment fines and denial of insurance benefits. 1SO Properties Inc. 2003 Page 1 of 1 IL N 098 09 03 | 2 |
SNIL PN 003 42 Ed. 06 10 EXCLUSION ASBESTOS ADVISORY NOTICE TO POLICYHOLDERS This Notice does NOT form a part of your insurance contract. The Notice is designed to alert you to coverage changes when the exclusion for silica or silica related dust is attached to this policy. If there is any conflict between this Notice and the policy including its endorsements the provisions of the policy including its endorsements apply. Please read your policy and the endorsements attached to your policy carefully. This Notice contains a brief synopsis of the following endorsements SNGL 044 0514 Asbestos Exclusion When this endorsement is attached to your policy coverage is excluded for bodily injury or property damage arising out of the inhalation ingestion or prolonged physical exposure to asbestos or goods or products con taining asbestos the use of asbestos in constructing or manufacturing any goods products or structure the removal of asbestos from any goods products or structure the manufacture sale transportation storage or disposal of asbestos or goods or products containing asbestos. Coverage is also excluded for payment for the investigation or defense of any claim or suit or any loss cost expense fine or penalty related to the exclusion outlined above. The attachment of this endorsement may result in a restriction of coverage. SNIL PN 003 42 Ed. 06 10 1SO Properties Inc. 2004 Page 1 of 1 | 2 |
SNIL PN 002 42 Ed. 04 09 EXCLUSION LEAD CONTAMINATION ADVISORY NOTICE TO POLICYHOLDERS This Notice does NOT form a part of your insurance contract. The Notice is designed to alert you to coverage changes when the exclusion for silica or silica related dust is attached to this policy. If there is any conflict between this Notice and the policy including its endorsements the provisions of the policy including its endorsements apply. Please read your policy and the endorsements attached to your policy carefully. This Notice contains a brief synopsis of the following endorsements SNGL 043 0514 Lead Contamination Exclusion When this endorsement is attached to your policy coverage is excluded for bodily injury or property dam age arising out of the actual or alleged or suspected ingestion inhalation absorption or prolonged physic al exposure or threat of exposure to lead in any form or goods or products containing any form of lead use of any form of lead in constructing or manufacturing any good product or structure removal of any form of lead from any good product or structure or manufacture sale transportation storage or disposal of lead or goods or products containing any form of lead. Coverage is also excluded for 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 lead due to any request demand claim or suit on the part of any insured governmental authority or others. The attachment of this endorsement may result in a restriction of coverage. SNIL PN 002 42 Ed. 04 09 1SO Properties Inc. 2004 Page 1 of 1 | 2 |
SNIL PN 001 42 Ed. 01 13 IMPORTANT NOTICE To obtain information or make a complaint You may call safety National Casualty Corporation s toll free telephone number for information or to make a complaint at 1 888 995 5300 You may also write to Safety National Casualty Corporation at Safety National Casualty Corporation 1832 Schuetz Road St. Louis MO 63146 You may contact the Texas Department of Insurance to obtain information on companies coverages rights or complaints at 1 800 252 3439 You may write the Texas Department of Insurance Texas Department of Insurance P. O. Box 149104 Austin TX 78714 9104 Fax 512 475 1771 Web httpwww.tdi.texas.gov E mail ConsumerProtectiontdi.texas.gov PREMIUM OR CLAIM DISPUTES Should you have a dispute concerning your premium or about a claim you should contact the agent or the company first. If the dispute is not resolved you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY This notice is for information only and does not become a part or condition of the attached document. Date of Notice 01252019 Policy Period 01012019 to 01012020 Page 1 of 1 Insured FIRST DATA CORPORATION Policy No. GL 4056109 | 2 |
IL N 106 09 03 VIRGINIA FRAUD STATEMENT Itis a crime to knowingly provide false incomplete or misleading information to an insurance company for the pur pose of defrauding the company. Penalties include imprisonment fines and denial of insurance benefits. 1SO Properties Inc. 2003 Page 1 of 1 IL N 106 09 03 | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED CLUB MEMBERS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART. WHO IS AN INSURED Section Il is amended to include as an insured any of your members but only with re spect to their liability for your activities or activities they perform on your behalf. CG 20021185 Copyright Insurance Services Office Inc. 1984 Page 1 of 1 | 2 |
POLICY NUMBER GL 4056109 POLICY NUMBER GL 4056109 COMMERCIAL GENERAL LIABILITY CG 20050413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED CONTROLLING INTEREST This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Persons Or Organizations As required by written contract or agreement when such written contract or agreement is executed prior to an occurrence offense or loss to which this endorsement applies but only for the limits agreed to in such contract or the Limits of Liability provided by this policy whichever is less. Any individually scheduled additional insureds shall not be construed to override nor negate this blanket additional insured. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to their liability arising out of 1. Their financial control of you or 2. Premises they own maintain or control while you lease or occupy these premises. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. This insurance does not apply to structural alterations new construction and demolition operations performed by or for that person or organization. C. With respect to the insurance afforded to these additional insureds the following is added to Section Il Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20050413 Insurance Services Office Inc. 2012 Page 1 of 1 | 2 |
POLICY NUMBER GL 4056109 POLICY NUMBER GL 4056109 COMMERCIAL GENERAL LIABILITY CG 20260413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations As required by written contract or agreement when such written contract or agreement is executed prior to an occurrence offense or loss to which this endorsement applies but only for the limits agreed to in such contract or the Limits of Liability provided by this policy whichever is less. Any individually scheduled additional insureds shall not be construed to override nor negate this blanket additional insured. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the persons or additional insureds the following is added to organizations shown in the Schedule but only Section Ill Limits Of Insurance with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by your acts or omissions or the acts or omissions of those acting amount of insurance on your behalf. L 1. Required by the contract or agreement or 1. In the performance of your ongoing operations or 2. Available under the applicable Limits of. Insurance shown in the Declarations 2. In connection with your premises owned by or rented to you. whichever is less. However This endorsement shall not increase the 1. The insurance afforded to such additional appllcabe Limits of Insurance shown in the h. Declarations. insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the CG 20260413 Insurance Services Office Inc. 2012 Page 1 of 1 | 2 |
POLICY NUMBER GL 4056109 POLICY NUMBER GL 4056109 COMMERCIAL GENERAL LIABILITY CG20110413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Designation Of Premises Part Leased To You locations owned by leased to or occupied by the insured. Name Of Persons Or Organizations Additional Insured As required by written contract or agreement when such written contract or agreement is executed prior to an occurrence offense or loss to which this endorsement applies but only for the limits agreed to in such contract or the Limits of Liability provided by this policy whichever is less. Any individually scheduled additional insureds shall not be construed to override nor negate this blanket additional insured. Additional Premium Included Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability arising out of the ownership maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions This insurance does not apply to 1. Any occurrence which takes place after you cease to be a tenant in that premises. 2. Structural alterations new construction or demolition operations performed by or on behalf of the persons or organizations shown in the Schedule. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 11 locations owned by leased to or occupied by the insured. amended to he persons chedule but g out of the that part of hown in the ng additional CG20110413 Insurance Services Office Inc. 2012 Page 1 of 1 | 2 |
POLICY NUMBER GL 4056109 POLICY NUMBER GL 4056109 COMMERCIAL GENERAL LIABILITY CG 20370413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS COMPLETED OPERATIONS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Location And Description Of Completed Operations As required by written contract or agreement when such written contract or agreement is executed prior to an occurrence offense or loss to which this endorsement applies but only for the limits agreed to in such contract or the Limits of Liability provided by this policy whichever is less. Any individually scheduled additional insureds shall not be construed to override nor negate this blanket additional insured. A1l your owned or leased locations or premises Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury or property damage caused in whole or in part by your work at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the products completed operations hazard. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following is added to Section Il Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. emises idividually scheduled additional 1sureds shall not be construed to rerride nor negate this blanket iditional insured. CG 20370413 Insurance Services Office Inc. 2012 Page 1 of 1 | 2 |
POLICY NUMBER GL 4056109 POLICY NUMBER GL 4056109 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured Persons Or Organizations Locations Of Covered Operations As required by written contract or agreement when such written contract or agreement is executed prior to an occurrence offense or loss to which this endorsement applies but only for the limits agreed to in such contract or the Limits of Liability provided by this policy whichever is less. Any individually scheduled additional insureds shall not be construed to override nor negate this blanket additional insured. ALl your owned or leased locations or premises Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by 1. Your acts or omissions or 2. The acts or omissions of those acting on your behalf in the performance of your ongoing operations for the additional insureds at the locations designated above. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following additional exclusions apply This insurance does not apply to bodily injury or property damage occurring after 1. Al work including materials parts or equipment furnished in connection with such work on the project other than service maintenance or repairs to be performed by or on behalf of the additional insureds at the location of the covered operations has been completed or 2. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG20100413 Insurance Services Office Inc. 2012 Page 1 of 2 | 2 |
C. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 Insurance Services Office Inc. 2012 CG20100413 | 2 |
POLICY NUMBER GL 4056109 POLICY NUMBER GL 4056109 COMMERCIAL GENERAL LIABILITY CG20150413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED VENDORS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Vendor Your Products As required by written contract or agreement when such written contract or agreement is executed prior to an occurrence offense or loss to which this endorsement applies but only for the limits agreed to in such contract or the Limits of Liability provided by this policy whichever is less. Any individually scheduled additional insureds shall not be construed to override nor negate this blanket additional insured. A1l your Products Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured any persons or organizations referred to throughout this endorsement as vendor shown in the Schedule but only with respect to bodily injury or property damage arising out of your products shown in the Schedule which are distributed or sold in the regular course of the vendor s business. However 1. The insurance afforded to such vendor only applies to the extent permitted by law and 2. If coverage provided to the vendor is required by a contract or agreement the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. B. With respect to the insurance afforded to these vendors the following additional exclusions apply 1. The insurance afforded the vendor does not apply to a. Bodily injury or property damage for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement b. Any express warranty unauthorized by you c. Any physical or chemical change in the product made intentionally by the vendor d. Repackaging except when unpacked solely for the purpose of inspection demonstration testing or the substitution of parts under instructions from the manufacturer and then repackaged in the original container CG20150413 Insurance Services Office Inc. 2012 Page 1 of 2 | 2 |
. Bodily Any failure to make such inspections adjustments tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the distribution or sale of the products Demonstration installation servicing or repair operations except such operations performed at the vendor s premises in connection with the sale of the product. Products which after distribution or sale by you have been labeled or relabeled or used as a container part or ingredient of any other thing or substance by or for the vendor or injury or property damage arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However this exclusion does not apply to 1 The exceptions contained paragraphs d. or f. or in Sub 2 Such inspections adjustments tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization from whom you have acquired such products or any ingredient part or container entering into accompanying or containing such products. C. With respect to the insurance afforded to these vendors the following is added to Section Il Limits Of Insurance If coverage provided to the vendor is required by a contract or agreement the most we will pay on behalf of the vendor is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 Insurance Services Office Inc. 2012 CG 20150413 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ALIENATED PREMISES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM CHANGE The following is deleted in its entirety SECTION COVERAGE COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2. Exclusions j.2 for COMMERCIAL GENERAL LIABILITY COVERAGE FORM or SECTION COVERAGE COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2. Exclusions g.2 for PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. The information below is required only when this endorsement is issued subsequent to preparation of the policy. Endorsement Effective 01012019 Policy No. GL 4056109 Endorsement No. Named Insured FIRST DATA CORPORATION Premium Included Insurance Company Safety National Casualty Corporation Countersigned By SNGL 028 1111 Safety National Casualty Corporation Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDED DEFINITION OF BODILY INJURY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM POLLUTION LIABILITY COVERAGE FORM CHANGE Under SECTION V DEFINITIONS and SECTION VI DEFINITIONS for POLLUTION LIABILITY COVERAGE FORM the definition of Bodily injury is amended to include the following Bodily injury shall also mean mental anguish shock humiliation or emotional distress sustained by a person in conjunction with a covered occurrence or offense when accompanied by physical injury sickness or disease. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. The information below is required only when this endorsement is issued subsequent to preparation of the policy. Endorsement Effective 01012019 Policy No. GL 4056109 Endorsement No. Named Insured FIRST DATA CORPORATION Premium Included Insurance Company Safety National Casualty Corporation Countersigned By SNGL 004 1111 Safety National Casualty Corporation Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ASBESTOS EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART CHANGE This insurance does not apply to bodily injury or property damage arising out of 1 The inhalation ingestion or prolonged physical exposure to asbestos or goods or products containing asbestos 2 The use of asbestos in constructing or manufacturing any goods products or structure 3 The removal of asbestos from any goods products or structure 4 The manufacture sale transportation storage or disposal of asbestos or goods or products containing asbestos or 5 Payment for the investigation or defense of any claim or suit or any loss cost expense fine or penalty related to the above exclusions. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. The information below is required only when this endorsement is issued subsequent to preparation of the policy. Endorsement Effective 01012019 Policy No. GL 4056109 Endorsement No. Named Insured FIRST DATA CORPORATION Premium Included Insurance Company Safety National Casualty Corporation Countersigned By Countersignature by the Broker or Agent shall only occur in the mailing states that require countersignature SNGL 044 0514 Safety National Casualty Corporation Page 1 of 1 | 2 |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.