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Named Insured Craneworks Inc. Endorsement Number Policy Symbol GLW Policy Number G27097121 001 Policy Period 11082013 7o 11082014 Effective Date of Endorsement 11082013 Insured By Name of Insurance Company lllinois Union Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SILICA DUST AND PARTICULATE MATTER EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM This insurance does not apply to any injury damage expense cost loss liability or legal obligation arising out of resulting from or in any way related to in whole or in part the respiration inspiration inhalation or breathing in of dust or particulate matter. Dust or particulate matter may include but is not limited to dust particulate matter inspirable dust respirable dust smoke mist dirt fibers grit soot salt acids bases metals aerosols crystals minerals sand silicates or silica. The addition of this endorsement does not imply that other policy provisions including but not limited to any pollution exclusion or asbestos exclusion do not also exclude coverage for dust or particulate matter related injury damage expense cost loss liability or legal obligation. Authorized Representative LD15270 0104 Reprinted in part with permission of ISO Properties Inc. 2001 Page 1 of 1 | 2 |
AIRCRAFT PRODUCTS OR GROUNDING EXCLUSION Named Insured Craneworks Inc. Endorsement Number Policy Symbol Policy Number Policy Period Effective Date of Endorsement GLW G27097121 001 11082013 7o 11082014 11082013 Insured By Name of Insurance Company Illinois Union Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM This insurance does not apply to Bodily Injury or Property Damage included in the Products Completed Operations Hazard and arising out of Aircraft Products upon which you have performed work or which were designed manufactured sold handled distributed or disposed of by you or by another trading under your name when such products are used in or on or attached to any aircraft or missile or any component part or sub assembly thereof or in connection with the use of aircraft. Aircraft Products means 1. Aircraft including missiles or spacecraft and any ground support maintenance of control equipment used therewith 2. Any articles furnished by an insured and installed in aircraft or used in connection with aircraft or for spare parts for aircraft 3. Ground handling tools and equipment 4. Training aids instruction manuals blueprints maps and guides engineering or other data engineering or other advice and services and labor relating to such aircraft or articles described above. This insurance does not apply to any damage of any kind whatsoever which arises out of grounding liability. Grounding means the withdrawal of aircraft whether or not owned or operated by you from flight operations in the interest of safety or for any other reason whether or not such grounding was ordered by a governmental agency. All other terms and conditions of this policy remain unchanged. Copyright 2001 MANAOQ073 0201 Page 1 of 1 | 2 |
CROSS SUITS EXCLUSION Named Insured Craneworks Inc. Endorsement Number Policy Symbol GLW Policy Number G27097121 001 Policy Period 11082013 to 11082014 Effective Date of Endorsement 11082013 Issued By Name of Insurance Company lllinois Union Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM This policy does not apply to bodily injury property damage or personal and advertising injury arising out of suits brought by any Named Insured against another Named Insured. All other terms and conditions of this policy remain unchanged. Copyright 2003 MANAO115 0903 Page 1 of 1 | 2 |
LEAD EXCLUSION Named Insured Craneworks Inc. Endorsement Number Policy Symbol GLW Policy Number G27097121 001 Policy Period 11082013 7o 11082014 Effective Date of Endorsement 11082013 Insured By Name of Insurance Company lllinois Union Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM This policy does not apply to 1. Bodily injury property damage personal injury advertising injury or any other liability or damage arising out of or involving lead paint containing lead or any other product containing lead or 2. Any fees costs or expenses of any nature whatsoever in the investigation or defense of any claim or suit arising out of or involving lead paint containing lead or any other product containing lead. All other terms and conditions of this policy remain unchanged. Copyright 1997 ULX0005 0197 Page 1 of 1 | 2 |
ABSOLUTE ASBESTOS EXCLUSION Named Insured Craneworks Inc. Endorsement Number Policy Symbol GLW Policy Number G27097121 001 Policy Period 11082013 7o 11082014 Effective Dale of Endorsement 11082013 Insured By Name of Insurance Company Illinois Union Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM This policy does not apply to bodily injury property damage personal injury or advertising injury or any other liability or damage arising out of or involving asbestos asbestos fibers or any product containing asbestos or asbestos fibers. Coverage for any fees costs or expenses of any nature whatsoever in the investigation or defense of any claim or suit arising out of or involving asbestos asbestos fibers or any product containing asbestos or asbestos fibers. All other terms and conditions of this policy remain unchanged. Copyright 1998 4 ULX0006 0498 Page 1 of 1 | 2 |
POLICY NUMBER G27097121 001 POLICY NUMBER G27097121 001 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization As required by written contract signed by both parties prior to loss Information required to complete this Schedule if not shown above will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV Conditions We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 Insurance Services Office Inc. 2008 Page 1 of 1 o | 2 |
COMMERCIAL GENERAL LIABILITY CG 24100798 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCESS PROVISION VENDORS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART When you are added to a manufacturer s or distributor s policy as an additional insured because you are a vendor for such manufacturer s or distributor s products Paragraph 4. Other Insurance of Conditions Section IV is amended by the addition of the following The coverage afforded the insured under this Coverage Part will be excess over any valid and collectible insur ance available to the insured as an additional insured under a policy issued to a manufacturer or distributor for products manufactured sold handled or distributed. CG 24100798 Copyright Insurance Services Office Inc. 1997 Page 1 of 1 a | 2 |
POLICY NUMBER G27097121 001 IUMBER G27097121 001 COMMERCIAL GENERAL LIABILITY CG 2503 0509 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECTS GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects All projects Information required to complete this Schedule if not shown above will be shown in the Declarations. A. For all sums which the insured becomes legally obli 3. Any payments made under Coverage A for dam gated to pay as damages caused by occurrences under Section Coverage A and for all medical e xpenses caused by accidents under Section I Co verage C which can be attributed only to ongoing operations at a single designated construction pro ject shown in the Schedule above 1. A separate Designated Construction Project Ge neral Aggregate Limit applies to each designated construction project and that limit is equal to t he amount of the General Aggregate Limit sho wn in the Declarations. 2. The Designated Construction Project General Ag gregate Limit is the most we will pay for the sum of all damages under Coverage A except dam ages because of bodily injury or property da mage included in the products completed ope rations hazard and for medical expenses under Coverage C regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bri nging suits. ages or under Coverage C for medical expenses shall reduce the Designated Construction Proje ct General Aggregate Limit for that designated c onstruction project. Such payments shall not re duce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Des ignated Construction Project General Aggregate Limit for any other designated construction pro ject shown in the Schedule above. 4. The limits shown in the Declarations for Each O ccurrence Damage To Premises Rented To You and Medical Expense continue to apply. Howev er instead of being subject to the General Aggr egate Limit shown in the Declarations such lim its will be subject to the applicable Designated Construction Project General Aggregate Limit. CG 25030509 Insurance Services Office Inc. 2008 Page 1 of 2 | 2 |
B. For all sums which the insured becomes legally ob ligated to pay as damages caused by occurrences under Section Coverage A and for all medical e xpenses caused by accidents under Section I Cov erage C which can not be attributed only to ongoing operations at a single designated construction proje ct shown in the Schedule above 1. Any payments made under Coverage A for dam ages or under Coverage C for medical expenses shall reduce the amount available under the Ge neral Aggregate Limit or the Products completed Operations Aggregate Limit whichever is applic able and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the prod ucts completed operations hazard is provided any payments for damages because of bodily injury or property damage included in the products comp leted operations hazard will reduce the Products completed Operations Aggregate Limit and not red uce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned delayed or abandoned and then restarted or if the authorized contracting parties de viate from plans blueprints designs specifications or timetables the project will still be deemed to be the same construction project. E. The provisions of Section Ill Limits Of Insurance not otherwise modified by this endorsement shall c ontinue to apply as stipulated. CG 2503 0509 Page 2 of 2 Insurance Services Office Inc. 2008 | 2 |
POLICY NUMBER G27097121 001 POLICY NUMBER G27097121 001 COMMERCIAL GENERAL LIABILITY CG 25 04 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED LOCATIONS GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Locations All locations. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. For all sums which the insured becomes legally b. Claims made or suits brought or obligated to pay as damages caused by occur rences under Section Coverage A and for all medical expenses caused by accidents under Section Coverage C which can be attributed only to operations at a single designated loca tion shown in the Schedule above 1. A separate Designated Location General Aggregate Limit applies to each designated location and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Location General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A except dam ages because of bodily injury or property damage included in the products completed operations hazard and for medical expenses under Coverage C regardless of the number of a. Insureds c. Persons or organizations making claims or bringing suits. 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Loca tion General Aggregate Limit for that desig nated location. Such payments shall not re duce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Location General Aggre gate Limit for any other designated location shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence Damage To Premises Rented To You and Medical Expense continue to apply. However instead of being subject to the General Aggregate Limit shown in the Decla rations such limits will be subject to the appli cable Designated Location General Aggre gate Limit. CG 2504 05 09 Insurance Services Office Inc. 2008 Page 1 of 2 o | 2 |
C. When coverage for liability arising out of the products completed operations hazard is pro vided any payments for damages because of bodily injury or property damage included in the products completed operations hazard will reduce the Products completed Operations Ag gregate Limit and not reduce the General Ag gregate Limit nor the Designated Location Gen eral Aggregate Limit. D. For the purposes of this endorsement the Defi nitions Section is amended by the addition of the following definition Location means premises involving the same or connecting lots or premises whose connection is interrupted only by a street roadway waterway or right of way of a railroad. E. The provisions of Section Ill Limits Of Insur ance not otherwise modified by this endorsement shall continue to apply as stipulated. B. For all sums which the insured becomes legally obligated to pay as damages caused by occur rences under Section Coverage A and for all medical expenses caused by accidents under Section Coverage C which can not be attrib uted only to operations at a single designated location shown in the Schedule above 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products completed Operations Aggregate Limit whichever is applicable and 2. Such payments shall not reduce any Desig nated Location General Aggregate Limit. Page 2 of 2 Insurance Services Office Inc. 2008 CG 2504 05 09 o | 2 |
Named Insured Craneworks Inc. Policy Symbol Policy Number Endorsement Number GLW G27097121 001 Issued By Name of Insurance Company Policy Period 11082013 to 11082014 Effective Dale of Endorsement 11082013 lllinois Union Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYEE BENEFITS LIABILITY ENDORSEMENT Item Four of the Declarations Limits of Insurance is amended to include the following E 1000000 EACH WRONGFUL ACT OR SERIES OF RELATED WRONGFUL ACTS 1000000 EMPLOYEE BENEFITS LIABILITY AGGREGATE INSURING AGREEMENT A. We will pay those sums which the insured shall become legally obligated to pay as damages because of a wrongful act in the administration of Employee Benefits. We will have the right and duty to defend any suit seeking those damages. We may at our discretion investigate any wrongful act and settle any claim or suit that may result. But 1 The amount that we will pay for damages is limited as described above in paragraph 1. and Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements. B. This insurance applies only to a wrongful act in the administration of the insured s Employee Benefits which occur during the policy period and take place in the coverage territory. EXCLUSIONS This insurance does not apply to 3 Any dishonest fraudulent criminal or malicious act or omission libel slander discrimination or humiliation or willful or reckless violation of any statute. Any fines penalties or taxes. Any claim or suit arising out of loss of currency coins bank notes bullion checks money orders and all negotiable and non negotiable instruments or contracts representing money. Any claim or suit arising out of the insured s failure to comply with any law concerning Workers Compensation Unemployment Insurance Social Security Disability Benefits or any similar law. GLE0027 08 98 Page 10f 3 | 2 |
5 Any claim or suit arising out of failure of performance of contract by any insurer. 6 Any claim or suit based upon i Failure of any investment to perform as represented by any insured or ii Advice given by an insured to participate or not to participate in any Employee Benefit Plan. Any claim or suit arising out of an insufficiency of funds to meet any obligation under any Employee Benefits Plan. 8 Any known claims or suits arising out of any wrongful act which has occurred been notified to any insurer or known to the insured prior to the inception of this policy. 9 Any breach of fiduciary duty by any other person for which the insured is legally responsible and arising out of the insured s activity as a fiduciary of any plan covered by this endorsement. For the purpose of this endorsement the term breach of fiduciary duty shall mean the violation of any of the responsibilities or obligations of duties imposed upon fiduciaries by the EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 or amendments thereto with respect to any plan covered by this endorsement. 10 Any claim or suit made against the insured based on or attributable to any wrongful act or failure on the part of the insured to effect and maintain insurance or bonding for plan property or assets. 11 Any liability arising out of the bankruptcy or insolvency of the insured. 12 Bodily Injury Property Damage Personal Injury or Advertising Injury. DEFINITIONS For the purposes of this endorsement the following Definitions are added to the policy EMPLOYEE BENEFITS means group life insurance group accident or health insurance profit sharing plans pension plans employee stock subscription plans 401 K savings plan workers compensation unemployment insurance social security and disability benefits insurance. ADMINISTRATION. As respects the insurance afforded hereby the unqualified word administration wherever used shall mean a Giving counsel to employees including their dependents and beneficiaries with respect to the Employee Benefits b Interpreting Employee Benefits c Handling records in connection with Employee Benefits d Effecting enrollment termination or cancellaton of employees under Employee Benefit Programs performed by a person authorized by the Named Insured to do such acts. GLE0027 08 98 Page 2 of 3 | 2 |
3 WRONGFUL ACT means any actual or alleged negligent act error or omission in the administration of the Employee Benefits Plan. LIMITS OF INSURANCE The following is added to Section Ill LIMITS OF INSURANCE as paragraph 8. 8. The Employee Benefits Liability Aggregate is the most we will pay for all damages because of a wrongful act included in the Employee Benefits Liability Endorsement. CONDITIONS The Conditions of the policy apply to this insurance unless specifically modified below Insured s Duties In The Event Of Occurrence Offense Claim Or Suit. Condition 2. of the policy applies provided that wherever the word occurrence appears it is deleted and the phrase wrongful act is substituted. Authorized Representative GLE0027 08 98 Page 3 of 3 | 2 |
NAMED INSURED AMENDED Named Insured Endorsement Number Craneworks Inc. Policy Symbol Policy Number Policy Period Effective Date of Endorsement GLW G27097121 001 11082013 to 11082014 11082013 Issued By Name of Insurance Company lllinois Union Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM Item One of the Declarations Named Insured is completed to read as follows Craneworks Inc. Craneworks Rentals LLC Collis Craneworks Inc. All other terms and conditions of this policy remain unchanged. GLE 0034 0199 Page 1 of 1 | 2 |
PREMIUM AUDIT TERM MINIMUM PREMIUM MINIMUM EARNED PREMIUM Named Insured Craneworks Inc. Endorsement Number Policy Symbol GLW Policy Number G27097121 001 Policy Period 11082013 to 11082014 Effective Dale of Endorsement 11082013 Issued By Name of Insurance Company lllinois Union Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM 1. Premium Audit The Premium Audit condition under SECTION 1V is deleted and replaced by the following Premium Audit a. Atthe close of each audit period we may at our sole discretion compute the audit premium for that period. If the audit premium is less than any applicable Term Minimum Premium as determined by item 3. below then there will be no return premium due. If the audit premium exceeds the advance premium paid then you will be responsible for paying as additional premium the difference between the audit premium and advance premium paid. b. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. Minimum Earned Premium In the event this policy is cancelled before the expiration date shown in Item 2. of the Declarations the Minimum Earned Premium for this policy is the greater of a. The audit premium if applicable as described in 1. above or b. The pro rata amount of the advance premium based on the length of the cancelled policy term or c. 25 of the advance premium if cancellation is at the request of the insured. If no percentage is stated here then item 2. of this endorsement does not apply. If cancellation is at the request of the insured the premium specified in items a. or b. above may also be subject to a short rate adjustment calculated at 90 pro rata unearned premium amount. Copyright 2013 GLE 0052 0113 Page 1 0of 2 | 2 |
3. Term Minimum Premium If this policy continues in effect until the expiration date shown in Item 2. of the Declarations and if the premium is to be determined on an adjustable basis then the Term Minimum Premium for this policy is 100 of the advance premium. If no percentage is stated here then item 3. of this endorsement does not apply. Al other terms and conditions of the policy remain unchanged. Copyright 2013 GLE 0052 0113 Page 2 of 2 | 2 |
NON CONTRIBUTORY OTHER INSURANCE ENDORSEMENT Named Insured Craneworks Inc. Endorsement Number Policy Symbol GLW Policy Number G27097121 001 Policy Period 11082013 7o 11082014 Effective Date of Endorsement 11082013 Issued By Name of Insurance Company lllinois Union Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM Paragraph 4. c. of SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS is deleted in its entirety and replaced by the following Method of Sharing If all of the other insurance permits contribution by equal shares we will follow this method unless you are required by written contract to provide insurance that is primary and non contributory and the contract has been signed by you prior to any loss. Where required by such a written contract this insurance will be primary and non contributory only when and to the extent required by that written contract. However under the contributory approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. All other terms and conditions remain unchanged. Cnpyrigm 2010E GLE0095 0710 Page 1 of 1 | 2 |
IL 0017 1198 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declara tions may cancel this policy by mailing or de livering to us advance written notice of cancel lation. 2. We may cancel this policy by mailing or deliv ering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancel lation if we cancel for nonpayment of pre mium or b. 30 days before the effective date of cancel lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be ef fective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be suf ficient proof of notice.. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy s terms can be amended or waived only by endorsement issued by us and made a part of this policy.. Examination Of Your Books And Records We may examine and audit your books and rec ords as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspections And Surveys 1. We have the right to a. Make inspections and surveys at any time b. Give you reports on the conditions we find and c. Recommend changes. 2. We are not obligated to make any inspections surveys reports or recommendations and any such actions we do undertake relate only to in surability and the premiums to be charged. We do not make safety inspections. We do not un dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions a. Are safe or healthful or b. Comply with laws regulations codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us but also to any rating advisory rate service or similar organization which makes insurance inspections surveys reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections surveys reports or recom mendations we may make relative to certifica tion under state or municipal statutes ordi nances or regulations of boilers pressure ves sels or elevators. E. Premiums The first Named Insured shown in the Declara tions 1. Is responsible for the payment of all premiums and 2. Will be the payee for any return premiums we pay.. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die your rights and duties will be trans ferred to your legal representative but only while acting within the scope of duties as your legal rep resentative. Until your legal representative is ap pointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. Copyright Insurance Services Office Inc. 1998 Page 1 of 1 a IL0017 1198 | 2 |
Named Insured Craneworks Inc. Policy Symbol Policy Number Policy Period Endorsement Number GLW G27097121 001 Issued By Name of Insurance Company 11082013 to 11082014 Effective Dale of Endorsement 11082013 lllinois Union Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE APPLICABLE TO INDEMNITY AND EXPENSE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Amount and Basis of Deductible PER CLAIM or PER OCCURRENCE Not Applicable Not Applicable Not Applicable Not Applicable Not Applicable 5000 Coverage Bodily Injury Liability OR Property Damage Liability OR Bodily Injury Liability andor Property Damage Liability Combined OR Personal and Advertising Injury Liability Not Applicable 5000 If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. APPLICATION OF ENDORSEMENT Enter below any limitations on the application of this endorsement. If no limitation is entered the deductibles apply to damages for all bodily injury property damage and personal and advertising injury however caused A. Our obligation under the Bodily Injury Liability in the Schedule above. Expenses include all costs and Property Damage Liability and under and expenses payable under the Supplementary Personal and Advertising Injury Liability Payments section of the Coverage Form. Coverages to pay damages on your behalf B. You may select a deductible amount on either applies only to the amount of damages and a per claim or a per occurrence basis. Your se expenses in excess of any deductible amounts lected deductible applies to the coverage option stated in the Schedule above as applicable to and to the basis of the deductible indicated by such coverages. the placement of the deductible amount in the Both damages and expenses shall contribute to Schedule above. The deductible amount stated the exhaustion of the deductible amounts stated in the Schedule above applies as follows MANAQ097 12 02 Page 1 of 2 in the Schedule above. Expenses include all costs and expenses payable under the Supplementary Payments section of the Coverage Form.. You may select a deductible amount on either a per claim or a per occurrence basis. Your se lected deductible applies to the coverage option and to the basis of the deductible indicated by the placement of the deductible amount in the Schedule above. The deductible amount stated in the Schedule above applies as follows Page 1 of 2 | 2 |
1. PER CLAIM BASIS. If the deductible amount indicated in the Schedule above is on a per claim basis that deductible applies as follows a. Under Bodily Injury Liability Coverage to all damages sustained by any one person because of bodily injury b. Under Property Damage Liability Coverage to all damages sustained by any one person because of property damage or c. Under Bodily Injury Liability andor Property Damage Liability Coverage Combined to all damages sustained by any one person because of 1 Bodily injury 2 Property damage or 3 Bodily injury and property damage combined as the result of any one occurrence. If damages are claimed for care loss of ser vices or death resulting at any time from bodily injury a separate deductible amount will be applied to each person making a claim for such damages. With respect to property damage person includes an organization. d. Under Personal and Advertising Injury Lia bility to all damages sustained by any one person or organization because of personal and advertising injury as a result of any one offense. 2. PER OCCURRENCE BASIS. If the deductible amount indicated in the Schedule above is on a per occurrence basis that deductible amount applies as follows a. Under Bodily Injury Liability Coverage to all damages because of bodily injury b. Under Property Damage Liability Coverage to all damages because of property damage or c. Under Bodily Injury Liability andor Property Damage Liability Coverage Combined to all damages because of 1 Bodily injury 2 Property damage or 3 Bodily injury and property damage combined as the result of any one occurrence regard less of the number of persons or organizations who sustain damages because of that occurrence. d. Under Personal and Advertising Injury Li ability to all damages because of Personal and Advertising Injury as a result of any one offense regardless of the number of persons or organizations who sustain damage because of that offense. C. The terms of this insurance including those with respect to 1. Our right and duty to defend the insured against any suits seeking those damages and. Your duties in the event of an occurrence claim or suit apply irrespective of the application of the deductible amount. D. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification of the action taken you shall promptly reimburse us for such part of the deductible amount as has been paid by us. MANA0097 12 02 Page 2 of 2 | 2 |
SERVICE OF SUIT ENDORSEMENT Named Insured Endorsement Number Craneworks Inc. Policy Symbol Policy Number. Policy Period Effective Date of Endorsement GLW G27097121 001 11082013 to 11082014 11082013 Tssued By Name of Insurance Company lllinois Union Insurance Company Insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Information about service of suits upon the company is given below. Service of process of suits against the company may be made upon the following person or another person the company may designate Saverio Rocca Assistant General Counsel ACE Group of Insurance Companies 436 Walnut Street Philadelphia PA 19106 3703 The person named above is authorized and directed to accept service of process on the company s behalf in any action suit or proceeding instituted against the company. If the insured requests the company will give the insured a written promise that a general appearance will be entered on the company s behalf if a suit is brought. If the insured requests the company will submit to the jurisdiction of any court of competent jurisdiction. The company will accept the final decision of that court or any Appellate Court in the event of an appeal. However nothing in this endorsement constitutes a waiver of company s right to remove an action to a United States District Court or to seek a transfer of a case to another court as permitted by the laws of the United States or of any state in the United States. The law of some jurisdictions of the United States of America requires that the Superintendent Commissioner or Director of Insurance or their successor in office be designated as the company s agent for service of process. In these jurisdictions the company designates the Director of Insurance as the company s true and lawful attorney upon whom service of process on the company s behalf may be made. The company also authorizes the Director of Insurance to mail process received on the company s behalf to the company person named above. If the insured is a resident of Canada the insured may also serve suit upon the company by serving the government official designated by the law of the insured s province. NOTHING HEREIN CONTAINED SHALL BE HELD TO VARY ALTER WAIVE OR EXTEND ANY OF THE TERMS CONDITIONS OR LIMITATIONS OF THE POLICY TO WHICH THIS ENDORSEMENT IS ATTACHED OTHER THAN AS ABOVE STATED. Authorized Representative SL34255 0911 | 2 |
TRADE OR ECONOMIC SANCTIONS ENDORSEMENT Named Insured Endorsement Number Craneworks Inc. Policy Symbol Policy Number Policy Period Effective Date of Endorsement GLW G27097121 001 11082013 to 11082014 11082013 Issued By Name of Insurance Company lllinois Union Insurance Company Insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This insurance does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing insurance including but not limited to the payment of claims. All other terms and conditions of policy remain unchanged. Authorized Agent ALL21101 11 06 Ptd. In U.S.A. Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG 21700108 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk Insur ance Act exceed 100 billion in a Program Year January 1 through December 31 and we have met our insurer deductible under the Terrorism Risk Insur ance 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 ac cordance with procedures established by the Secre tary of the Treasury. Certified act of terrorism means an act that is certi fied by the Secretary of the Treasury in concurrence with the Secretary of State and the Attorney General of the United States to be an act of terrorism pursu ant to the federal Terrorism Risk Insurance Act. The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following 1. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. CG 21700108 ISO Properties Inc. 2007 Page 1 of 1 o | 2 |
POLICY NUMBER G27097121 001 IL 09 8501 08 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SCHEDULE Terrorism Premium Certified Acts 4000 Forms andor Policys This premium is the total Certified Acts premium attributable to the following Coverage Parts Coverage Additional information if any concerning the terrorism premium 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 Insur ance Act we are required to provide you with a no tice 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 in sured under the federal program. The federal share equals 85 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 Program Year January 1 through December 31 the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. 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 Program Year January 1 through December 31 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. dditional information if any concerning the terrorism premium ISO Properties Inc. 2007 Page 1 of 1 IL 09 850108 | 2 |
ACE Producer Compensation Practices Policies ACE believes that policyholders should have access to information about ACE s practices and policies related to the payment of compensation to brokers and independent agents. You can obtain that information by accessing our website athttpwww.aceproducercompensation.com or by calling the following toll free telephone number 1 866 512 2862. ALL20887 1006 Page 1 of 1 | 2 |
ace group Information and Complaints This information is being provided to you pursuant to the requirements of Title 28 Part 1 Chapter 1 Subchapter E. 1.601 of the Texas Administrative Code relating to our Toll Free information and complaint number. IMPORTANT NOTICE To obtain information or make a complaint You may call the Company s toll free telephone number for information or to make a complaint at 1800 352 4462 You may also write to the Company at ACE USA Customer Services PO Box 1000 Philadelphia PA 19106 3703 You may contact the Texas Department of Insurance to obtain information on companies coverages rights or complaints at AVISO IMPORTANTE Para obtener informacion o para someter una queja Usted puede llamar al numero de telefono gratis de la Compania para informacion o para someter una queja al 1800 352 4462 Usted tambien puede escribir a la Compania ACE USA Customer Services PO Box 1000 Philadelphia PA 19106 3703 Puede communicarse con el Departmento de Seguros de Texas para obtener informacion acerca de companias coberturas derechos o quejas al 1800 252 3439 Puede escribir al Departamento de Seguros de Texas P.O. Box 149104 AUSTIN TX 78714 9104 FAX 512 475 1771 Web httpwww.tdi.texas.gov E mail ConsumerProtectiontdi.texas.gov DISPUTAS SOBRE PRIMAS O RECLAMOS Si tiene una disputa concerniente a su prima o un reclamo debe comunicarse con el agente o la compania primero. Si no se resuelve la disputa puede entonces communicarse con el departmento de Seguros en Texas UNA ESTE AVISO A SU POLIZA Este aviso es solo para proposito de informacion y no se convierte en parte o condicion del documento adjunto. 1800 252 3439 You may write the Texas Department of Insurance P. 0. 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 your 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. ALL4Y30e 0713 | 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 Presiden tial 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 nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. IL P 001 01 04 ISO Properties Inc. 2004 Page 1 of 1 | 2 |
POLICYHOLDER NOTICE TEXAS POLICYHOLDERS The Texas Department of Insurance requires that policies containing certain exclusionary endorsements be specifically pointed out to our policyholders. In compliance with this provision this notice is to advise you that one or more of the following exclusionary endorsements may be attached to your policy. These are not all of the exclusions contained in your policy and you are advised to read your policy and all attached endorsements carefully and discuss any questions with your agent or a company representative. ULX 0005 Lead Exclusion ULX 0006 Absolute Asbestos Exclusion LD15270 Silica Dust and Particulate Matter Exclusion X X XX E121 Silica Dust and Particulate Matter Exclusion LD15739 11 04 Page 1 of 1 | 2 |
Claims Directory Primary General Liability and Auto Claims or Loss Notices related to this policy should be reported to the following Claim Office Email and Fax Location ACE First Notices Email P.O. Box 5119 Westchester WSGCASCLAIMSACEGROUP.COM Scranton PA Claims 18505 0549 First Notices Fax 215.640.5041 or 1.877.746.4686 General Correspondence Fax 1 866 635 5688 H or 686 dence Fax 688 MA608255 g 0809 Page 1 of 1 | 2 |
Illinois Union Insurance Company 525 West Monroe Street Suite 400 Chicago IL 60661 NOTICE POLICY NO. G27097121 001 NAME OF INSURED Craneworks Inc. ADDRESS 7795 E. Little York Road Houston Texas 77016 We are pleased to enclose your policy for this account. Please be advised that by binding this risk with the above referenced Surplus Lines Insurance Company you agree that as the Surplus Lines Broker responsible for the placement of this insurance policy it is your obligation to comply with all States Surplus Lines Laws including completion of any declarations affidavits that must be filed as well as payment of any and all Surplus Lines taxes that must be remitted to the States. We will look to you for indemnification if controlling Surplus Lines Laws are violated by you as the Surplus Lines broker responsible for the placement. You further confirm that any applicable state requirement concerning a diligent search for coverage by admitted carriers has been fulfilled in accordance with state law. Thank you for this placement and your regulatory compliance. Date 11202013 WSG084 0511 Page 1 of 1 | 2 |
CNA IMPORTANT INFORMATION NOTICE OFFER OF TERRORISM COVERAGE NOTICE DISCLOSURE OF PREMIUM THIS NOTICE DOES NOT FORM A PART OF YOUR POLICY GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY You are hereby notified that under the Terrorism Risk Insurance Act as extended and reauthorized Act you have a right to purchase insurance coverage of losses arising out of acts of terrorism as defined in Section 1021 of the Act subject to all applicable policy provisions. The Terrorism Risk Insurance Act established a federal program within the Department of the Treasury under which the federal government shares with the insurance industry the risk of loss from future terrorist attacks. This Notice is designed to alert you to coverage restrictions and to certain terrorism provisions in the policy. If there is any conflict between this Notice and the policy including its endorsements the provisions of the policy including its endorsements apply. CHANGE IN THE DEFINITION OF A CERTIFIED ACT OF TERRORISM The Act applies when the Secretary of the Treasury certifies that an event meets the definition of an act of terrorism. Originally the Act provides that to be certified an act of terrorism must cause losses of at least five million dollars and must have been committed by an individual or individuals acting on behalf of any foreign person or foreign interest to coerce the government or population of the United States. However the 2007 reauthorization of the Act no longer requires the act of terrorism to be committed by or on behalf of a foreign interest and certified acts of terrorism now encompass for example a terrorist act committed against the United States government by a United States citizen when the act is determined by the federal government to be a certified act of terrorism. In accordance with the Act we are required to offer you coverage for losses resulting from an act of terrorism that is certified under the federal program. The policy s other provisions including nuclear war or military action exclusions will still apply to such an act. The premium charge for terrorism coverage is shown separately on your Policy Declarations and is also included in the total premium. 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 85 of that portion of the amount of such insured losses that exceeds the applicable insurer retention. LIMITATION ON PAYMENT OF TERRORISM LOSSES applies to policies which cover terrorism losses insured under the federal program including those which only cover fire losses If aggregate insured losses attributable to terrorist acts certified under the Act exceed 100 billion in a Program Year January 1 through December 31 the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. Further this coverage is subject to a limit on our liability pursuant to the federal law where if aggregate insured losses attributable to terrorist acts certified under the Act exceed 100 billion in a Program Year January 1 through December 31 and we have met our insurer deductible under the 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. G144233 F Page 1 of 1 Ed. 0108 2261 16YE1BYE0Y 16000200 | 2 |
Surplus Lines Licensing Information Form CNA THIS INSURANCE CONTRACT WILL BE WRITTEN ON A SURPLUS LINES BASIS. FIRST NAMED INSURED RED OAK HEALTH SERVICES INC INSURED ADDRESS 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 POLICY NUMBER 4034813491 POLICY NUMBER AGENCY BROKERAGE INFORMATION Name Address Telephone FEIN Tax ID AGENCY BROKERAGE SURPLUS LINES LICENSE STATE OF LICENSURE LICENSE NUMBER EFFECTIVE DATE EXPIRATION DATE AGENT BROKER INFORMATION Name Address Telephone FEIN Tax ID AGENT BROKER PC LICENSE STATE OF LICENSURE LICENSE NUMBER EFFECTIVE DATE EXPIRATION DATE GSL5776XX Ed. 1113 Copyright CNA All Rights Reserved | 2 |
Surplus Lines Licensing CNA Information Form METHOD OF REPORTING Select one of the following four surplus lines tax reporting options and enter the requested information for that section as well as for the Premium Allocation section. 1 Iwill submit the surplus lines tax and report relative to my authority as a resident surplus lines licensee. AGENT BROKER SURPLUS LINES LICENSE STATE OF LICENSURE LICENSE NUMBER EFFECTIVE DATE EXPIRAT EFFECTIVE DATE EXPIRATION DATE By Signature of Licensed Resident Surplus Lines AgentBroker 2 I will submit the surplus lines tax and report relative to my authority as a non resident surplus lines licensee. AGENT BROKER NON RESIDENT SURPLUS LINES LICENSE STATE OF LICENSURE LICENSE NUMBER EFFECTIVE DATE EXPIRATION EFFECTIVE DATE EXPIRATION DATE 2002000014034813491192 By Signature of Licensed Non Resident Surplus Lines AgentBroker 3 The services of a clearinghouse will be utilized to submit the surplus lines tax and report. The clearinghouse filer is 4 The services of a courtesy filer will be utilized to submit the surplus lines tax and report. The courtesy filer is PREMIUM ALLOCATION Enter the States to which the payment of Surplus Lines Tax will be made and its percentage. STATE PERCENTAGE OF PREMIUM The cour This Surplus Lines Licensing Information Form should be submitted to HealthcareAgingSvcsSLInfocna.com CNA GSL5776XX Ed. 1113 Copyright CNA All Rights Reserved | 2 |
CNA Long Term Care Commercial Liability Policy Renewal Declaration POLICY NUMBER 4034813491 COVERAGE PROVIDED BY FROM PO COLUMBIA CASUALTY COMPANY 1231201 333 S. WABASH CHICAGO IL. 60604 INSURED NAME AND ADDRESS RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 REFER TO ADDITIONAL NAMED INSUREDS SCHEDULE AGENCY NAME AND ADDRESS LOCKTON COMPANIES LLC 1015 NORTH 98TH ST SUITE 101 OMAHA NE 68114 Phone Number 402970 6100 BRANCH NAME AND ADDRESS HPRO LONG TERM CARE 333 S WABASH AVE 19 SOUTH CHICAGO IL 60604 Phone Number 800863 0341 FROM POLICY PERIOD TO 12312014 12312015 AGENCY NUMBER 064099 BRANCH NUMBER 977 This policy becomes effective and expires at 12 address on the dates shown above. The Named Insured is a Corporation. The Policy Premium is Your Premium includes the following amount for Certified Acts of Terrorism Coverage 01 A.M. standard time at your mailing 153199.00 304.00 153199.00 304.00 Page 12 INSURED | 2 |
POLICY NUMBER 4034813491 POLICY NUMBER INSURED NAME AND ADDRESS 4034813491 RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 IMPORTANT NOTICE THIS POLICY PROVIDES CLAIMS MADE COVERAGE. PLEASE READ IT CAREFULLY ESPECIALLY YOUR DUTIES IN THE EVENT OF A CLAIM AND EXTENDED REPORTING PERIOD SECTIONS. RETROACTIVE DATE 02282003 See G144037 A For Additional Retroactive Dates That May Apply to Your Policy In return for the payment of the premium and subject to all the terms and conditions contained here in we agree to provide the insurance as stated. COVERAGE PARTS Only those COVERAGE PARTS for which a premium is indicated are included in this policy. PROFESSIONAL LIABILITY CLAIMS MADE INCLUDED GENERAL LIABILITY CLAIMS MADE INCLUDED INCLUDED INCLUDED LIMITS OF LIABILITY POLICY AGGREGATE LIMIT OF LIABILITY PROFESSIONAL LIABILITY CLAIMS MADE GENERAL LIABILITY CLAIMS MADE 1000000 Each Claim 3000000 Aggregate Deductible Each Incident Aggregate SIR Each Claim Aggregate Disciplinary Proceedings 1000000 3000000 INCLUDED 5000 1000000 100 000 50000 Each Occurrence Limit General Aggregate Limit Products Completed Operations Aggregate Medical Expense Limit Personal Advertising Injury Limit Damage to Premises Rented To You Limit Legal Media Expenses Emergency Evacuation Expenses Deductible Each Incident Aggregate SIR Each Claim Aggregate 5000 1000000 SIR Each Claim Aggregate 100 000 Disciplinary Proceedings Page 12 INSURED | 2 |
POLICY NUMBER 4034813491 INSURED NAME AND ADDRESS RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 SCHEDULE OF COVERAGES POLICY LEVEL COVERAGES Class Code C00007 Employee Benefits Liability Class Code C00606 Outpatient Therapy Coverage INSURED LOCATIONS SCHEDULE Location 1 1702 HILLCREST DR BELLEVUE NE 68123 Class Code 80904 Exercise Weight Rooms Class Code 80908 Skilled Nursing For Profit Class Code 80920 Assisted Living For Profit Class Code 80920 Assisted Living For Profit Location 2 4609 HILLTOP ST PAPILLION NE 68133 Class Code 80920 Assisted Living For Profit Location 3 1804 HILLCREST DR BELLEVUE NE 68005 Class Code 61226 Buildings or Premises office other than not for profit not otherwise classified. Products completed operations are subject to the General Aggregate Limit. Location 4 11340 S 60TH CT PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Page 12 INSURED | 2 |
POLICY NUMBER 4034813491 INSURED NAME AND ADDRESS RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 INSURED LOCATIONS SCHEDULE Class Code 80908 Skilled Nursing For Profit Location 5 11350 S 60TH CT PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Class Code 80908 Skilled Nursing For Profit Location 6 11380 S 60TH CT PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Class Code 80908 Skilled Nursing For Profit Location 7 11390 S 60TH CT PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Class Code 80908 Skilled Nursing For Profit Location 8 11360 S 60TH CT PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Class Code 80908 Skilled Nursing For Profit Location 9 11370 S 60TH CT PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Class Code 80908 Skilled Nursing For Profit Page 12 INSURED | 2 |
POLICY NUMBER 4034813491 INSURED NAME AND ADDRESS RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 INSURED LOCATIONS SCHEDULE Location 10 6223 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 11 1820 HILLCREST DR BELLEVUE NE 68005 Class Code 80916 Home Health Care For Profit Location 12 6114 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 13 6125 6127 MARK ST PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 14 6110 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Class Code 80905 Independent Living For Profit Location 15 6219 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 16 6119 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 17 6207 GRAND LODGE AVE Page 12 INSURED | 2 |
POLICY NUMBER 4034813491 INSURED NAME AND ADDRESS RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 INSURED LOCATIONS SCHEDULE Location 17 PAPILLION NE 68133 Class Code 80905 Independent Living For Location 18 6216 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Location 19 6227 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Location 20 6220 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Location 21 6102 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Location 22 6127 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Location 23 6119 MARK ST PAPILLION NE 68133 Class Code 80905 Independent Living For Location 24 6121 MARK ST PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Profit Profit Profit Profit Profit Profit Profit Page 12 INSURED | 2 |
POLICY NUMBER 4034813491 INSURED NAME AND ADDRESS RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 INSURED LOCATIONS SCHEDULE Location 25 6082 GRAND LODGE AVE PAPILLION NE 68133 Class Code 61226 Buildings or Premises office other than not for profit not otherwise classified. Products completed operations are subject to the General Aggregate Limit. Class Code 80908 Skilled Nursing For Profit Location 26 6122 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 27 6207 MARK ST PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 28 6205 MARK ST PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 29 6118 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 30 6123 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 31 6072 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80908 Skilled Nursing For Profit Page 12 INSURED | 2 |
POLICY NUMBER 4034813491 INSURED NAME AND ADDRESS RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 INSURED LOCATIONS SCHEDULE Location 32 6208 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 33 6212 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 34 6106 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 35 6204 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 36 6113 MARK ST PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 37 6115 MARK ST PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 38 6131 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 39 6203 GRAND LODGE AVE PAPILLION NE 68133 Page 12 INSURED | 2 |
POLICY NUMBER 4034813491 INSURED NAME AND ADDRESS RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 INSURED LOCATIONS SCHEDULE Class Code 80905 Independent Living For Profit Location 40 6211 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 41 6215 GRAND LODGE AVE PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 42 11382 S 61ST ST PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 43 1902 HARLAN DR SUITE A BELLEVUE NE 68005 Class Code 61226 Buildings or Premises office other than not for profit not otherwise classified. Products completed operations are subject to the General Aggregate Limit. Location 44 11372 S. 61ST STREET PAPILLION NE 68133 Class Code 80905 Independent Living For Profit Location 45 6021 GRAND LODGE AVENUE PAPILLION NE 68133 Class Code 49452 Vacant Land not for profit only. Products completed operations are subject to the General Aggregate Limit. Location 46 6109 MARK STREET PAPILLION NE 68133 Page 12 INSURED | 2 |
POLICY NUMBER 4034813491 INSURED NAME AND ADDRESS RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 INSURED LOCATIONS SCHEDULE Class Code 80905 Independent Living For Profit Location 48 3504 BLACKHAWK DRIVE BELLEVUE NE 68123 Class Code 63010 Dwellings one family lessor s risk only. Products completed operations are subject to the General Aggregate Limit. Location 49 1811 HILLCREST DRIVE BELLEVUE NE 68005 Class Code 47051 Real Estate Development Property. Products completed operations are subject to the General Aggregate Limit. Page 10 of 12 INSURED | 2 |
POLICY NUMBER 4034813491 INSURED NAME AND ADDRESS RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 ADDITIONAL INSURED SCHEDULE Additional Insured Name and Address Fannie Mae ISOA ATIMA c o Lancaster Pollard Mortgage Co 65 E. State St 16th Floor Columbus OH 43215 1lth Floor Columbus OH 43215 TYPE Additional Insured Mortgagee Assignee or Receiver ADDITIONAL NAMED INSUREDS SCHEDULE JORO LLC RED OAK HEALTH SERVICES INC. RED OAK HEALTH SERVICES INC. RED OAK HEALTH SERVICES INC. HILLCREST PROPERTIES INC. RED OAK HEALTH SERVICES INC. DBA HILLCREST HEALTH AND REHAB DBA HILLCREST VICTORIA GARDENS DBA HILLCREST PHYSICAL THERAPY DBA LILLIE S HOUSE Page 11 of 12 INSURED | 2 |
POLICY NUMBER 4034813491 INSURED NAME AND ADDRESS RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 Form Number CG0002 CG0435 CG2018 GSL22746XX GSL2430XX GSL2499XX GSL3842XX GSL5803XX GSL5804XX GSL6672XX G141432B G141433C Gl41442c G142859A G300303A 122007 102001 111985 012011 022013 032008 012008 012009 012009 082009 072010 112012 082009 042002 052006 FORMS AND ENDORSEMENTS SCHEDULE Form Title Commercial General Liability Form Employee Benefits Liability Coverage Add Ins Mortgagee Assignee or Receiver Disciplinary Proceedings Supplementary Payments Pre Claim Assistance Endorsement Media Expenses Endorsement Coverage and Cap on Losses from Certified Acts of Punitive Damages Exclusion GL Punitive Damages Exclusion PL LTC Bridge Endorsement Common Conditions LTC General Liability Amendatory Endorsement LTC Professional Liability Coverage Claims Made Rbuse Molestation Exclusion Endorsement Fellow Employee Bodily Injury Endorsement PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY Form Number Form Title GSL5776XX 112013 Surplus Lines Licensing Information Form G144233F 012008 Notice Offer of Terrorism Disclosure of Premium Countersignature Mum Yoowad MeZarnl Chairman of the Board G141434 A Ed. 0202 Page 12 of 12 INSURED | 2 |
COMMERCIAL GENERAL LIABILITY CG 00021207 COMMERCIAL GENERAL LIABILITY COVERAGE FORM COVERAGES A AND B PROVIDE CLAIMS MADE COVERAGE PLEASE READ THE ENTIRE FORM CAREFULLY Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the Company providing this insurance. The word insured means any person or organization qualifying as such under Section Il Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section VI Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section Il Limits Of Insurance and 2 Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 The bodily injury or property damage did not occur before the Retroactive Date if CG 00021207 Copyright ISO Properties Inc. 2006 any shown in the Declarations or after the end of the policy period and 3 A claim for damages because of the bodily injury or property damage is first made against any insured in accordance with Paragraph c. below during the policy period or any Extended Reporting Period we provide under Section V Extended Reporting Periods. c. A claim by a person or organization seeking damages will be deemed to have been made at the earlier of the following times 1 When notice of such claim is received and recorded by any insured or by us whichever comes first or 2 When we make settlement in accordance with Paragraph a. above. All claims for damages because of bodily injury to the same person including damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury will be deemed to have been made at the time the first of those claims is made against any insured. All claims for damages because of property damage causing loss to the same person or organization will be deemed to have been made at the time the first of those claims is made against any insured. 2. Exclusions This insurance does not apply to a. Expected Or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Contractual Liability Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the absence of the contract or agreement or 2 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs Page 1 of 16 1E6116VE1BPE07 160002002 CG 00021207 | 0 |
subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and b Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. This exclusion applies only if you are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages. d. Workers Compensation And Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law. e. Employer s Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a Employment by the insured or b Performing duties related to the conduct of the insured s business or 2 The spouse child parent brother or sister of that employee as a consequence of Paragraph 1 above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. Page 2 of 16 Copyright I1SO Prc ion of the contract f. the purposes of insured contract s and necessary d by or for a party re deemed to be bodily injury or a ed for or for the cost se has also been same insured s and litigation ense of that party Iternative dispute ing in which this insurance amage for which by reason of the intoxication of ic beverages to a drinking age or hol or regulation relating ution or use of if you are in the istributing selling beverages. Similar Laws under a workers benefits or law or any similar b ired arising out of c sured or related to i s business or brother or sister consequence of the r the insured may or in any other gation to share ne else who must njury. apply to liability nder an insured Copyright ISO Properties Inc. 2006 Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants At or from any premises site or location which is or was at any time owned or occupied by or rented or loaned to any insured. However this subparagraph does not apply to i Bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or originating from equipment that is used to heat cool or dehumidify the building or equipment that is used to heat water for personal use by the building s occupants or their guests Bodily injury or property damage for which you may be held liable if you are a contractor and the owner or lessee of such premises site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not or never was owned or occupied by or rented or loaned to any insured other than that additional insured or Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire At or from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste Which are or were at any time transported handled stored treated disposed of or processed as waste by or for i Any insured or ii Any person or organization for whom you may be legally responsible or At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by such insured i CG 00021207 | 1 |
e contractor or subcontractor. However this subparagraph does not apply to i Bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or released as part of the operations being performed by such insured contractor or subcontractor i Bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the operations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a b CG 00021207 Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or g. Aircraft Bodily in of the entrustme watercraff loaned to and load This exclt any inst wrongdoir employme that insur the bodil the owner to others is owned any insure This exclt 1 Awa own 2 Awat L b N p 3 Parki to pr auto to you 4 Liabil contr use o 5 Bodi out of T e 9 b T 0 0 e Copyright ISO Properties Inc. 2006 in any way responding to or assessing the effects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a governmental authority. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured 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 in the state where it is licensed or principally garaged or The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definition of mobile equipment. b 2661 16YE18VE0Y 16000200 Page 3 of 16 | 1 |
h. Mobile Equipment To Premi Bodily injury or property damage arising out Section Il of Paragrap 1 The transportation of mobile equipment by the premi an auto owned or operated by or rented or occupied loaned to any insured or Paragrap 2 The use of mobile equipment in or while dp not in practice for or while being prepared for sidetrack any prearranged racing speed demolition Paragrap or stunting activity. property i. War completec Bodily injury or property damage however k. Damage caused arising directly or indirectly out of Property 1 War including undeclared or civil war ofitor an 2 Warlike action by a military force including I Damage action in hindering or defending against an Property actual or expected attack by any itorany government sovereign or other authority complete using military personnel or other agents or This excl 3 Insurrection rebellion revolution usurped work or power or action taken by governmental arises W authority in hindering or defending against subcontra any of these. m. Damage j. Damage To Property Not Phys Property damage to Property 1 Property you own rent or occupy including property any costs or expenses incurred by you or arising ou any other person organization or entity for 1 A d repair replacement enhancement dange restoration or maintenance of such property your for any reason including prevention of ini. 2 A del injury to a person or damage to another s on y property agree 2 Premises you sell give away or abandon if Ve dl This exclt the property damage arises out of any part of other of those premises accidenta 3 Property loaned to you your wor 4 Personal property in the care custody or use. control of the insured n. Recall 5 That particular part of real property on Property which you or any contractors or Damages subcontractors working directly or indirectly incurred on your behalf are performing operations if withdrawe the property damage arises out of those replacems operations or of 6 That particular part of any property that 1 Your must be restored repaired or replaced 2 Your because your work was incorrectly. performed on it. 3 Impz Paragraphs 1 3 and 4 of this exclusion do if such pr not apply to property damage other than or recalle damage by fire to premises including the person or contents of such premises rented to you for a suspectec period of 7 or fewer consecutive days. A dangerou separate limit of insurance applies to Damage Page 4 of 16 Copyright ISO Properties Inc. 2006 To Premises Rented To You as described in Section Il Limits Of Insurance. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard. Damage To Your Product Property damage to your product arising out of it or any part of it. Damage To Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor.. Damage To Impaired Property Or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 A defect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use. Recall Of Products Work Or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it. CG 00021207 | 1 |
o. Personal And Advertising Injury Bodily injury arising out of personal and advertising injury. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. 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. Distribution Of Material In Violation Of Statutes Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law or 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law or 3 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. Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section Il Limits Of Insurance. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement CG 00021207 We will pay those sums that the insured becomes legally obligated to pay as damages because of personal and advertising injury to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for personal and advertising injury to which this insurance does not apply. We may at our discretion investigate any offense and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section Il Limits Of Insurance and 2 Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settle medic No other perform explicitly Payments This ins advertisin out of you 1 The perioc 3 A cl pers made with perioc we p Repo A claim seeking d made at t 1 Wher recort whick 2 Wher with F Al claims and adve organizati deemed t of those 2. Exclusions This insuranc Knowing Personal at the knowledg of anoth advertisin Material Falsity Personal oral or wr or at the of its falsi Material Personal oral or wr publicatio Date if ar Copyright ISO Properties Inc. 2006 settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. This insurance applies to personal and advertising injury caused by an offense arising out of your business but only if 1 The offense was committed in the coverage territory 2 The offense was not committed before the Retroactive Date if any shown in the Declarations or after the end of the policy period and 3 A claim for damages because of the personal and advertising injury is first made against any insured in accordance with Paragraph c. below during the policy period or any Extended Reporting Period we provide under Section V Extended Reporting Periods. A claim made by a person or organization seeking damages will be deemed to have been made at the earlier of the following times 1 When notice of such claim is received and recorded by any insured or by us whichever comes first or 2 When we make settlement in accordance with Paragraph a. above. All claims for damages because of personal and advertising injury to the same person or organization as a result of an offense will be deemed to have been made at the time the first of those claims is made against any insured. 2. Exclusions This insurance does not apply to Knowing Violation Of Rights Of Another Personal and advertising injury caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising injury. Material Published With Knowledge Of Falsity Personal and advertising injury arising out of oral or written publication of material if done by or at the direction of the insured with knowledge of its falsity. Material Published Prior To Policy Period Personal and advertising injury arising out of oral or written publication of material whose first publication took place before the Retroactive Date if any shown in the Declarations. E6H16YE18VE0Y 16000200 Page 5 of 16 | 1 |
Page 6 of 16 Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement. Breach Of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s advertising idea in your advertisement. Quality Or Performance Of Goods Failure To Conform To Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your advertisement. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Infringement of Copyright Patent Trademark Or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trademark trade secret or other intellectual property rights. Under this exclusion such other intellectual property rights do not include the use of another s advertising idea in your advertisement. However this exclusion does not apply to infringement in your advertisement of copyright trade dress or slogan. Insureds In Media And Internet Type Businesses Personal and advertising injury committed by an insured whose business is 1 Advertising broadcasting publishing or telecasting 2 Designing or determining content or web sites for others or 3 An Internet search access content or service provider. However this exclusion does not apply to Paragraphs 14.a. b. and c. of personal and advertising injury under the Definitions Section. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting. Copyright ISO Properties Inc. 2006 k. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the insured hosts owns or over which the insured exercises control. Unauthorized Use Of Another s Name Or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain name or metatag or any other similar tactics to mislead another s potential customers.. Pollution Personal and advertising injury arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants at any time. Pollution Related Any loss cost or expense arising out of any 1 Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. Distribution Of Material In Violation Of Statutes Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law or 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law or 3 CG 00021207 | 1 |
3 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. COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement We will pay medical expenses as described below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that a The accident takes place in the coverage territory and during the policy period b The expenses are incurred and reported to us within one year of the date of the accident and c The injured person submits to examination at our expense by physicians of our choice as often as we reasonably require. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for 1 First aid administered at the time of an accident 2 Necessary medical surgical x ray and dental services including prosthetic devices and 3 Necessary ambulance hospital professional nursing and funeral services. 2. Exclusions We will not pay expenses for bodily injury Any Insured To any insured except volunteer workers. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. Workers Compensation And Similar Laws To a person whether or not an employee of any insured if benefits for the bodily injury are payable or must be provided under a workers compensation or disability benefits law or a similar law. regulation other PAM Act of 2003 s the sending ing or distribution ses as described d by an accident ent S you own or rent S s place in the and during the incurred and one year of the ind on submits to Irexpense by ice as often as we nts regardless of not exceed the e. We will pay t the time of an gical x ray and iding prosthetic ce hospital uneral services. ly injury eer workers. for or on behalf of insured. i Premises rt of premises you rmally occupies. Similar Laws an employee of bodily injury are under a workers enefits law or a e. Athletics Activities To a person injured while practicing instructing or participating in any physical exercises or games sports or athletic contests. Products Completed Operations Hazard Included within the products completed operations hazard. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS COVERAGES A AND B 1. We will pay with respect to any claim we investigate or settle or any suit against an insured we defend a. b. All expenses we incur. Up to 250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. The cost of bonds to release attachments but only for bond amounts within the applicable limit of insurance. We do not have to fumish these bonds. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from work. All court costs taxed against the insured in the suit. However these payments do not include attorneys fees or attorneys expenses taxed against the insured. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment interest based on that period of time after the offer. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance. If we defend an insured against a suit and an indemnitee of the insured is also named as a party to the sui we will defend that indemnitee if all of the following conditions are met The suit against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an insured contract This insurance applies to such liability assumed by the insured Copyright ISO Properties Inc. 2006 Page 7 of 16 VEGHIGYEIBYE0Y 16000200 CG 00021207 Page 7 of 16 | 1 |
c. The obligation to defend or the cost of the defense of that indemnitee has also been assumed by the insured in the same insured contract d. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the insured and the indemnitee and f. The indemnitee 1 Agrees in writing to a Cooperate with us in the investigation settlement or defense of the suit Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit c Notify any other insurer whose coverage is available to the indemnitee and Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee and 2 Provides us with written authorization to a Obtain records and other information related to the suit and b Conduct and control the defense of the indemnitee in such suit. So long as the above conditions are met attorneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.2 of Section Coverage A Bodily Injury And Property Damage Liability such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the limits of insurance. Our obligation to defend an insured s indemnitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above or the terms of the agreement described in Paragraph f. above are no longer met. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. Page 8 of 16 b d A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. Each of the following is also an insured Copyright ISO Properties Inc. 2006 Your volunteer workers only while performing duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a partnership joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees or volunteer workers are insureds for 1 Bodily injury or personal and advertising injury a To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company to a coemployee while in the course of his or her employment or performing duties related to the conduct of your business or to your other volunteer workers while performing duties related to the conduct of your business To the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of Paragraph a above c For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs or b above or Arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b CG 00021207 | 1 |
b Rented to in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees volunteer workers any partner or member if you are a partnership or joint venture or any member if you are a limited liability company. b. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that property and 2 Until your legal representative has been appointed. d. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown as aNamed Insured in the Declarations. SECTION Ill LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C CG 00021207 Copyright ISO Properties Inc. 2006 b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. 3. The Products Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. 4. Subject to Paragraph 2. above the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all personal and advertising injury sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above whichever applies the Each Occurrence Limit is the most we will pay for the sum of a. Damages under Coverage A and b. Medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to Paragraph 5. above the Damage To Premises Rented To You Limit is the most we wil pay under Coverage A for damages because of property damage to any one premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence Offense Claim Or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or offense which may result in a claim. To the extent possible notice should include 1 How when and where the occurrence or offense took place COMMERCIAL GENERAL Page 9 of 16 SE6HI6YE1BVE0Y 16000200 Page 9 of 16 | 1 |
2 The names and addresses of any injured persons and witnesses and 3 The nature and location of any injury or damage arising out of the occurrence or offense. Notice of an occurrence or offense is not notice of a claim. b. If a claim is received by any insured you must 1 Immediately record the specifics of the claim and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or a suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent. Legal Action Against Us No person or organization has a right under this Coverage Part a. Tojoin us as a party or otherwise bring us into a suit asking for damages from an insured or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us the insured and the claimant or the claimant s legal representative. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part our obligations are limited as follows es of any injured d of any injury or e occurrence or or offense is not sured you must specifics of the able. sured must copies of any monses or legal nection with the ecords and other e investigation or r defense against request in the gainst any person y be liable to the ry or damage to also apply. at insured s own nent assume any se other than for 2 right under this ise bring us into a an insured or art unless all of its d with. us to recover on judgment against for damages that of this Coverage applicable limit of ment means a signed by us the claimant s legal nce is available to der Coverages A Ir obligations are Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method described in Paragraph c. below. Excess Insurance 1 This insurance is excess over a Any of the other insurance whether primary excess contingent or on any other basis i That is effective prior to the beginning of the policy period shown in the Declarations of this insurance and applies to bodily injury or property damage on other than a claims made basis if i. No Retroactive Date is shown in the Declarations of this insurance or ii. The other insurance has a policy period which continues after the Retroactive Date shown in the Declarations of this insurance i That is Fire Extended Coverage Builders Risk Installation Risk or similar coverage for your work iii That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner iv That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner or If the loss arises out of the maintenance or use of aircraft autos or watercraft to the extent not subject to Exclusion g. of Section Coverage A Bodily Injury And Property Damage Liability. b Any other primary insurance available to you covering liability for damages arising out of the premises or operations or the products and completed operations for which you have been added as an additional insured by attachment of an endorsement. 2 When this insurance is excess we will have no duty under Coverages A or B to defend the insured against any suit if any other insurer has a duty to defend the insured V Copyright ISO Properties Inc. 2006 CG 00021207 Page 10 of 16 | 1 |
against that suit. If no other insurer defends we will undertake to do so but we will be entitled to the insured s rights against all those other insurers. When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of a The total amount that all such other insurance would pay for the loss in the absence of this insurance and b The total of all deductible and self insured amounts under all that other insurance. We will share the remaining loss if any with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. Method Of Sharing If all of the other insurance permits contribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 4 5. Premium Audit We will compute all premiums for this Coverage Part in accordance with our rules and rates. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium we will return the excess to the first Named Insured. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. 6. Representations By accepting this policy you agree The statements in the Declarations are accurate and complete no other insurer e to do so but we insured s rights urers. 2Xcess over other y our share of the that exceeds the at all such other for the loss in the ince and Juctible and self der all that other ning loss if any ce that is not xcess Insurance ight specifically to imits of Insurance 5 of this Coverage 2rmits contribution this method also. 1surer contributes aid its applicable the loss remains does not permit we will contribute d each insurers its applicable limit plicable limits of for this Coverage les and rates. overage Part as premium only. At i we will compute period and send red. The due date miums is the date bill. If the sum of iums paid for the han the earned 2xcess to the first t keep records of d for premium ies at such times tions are accurate 10. b. Those statements are based upon representations you made to us and c. We have issued this policy in reliance upon your representations. Separation Of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this Coverage Part to the first Named Insured this insurance applies a. As if each Named Insured were the only Named Insured and b. Separately to each insured against whom claim is made or suit is brought. Transfer Of Rights Of Recovery Against Others ToUs If the insured has rights to recover all or part of any payment we have made under this Coverage Part those rights are transferred to us. The insured must do nothing after loss to impair them. At our request the insured will bring suit or transfer those rights to us and help us enforce them. When We Do Not Renew If we decide not to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. Your Right To Claim And Occurrence Information We will provide the first Named Insured shown in the Declarations the following information relating to this and any preceding general liability claims made Coverage Part we have issued to you during the previous three years a. A list or other record of each occurrence not previously reported to any other insurer of which we were notified in accordance with Paragraph 2.a. of the Section IV Duties In The Event Of Occurrence Offense Claim Or Suit Condition. We will include the date and brief description of the occurrence if that information was in the notice we received. b. A summary by policy year of payments made and amounts reserved stated separately under any applicable General Aggregate Limit and Products Completed Operations Aggregate Limit. Amounts reserved are based on our judgment. They are subject to change and should not be regarded as ultimate settlement values. You must not disclose this information to any claimant or any claimant s representative without our consent. If we cancel or elect not to renew this Coverage Part we will provide such information no later than Copyright ISO Properties Inc. 2006 Page 11 of 16 9E6116YE18VE0Y 16000200 CG 00021207 | 1 |
30 days before the date of policy termination. In other circumstances we will provide this information only if we receive a written request from the first Named Insured within 60 days after the end of the policy period. In this case we will provide this information within 45 days of receipt of the request. We compile claim and occurrence information for our own business purposes and exercise reasonable care in doing so. In providing this information to the first Named Insured we make no representations or warranties to insureds insurers or others to whom this information is furnished by or on behalf of any insured. Cancellation or non renewal will be effective even if we inadvertently provide inaccurate information. SECTION V EXTENDED REPORTING PERIODS 1. We will provide one or more Extended Reporting Periods as described below if a. This Coverage Part is canceled or not renewed or b. We renew or replace this Coverage Part with insurance that 1 Has a Retroactive Date later than the date shown in the Declarations of this Coverage Part or 2 Does not apply to bodily injury property damage or personal and advertising injury on a claims made basis. 2. Extended Reporting Periods do not extend the policy period or change the scope of coverage provided. They apply only to claims for a. Bodily injury or property damage that occurs before the end of the policy period but not before the Retroactive Date if any shown in the Declarations or b. Personal and advertising injury caused by an offense committed before the end of the policy period but not before the Retroactive Date if any shown in the Declarations. Once in effect Extended Reporting Periods may not be canceled. 3. A Basic Extended Reporting Period is automatically provided without additional charge. This period starts with the end of the policy period and lasts for a. Five years with respect to claims because of bodily injury and property damage arising out of an occurrence reported to us not later than 60 days after the end of the policy period in accordance with Paragraph 2.a. of the Section IV Duties In The Event Of Occurrence Offense Claim Or Suit Condition b. Five years with respect to claims because of personal and advertising injury arising out of an offense reported to us not later than 60 days after the end of the policy period in accordance with Paragraph 2.a. of the Section IV Duties In The Event Of Occurrence Offense Claim Or Suit Condition and Page 12 of 16 Copyright ISO Prc cy termination. In e this information est from the first ter the end of the will provide this pt of the request. nformation for our easonable care in to the first Named or warranties to this information is d. Cancellation or we inadvertently IG PERIODS tended Reporting d or not renewed overage Part with ater than the date 5 of this Coverage injury property and advertising asis. t extend the policy overage provided. mage that occurs y period but not any shown in the Iry caused by an end of the policy stroactive Date if g Periods may not d is automatically rge. This period riod and lasts for laims because of amage arising out us not later than policy period in.a. of the Section Of Occurrence on laims because of Iry arising out of later than 60 days od in accordance tion IV Duties In ffense Claim Or c. Sixty days with respect to claims arising from occurrences or offenses not previously reported to us. The Basic Extended Reporting Period does not apply to claims that are covered under any subsequent insurance you purchase or that would be covered but for exhaustion of the amount of insurance applicable to such claims. The Basic Extended Reporting Period does not reinstate or increase the Limits of Insurance. A Supplemental Extended Reporting Period of unlimited duration is available but only by an endorsement and for an extra charge. This supplemental period starts when the Basic Extended Reporting Period set forth in Paragraph 3. above ends. You must give us a written request for the endorsement within 60 days after the end of the policy period. The Supplemental Extended Reporting Period will not go into effect unless you pay the additional premium promptly when due. We will determine the additional premium in accordance with our rules and rates. In doing so we may take into account the following a. The exposures insured b. Previous types and amounts of insurance c. Limits of Insurance available under this Coverage Part for future payment of damages and d. Other related factors. The additional premium will not exceed 200 of the annual premium for this Coverage Part. This endorsement shall set forth the terms not inconsistent with this Section applicable to the Supplemental Extended Reporting Period including a provision to the effect that the insurance afforded for claims first received during such period is excess over any other valid and collectible insurance available under policies in force after the Supplemental Extended Reporting Period starts. If the Supplemental Extended Reporting Period is in effect we will provide the supplemental aggregate limits of insurance described below but only for claims first received and recorded during the Supplemental Extended Reporting Period. The supplemental aggregate limits of insurance will be equal to the dollar amount shown in the Declarations in effect at the end of the policy period for such of the following limits of insurance for which a dollar amount has been entered General Aggregate Limit Products Completed Operations Aggregate Limit Paragraphs 2. and 3. of Section ll Limits Of Insurance will be amended accordingly. The Personal and Advertising Injury Limit the Each Occurrence Limit and the Damage To Premises Rented To You Limit shown in the Declarations will Copyright ISO Properties Inc. 2006 CG 00021207 | 1 |
then continue to apply as set forth in Paragraphs 4. 5. and 6. of that Section. SECTION VI DEFINITIONS 1. Advertisement means a notice that is broadcast or published to the general public or specific market segments about your goods products or services for the purpose of attracting customers or supporters. For the purposes of this definition a. Notices that are published include material placed on the Internet or on similar electronic means of communication and b. Regarding web sites only that part of a web site that is about your goods products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. Auto means a. A land motor vehicle trailer or semitrailer designed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. However auto does not include mobile equipment. 3. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time. 4. Coverage territory means a. The United States of America including its territories and possessions Puerto Rico and Canada b. International waters or airspace but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above or c. All other parts of the world if the injury or damage arises out of 1 Goods or products made or sold by you in the territory described in Paragraph a. above The activities of a person whose home is in the territory described in Paragraph a. above but is away for a short time on your business or Personal and advertising injury offenses that take place through the Internet or similar electronic means of communication provided the insured s responsibility to pay damages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to. 5. Employee includes a leased worker. Employee does not include a temporary worker. 6. Executive officer means a person holding any of the officer positions created by your charter CG 00021207 3 Copyright ISO Properties Inc. 2006 constitution by laws or any other similar governing document. Hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be. Impaired property means tangible property other than your product or your work that can not be used or is less useful because a. ltincorporates your product or your work that is known or thought to be defective deficient inadequate or dangerous or b. You have failed to fulfill the terms of a contract or agreement if such property can be restored to use by the repair replacement adjustment or removal of your product or your work or your fulfilling the terms of the contract or agreement. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract A sidetrack agreement Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality e. An elevator maintenance agreement f. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks roadbeds tunnel underpass or crossing That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys Page 13 of 16 LE6HIGYEIBYE0Y 16000200 | 1 |
field orders change orders or drawings and specifications or b Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or 3 Under which the insured if an architect engineer or surveyor assumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in Paragraph 2 above and supervisory inspection architectural or engineering activities. 10. Leased worker means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker. 11. Loading or unloading means the handling of property a. After it is moved from the place where it is accepted for movement into or onto an aircraft watercraft or auto b. While it is in or on an aircraft watercraft or auto or c. While it is being moved from an aircraft watercraft or auto to the place where it is finally delivered but loading or unloading does not include the movement of property by means of a mechanical device other than a hand truck that is not attached to the aircraft watercraft or auto. 12. Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment a. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads b. Vehicles maintained for use solely on or next to premises you own or rent c. Vehicles that travel on crawler treads d. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers e. Vehicles not described in Paragraph a. b.. 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 13. 14. clean and v 2 Chen raise Vehicles 1 d. above other tha cargo. However following equipmen be consid 1 Equip a b F c c S 2 Chen on au raise 3 Air incluc clean and v However mc vehicles that 2 responsibility law in the stz garaged. Lan financial resp insurance law Occurrence continuous or same general Personal an including cons one or more 0 a. b. c. False arre Malicious The wron or invasio room dv occupies owner lar Oral or v material organizati organizati Oral or v material tt The use advertise Infringing or slogan Page 14 of 16 Copyright ISO Properties Inc. 2006 13. 14. cleaning geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers f. Vehicles not described in Paragraph a. b.. 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 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. However mobile equipment does not include land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state 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. Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution c. The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies committed by or on behalf of its owner landlord or lessor d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services e. Oral or written publication in any manner of material that violates a person s right of privacy f. The use of another s advertising idea in your advertisement or g. Infringing upon another s copyright trade dress or slogan in your advertisement. 3 Page 14 of 16 CG 00021207 | 1 |
15. Pollutants mean any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals and waste. Waste includes materials to be recycled reconditioned or reclaimed. 16. Products completed operations hazard a. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 Products that are still in your physical possession or 2 Work that has not yet been completed or abandoned. However your work will be deemed completed at the earliest of the following times a When all of the work called for in your contract has been completed. 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. When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. b. Does not include bodily injury or property damage arising out of 1 The transportation of property unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you and that condition was created by the loading or unloading of that vehicle by any insured 2 The existence of tools uninstalled equipment or abandoned or unused materials or 3 Products or operations for which the classification listed in the Declarations or in a policy schedule states that products completed operations are subject to the General Aggregate Limit. 17. Property damage means a. Physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. CG 00021207 b c Copyright ISO Properties Inc. 2006 For the purposes of this insurance electronic data is not tangible property. As used in this definition electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMS tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. 18. Suit means a civil proceeding in which damages because of bodily injury property damage or personal and advertising injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 19. Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. 20. Volunteer worker means a person who is not your employee and who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other compensation by you or anyone else for their work performed for you. 21. Your product a. Means 1 Any goods or products other than real property manufactured sold handled distributed or disposed of by a You b Others trading under your name or c A person or organization whose business or assets you have acquired and 2 Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 22. Your work a. Means Page 15 of 16 BE6H16YE18VE0Y 16000200 Page 15 of 16 | 1 |
1 Work or operations performed by you or on your behalf and 2 Materials parts or equipment furnished in connection with such work or operations. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your work and 2 The providing of or failure to provide warnings or instructions. Page 16 of 16 Copyright ISO Properties Inc. 2006 CG 00021207 | 1 |
POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 04351001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYEE BENEFITS LIABILITY COVERAGE THIS ENDORSEMENT PROVIDES CLAIMS MADE COVERAGE. PLEASE READ THE ENTIRE ENDORSEMENT CAREFULLY. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Coverage Limit Of Insurance Deductible Premium Employee Benefits Programs 1000000 each 1000 each INCLUDED employee employee 1000000 aggregate Retroactive Date 02282003 If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. A. The following is added to Section Coverages No other obligation or liability to pay sums COVERAGE EMPLOYEE BENEFITS LIABILITY or perform acts or services is covered unless explicitty provided for under 1. Insuring Agreement Supplementary Payments. a. We will pay those sums that the insured b. This insurance applies to damages only if becomes legally obligated to pay as damages because of any act error or omission of the insured or of any other person for whose acts the insured is legally liable to which this insurance applies. We 1 The act error or omission is negligently committed in the administration of your employee benefit program will have the right and duty to defend the 2 The act error or omission did not take insured against any suit seeking those place before the Retroactive Date if damages. However we will have no duty to any shown in the Schedule nor after defend the insured against any suit the end of the policy period and seeking damages to which this insurance 3 A claim for damages because of an does not apply. We may at our discretion act error or omission is first made invgstigate any report of an act eror or against any insured in accordance with omission and settle any claim or suit that Paragraph c. below during the policy may result. But period or an Extended Reporting Period 1 The amount we will pay for damages is we provide under Paragraph G. of this limited as described in Paragraph E. endorsement. Section Il Limits Of Insurance and c. A claim seeking damages will be deemed 2 Our right and duty to defend ends when to have been made at the earlier of the we have used up the applicable limit of following times insurance in the payment of judgments 1 When notice of such claim is received or settlements. and recorded by any insured or by us e Y e No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments. This insurance applies to damages only if 1 The act error or omission is negligently committed in the administration of your employee benefit program 2 The act error or omission did not take place before the Retroactive Date if any shown in the Schedule nor after the end of the policy period and 3 A claim for damages because of an act error or omission is first made against any insured in accordance with Paragraph c. below during the policy period or an Extended Reporting Period we provide under Paragraph G. of this endorsement. A claim seeking damages will be deemed to have been made at the earlier of the following times 1 When notice of such claim is received and recorded by any insured or by us whichever comes first or 6E6H16YE18VE07 16000200 CG 04351001 IS0 Properties Inc. 2000 Page 1 of 6 | 2 |
2 When we make settlement in accordance with Paragraph 1.a. above. A claim received and recorded by the insured within 60 days after the end of the policy period will be considered to have been received within the policy period if no subsequent policy is available to cover the claim. d. All claims for damages made by an employee because of any act error or omission or a series of related acts errors or omissions including damages claimed by such employee s dependents and beneficiaries will be deemed to have been made at the time the first of those claims is made against any insured. Exclusions This insurance does not apply to Dishonest Fraudulent Criminal Or Malicious Act Damages arising out of any intentional dishonest fraudulent criminal or malicious act error or omission committed by any insured including the willful or reckless violation of any statute. Bodily Injury Property Damage Or Personal And Advertising Injury Bodily injury property damage or personal and advertising injury. Failure To Perform A Contract Damages arising out of failure of performance of contract by any insurer. Insufficiency Of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the employee benefit program. Inadequacy Of Performance Of Investment Advice Given With Respect To Participation Any claim based upon 1 Failure of any investment to perform 2 Errors in providing information on past performance of investment vehicles or 3 Advice given to any person with respect to that person s decision to participate or not to participate in any plan included in the employee benefit program. f. Workers Compensation And Similar Laws Any claim arising out of your failure to comply with the mandatory provisions of any workers compensation unemployment compensation insurance social security or disability benefits law or any similar law. g. ERISA Damages for which any insured is liable because of liability imposed on a fiduciary by the Employee Retirement Income Security Act of 1974 as now or hereafter amended or by any similar federal state or local laws. h. Available Benefits Any claim for benefits to the extent that such benefits are available with reasonable effort and cooperation of the insured from the applicable funds accrued or other collectible insurance. i. Taxes Fines Or Penalties Taxes fines or penalties including those imposed under the Internal Revenue Code or any similar state or local law. j. Employment Related Practices Damages arising out of wrongful termination of employment discrimination or other employment related practices. For the purposes of the coverage provided by this endorsement 1. All references to Supplementary Payments Coverages A and B are replaced by Supplementary Payments Coverages A B and Employee Benefits Liability. 2. Paragraphs 1.b. and 2. of the Supplementary Payments provision do not apply. For the purposes of the coverage provided by this endorsement Paragraphs 2. and 4. of Section Il Who Is An Insured are replaced by the following 2. Each of the following is also an insured a. Each of your employees who is or was authorized to administer your employee benefit program. b. Any persons organizations or employees having proper temporary authorization to administer your employee benefit program if you die but only until your legal representative is appointed. c. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Endorsement. Page 2 of 6 IS0 Properties Inc. 2000 CG 04351001 | 2 |
4. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if no other similar insurance applies to that organization. However Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier. Coverage under this provision does not apply to any act error or omission that was committed before you acquired or formed the organization. D. For the purposes of the coverage provided by this endorsement Paragraph 3. of Section Il Who Is An Insured does not apply. E. For the purposes of the coverage provided by this endorsement Section Ill Limits Of Insurance is replaced by the following 1. Limits Of Insurance The Limits of Insurance shown in the Schedule and the rules below fix the most we will pay regardless of the number of 1 Insureds 2 Claims made or suits brought 3 Persons or organizations making claims or bringing suits 4 Acts errors or omissions or 5 Benefits included in your employee benefit program. The Aggregate Limit is the most we will pay for all damages because of acts errors or omissions negligently committed in the administration or your employee benefit program. Subject to the Aggregate Limit the Each Employee Limit is the most we will pay for all damages sustained by any one employee including damages sustained by such employee s dependents and beneficiaries as a result of 1 An act error or omission or 2 A series of related acts errors or omissions negligently committed in the administration of your employee benefit program. However the amount paid under this endorsement shall not exceed and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the employee benefit program. The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations of the policy to which this endorsement is attached unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits Of Insurance. Deductible a. Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of the deductible amount stated in the Schedule as applicable to Each Employee. The limits of insurance shall not be reduced by the amount of this deductible. b. The deductible amount stated in the Schedule applies to all damages sustained by any one employee including such employee s dependents and beneficiaries because of all acts errors or omissions to which this insurance applies. c. The terms of this insurance including those with respect to 1 Our right and duty to defend any suits seeking those damages and 2 Your duties and the duties of any other involved insured in the event of an act error or omission or claim apply irrespective of the application of the deductible amount. d. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification of the action taken you shall promptly reimburse us for such part of the deductible amount as we have paid. OVBHIGYEIBYE0Y 16000200 CG 04351001 IS0 Properties Inc. 2000 Page 3 of 6 | 2 |
F. For the purposes of the coverage provided by this endorsement Conditions 2. and 4. of Section IV Conditions are replaced by the following 2. Duties In The Event Of An Act Error Or Omission Or Claim Or S a. You must see to it that we are notified as soon as practicable of an act error or omission which may result in a claim. To the extent possible notice should include 1 What the act error or omission was and when it occurred and 2 The names and addresses of anyone who may suffer damages as a result of the act error or omission. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit Authorize us to obtain records and other information Cooperate with us in the investigation or settlement of the claim or defense against the suit and Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of an act error or omission to which this insurance may also apply. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense without our consent. 3 4 Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this endorsement our obligations are limited as follows Primary Insurance This insurance is primary except when b. below applies. If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method described in. below. Excess Insurance This insurance is excess over any of the other insurance whether primary excess contingent or on any other basis 1 That is effective prior to the beginning of the policy period shown in the Schedule of this insurance and that applies to an act error or omission on other than a claims made basis if a No Retroactive Date is shown in the Schedule of this insurance or b The other insurance has a policy period which continues after the Retroactive Date shown in the Schedule of this insurance. When this insurance is excess we will have no duty to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be entited to the insured s rights against all those other insurers. When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of the total amount that all such other insurance would pay for the loss in absence of this insurance and the total of all deductible and self insured amounts under all that other insurance. We will share the remaining loss if any with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Schedule of this endorsement. Page 4 of 6 IS0 Properties Inc. 2000 CG 04351001 | 2 |
c. Method Of Sharing If all of the other insurance permits contribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limits of insurance of all insurers. G. For the purposes of the coverage provided by this endorsement the following Extended Reporting Period provisions are added or if this endorsement is attached to a claims made Coverage Part replaces any similar Section in that Coverage Part EXTENDED REPORTING PERIOD 1. You will have the right to purchase an Extended Reporting Period as described below if a. This endorsement is canceled or not renewed or b. We renew or replace this endorsement with insurance that 1 Has a Retroactive Date later than the date shown in the Schedule of this endorsement or 2 Does not apply to an act error or omission on a claims made basis. The Extended Reporting Period does not extend the policy period or change the scope of coverage provided. It applies only to claims for acts errors or omissions that were first committed before the end of the policy period but not before the Retroactive Date if any shown in the Schedule. Once in effect the Extended Reporting Period may not be canceled. An Extended Reporting Period of unlimited duration is available but only by an endorsement and for an extra charge. You must give us a written request for the endorsement within 60 days after the end of the policy period. The Extended Reporting Period will not go into effect unless you pay the additional premium promptly when due. We will determine the additional premium in accordance with our rules and rates. In doing s0 we may take into account the following a. The employee benefit programs insured b. Previous types and amounts of insurance c. Limits of insurance available under this endorsement for future payment of damages and d. Other related factors. The additional premium will not exceed 200 of the annual premium for this endorsement. The Extended Reporting Period endorsement applicable to this coverage shall set forth the terms not inconsistent with this Section applicable to the Extended Reporting Period including a provision to the effect that the insurance afforded for claims first received during such period is excess over any other valid and collectible insurance available under policies in force after the Extended Reporting Period starts. 4. If the Extended Reporting Period is in effect we will provide an extended reporting period aggregate limit of insurance described below but only for claims first received and recorded during the Extended Reporting Period. The extended reporting period aggregate limit of insurance will be equal to the dollar amount shown in the Schedule of this endorsement under Limits of Insurance. Paragraph E.1.b. of this endorsement will be amended accordingly. The Each Employee Limit shown in the Declarations will then continue to apply as set forth in Paragraph E.1.c. H. For the purposes of the coverage provided by this endorsement the following definitions are added to the Definitions Section 1. Administration means a. Providing information to employees including their dependents and beneficiaries with respect to eligibility for or scope of employee benefit programs b. Handling records in connection with the employee benefit program or c. Effecting continuing or terminating any employee s participation in any benefit included in the employee benefit program. However administration does not include handling payroll deductions. Y51 L6VEIBPE0Y 160002002 CG 04351001 IS0 Properties Inc. 2000 Page 5 of 6 | 2 |
Cafeteria plans means plans authorized by applicable law to allow employees to elect to pay for certain benefits with pre tax dollars. Claim means any demand or suit made by an employee or an employee s dependents and beneficiaries for damages as the result of an act error or omission. Employee benefit program means a program providing some or all of the following benefits to employees whether provided through a cafeteria plan or otherwise a. Group life insurance group accident or health insurance dental vision and hearing plans and flexible spending accounts provided that no one other than an employee may subscribe to such benefits and such benefits are made generally available to those employees who satisfy the plan s eligibility requirements b. Profit sharing plans employee savings plans employee stock ownership plans pension plans and stock subscription plans provided that no one other than an employee may subscribe to such benefits and such benefits are made generally available to all employees who are eligible under the plan for such benefits c. Unemployment insurance social security benefits workers compensation and disability benefits d. Vacation plans including buy and sell programs leave of absence programs including military maternity family and civil leave tuition assistance plans transportation and health club subsidies and e. Any other similar benefits designated in the Schedule or added thereto by endorsement. For the purposes of the coverage provided by this endorsement Definitions 5. and 18. in the Definitions Section are replaced by the following 5. Employee means a person actively employed formerly employed on leave of absence or disabled or retired. Employee includes a leased worker. Employee does not include a temporary worker. 18. Suit means a civil proceeding in which damages because of an act error or omission to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. Page 6 of 6 IS0 Properties Inc. 2000 CG 04351001 | 2 |
POLICY NUMBER CG20181185 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED MORTGAGEE ASSIGNEE OR RECEIVER This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization REFER TO ADDITIONAL INSURED SCHEDULE Designation of Premises REFER TO ADDITIONAL INSURED SCHEDULE If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. 1. WHO IS AN INSURED Section Il is amended to 2. This insurance does not apply to structural alterations include as an insured the persons or organizations new construction and demolition operations performed shown in the Schedule but only with respect to their by or for that person or organization. liability as mortgagee assignee or receiver and arising out of the ownership maintenance or use of the premises by you and shown in the Schedule. 261 I6YEIBYE0Y 16000200 CG20181185 Copyright Insurance Services Office Inc. 1984 | 2 |
GSL22746XX Ed. 01 11 CNA DISCIPLINARY PROCEEDINGS SUPPLEMENTARY PAYMENTS ENDORSEMENT This endorsement modifies insurance provided under the following Professional Liability Coverage Form Itis understood and agreed that in consideration for premium paid this endorsement amends coverage under the Policy as follows 1. Section Coverage Agreements paragraph 3. Supplemental Payments of the Professional Liability Coverage Form is amended by the addition of the following Disciplinary Proceedings a. Subject to the terms and conditions of this endorsement we will pay up to the Disciplinary Proceedings Limit of Insurance in the amount of 25000.00 unless a higher limit of insurance is shown on the Declarations for Disciplinary Proceedings for attorney fees charged by an attorney selected by us and for other reasonable costs expenses or fees paid to third parties incurred as a result of Disciplinary Proceedings arising out of the performance of professional services by an insured provided that 1. the Named Insured consents to the coverage provided by this endorsement for the insured who is subject to such proceeding 2. notice of such proceeding is first received by the insured during the policy period and 3. notice of such proceeding is reported to us in writing within 30 days of the insured s receipt of such notice. b. The Disciplinary Proceedings Limit of Insurance set forth in paragraph a. above is our maximum limit of liability for all covered Disciplinary Proceedings regardless of the number of persons and organizations who are insureds the number of Disciplinary Proceedings or the number of persons or entities making or bringing complaints that are the subject of such proceedings. c. Payments made under the Disciplinary Proceedings Limit of Insurance set forth in paragraph a. above are Supplemental Payments and are in addition to the Limits of Insurance set forth on the Declarations. d. Notwithstanding any terms and conditions of the Policy or any endorsement thereto to the contrary any Supplemental Payments for Disciplinary Proceedings made hereunder are not subject to the Policy deductible if any. Solely with respect to coverage pursuant to the terms of this endorsement Section V Additional Definitions is amended as follows The definiton of Disciplinary Proceeding is added as follows Disciplinary proceeding means any pending matter including an initial inquiry before a state or federal licensing board to investigate charges alleging a violation of any rule of professional conduct in the performance of professional services. Disciplinary proceedings do not include any complaint or proceeding instituted against an insured by the Department of Health and Human Services or its designee relative to a failure to comply with the Health Insurance Portability and Accountability Act HIPAA. The definition of Professional services is deleted and replaced by the following Professional services means the performance of healthcare services. V61 I6YEIBYE0Y 16000200 All other terms and conditions of the Policy remain unchanged. GSL22746XX Ed. 01 11 Page 1 of 1 | 2 |
GSL2430XX Ed. 0213 CNA PRE CLAIMS ASSISTANCE ENDORSEMENT This endorsement modifies insurance provided under Professional Liability Coverage Form Claims Made Commercial General Liability Coverage Form Claims Made Common Conditions In consideration of the premium paid it is understood and agreed that the Policy is amended as set forth below The Common Conditions is amended to add a new paragraph as follows Free Pre claims Assistance Until the date a claim is made we may pay for all costs or expenses we incur at our sole discretion as a result of investigating an incident that the insured reports in accordance with a. the Section entitted Additional Conditions Applicable To This Coverage Form paragraph 1.b. of the Professional Liability Coverage Form and b. the Section entitted COMMERCIAL GENERAL LIABILITY CONDITIONS Paragraph 2 Duties in the Event of Occurrence Offense Claim or Suit as set forth in the General Liability Amendatory Endorsement. All other terms and conditions of the Policy remain unchanged. V61 IGYEIBYE0Y 16000200 GSL2430XX 0213 Page 1 of 1 Copyright CNA Al Rights Reserved. | 2 |
GSL2499XX Ed. 308 CNA MEDIA EXPENSES ENDORSEMENT In consideration of the premium charged it is agreed as follows A. Section Coverage Agreements paragraph 3. Supplemental Payments is amended to add the following new paragraphs MEDIA EXPENSES AGREEMENT We will also reimburse you for Media Expenses up to the Media Expenses Limit of Insurance shown on the Declarations resulting from a Formal Proceeding that occurs during the policy period. COVERAGE The Media Expenses Limit of Insurance as shown on the Declarations is applicable to all Media Expenses for each Formal Proceeding and all Formal Proceedings in the aggregate regardless of the number of persons and organizations who are insureds and the number of Formal Proceedings. The Media Expenses Limits of Liability as shown on the Declarations are in addition to the Professional Liability each claim and aggregate limits of insurance shown on the Declarations. No Deductible applies to media expenses. B. Solely with respect to Formal Proceedings Section VL. Additional Conditions Applicable To Coverage Under This Coverage Form paragraph 1. Duties In The Event Of A Claim Or Potential Claim is deleted in its entirety and replaced as follows You must give us notice of a Formal Proceeding no later than sixty day after the first discovery of the Formal Proceeding by any insured. In the event of a Formal Proceeding you shall notify us of any other insurance policy prepaid legal service contract or legal practitioner retainer agreement available to you with respect to such Formal Proceeding. You shall take all reasonable steps to prevent a Formal Proceeding and to mitigate Media Expenses. In all events you shall not take any action or fail to take any action without our prior written consent which prejudices our rights under this Policy. C. Solely with respect to Formal Proceedings the following exclusions are added We will not pay for any Media Expenses based on arising out of or in any way related to any Formal Proceeding that any insured s director s officers trustees governors management committee members members of the management board or partners or the equivalent positions knew or reasonably could have foreseen prior to the occurrence of that such Formal Proceeding. D. Solely with respect to Formal Proceedings Section V. ADDITIONAL DEFINITIONS is amended to add the following new definitions Formal Proceeding means a criminal investigation complaint or indictment or a formal administrative proceeding against you relating to an actual or alleged violation or infringement of any federal state or local statute or regulation designed to protect the rights or safety of elderly persons and persons in long term care facilities including but not limited to statutes or regulations concerning elder abuse patient privacy including the handling of protected health information or hiring practices and reference checking with respect to potential employees. Media Expenses means the reasonable and necessary charges and fees incurred by you to manage the Formal Proceeding including but not limited to fees and charges for third party consultants. Media Expenses do not include any amounts incurred by you to defend yourself against the criminal investigation complaint or indictment. All Media Expenses must be incurred within six 6 months following discovery of a covered Formal Proceeding. All other terms and conditions of the Policy remain unchanged. This endorsement which forms a part of and is for attachment to the Policy issued by the designated Insurers takes effect on the effective date of said Policy at the hour stated in said Policy and expires concurrently with said Policy unless another effective date is shown below. By Authorized Representative No signature is required if issued with the Policy or if it is effective on the Policy Effective Date GSL2499XX Ed. 0308 Page 1 of 1 Insured Named Policy No Endorsement No Effective Date Copyright CNA Al Rights Reserved. SVBHIGYEIBYE0Y 16000200 Copyright CNA Al Rights Reserved. | 2 |
GSL3842XX Ed. 0108 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COVERAGE AND CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM Wherever used in this endorsement 1 We means the insurer listed on the policy declarations page and 2 Your means the Named Insured listed on the policy declarations page. This endorsement modifies insurance provided under your policy. In consideration of the premium charge of This policy provides coverage for losses arising from Certified Acts of Terrorism subject to all other terms and conditions of this policy. If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk Insurance Act exceed 100 billion in a Program Year January 1 through December 31 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. it is agreed as follows Certified act of terrorism means an act that is certified by the Secretary of the Treasury in concurrence with the Secretary of State and the Attorney General of the United States to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following 1. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. 9VBHIGYEIBYE0Y 16000200 GSL3842XX Ed. 0108 Page 1 of 1 | 2 |
CNA cA GSL5803XX Ed. 0109 PUNITIVE DAMAGES EXCLUSION ENDORSEMENT COMMERCIAL GENERAL LIABILITY In consideration of the premium paid the following exclusion is added to Paragraph 2. Exclusions of SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY and Paragraph 2. Exclusions of SECTION COVERAGES COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY. This insurance does not apply to punitive or exemplary amounts. All other terms and conditions of the Policy remain unchanged. LVBLIGYEIBYE0Y 16000200 GSL5803XX Ed. 0109 Page 1 of 1 Copyright CNA Al Rights Reserved. | 2 |
CNA GSLEB04XX Ed. 0109 PUNITIVE DAMAGES EXCLUSION ENDORSEMENT PROFESSIONAL LIABILITY In consideration of the premium paid the Damages definition under Section V Additional Definitions is amended to add the following Damages does not include punitive or exemplary amounts or plaintiff s attorney s fees associated with such amounts. All other terms and conditions of the Policy remain unchanged. 8V6116YE18VE0Y 16000200 GSLEB04XX Ed. 0109 Page 1 of 1 Copyright CNA Al Rights Reserved. | 2 |
GSLE672XX Ed. 0809 CNA LTC BRIDGE ENDORSEMENT This endorsement modifies insurance provided under Long Term Care Facilities Professional Liability Coverage Form Claims Made G141442 Common Conditions G141432 Commercial General Liability Coverage Form Claims Made version CG 00 02 The following new Condition is added to the Common Conditions and applies to all Coverage Forms and all endorsements attached to this Policy 1. With respect to any endorsement attached to this Policy modifying the Long Term Care Professional Liability Coverage Form Claims Made G141442 any reference to a form or endorsement edition date is deleted and replaced with the edition date specified on the Forms and Endorsement Schedule for the Long Term Care Professional Liability Coverage Form and Any reference to an alphabetic designator A or B etc. following a form or endorsement number is deleted and not replaced. With respect to any endorsement attached to this Policy modifying the Commercial General Liability Coverage Form and Commercial General Liability Coverage Part any reference to the Coverage Form or Coverage Part edition date is deleted and replaced with the edition date specified on the Forms and Endorsement Schedule for the Commercial General Liability Coverage Form and Any reference to an alphabetic designator A or B etc. following a form or endorsement number is deleted and not replaced. All other terms and conditions of the Policy remain unchanged. 6V6116YE18VE0Y 16000200 GSLE672XX Ed. 0809 Page 1 of 1 | 2 |
G1414328 Ed. 0710 CNA COMMON CONDITIONS Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the Company providing this insurance. Other words and phrases that appear in quotation marks have special meaning. Refer to Section XXVII Definitions. Terms and Conditions Your Duties As The First Named Insured On The Declarations Limits of Insurance Assistance and Cooperation Separation of Insureds Inspections and Surveys Examination of Your Books and Records Changes Transfer of Interest Other Insurance or Risk Transfer Arrangements Insurance Under More Than One Coverage Transfer Of Rights Of Recovery Legal Action Limitation Bankruptcy Premium Non renewal Cancellation Entire Contract Headings Subrogation Subsidiaries Newly Acquired Subsidiary Changes To Your Business Acquisitions And Mergers Legal Representatives Waiver of Immunity Extended Reporting Period Economic and Trade Sanctions Condition Definitions Service of Suit oloaaloassss s s 8 wwwwwwwwnn oo 0561 16YE18VE07 16000200 G141432B Ed. 0710 Page 10f 6 | 2 |
G1414328 Ed. 0710 I. Terms and Conditions Designated Premises The terms and conditions of each Coverage Form apply only to that Coverage Form and shall not apply to any other Coverage Form. If any provision in these Common Conditions is inconsistent or in conflict with the terms and conditions of any Coverage Form the terms and conditions of such Coverage Form shall control for purposes of that Coverage Form. This insurance applies only to bodily injury property damage personal and advertising injury medical expenses and medical incidents arising out of the ownership maintenance or use of the premises shown in the Declarations and at additional locations as may be required within the scope of the definition of professional services. IIl. Your Duties As The First Named Insured On the Declarations When there is more than one of you named in the Declarations the first of you named on behalf of all others will be A. authorized to make changes in the terms of this policy with our consent B. the payee of any premiums we refund C. responsible for 1. the payment of all premiums due 2. keeping records of the information we need for premium computation and sending us copies at such times as we may request 3. notifying us that you want to cancel this policy. llIl. Limits of Insurance A. Claim expenses are in addition to the limits of insurance. We shall pay claim expenses in connection with covered claims. B. The Limits of Insurance are subject to the rules set forth under each coverage form under the sections entitled limits of insurance. C. The Limits of Insurance for each coverage form are subject to the Policy Aggregate Limit of Insurance if and as specified in Item 5 of the Declarations. As such each such coverage form limit of insurance is a sublimit which further limits and does not increase our maximum liability for all such coverage forms. If no Policy Aggregate Limit of Insurance is set forth in the Declarations the limits of insurance set forth in each coverage part are not subject to a Policy Aggregate Limit of Insurance IV. Assistance and Cooperation If there is a claim the Insured must G141432B Ed. 0710 A. forward to us or to our designee all notices summonses or other or any other documents regarding legal proceedings B. fully cooperate with us or our designee in the making of settlements the conduct of suits or other proceedings enforcing any right of contribution or indemnity against another who may be liable to the Insured because of the claim. The Insured shall attend hearings and trials assist in securing and giving evidence and obtaining the attendance of witnesses C. refuse except at the Insured s own cost to voluntarily make any payment assume any obligation or incur any expense other than reasonable medical expenses incurred at the time of the event. V. Separation of Insureds This policy applies separately to each of you against whom a claim is brought except with respect to A. the limits of insurance and B. any of your duties as the first named insured on the Declarations. VL. Inspections and Surveys We have the right but are not obligated to A. make inspections and surveys at any time B. give you reports on the conditions we find C. recommend changes or D. conduct loss control and prevention activity. Any inspections surveys reports or recommendations relate only to insurability and the premiums to be charged. We do not A. make safety inspections B. undertake to perform the duty of any entity to provide for the health or safety of workers or the public nor C. warrant that conditions 1. are safe or healthful or 2. comply with codes or standards. laws regulations This provision applies not only to us but also to any rating advisory rate service or similar organization which makes insurance inspections surveys recommendations reports or gives loss control or prevention advice on our behalf. Vil Examination of Your Books and Records We may examine and audit your books and records as they relate to this policy at any time during the Policy period and up to 3 years afterward. Page 20f 6 remiums we refund f all premiums due ds of the information we need computation and sending us 1 times as we may request that you want to cancel this are in addition to the limits of hall pay claim expenses in vered claims. rance are subject to the rules set 1 coverage form under the imits of insurance. rrance for each coverage form he Policy Aggregate Limit of as specified in Item 5 of the uch each such coverage form is a sublimit which further limits ase our maximum liability for all orms. If no Policy Aggregate is set forth in the Declarations ance set forth in each coverage VI Page 20f 6 | 2 |
G1414328 Ed. 0710 VIIl. Changes Notice to any of our agents or knowledge possessed by any such agent or any other person shall not act as a waiver or change in any part of this policy. It also will not prevent us from asserting any rights under the provisions of this policy. of the provisions of this policy will be waived changed or modified except by written endorsement issued to form a part of this policy. At some time we may make changes in our insurance policy forms. Where appropriate these changes must conform to and be filed with state insurance supervisory authorities for approval. If during your Policy period we make a policy change that extends or broadens your coverage without increasing your premium your coverage will automatically include such extension or broadening on the effective date the change is approved in your state except that this provision will not apply to claims that were reported to us prior to the effective date of such revision. IX. Transfer of Interest Assignment of interest under this policy shall not bind us unless our consent is endorsed hereon. X. Other Insurance or Risk Transfer Arrangements Any claim insured under any other insurance policy or risk transfer instrument including but not limited to self insured retentions deductibles or other alternative arrangements which applies to this claim shall be paid first by those instruments policies or other arrangements. It is the intent of this policy to apply only to loss that is more than the total limit of all deductibles retentions limits of insurance self insured amounts or other valid and collectible insurance or risk transfer arrangements whether primary contributory excess contingent or otherwise. In no event will we pay more than our limit of insurance. If this policy and any other policy issued by us our predecessor or any of our affiliated companies or their predecessors apply to the same claim the limits of insurance which apply to such claim will be the highest of the limits of insurance available under this policy or any other single policy. These provisions do not apply to other insurance policies or risk transfer arrangements written as specific excess insurance over the limits of insurance of the policy. XI. Insurance Under More Than One Coverage If more than one of this policy s coverage forms applies to the same claim only the coverage form most applicable to that type of claim or suit shall apply to it. We will not pay more than the limit of insurance of the one individual coverage form or the actual amount of damages for which the Insured is liable whichever is less. G141432B Ed. 0710 XIl. Transfer of Rights of Recovery If any Insured for whom we make payment under this policy has rights to recover amounts from another those rights are transferred to us to the extent of our payment. The Insured must do everything necessary to secure our rights and must do nothing after a claim to impair them. Xl Legal Action Limitation No Insured may bring any legal action against us concerning this policy until A. the terms and conditions of this Policy have been fully complied with and B. the amount of the Insured s obligation to pay has been decided. Such amount can be set by judgment against the Insured after actual trial or by written agreement between the Insured the claimant and us. Any entity or its legal representative is entitled to recover under this policy after it has secured a judgment or written agreement. Recovery is limited to the extent of the insurance afforded by this policy. No entity has any right under this policy to include us in any action against any Insured to determine their liability nor will any Insured or their representative bring us into such an action. XIV. Bankruptcy If you or your estate becomes bankrupt or insolvent it does not change any of our obligations under this policy. XV. Premium All premium charges under this policy will be computed according to our rules and rating plans which apply at the inception of the current Policy period. They may be paid to our authorized representative or us. The deposit premium is due on the inception date of the policy. We compute the premium you pay for this policy using information available prior to the effective date of the policy. On some policies we charge a fixed amount with no adjustment later. On other policies all or part of your premium may be based on estimates. If estimates are used we compute your actual premium when complete information is available after the end of the Policy period. If it is more than you have already paid you owe us the difference. If it is less we shall pay you back the difference. But you will not pay less than any minimum annual premium agreed upon. You must keep accurate records of the information we will need to compute your premium. You agree to send us these records at the end of each Policy period or any other time we request them. Page 30f 6 make changes in our insurance propriate these changes must filed with state insurance for approval. If during your e a policy change that extends erage without increasing your ige will automatically include adening on the effective date d in your state except that this to claims that were reported ve date of such revision. under this policy shall not bind s endorsed hereon. sk Transfer Arrangements v ary thar inetirance nAling 1561 16VE4BPE07 160002002 Page 30f 6 | 2 |
G1414328 Ed. 0710 XVL. Non renewal We can non renew this policy by giving written notice to the first of you named on the Declarations at your last known address at least 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. XVIL. Cancellation A. This policy can be cancelled by either the first of you named on the Declarations or us. B. Only the first of you named may cancel this policy at any time. To do so you must 1. return the policy to us or any of our authorized representatives indicating the effective date of cancellation or 2. provide a written notice to us stating when the cancellation is to be effective. We must receive the policy or written notice before the cancellation date. We can cancel this policy by giving written notice to the first of you named on the Declarations at your last known address at least 1. 10 days if we cancel for non payment of premium or 2. 30 days if we cancel for any other reason before the effective date of cancellation. C. Notice of cancellation will state the effective date of cancellation. The policy will end on that date. D. If we cancel the refund will be pro rata. If you cancel the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. E. If notice is mailed proof of mailing wil be sufficient proof of notice. XVIIL. Entire Contract By acceptance of this Policy the Insureds agree that A. this Policy consisting of the Application these Common Conditions the Coverage Forms and all endorsements listed in the Declarations constitute the entire contract existing between them and us relating to this insurance and B. this Policy is issued in reliance upon the Insured s representations C. the misrepresentation of any material matter by the Insured or the Insured s agent will render this Policy and void and relieve us from all liability herein. G141432B Ed. 0710 XIX. Headings The description in the headings and subheadings of this policy is solely for convenience and forms no part of the terms and conditions of coverage. XX. Subrogation In the event of any payment under this Policy we shall be subrogated to all the Insured s rights of recovery thereof against any person or organization including any rights such Insured may have against any other Insured involved in dishonest fraudulent criminal malicious or intentional conduct. The Insured shall execute and deliver instruments and papers and do whatever else is necessary to secure and collect upon such rights. The Insured shall do nothing to prejudice such rights. XXI. Subsidiaries And Newly Acquired Subsidiary 1. With respect to any subsidiary on the date during the Policy period that your direct or indirect ownership interest in a subsidiary becomes less than 50 of the issued and outstanding voting stock such corporation shall cease to be a subsidiary under the terms of this Policy. In such event coverage will be provided to such subsidiary under the Policy but only with respect to incidents committed prior to such date in accordance with all other terms and conditions of this Policy. No coverage will be afforded under the Policy with respect to claims made against such subsidiary based on any incident committed or allegedly committed on or subsequent to such date. 2. No newly acquired subsidiary is an insured unless we have specifically agreed in writing to add such newly acquired subsidiary to the policy as an insured by endorsement specifying the terms and conditions of its coverage. XXIl. Changes To Your Business Acquisitions And Mergers 1. The first of you named on the Declarations must provide prior notice to us of the following events a. material or significant changes to the type or volume of the professional services reported to us in your application. b. your merger with another entity or c. the acquisition of all or substantially all of your assets by another entity 2. Upon receipt of such notice we may a. adjust the premium to reflect the added exposure or b. solely with respect to items b and deem this Policy to have ceased with respect to claims made against the Insured based on any Page 4 of 6 an be cancelled by either the first of n the Declarations or us. of you named may cancel this policy 0 do so you must e policy to us or any of our authorized tatives indicating the effective date G141432B Ed. 0710 | 2 |
G1414328 Ed. 0710 incident committed or allegedly committed on or subsequent to the time and date of said event. In such case the Policy period shall remain unaltered and coverage will continue but only with respect to an incident committed prior to the time and date of any such events in accordance with all other terms and conditions of this Policy. XXIIl. Legal Representatives An Insured s estate heirs executors administrators assigns and legal representatives shall be considered insured under this Policy in the event of such Insured s death incapacity insolvency or bankruptcy but only to the extent that such Insured would have been provided coverage under this Policy. XXIV. Waiver of Inmunity We will waive both in the adjustment of claims and in the defense of suits against the insured any charitable immunity of the insured unless the insured requests in writing that we do not do so. Waiver of immunity as a defense will not subject us to liability for any portion of a claim or judgment in excess of the applicable limit of insurance. XXV. Extended Reporting Period 1. Automatic Extended Reporting Period If this policy is terminated for any reason by either the Company or by you we will provide you with an automatic noncancelable extended reporting period starting at the termination of the Policy period if you have not obtained a replacement policy of insurance within sixty 60 days of the termination of this Policy. This automatic extended reporting period will terminate after sixty 60 days. As used herein replacement policy of insurance means any other insurance policy or risk transfer instrument including but not limited to self insured retentions deductibles or other alternative arrangements 2. Optional Extended Reported Period If you write to us within 60 days of the termination date telling us that you want to purchase an optional extended reporting period and you pay the premium to us promptly when due together with any earned but unpaid premium which may be due under the terminated policy an optional extended reporting period will be provided to you in accordance with our rules rates and rating plans. Once paid the premium for this option is non refundable and considered fully earned. 3. Extended reporting periods limits of insurance Our limit of insurance for all claims reported during the automatic and optional extended reporting periods shall be part of and not in G141432B Ed. 0710 addition to the limits of insurance for the Policy period as set forth in the Declarations. 4. Such extended reporting periods as set forth in 1. or 2. shall not apply to claims that are covered under any subsequent insurance you purchase or that would be covered but for exhaustion of the limit of insurance applicable to such claims. 5. It is understood and agreed that the extended reporting period shall not be construed to be a new policy and any claim submitted during such period shall otherwise be governed by this Policy. 6. The optional extended reporting period will cover collectively the initial 60 day automatic extended reporting period and the optional extended reporting period if purchased. Extended reporting period coverage may not be cancelled. XXVI. Economic And Trade Sanctions Condition In accordance with laws and regulations of the United States concerning economic and trade embargoes this policy is void ab initio void from its inception with respect to any term or condition of this policy that violates any laws or regulations of the United States concerning economic and trade embargoes including but not limited to the following 1. Any insured or any person or entity claiming the benefits of an insured who is or becomes a Specially Designated National or Blocked Person or who is otherwise subject to U.S. economic or trade sanctions 2. Any claim or suit that is brought in a Sanctioned Country or by a Sanctioned Country Government where any action in connection with such claim or suit is prohibited by U.S. economic or trade sanctions 3. Any claim or suit that is brought by any Specially Designated National or Blocked Person or any person or entity who is otherwise subject to U.S. economic or trade sanctions 4. Property that is located in a Sanctioned Country or that is owned by rented to or in the care custody or control of a Sanctioned Country Government where any activities related to such property are prohibited by U.S. economic or trade sanctions or 5. Property that is owned by rented to or in the care custody or control of a Specially Designated National or Blocked Person or any person or entity who is otherwise subject to U.S. economic or trade sanctions. As used in this endorsement a Specially Designated National or Blocked Person is any person or entity that is on the list of Specially Designated Nationals and Blocked Persons issued by the U.S. Treasury Page 50f 6 2561 16YE18VE0Y 16000200 | 2 |
G1414328 Ed. 0710 Department s Office of Foreign Asset Control O.F.A.C. as it may be from time to time amended. As used in this endorsement a Sanctioned Country is any country that is the subject of trade or economic embargoes imposed by the laws or regulations of the United States of America. XXVIL. Definitions For purposes of this Policy words in quotation marks have the meaning set forth below. However any word in quotations referenced in these Common Conditions but defined in a Coverage Form shall for purposes of coverage under that Coverage Form have the meaning set forth in that Coverage Form. Application means all signed applications for this Policy and for any policy in an uninterrupted series of policies issued by us or any affiliate of ours of which this Policy is a renewal or replacement. Application includes any materials submitted or required to be submitted therewith. An affiliate means an insurer controlling controlled by or under common control with us. Claim as used in these Common Conditions has the same meaning as the defined word claim in the applicable Coverage Forms. Coverage Form means only those coverage forms designated as included in Item 4 of the Declarations. Extended reporting period means the period of time after the termination of the Policy period for reporting claims to us that are made against the Insured during the applicable extended reporting period by reason of an incident that happened after the retroactive date and prior to the termination of the Policy period and is otherwise covered by this Policy Incident means an occurrence a medical incident and a personal and advertising injury as those terms are used in each individual Coverage Form. Insured has the meaning set forth in each Coverage Form. Newly acquired subsidiary means any entity newly formed or acquired by you during the Policy period Prejudgment interest and postjudgment interest means interest that accrues prior to or after entry of a judgment verdict or award. However any interest which is awarded as a penalty against an Insured does not constitute prejudgment interest and postjudgment interest. Policy period means the time from 1201 A.M. on the effective date of this Policy as set forth in Item 2 of the Declarations to the earlier of 1201 AM. of the expiration termination or cancellation date of this Policy. Subsidiary means those of you other than the first of you listed on the Declarations at the inception of this Policy. XXVIIL Service of Suit In the event of our failure to pay any amount claimed to be due hereunder we at the request of the Insured will submit to the jurisdiction of any court of competent jurisdiction within the United States and will comply with all requirements necessary to give such court jurisdiction and all matters arising hereunder shall be determined in accordance with the law and practice of such court. Service of process in such suit may be made upon the General Counsel Columbia Casualty Company 333 S. Wabash Ave. Chicago lllinois 60604 and that in any suit instituted against such person upon this Policy we will abide by the final decision of such court or of any appellate court in the event of an appeal. The General Counsel is authorized and directed to accept service of process on behalf of our behalf in any such suit and upon the request of the Insured to give a written undertaking to the Insured that he will enter a general appearance upon us in the event such suit shall be instituted. Further pursuant to any statute of any state territory or district of the United States which makes provision therefore we hereby designate the Superintendent Commissioner or Director of Insurance or other officer as designated in such statute as its true and lawful attorney upon whom may be served any lawful process in any action suit or proceeding instituted by or on behalf of the Insured or any beneficiary hereunder arising out of this Policy of insurance and hereby designates the above named as the person to whom the said officer is authorized and directed to accept service of process on our behalf in any such suit. Your policy has been signed below on our behalf by our Chairman and by our Secretary. However your policy will not be binding on us unless it is also countersigned by one of our duly authorized agents. Chairman Yl mal Mol Secretary 71 AN 71 AN G141432B Ed. 0710 Page 6 of 6 | 2 |
G141433 C Ed. 1112 CNA LONG TERM CARE GENERAL LIABILITY AMENDATORY ENDORSEMENT This endorsement modifies insurance provided under the following Commercial General Liability Coverage Form Claims Made CG 00 02 1. Section Coverage A BODILY INJURY AND PROPERTY DAMAGE LIABILITY paragraph 1. Insuring Agreement is amended to delete all of the language following paragraph. 2. in its entirety and replace it as follows All related claims involving the same or related occurrences will be deemed one claim. That one claim will be deemed to have been first made against the insured at the time that the earliest claim among those related claims was made. Section Coverage A BODILY INJURY AND PROPERTY DAMAGE LIABILITY paragraph 2. Exclusions the last paragraph of Exclusions Coverage A Section is replaced by the following Exclusions. through n. do not apply to damage by fire explosion smoke or leaks from automatic fire protective systems to premises rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section lll Limits of Insurance. Section Coverage A BODILY INJURY AND PROPERTY DAMAGE LIABILITY paragraph 2. Exclusions is amended to add the following exclusions This insurance does not apply to Prior knowledge prior notice and pending matters Any claim arising out of an occurrence 1 which occurred on or after the Retroactive Date as indicated on the Declarations if on the effective date of this policy the insured knew or had been told that it would result in a claim 2 which you reported to another insurer as a claim occurrence accident circumstance or loss prior to the policy period of this policy or which on the effective date of this policy is the subject of a a pending claim or proceeding or b paid claim Professional Services any claim arising out of the performance of professional services. Rights of Residents any claim arising out of the violation of rights of residents. Employment Bodily injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demotion evaluation reassignment discipline defamation harassment humiliation or discrimination directed at that person or 2 The spouse child parent brother or sister of that person as a consequence of bodily injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after employment of that person G141433 C Ed. 1112 Page 10f 7 8561 16YE18VE07 16000200 Copyright CNA Al Rights Reserved. | 2 |
G141433 C Ed. 1112 2 Whether the insured may be liable as an employer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. Fungi and Microbes 1 Bodily injury or property damage arising out of or relating to in whole or in part the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or growth or presence of any fungi or microbes. 2 Any loss cost or expense arising out of or relating to the 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 microbes by any insured or by anyone else. 3 Property damage caused by water where there also exists any property damage arising out of or relating to in whole or in part the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or growth or presence of any fungi or microbes. This exclusion applies regardless of any other cause or event that contributes concurrently or in any sequence to such injury or damage loss cost or expense. For example property damage caused first by water then partially or entirely worsened by fungi or microbes is totally excluded. However this exclusion does not apply if your business includes the processing sales or serving of food and the bodily injury is caused solely by food poisoning in connection with such processing sales or serving of food. Respirable Dust 1. Bodily injury arising in whole or in part out of the actual alleged or threatened respiration or ingestion at any time of respirable dust or 2. Property damage arising in whole or in part out of the actual alleged or threatened presence of respirable dust. Silica 1. Bodily injury arising in whole or in part out of the actual alleged or threatened respiration or ingestion at any time of silica or 2. Property damage arising in whole or in part out of the actual alleged or threatened presence of silica. Asbestos 1 Bodily injury or property damage arising out of the actual alleged or threatened exposure at any time to asbestos or 2 Any loss cost or expense that may be awarded or incurred a by reason of a claim or suit for any such injury or damage or b in complying with a governmental direction or request to test for monitor clean up remove contain or dispose of asbestos. Lead Paint Bodily injury or property damage arising out of the actual or alleged manufacture distribution sale resale re branding installation repair removal encapsulation abatement replacement or handling of or exposure to lead paint or products containing lead whether or not the lead is or was at any time airborne as a particle contained in a product ingested inhaled transmitted in any fashion or found in any form whatsoever. 4. Section Coverage B PERSONAL AND ADVERTISING INJURY LIABILITY paragraph 1. Insuring Agreement is amended to delete all of the language following paragraph c. 2. in its entirety and replace it as follows All related claims involving the same or related offenses will be deemed one claim. That one claim will be deemed to have been first made against the insured at the time that the earliest claim among those related claims was made. G141433 C Ed. 1112 Page 20f 7 Copyright CNA Al Rights Reserved. | 2 |
G141433 C Ed. 1112 Section Coverage B PERSONAL AND ADVERTISING INJURY LIABILITY paragraph 2. Exclusions is amended to add the following exclusions This insurance does not apply to Prior knowledge prior notice and pending matters Any claim arising out of an offense 1 which occurred on or after the Retroactive Date as indicated on the Declarations if on the effective date of this policy the insured knew or had been told that it would result in a claim 2 which you reported to another insurer as a claim offense accident circumstance or loss prior to the policy period of this policy or 3 which on the effective date of this policy is the subject of a a pending claim or proceeding or b paid claim Professional Services Any claim arising out of the performance of professional services. Rights of Residents Any claim arising out of the violation of rights of residents. Fungi and Microbes 1 Personal and advertising injury arising out of or relating to in whole or in part the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or growth or presence of any fungi or microbes. 2 Any loss cost or expense arising out of or relating to the 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 microbes by any insured or by anyone else. This exclusion applies regardless of any other cause or event that contributes concurrently or in any sequence to such injury loss cost or expense. Respirable Dust Personal and advertising injury arising in whole or in part out of the actual alleged or threatened exposure at any time to or the presence of respirable dust. Silica Personal and advertising injury arising in whole or in part out of the actual alleged or threatened exposure at any time to or the presence of silica. Asbestos 1 Personal and advertising injury arising out of the actual alleged or threatened exposure at any time to asbestos or 2 Any loss cost or expense that may be awarded or incurred a by reason of a claim or suit for any such injury or damage or b in complying with a governmental direction or request to test for monitor clean up remove contain or dispose of asbestos. Lead Paint Personal and advertising injury arising out of the actual or alleged manufacture distribution sale resale re branding installation repair removal encapsulation abatement replacement or handling of or exposure to lead paint or products containing lead whether or not the lead is or was at any time airborne as a particle contained in a product ingested inhaled transmitted in any fashion or found in any form whatsoever. Y561 16YE18VE0Y 16000200 L DY TRy MR M A I AR TRy M AT M T e a by reason of a claim or suit for any such injury or damage or b in complying with a governmental direction or request to test for monitor clean up remove contain or dispose of asbestos. Lead Paint Personal and advertising injury arising out of the actual or alleged manufacture distribution sale resale re branding installation repair removal encapsulation abatement replacement or handling of or exposure to lead paint or products containing lead whether or not the lead is or was at any time airborne as a particle contained in a product ingested inhaled transmitted in any fashion or found in any form whatsoever. G141433 C Ed. 1112 Page 30f 7 Copyright CNA Al Rights Reserved. | 2 |
G141433 C Ed. 1112 Employment Personal and advertising injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demotion evaluation reassignment discipline defamation harassment humiliation discrimination or malicious prosecution directed at that person or 2 The spouse child parent brother or sister of that person as a consequence of personal and advertising injury to that person at whom any of the employment related practices described in Paragraphs a b or a b above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after employment of that person 2 Whether the insured may be liable as an employer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. 6. Section Coverage C Medical Payments Paragraph 2. Exclusions is amended as follows Exclusion a. of Coverage C Section 1 does not apply to those insureds who are your students or volunteer workers engaged in maintaining or repairing your premises or engaged in alteration demolition or new construction at your premises. Exclusion b. of Coverage C Section 1 does not apply to if such person is hired only for 1. The maintenance or repair of your premises or 2. Structural alterations to your premises which do not involve changing the size of or moving any building or structure. The following additional exclusions apply to Coverage C Section I. We will not pay expenses for bodily injury i to residents. This exclusion does not apply to medical expenses for persons who are receiving treatment on an outpatient basis. i to employees of residents or other persons who regularly reside on the insured premises if the bodily injury arises out of and in the course of their employment. As used herein Residents means persons who are being cared for at your resident health care facility. 7. Section Il WHO IS AN INSURED paragraph 2.a. is deleted in its entirety and replaced as follows a. Your employees but only while acting within the scope of their duties for you as employees. ity for 1 Your employees for bodily injury to another employee of yours arising out of and in the course of their employment. 2 Your employees for personal or advertising injury to you your partners or joint venturers arising out of and in the course of their employment. 3 Your employees for property damage to property that is owned used or in any way controlled by you another of your employees your partners or joint venturers. As used herein employee means a person whose work is engaged and directed by you including any of your students or volunteers and including seasonal temporary employees and employees leased to you. Employee does not include a Members or partners of a joint venture G141433 C Ed. 1112 Page 4 of 7 Copyright CNA Al Rights Reserved. | 2 |
G141433 C Ed. 1112 8. 10. 1. b Members of a limited liability company c Executive officers and directors of an organization other than a partnership joint venture or limited liability company d Independent Contractors. Section Il WHO IS AN INSURED is amended to delete paragraph 3. in its entirety and replace it with paragraph 2. of Section XXI of the Common Conditions. Section Il LIMITS OF INSURANCE Paragraphs 1. through 6. of Limits of Insurance Section lll are deleted in their entirety and replaced by the following 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A and c. Damages under Coverage B. 3. Subject to Paragraph 2. above the Products Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. 4. Subject to Paragraph 2. above the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all personal and advertising injury sustained by any one person or organization. 5. Subject to Paragraphs 2. and 3. above the Each Occurrence Limit is the most we will pay for the sum of a. Damages under Coverage A and b. Medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to Paragraph 5. above the Damage to Premises Rented To You Limit is the most we will pay under Coverage A for damages because of property damage to premises rented to you or in the case of damage by fire explosion smoke or leaks from automatic fire protective systems to premises rented to you or temporarily occupied by you with permission of the owner. Section IV COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to delete the following paragraphs in their entirety Section 1. Bankruptcy Section 3. Legal Action Against Us Section 4. Other Insurance Section 5. Premium Audit Section 6. Representations Section 7. Separation of Insureds Section 8. Transfer of Rights of Recovery Against Others to Us Section 9. When We Do Not Renew Section IV COMMERCIAL GENERAL LIABILITY CONDITIONS Paragraph 2 Duties in the Event of Occurrence Offense Claim or Suit is deleted in its entirety and replaced as follows Duties in the Event of a Claim or Potential Claim 1. The Insured must give us written notice as soon as reasonably possible during the policy period of any claim made against the Insured. 2. If during the policy period the Insured becomes aware of an occurrence or offense that is expected to be the basis of a claim against the Insured the Insured must give written notice to us as soon as reasonably G141433 C Ed. 1112 Page 50f 7 Copyright CNA Al Rights Reserved. | 2 |
G141433 C Ed. 1112 possible during the policy period. Such notice must state the reasons for anticipating a claim with full particulars including but not limited to a. specific information regarding the occurrence or offense b. the dates and persons involved c. the identities of anticipated or possible claimants d. the circumstances by which the Insured first became aware of the possible claim. If such notice is given then any such claim that is subsequently made against the Insured and reported to us shall be deemed to have been made at the time such written notice was given to us. 12. Section V EXTENDED REPORTING PERIODS is deleted in its entirety and replaced with the following We will provide an Extended Reporting Period in accordance with Section XXV. of the Common Conditions. 13. Section VI DEFINITIONS is amended as follows Item 9. the definition of Insured Contract is amended to delete the second sentence of paragraph a. in its entirety and replace it as follows However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire explosion smoke or leaks from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract Item 16. the definition of Products completed operations hazard is amended by deleting paragraph b 3 in its entirety. 14. Section VI DEFINITIONS is amended to add the following new definitions Claim means an oral or written demand received by the Insured for money arising out of an occurrence. The service of suit or the institution of an arbitration proceeding against the Insured arising out of an occurrence will also be considered a demand. In this Coverage Form wherever the words claim or suit appear they shall be deemed to be replaced with the defined term claim above. The term policy period has the meaning set forth in the Common Conditions. The terms professional services and rights of residents have the meaning set forth in the Professional Liability Coverage Part. Asbestos means the mineral in any form whether or not the asbestos was at any time 1 airborne as a fiber particle or dust 2 contained in or formed a part of a product structure or other real or personal property 3 carried on clothing 4 inhaled or ingested or 5 transmitted by any other means. Fungi means any form of fungus including but not limited to yeast mold mildew rust smut or mushroom and including any spores mycotoxins odors or any other substances products or byproducts produced by released by or arising out of the current or past presence of fungi. But fungi does not include any fungi intended by the insured for consumption. Microbe means any non fungal microorganism or non fungal colony form organism that causes infection or disease. Microbe includes any spores mycotoxins odors or any other substances products or byproducts produced by released by or arising out of the current or past presence of microbes. But microbe does not mean microbes that were transmitted directly from person to person. Respirable dust means respirable particulate matter in the solid state excluding living organisms which contains any the following materials including but not limited to aluminum antimony attapulgite beryllium bentonite cadmium cement chromite coal cobalt erionite fuller s earth gypsum iron kaolin manganese micas mullite nepheline nickel palygorskite sepiolite sillimanite talc titanium tungsten carbide vermiculite wollastonite zirconium or similar organic or inorganic substances. G141433 C Ed. 1112 Page 6 of 7 Copyright CNA Al Rights Reserved. | 2 |
G141433 C Ed. 1112 Silica means the chemical compound silicon dioxide SiO2 in any form including dust which contains silica. 15. A new provision is added as follows We agree with you that coverage shall apply to any mortgagee landlord or lessor of leased equipment hereafter called an Additional Insured that you are required in a written contract to name as an insured but only with respect to the additional insured s liability arising out of the maintenance operation or use by you of the premises andor leased equipment subject to the following provisions as set forth below 1. The limits of insurance and coverages provided on behalf of the additional insured are not greater than those required by such written contract. 2. Inno event shall the limits of liability or coverages in the coverage form be increased by such written contract. All insuring agreements exclusions and conditions of the coverage form shall apply to this provision. All other terms and conditions of the Policy remain unchanged. 9561 16YE18VE07 16000200 G141433 C Ed. 1112 Page 7of 7 Copyright CNA Al Rights Reserved. | 2 |
G141442 C Ed. 0809 CNA LONG TERM CARE FACILITIES PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE YOUR PROFESSIONAL LIABILITY INSURANCE IS WRITTEN ON A CLAIMSMADE BASIS AND PROVIDES COVERAGE FOR THOSE CLAIMS WHICH ARE THE RESULT OF INCIDENTS HAPPENING ON OR AFTER THE RETROACTIVE DATE STATED ON THE DECLARATIONS AND WHICH ARE FIRST MADE AGAINST YOU AND WHICH YOU FIRST REPORT TO US IN ACCORDANCE WITH SECTION VI. NO COVERAGE EXISTS FOR CLAIMS FIRST MADE AGAINST YOU AFTER THE END OF THE POLICY PERIOD UNLESS AND TO THE EXTENT THAT AN EXTENDED REPORTING PERIOD APPLIES. This Coverage Form provides coverage for professional liability claims brought against the Insureds. Words or phrases that appear in quotation marks are defined in Section XXVII. Definitions of the Common Conditions or Section V Additional Definitions of this Coverage Form. Section Coverage Agreements 1. Coverage We will pay all amounts up to our limit of insurance which the Insured becomes legally obligated to pay as damages as a result of a claim arising out of an incident provided that a. such claim is first made against the Insured during the policy period or any applicable Extended Reporting Period b. the incident did not occur before the retroactive date if any shown in the Declarations or after the end of the policy period c. on the effective date of this Policy no Insured had a basis to believe that such incident or related incident might reasonably result in a claim d. the Insured did not give notice to a prior insurer of a related claim. 2. Defense We shall have the right and duty to defend a covered claim even if any of the allegations of the claim are groundless false or fraudulent. We shall have the right to appoint counsel and to make such investigation defense and settlement of a claim as is deemed necessary by us. If a claim is submitted to arbitration or mediation we shall be entitled to exercise all of the Insured s rights in the choice of arbitrators or mediators and in the conduct of an arbitration or mediation proceeding. We are not obligated to investigate defend pay or settle or continue to investigate defend pay or settle a claim after the applicable limit of our liability has been exhausted. In such case we shall have the right to withdraw from the further investigation defense or settlement of such claim. 3. Supplemental Payments Payments made under this Section are in addition to the Limits of Insurance set forth in Section IV We will pay with respect to any claim we defend a. any 1. fees charged by an attorney we designate and 2. all other fees costs and expenses which result from the investigation adjustment defense and appeal of a claim. These expenses must be incurred by us or by you with our prior written consent. b. any premiums for appeal bonds or to release property that is being used to secure a legal obligation. We shall pay premium for bonds valued up to the limits of insurance. We have no obligation to apply for or furnish such bonds c. prejudgment interest and postjudgment interest that is awarded in connection with a judgment made against the Insured or that portion of the judgment that is within the applicable limits of insurance. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment interest and postjudgment interest based on that period of time after the offer d. all reasonable expenses incurred by the Insured at our request to assist us in the investigation or defense of the claim. This includes actual loss of earnings up to 500 per day because of time off from work. Section Il Exclusions We will not defend any claim for or pay any damages or claim expenses based on arising out of or related to 1. property damage 2. discrimination based on but not limited to race color creed sex religion age national origin physical handicap andor sexual preference whether or not for alleged violation of any federal state or local governmental law or regulation prohibiting such discrimination erage Agreements y all amounts up to our limit of insurance 1sured becomes legally obligated to pay as as a result of a claim arising out of an rovided that claim is first made against the Insured the policy period or any applicable ed Reporting Period ident did not occur before the retroactive any shown in the Declarations or after the he policy period effective date of this Policy no Insured had to believe that such incident or related t might reasonably result in a claim ured did not give notice to a prior insurer of ed claim. ve the right and duty to defend a covered 1 if any of the allegations of the claim are false or fraudulent. We shall have the right counsel and to make such investigation d settlement of a claim as is deemed oy us. If a claim is submitted to arbitration n we shall be entitled to exercise all of the ights in the choice of arbitrators or G141442 C Ed. 0809 Page 1 0f 4 | 2 |
G141442 C Ed. 0809 3. any obligation of the Insured under workers compensation disability benefits or unemployment compensation law or any similar law 4. injury to any of your employees during the course of their employment by you or to injury to the spouse child parent brother or sister of such employees arising out of such injury. This exclusion applies whether you may be liable as an employer or in any other capacity and to any obligation to indemnify another because of damages or injury 5. an Insured s alleged liability under any oral or written contract or the liability of others an Insured assumes under any oral or written contract except that coverage otherwise available to an Insured shall apply to an Insured s liability that exists in the absence of such contract. 6. termination of employment coercion demotion evaluation reassignment discipline defamation harassment humiliation discrimination or other employment related practices policies acts or omissions. the medical treatment of residents by a physician intentionally wrongful dishonest fraudulent malicious or criminal conduct committed by an Insured or at an Insured s direction or with the Insured s prior knowledge. 9. the ownership maintenance use or entrustment to others of any aircraft automobile or watercraft owned or operated by or rented or loaned to the Insured. Use includes operation and loading or unloading. 10. any actual alleged or threatened discharge release escape or disposal of or exposure to pollutants any request direction or order that any of the Insureds test for monitor clean up remove contain treat detoxify neutralize or in any way respond to or assess the effect of pollutants or any voluntary decision to do so or any actual or alleged property damage or bodily injury of any person or financial loss to you In addition this policy does not cover any claim brought by or on behalf of any federal state or local government agency. Section Il Who is an Insured You are an Insured. In addition the persons described below are Insureds 1. any individual who is or becomes your employee or administrator during the policy period but only for professional services performed on your behalf. 2. any individual previously affiliated with you as an employee or administrator but only for professional services performed on your behalf at the time of such affiliation. 3. beauticians and barbers who are not your employees but who are invited onto an insured location by you to perform beauticians and barbers services and only while performing beauticians and barbers services at the Insured Location for the named insured. Section IV Limits of Insurance 1. If set forth in item 3. of the Declarations the limits below are subject to a Policy Aggregate Limit of Insurance. Limit of liability each claim Subject to paragraph 2. below our limit of insurance for damages for each claim shall not exceed the amount stated in the Declarations for each claim. 2. Limit of liability in the aggregate Our limit of insurance for damages for all claims shall not exceed the amount stated in the Declarations as the aggregate. 3. Multiple insureds claims and claimants The limits of insurance shown in the Declarations and subject to the provisions of this Policy is the amount the Company will pay as damages and claim expenses regardless of the number of Insureds claims made or persons or entities making claims. 4. Related claims If related claims are subsequently made against the Insured and reported to the Company all such related claims whenever made shall be considered a single claim first made and reported to the Company within the policy period in which the earliest of the related claims was first made and reported to the Company. Section V Additional Defi Administrator means any facility medical administrator or the medical director in their performance of administrative services. itions Administrative services mean the planning organizing directing and controlling of your resident health care operations. Automobile means a land motor vehicle trailer or semitrailer designed for travel on public roads including any attached machinery or equipment. Beauticians and Barbers Services means those services rendered by licensed beauticians and barbers in their capacity as such. Claim means an oral or written demand received by the Insured for money arising out of an incident. The service of suit or the institution of an arbitration proceeding against the Insured arising out of an incident will also be considered a demand. G141442 C Ed. 0809 Page 2 of 4 | 2 |
G141442 C Ed. 0809 20020000140348134911958 Claim expenses mean all of those amounts specified in paragraphs a. b. and of Section Supplementary Payments. Damages mean judgments awards and settlements provided any settlement is made with our prior written consent than an Insured is legally obligated to pay on account of a covered claim. Damages do not include 1. the return or restitution of fees expenses or costs 2. civil or criminal fines sanctions penalties or forfeitures whether pursuant to law statute regulation or court rule injunctive or declaratory relief any amount that is not insurable under any applicable law 5. expenses incurred for first aid at the time of an incident the multiplied portion or any multiplied award or 7. plaintiff s attorney s fees associated with any of the above. Employee means a person whose work is engaged and directed by you including any of your students or volunteers and including seasonal and temporary employees and employees leased to you. Employee does not include an independent contractor. Healthcare services means services performed by an Insured to care for or assist your patients provided such Insured is licensed trained or qualified to perform such services in the jurisdiction in which such services are rendered. Incident means any medical incident any act error or omission in the course of rendering beauticians and barbers services and any violation of rights of residents. Insured location means the location of each of you as specified on the Declaration or additional locations where you render professional services as may be specified by endorsement. Loading or unloading means the handling of property 1. after it is moved from the place where it is accepted for movement into or onto the aircraft watercraft or automobile 2. while it is in or on an aircraft watercraft or automobile or 3. while it is being moved from an aircraft watercraft or automobile to the place where it is finally delivered Medical Incident means an act error or omission in the providing of professional services. This includes such Insured s responsibility for anyone acting under their direction or control. Pollutants means any substance exhibiting hazardous characteristics as is or may be defined or identified on any list of hazardous substances issued by the United States Environmental Protection Agency or any state local or foreign counterpart. Pollutants also means without limitation any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals or waste including materials to be recycled reconditioned or reclaimed as well as any air emission odor waste water oil or oil products infectious or medical waste asbestos or asbestos products or any noise. Property damage means 1. physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or 2. of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the incident that caused it. Professional services means the following services done on your behalf 1. performance of administrative services 2. performance of healthcare services 3. beauticians and barbers services. Professional services do not include any services performed by any Insured in his or her capacity as an intern medical resident physician surgeon dentist psychiatrist chiropractor or physicians assistant except to the extent such services are performed by the Medical Director in the attending physician s absence and on an emergency basis. Related incidents mean all incidents that are logically or causally connected by any common fact circumstance situation transaction event advice or decision. Related claims mean all claims arising out of a single act or omission or arising out of related incidents. Resident means a person who is being cared for at your facility. Rights of Residents means 1. Any right granted to a nursing home resident under any state law regulating your business as a resident health facility. 2. The rights of residents as included in the United States Department of Health and Welfare regulations governing participation of Intermediate Care Facilities and Skilled Nursing Facilities regardless of whether your facility is subject to those regulations. VI. Additional Conditions Applicable To This Coverage Form G141442 C Ed. 0809 Page 3 of 4 | 2 |
G141442 C Ed. 0809 1. Duties In The Event Of A Claim Or Potential Claim The Insured must give us written notice as soon as reasonably possible of any claim made against the Insured during the policy period. If during the policy period the Insured becomes aware of an incident that is expected to be the basis of a claim against the Insured the Insured must give written notice to us as soon as reasonably possible during the policy period. Such notice must state the reasons for anticipating a claim with full particulars including but not limited to i. the specific act or omission the dates and persons involved the identities of anticipated or possible claimants iv. the circumstances by which the Insured first became aware of the possible claim. If such notice is given then any such claim that is subsequently made against the Insured and reported to us shall be deemed to have been made at the time such written notice was given to us. c. Aclaim shall be deemed made i. inthe case of a civil proceeding or arbitration on the earliest of the date of service upon or other receipt by any Insured of a complaint indictment notice of charge or similar document against the Insured in such proceeding or arbitration ii. in the case of a written demand for money upon receipt of such written demand by the Insured. 2. Coverage Territory This coverage form applies worldwide provided that the claim is made and any legal proceedings are pursued within the United States of America its territories possessions or commonwealths or Canada. G141442 C Ed. 0809 Page 4 of 4 | 2 |
G142859 A Ed. 0402 CNA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ABUSE OR MOLESTATION EXCLUSION ENDORSEMENT This endorsement modifies insurance provided under the GENERAL LIABILITY COVERAGE PART and the PROFESSIONAL LIABILITY COVERAGE PART THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SEXUAL OR PHYSICAL ABUSE OR MOLESTATION EXCLUSION The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability of the General Liabilty Coverage Form and Section Il Exclusions of the Professional Liability Coverage Form This Insurance does not apply to any claim for damages 1. whether or not intentional based upon arising out of or in any way related to the actual alleged attempted or proposed or threatened sexual abuse molestation assault or battery of any person 2. based upon arising out of or in any way related to self inflicted injuries This exclusion applies regardless of the legal theory or basis upon which the insured is alleged to be liable for any damages arising out of the activity described in 1 or 2 above including but not limited to assertions of improper or negligent employment continued employment investigation failure to investigate supervision or failure to supervise. 6561 16YE18VE07 16000200 G142859 A Ed. 0402 Page 1 of 1 | 2 |
G300303 A Ed. 0506 CNA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FELLOW EMPLOYEE BODILY INJURY ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to paragraph 2.a. 1 of Section The coverage provided by this endorsement is Il Who Is An Insured over any other valid and collectible insurance tt covers the liability of any employee that is cove Subparagraphs a b and c above do not apply to paragraph A. of this endorsement. any employees with respect to bodily injury to a co employee B. The following is added to Paragraph 4. Other Insurance Condition under Section IV Commercial General Liability Conditions The coverage provided by this endorsement is excess over any other valid and collectible insurance that also covers the liability of any employee that is covered by paragraph A. of this endorsement. 0961 46YE18VE07 16000200 G300303 A Ed. 0506 Page 1 of 1 | 2 |
CNA 333 S Wabash Chicago lllinois 60604 Policy Number From Policy Period To 4034813491 123114 123115 Named Insured And Address RED OAK HEALTH SERVICES INC 1902 HARLAN DRIVE SUITE A BELLEVUE NE 68005 Coverage Is Provided By Agency Columbia Casualty Company 064099977 Agent LOCKTON COMPANIES LLC 1015 NORTH 98TH ST SUITE 101 OMAHA NE 68114 nd Address ICES INC PAYMENT PLAN SCHEDULE IT IS AGREED THAT THE TOTAL ESTIMATED PREMIUM SHOWN IN THE DECLARATIONS OF THIS POLICY IS PAYABLE AS FOLLOWS EFFECTIVE DATE 12312014 TOTAL PREMIUM PREMIUM 153199.00 153199.00 1961 16VE1BPE07 160002002 ISSUE DATE 112414 | 2 |
2961 16YE18VE07 160002002 END OF COPY | 2 |
nan nan nan nan 113.0 20113 RENEWAL AMCO INSURANCE COMPANY 20113 1100 LOCUST ST DEPT 1100 RENEWAL DES MOINES IA 50391 2000 1 515 280 4211 COMMERCIAL GENERAL LIABILITY DECLARATIONS Policy Number ACP GLAO 3028548677 Named Insured NUSSBECK PROPERTIES LLC NUSSBECK PROPERTIES 1 INC Address 4141 NE LAKEWOOD WAY LEE S SUMMIT MO 64064 1704 Agent LOCKTON COMPANIES LLC 15 20113 713 Address KANSAS CITY MO 64112 PRODUCER JOHN S LOCKTON Policy Period From 010118 to 010119 1201 A.M. standard time at the address of the named insured as stated herein. In return for the payment of the premium and subject to all the terms of this policy we agree with you to provide the insurance as stated in this policy. LIMITS OF INSURANCE GENERAL AGGREGATE LIMIT other than roducls cumleled operations PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT PERSONAL AND ADVERTISING INJURY LIMIT EACH OCCURRENCE LIMIT DAMAGE TO PREMISES RENTED TO YOU LIMIT any one premises MEDICAL EXPENSE LIMIT any one person Arnnnen Retroactive Date CG0002 only The Named Insured is LIMITED LIABILITY CO Business of the Named Insured is OFFICE Audit Period ENDORSEMENTS ATTACHED TO THIS POLICY SEE COMMERCIAL GENERAL LIABILITY FORMS AND ENDORSEMENTS SCHEDULE TOTAL ADVANCE PREMIUM nan nan nan nan 840.0 Replacement or Renewal Number ACP GLA0O3027140646 A PACKAGE MODIFICATION FACTOR HAS BEEN APPLIED Countersigned By Authorized Representative GL D 10 98 IRECT BILL L7BK 17362 INSURED COPY ACP GLAOD 3028548677 928043783 43 0006810 GL D 10 98 DIRECT BILL L7BK 17362 INSURED COPY | 2 |
AMCO INSURANCE COMPANY IN WITNESS WHEREOF the Company has caused this policy to be signed by its president and secretary and countersigned on the declarations page by a duly authorized representative of the company. ot e 7o WMMML SECRETARY PRESIDENT SP 00020916 ACP GLAO 3028548677 Page 1 of 1 43 0006811 INSURED COPY nan nan nan nan 928943783.0 | 2 |
AMCO INSURANCE COMPANY 1100 LOCUST ST DEPT 1100 DES MOINES 1A 50391 2000 1 515 280 4211 COMMERCIAL GENERAL LIABILITY SCHEDULE Policy Number ACP GLAO 3028548677 Item No. Location and Description of Hazards Code Premium No. Basis Rates Advance Premium OTHER PRICO OTHER PRICO 001A MO503 BUILDINGS OR PREMISES BANK OR OFFICE MERCANTILE OR MANUFACTURING MAINTAINED BY THE INSURED LESSOR S RISK ONLC PRODUCTS COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT OTHER THAN NOT FOR PROFIT 4141 NE LAKEWOOD WAY LEE S SUMMIT MO640641704 61217 AREA 13328 002A MO503 BUILDINGS OR PREMISES BANK OR OFFICE MERCANTILE OR MANUFACTURING MAINTAINED BY THE INSURED LESSOR S RISK ONLY PRODUCTS COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT OTHER THAN NOT FOR PROFIT 610 NW DUNLAP ST LEE S SUMMIT MO640631915 001C MO503 COMMERCIAL GENERAL LIABILITY ENHANCEMENT INCLUDING MEDICAL PAYMENTS CG7212 61217 AREA 4020 77429 FLAT CHARGE PER THOUSAND SQ. FT. 945 33. 453 PER THOUSAND SQ. FT. 5 33.94 137 250 4020 PER THOUSAND SQ. FT. 3.945 137 FLAT CHARGE 250 Total Advance Other and PR CO 840 TOTAL ADVANCE PREMIUM 840 NOTE For classes based on payroll each Executive Officer Sole Proprietor or Partner may be subject to a fixed amount. GL DS 12 93 DIRECT BILL L7BK 17362 INSURED COPY ACP GLAO 3028548677 928943783 43 00068 INSURED COPY ACP GLAO 3028548677 928943783 43 0006812 | 2 |
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