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GA4721L09 18 b. By way of an edition of an I1SO addi tional insured endorsement that in cludes arising out of your ongoing operations or arising out of your work then the phrase caused. in whole or in part by in Paragraph A.1.a. andor Para graph A.1.b. above whichever applies is replaced by the phrase arising out of. 3. With respect to the insurance afforded to the additional insureds described in Para graph A.1. the following additional exclu sion applies This insurance does not apply to bodily injury property damage or personal and advertising injury arising out of the rendering of or the failure to render any professional architectural engineering or surveying services including a. The preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or draw ings and specifications or b.. Supervisory inspection. architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hir ing. employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or prop erty damage. or the offense which caused the personal and advertising inju ry involved the rendering of or the fail ure to render any professional architec tural. engineering or surveying services. 4. This Paragraph A. does not apply to addi tional insureds described in Paragraph B. Additional Insured State Or Governmental Agency Or Subdivision Or Political Subdi vision Automatic Status When Required In Written Permits Or Authorizations 1. Section Il Who Is An Insured is amended to include as an additional in sured any state or governmental agency or subdivision or political subdivision you have agreed in writing in a contract agreement permit or authorization to add as an additional insured on this Coverage Part. Such state or governmental agency or subdivision or political subdivision is an additional insured only with respect to op erations performed by you or on your be half for which the state or governmental agency or subdivision or political subdivi sion issued in writing a contract agree ment permit or authorization. 2. With respect to the insurance afforded to the additional insureds described in Para graph B.1. the following additional exclu sions apply This insurance does not apply to a. Bodily injury property damage or personal and advertising injury aris ing out of operations performed for the federal government state or mu nicipality or b. Bodily injury or property damage included within the products completed operations hazard. C. The insurance afforded to additional insureds described in Paragraphs A. and B. 1. Only applies to the extent permitted by law and 2. Will not be broader than that which you are required by the written contract writ ten agreement written permit or written authorization to provide for such addition alinsured 3. Does not apply to any person organiza tion state governmental agency or sub division or political subdivision specifically named as an additional insured for the same project in the schedule of an en dorsement added to this Coverage Part and 4. Does not apply to the City of Chicago its officers employees and agents with re spect to liability caused by or arising from a. The building or disassembly of scaf folding by or for you or b. The use of such scaffolding. With respect to the insurance afforded to the additional insureds described in Paragraphs A. and B.. the following is added to Section Il Limits Of Insurance The most we will pay on behalf of the addi tional insured is the amount of insurance 1. Required by the written contract written agreement written permit or written au thorization described in Paragraphs A. and B. or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the appli cable Limits of Insurance shown in the Decla rations. Includes copyrighted material of Insurance Services Office Inc.. with its permission. Page2of 3 Page2of3 GA4721L09 18 | 2 |
2. You have agreed in writing in a contract agreement. permit or authorization de scribed in Paragraph A. or B. that this in surance would be primary to any other in surance available to the additional in sured. As used in this endorsement wrap up insur ance means any insurance provided by a con solidated wrap up insurance program. Primary And Noncontributory Insurance When Required By Written Contract Agreement Permit Or Authorization Except when wrap up insurance applies to the claim or suit on behalf of the additional in sured this insurance is primary to and will not seek contribution from any other insurance available to the additional insured described in Paragraphs A. and B. provided that 1. The additional insured is a Named In sured under such other insurance and 2. You have agreed in writing in a contract agreement permit or authorization de scribed in Paragraph A. or B. that this in surance would be primary and would not seek contribution from any other insur ance available to the additional insured. As used in this endorsement wrap up insur ance means any insurance provided by a con solidated wrap up insurance program. Section IV Commercial General Liability Conditions 9. Transfer Of Rights Of Re covery Against Others To Us is amended by the addition of the following We waive any right of recovery we may have against any additional insured under this en dorsement against whom you have agreed to waive such right of recovery in a written con tract written agreement written permit or writ ten authorization because of payments we make for injury or damage arising out of your ongoing operations or your work done under a written contract written agreement written permit or written authorization. However. our rights may only be waived prior to the occur rence giving rise to the injury or damage for which we make payment under this Coverage Part. The insured must do nothing after a loss to impair our rights. At our request. the insured will bring suit or transfer those rights to us and help us enforce those rights. Section IV Commercial General Liability Conditions is amended to add the following Automatic Additional Insured Provision This insurance applies only if the bodily inju ry or property damage occurs. or the per sonal and advertising injury offense is com mitted 1. During the policy period and 2. Subsequent to your execution of the writ ten contract or written agreement. or the issuance of a written permit or written au thorization. described in Paragraphs A. and B. Except when G. below applies. the following is added to Section IV Commercial General Liability Conditions 5. Other Insurance and supersedes any provision to the contrary When Other Additional Insured Coverage Applies On An Excess Basis This insurance is primary to other insurance available to the additional insured described in Paragraphs A. and B. except 1. As otherwise provided in Section IV Commercial General Liability Condi tions. 5. Other Insurance. b. Excess In surance or 2. For any other valid and collectible insur ance available to the additional insured as an additional insured by attachment of an endorsement to another insurance policy that is written on an excess basis. In such case this insurance is also excess. The following is added to Section IV Com mercial General Liability Conditions 5. Other Insurance and supersedes any provi sion to the contrary Primary Insurance When Required By Writ ten Contract Agreement Permit Or Au thorization Except when wrap up insurance applies to the claim or suit on behalf of the additional in sured. this insurance is primary to any other insurance available to the additional insured described in Paragraphs A. and B. provided that 1. The additional insured is a Named In sured under such other insurance and Includes copyrighted material of Insurance Services Office inc.. with its permission. Page3of 3 GA 4721L09 18 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BODILY INJURY EXCEPTIONS TO POLLUTANT EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART For purposes of insurance provided by this endorsement 1. Sudden and Accidental Exception Exclusion f. Pollutant 1a and 1d of SECTION COVERAGES COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY do not apply to bodily injury pro vided a. The release of pollutants from which the bodily injury arises is sudden and accidental and b. The injured person s first exposure to such pollutants occurred during the policy period and c. The injured person is clinically diagnosed or treated by a physician for the bodily injury caused by exposure to such pol futants within one year of such first ex posure. Amendment to On Premises Exception The on premises exception to the Pollutant Exclusion f.1a1 of SECTION COV ERAGES COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted in its entirety and replaced by the fol lowing c Within one year of such first exposure the person injured is clinically diagnosed or treated by a physician for the medical condition caused by the exposure to such vapors. However Paragraph c does not apply if the bodily injury is caused by vapors 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 Off Premises Exception Exclusion f. Pollutant 1d of SECTION COVERAGES COVERAGE A. BODILY IN JURY AND PROPERTY DAMAGE LIABILITY does not apply to bodily injury that is caused by gaseous or airborne pollutants provided a. The injured person s first exposure to gaseous or airborne pollutants occurred during the policy period and b. The injured person is clinically diagnose or treated by a physician for the bodil injury caused by the exposure to gase ous or airborne pollutants within one year of such first exposure. Amended Who Is An Insured As respects the insurance provided by Para graphs 1. and 3. of this endorsement the Sudden and Accidental Exception and the Off Premises Exception SECTION Il WHC IS AN INSURED is deleted in its entirety anc replaced by the following The coverage afforded shall apply only t Named Insureds. We shall have no duty defend or pay damages for any person or or ganization that is not a Named Insured. SECTION IV COMMERCIAL GENERAL LI ABILITY CONDITIONS 5. Other Insuranc b. Excess Insurance is amended to includ the following The insurance provided by Paragraphs 1 Sudden and Accidental Exception and 3 Off Premises Exception of this endorsemen is excess over any other valid and collectibl insurance whether primary excess contin gent or on any other basis except insuranc written specifically to cover as excess over the limits of insurance that apply in this endorse ment. As respects the insurance provided by Para graphs 1. and 3. of this endorsement SEC TION V DEFINITIONS is amended to ad the following 1. Accidental means unintended and ur expected. 2. Gaseous or airborne pollutants mean pollutants which a Are a gas smoke fume vapor c other similar airborne substance an b Are the result of the release of suc pollutants from materials machir ery or equipment brought on or t the work site by any Named Ir sured or any employees contrac tors or subcontractors working d b. The injured person is clinically diagnosed or treated by a physician for the bodily injury caused by the exposure to gase ous or airborne pollutants within one year of such first exposure. Amended Who Is An Insured As respects the insurance provided by Para graphs 1. and 3. of this endorsement the Sudden and Accidental Exception and the Off Premises Exception SECTION Il WHO IS AN INSURED is deleted in its entirety and replaced by the following The coverage afforded shall apply only to Named Insureds. We shall have no duty to defend or pay damages for any person or or ganization that is not a Named Insured. SECTION IV COMMERCIAL GENERAL LI ABILITY CONDITIONS 5. Other Insurance b. Excess Insurance is amended to include the following The insurance provided by Paragraphs 1. Sudden and Accidental Exception and 3. Oft Premises Exception of this endorsement is excess over any other valid and collectible insurance whether primary excess contin gent or on any other basis except insurance written specifically to cover as excess over the limits of insurance that apply in this endorse ment. As respects the insurance provided by Para graphs 1. and 3. of this endorsement SEC TION V DEFINITIONS is amended to add the following 1. Accidental means unintended and un expected. 2. Gaseous or airborne pollutants means pollutants which a Are a gas smoke fume vapor or other similar airborne substance and b Are the result of the release of such pollutants from materials machin ery or equipment brought on or to the work site by any Named In sured or any employees contrac tors or subcontractors working di Includes copyrighted material of Insurance Services Office Inc. with its permission. GA 4781204 Page 1 of 2 | 2 |
rectly or indirectly on any Named In sured s behalf. Gaseous or airborne pollutants does not include asbestos or lead. Release means actual discharge dis persal seepage migration release es cape or emission. Sudden means abrupt immediate and brief as well as unexpected and without prior notice. Sudden has a temporal element which requires that the release of pollutants begins and ends within a brief period of time. A release of a pollutant which results from a series of ongoing events which constitute a course of conduct or course of business is not sudden. Work site means any premises site or location while a Named Insured or a Named Insured s employees contrac tors or subcontractors are performing op erations directly or indirectly. on the Named Insured s behalf provided the premises site or location is not owned or occupied by or rented or loaned to a Named Insured. Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 2 of 2 GA 4781204 | 2 |
THE CINCINNATI INSURANCE COMPANY CLAIMS MADE EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM DECLARATIONS Attached to POLICY NUMBER EPP 060 55 64 Effective Date 03 01 2021 Named Insured is the same as it appears in the Common Policy Declarations unless another entry is made here LIMITS OF INSURANCE PER WRONGFUL ACT LIMIT 50000 AGGREGATE LIMIT 50000 DEDUCTIBLE RETROACTIVE DATE DEDUCTIBLE AMOUNT 2500 NONE PREMIUM TOTAL ANNUAL PREMIUM 825 FORMS AND OR ENDORSEMENTS APPLICABLE TO THIS COVERAGE PART GAll 0517 EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM GA234IL 0416 ILLINOIS CHANGES EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM GA391 0703 WAR LIABILITY EXCLUSION This Declarations page together with the completed applications. the Common Policy Declarations the Common Policy Conditions the Employment Practices Liability Coverage Form and any accompanying endorsements shall constitute the contract between the insureds and The Cincinnati Insurance Company. THIS INSURANCE COVERAGE CONTAINS CLAIMS MADE COVERAGE. EXCEPT AS MAY BE OTHERWISE PROVIDED HEREIN THIS INSURANCE IS LIMITED TO WRONGFUL ACTS FOR WHICH CLAIMS ARE FIRST MADE AGAINST THE INSURED DURING THE POLICY PERIOD. PLEASE READ AND REVIEW THIS INSURANCE CAREFULLY AND DISCUSS THE COVERAGE WITH YOUR AGENT. THE LIMITS OF INSURANCE AVAILABLE TO PAY JUDGMENTS OR SETTLEMENTS SHALL BE REDUCED BY AMOUNTS INCURRED FOR LEGAL DEFENSE. Pagel of 1 EPP 060 55 64 GA 53107 08 | 2 |
EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM TABLE OF CONTENTS Begins on Page Preamble SECTION EMPLOYMENT PRACTICES LIABILITY COVERAGE. A. Insuring Agreement.......... B. Exclusions............... C. Supplementary Payments SECTION II WHO IS AN INSURED. SECTION IIl LIMITS OF INSURANCE AND INSURED S DEDUCTIBLE........ SECTION IV CONDITIONS... Duties of the Insureds in the Event of Claim Legal Action Against Us Other Insuranc Warranties Transfer of Rights of Recovery Against Others To Us. Insured s Representative Clause..... Mediation and Allocation.... Acquisition of an Insured by Another Organization Cessation of Subsidiaries Three or Five Year Policies Office of Foreign Assets Control OFAC Compliance..... SECTION V EXTENDED REPORTING PERIODS SECTION VI DEFINITIONS A. Benefits B. Bodily injur. Claim... D. Coverage territory. E. Defense costs F. Domestic partner G. Employee....... H J. K. L. M N. o Ae zTommoonm Executive officer... Interrelated wrongful act Loss... Personal injury Pollutants Property damage Subsidiary.. Wrongful act... GA 116 0517 Page 1 of 10 | 2 |
NOTICE THIS INSURANCE COVERAGE CONTAINS CLAIMS MADE COVERAGE. EXCEPT AS MAY BE OTHERWISE PROVIDED HEREIN THIS INSURANCE IS LIMITED TO WRONGFUL ACTS FOR WHICH CLAIMS ARE FIRST MADE AGAINST THE INSURED DURING THE POLICY PERIOD. PLEASE READ AND REVIEW THIS INSURANCE CAREFULLY AND DIS CUSS THE COVERAGE WITH YOUR AGENT. THE LIMITS OF INSURANCE AVAILABLE TO PAY JUDGMENTS OR SETTLEMENTS SHALL BE REDUCED BY AMOUNTS INCURRED FOR LEGAL DEFENSE EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declara tions and any other person or organization qualify ing 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 organiza tion 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 EMPLOYMENT PRACTICES LIA BILITY COVERAGE A. Insuring Agreement 1. We will pay those sums that the insured becomes legally obligated to pay as dam ages because of all loss generated by a claim. We will have the right and duty to select counsel and defend the insured against any claim. However we will have no duty to defend the insured against any claim seeking damages to which this insurance does not apply. We may make any investigation we deem necessary and may with the consent of the insured make any settlement of any claim we deem expedient. However if the insured withholds consent to such set tlement our liability for all loss in con nection with such claim shall not exceed the amount for which we could have set tled such claim plus charges and ex penses which have accrued since the date such settlement was proposed in writing by us to the insured plus 2. 90 of any settlement or judgment in ex cess of the proposed settlement amount referenced in A.1. above plus 90 of any defense costs incurred after the date the insured refused to consent to the pro posed settlement. The remaining 10 of any settlement or judgment in excess of the proposed settlement amount refer GA 116 05 17 But enced in A.1. above plus 10 of any de fense costs incurred after the date the policy insureds refused to consent to the proposed settlement shall be borne by the insureds uninsured and at their own risk. a. The amount we will pay for all loss is limited as described in SECTION I LIMITS OF INSURANCE AND INSURED S DEDUCTIBLE and b. Our right and duty to defend ends when we have used up the applicable limit of insurance in the defense andor payment of judgments or set tlements of covered claims. No other obligation or liability to pay sums or perform acts or services is covered un less specifically provided for under Sup plementary Payments. This insurance applies to claims only if those claims a. Arise from a wrongful act commit ted attempted or allegedly committed or attempted 1 On or after the Retroactive Date if any shown in the Declarations and prior to the termination of this Coverage Form and 2 In the coverage territory and b. Are first made against any insured in accordance with Paragraph 4. below during the policy period or any Ex tended Reporting Period we may provide under SECTION V EX TENDED REPORTING PERIODS. A claim for all loss will be deemed to have been made at the earlier of the fol lowing times a. When an insured reports to us or an other insurer in writing an incident or circumstance that may lead to a claim or loss or Page 2 of 10 Page 2 of 10 | 2 |
2 Any direction or request to test for. monitor clean up. remove contain treat. detoxify. or neu tralize pollutants. including but not limited to claims alleging damage to an insured provided. however. this exclusion shall not apply to any claim under this Coverage Form for retaliatory treatment of a person with respect to actual or threatened disclosures by such person of matters described in 1 or 2 above. Prior Known Acts Any claim or loss based upon arising out of or in consequence of any actual or alleged wrongful act committed attempted. or allegedly committed or attempted prior to the effective date of this Coverage Form if 1 Notice of a claim or circum stances which may lead to a claim have been reported un der any previous policy. whether or not coverage applied of which this Coverage Form is a renewal or replacement or which it may succeed in time or 2 The insured knew or should have reasonably foreseen. prior to the effective date of the first consecutive Coverage Form is sued by us. that such circum stances might be the basis of a claim or loss or 3 Notice of a claim or circum stances which may lead to a claim is based upon. arises out of. directly or indirectly results from or in consequence of or in any way involves any prior or pending litigation. arbitration or administrative action as of the effective date of the first consec utive Coverage Form issued to the insured by us. Violation of Laws Any claim based upon arising out of. in consequence of or in any way involving any actual or alleged viola tions of any of the responsibilities. obligations. or duties imposed by the 1 Employee Retirement Income Security Act of 1974 or 2 Fair Labor Standards Act except the Equal Pay Act except we shall reimburse the insured for Page 3 of 10 b. When notice of such claim is re ceived in writing by an insured or by us. whichever comes first. B. Exclusions 1. This insurance does not apply to ADA Modifications Loss incurred by the insured in making physical changes. modifica tions alterations or improvements as part of an accommodation pursuant to the Americans With Disabilities Act or similar provisions of any federal. state or local statutory or common law. However this exclusion does not ap ply to defense costs. Bodily Injury and Property Damage Any claim or loss based upon arising out of. or in consequence of any actual or alleged bodily injury or property damage. Contractual Liability Any claim based upon arising out of. or in consequence of. any actual or alleged obligation or liability of oth ers assumed by an insured under any contract or agreement. either oral or written except to the extent the in sured would have been liable in the absence of the contract or agree ment. Fraudulent Act or Purposeful Vio lation Any claim or loss based upon. arising out of. or in consequence of any deliberately fraudulent. dishon est criminal or malicious act or omis sion or willful violation of any statute. law rule regulation. agreement or judicial or regulatory order. if a final and non appealable judgment or ad judication adverse to the insureds es tablishes a deliberately fraudulent. dishonest. criminal or malicious act or omission or willful violation of any statute law regulation. agreement or judicial or regulatory order. Pollutant Any claim based upon. arising out of. in consequence of. or in any way involving 1 The actual alleged. or threat ened discharge. dispersal seep age migration emission re lease or escape of pollutants or GA 116 05 17 | 2 |
up to a maximum payment of 100000 in defense costs that exceed the Deductible Amount as set forth in the Declarations. Any payment of defense costs shall be part of and not in addi tion to the Limit of Insurance set forth in the Declarations and such payment reduces the Limit of Insurance or 3 National Labor Relations Act in cluding the Labor Management Relations Act of 1947 or 4 Worker Adjustment and Retrain ing Notification Act or 5 Consolidated Omnibus Budget Reconciliation Act of 1985 or 6 Occupational Safety and Health Act or any amendments to or rules or regu lations promulgated pursuant to these laws or similar provisions of any federal state or local statutory or common law. However this exclusion shall not apply to a claim for retalia tory treatment of a person with re spect to actual or threatened disclo sures by such person of any actual or alleged violation of the Employee Re tirement Income Security Act. the Fair Labor Standards Act the Na tional Labor Relations Act including the Labor Management Relations Act of 1947 the Worker Adjustment and Retraining Notification Act. the Con solidated Omnibus Budget Reconcili ation Act or the Occupational Safety and Health Act by any insured. h. Workers Compensation and Simi lar Laws Any claim based upon arising out of in consequence of or in any way involves any actual or alleged obliga tion of any insured under a workers compensation unemployment insur ance. social security. disability bene fits or similar law or derivative ac tions arising out of any of these. However this exclusion shall not ap ply to any claim for retaliatory treatment by an insured due to the exercise of rights granted under any such law. 2. Severability of Exclusions With respect to the exclusions in this poli cy No fact regarding or knowledge pos sessed by any insured shall be imputed to GA 116 0517 any other insured to determine if coverage is available except that facts pertaining to and knowledge possessed by any past present or future Chief Financial Officer or Chief Executive Officer of the Named In sured shall be imputed to the Named In sured to determine if coverage is availa ble. C. Supplementary Payments We will pay with respect to any claim we de fend 1. The cost of any appeal bond attachment bond. or any similar bond but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim in cluding actual loss of earnings up to 250 a day because of time off from work. These payments will not reduce the limits of insurance. SECTION Ii WHO IS AN INSURED A. Ifyou are designated in the Declarations as 1 An individual you and your spouse or domestic. partner are insureds but only to the extent such spouse or domestic partner is a party to any claim solely in such person s capacity as a spouse or domestic partner of an insured and on ly if the claim seeks damages recovera ble from marital community property property jointly held by the insured and the spouse or domestic partner or property transferred from insured to the spouse or domestic partner but only with respect to the conduct of a business of which you are the sole owner. A partnership or joint venture you are an insured and any subsidiary. Your past. present and future members. your past. present and future partners and their spouses or domestic partners are also insureds but only to the extent such spouse or domestic partner is a party to any claim solely in such person s capaci ty as a spouse or domestic partner of an insured and only if the claim seeks damages recoverable from marital com munity property property jointly held by the insured and the spouse or domestic partner or property transferred from in sured to the spouse or domestic part ner but only with respect to the conduct of your business. A limited liability company and any sub sidiary. you are an insured. Your past Page 4 of 10 | 2 |
ship. joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION Il LIMITS OF INSURANCE AND IN SURED S DEDUCTIBLE A. The Limits of Insurance shown in the Declara tions and the rules below fix the most we will pay regardless of the number of 1. Insureds under this Coverage Form 2. Claims made or suits brought on ac count of wrongful acts or otherwise or 3. Persons or Organizations making claims or bringing suits. B. Subject to C. below. our maximum liability for each wrongful act shall be the Limit of Insur ance Per Wrongful Act as specified in the Dec larations. All loss arising out of the same wrongful act and all interrelated wrongful acts of any in sured shall be deemed one wrongful act and have been deemed to have originated in the earliest policy period in which a claim is first made against any insured alleging any such wrongful act or interrelated wrongful acts. C. The Aggregate Limit as specified in the Decla rations is the most we will pay for loss for all claims to which this insurance applies. D. Defense costs incurred by us or by the in sured with our written consent are part of and not in addition to the Limits of Insurance speci fied in the Declarations. Our payment of de fense costs reduces the Limits of Insurance. E. Our liability shall apply only to that part of each covered loss which is excess of the Deducti ble Amount specified in the Declarations and such Deductible Amount shall be borne by the insureds. F. Any claim which is made or maintained as a class action or other multiple plaintiff suit shall be deemed one wrongful act and shall be subject to the Per Wrongful Act Limit of Insur ance and Deductible Amount shown in the Declarations. G. Inthe event this Coverage Form is extended in accordance with the provisions of the Basic Extended Reporting Period. our total liability shall not exceed the Aggregate Limit shown in the Declarations for the last policy period in which coverage is provided hereunder. The Limits of Insurance of this Coverage Form ap ply 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 Page 5 of 10 present and future members are also in sureds but only with respect to the con duct of your business. Your past. present and future managers are insureds. but on ly with respect to their duties as your managers. 4. An organization other than a partnership. joint venture or limited liability company. you are an insured. Your past. present and future executive officers and direc tors are insureds. but only with respect to their duties as your officers or directors. Your past and present stockholders are also insureds. but only with respect to their liability as stockholders. B. Each of the following is also an insured 1. Your past. present and future employ ees other than either your executive of ficers 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 employ ment by you or while performing duties re lated to the conduct of your business. 2. Any natural person who is an independent contractor as determined by federal state or local law. but only while acting in the capacity as such for you or any subsidi ary pursuant to an express written agreement between the independent con tractor. or any entity on behalf of the inde pendent contractor. and you or any sub sidiary and only if you or any subsidiary agrees in writing to provide indemnifica tion to such independent contractor pro vided. however any coverage under this Coverage Part for any such independent contractor shall be excess of any indemni fication or insurance otherwise available to such independent contractor from any other source including their estates heirs legal representa tives or assigns in the event of their death in capacity or bankruptcy. 3. The estates heirs. legal representatives or assigns of insureds who are deceased or have been declared incompetent. C. Any organization you newly acquire or form other than a partnership. joint venture or lim ited fliability 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 coverage under this provision is af forded only until the 90th day after you acquire or form the organization or the end of the poli cy period whichever is earlier. No person or organization is an insured with re spect to the conduct of any current or past partner GA 116 05 17 | 2 |
preceding period for purposes of determining the Limits of Insurance. SECTION IV CONDITIONS A. Duties of the Insureds in the Event of a Claim As a condition precedent to coverage under this Coverage Form 1. The insureds shall give us written notice as soon as practicable of any claim made against an insured for a wrongful act and shall give such information and cooperation as we may reasonably re quire including but not limited to a de scription of the claim the nature of the alleged wrongful act the nature of the alleged injury. the names of the claimants and the manner in which the insured first became made aware of the claim. 2. The insureds shall provide us with all in formation assistance and cooperation which we reasonably request and agree that in the event of a claim the insureds will do nothing that may prejudice our po sition or our potential or actual rights of recovery. 3. The insureds shall not settle any claim incur any defense costs or otherwise assume any contractual obligation or ad mit any liability with respect to any claim without our written consent. which shall not be unreasonably withheld. We shall not be liable for any settlement defense costs assumed. obligation or admission to which we have not consented. B. Legal Action Against Us No action shall lie against us unless. as a con dition precedent thereto there shall have been full compliance with all of the terms of this Coverage Form nor until the amount of an in sured s obligation to pay shall have been finally determined either by judgment against an in sured after actual trial or by written agreement of the insured the claimant and us. Any person or organization or the legal repre sentative thereof who has secured such judg ment or written agreement shall thereafter be entitled to recover under this Coverage Form to the extent of the insurance afforded by this Coverage Form. No person or organization shall have any right under this Coverage Form to join us as a party to any action against an insured to determine an insured s liability. Bankruptcy or insolvency of an insured or of their estates shall not relieve us of any of our obligations hereunder. C. Other Insurance This insurance is primary except when all or any part of loss is also insured under any GA 116 05 17 other prior or current policy. Then this insur ance is excess over that other insurance whether primary excess. contingent or on any other basis unless that other insurance was purchased specifically to apply in excess of this Coverage Form. When this Coverage Form is excess 1. We will have no duty to defend any claim when any other insurer has that duty. If another insurer fails to defend and we incur costs as a result of such failure we will be entitled to the insured s rights against such other insurer and 2. 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 Coverage Form and b. The total of all deductible and self insured amounts under all such other insurance. Warranties By accepting this Coverage Form 1. The insureds warrant that the application is attached to and forms a part of this Coverage Form 2. Each and every person who accepts the benefits of coverage as an insured war rants a. That the statements in the application and Declarations are material to our acceptance of risk assumed by us and b.. That we have issued this Coverage Form in reliance upon the truth of the statements in the application and Declarations and c. That coverage depends upon the truth of such statements. Transfer of Rights of Recovery Against Others To Us In the event of any payment under this Cover age Form we shall be subrogated to the extent of such payment to all insured s rights of re covery. In such case the insured shall execute all papers required and shall do.everything necessary to secure and preserve such right including the execution of such documents necessary to enable us to effectively bring suit in the name of the insured. Page 6 of 10 | 2 |
tween us and the insured as to the proper allocation of covered and uncovered mat ters under Paragraph 2. of this condition shall be submitted to a nonbinding media tion prior to the commencement of an ac tion between the parties. In any event on ly one mediation as to the same issues shall be required. H. Acquisition of an Insured by Another Or ganization If i an insured merges into or consolidates with another organization or ii another or ganization or person or group of organizations andor persons acting in concert acquires se curities or voting rights which result in owner ship or voting control by the other organiza tions or persons of more than 50 of the outstanding securities representing the pre sent right to vote for election of an insured s di rectors coverage under this Coverage Form shall continue until its termination. but only with respect to claims for wrongful acts commit ted attempted or allegedly committed or at tempted. by insureds prior to such merger. consolidation or acquisition. I. Cessation of Subsidiaries In the event a2 Named Insured ceases to be a subsidiary coverage with respect to such subsidiary and its insureds shall continue un til termination of this Coverage Form but only with respect to claims for wrongful acts committed. attempted or allegedly committed or attempted prior to the date such organiza tion ceases to be a subsidiary. J. Three or Five Year Policies If this Coverage Form is issued for more than one year the premium shall be computed an nually based on our rates or premiums in ef fect at each anniversary. K. Office of Foreign Assets Control OFAC Compliance Whenever insurance coverage provided by this Coverage Form would be in violation of any United States economic or trade sanc tions. such insurance shall be and void. SECTION V EXTENDED REPORTING PERIODS A. Upon termination of this insurance for any rea son. other than cancellation for nonpayment of premium we may provide one or more Ex tended Reporting Periods as described below. B. Extended Reporting Periods do not extend the policy period or change the scope of coverage provided. They extend the claims reporting period. C. Such Extended Reporting Periods will apply solely with respect to claims first made in ac cordance with SECTION EMPLOYMENT Page 7 of 10 F. Insured s Representative Clause By acceptance of this Coverage Form the first Named Insured shown in the Declarations agrees to act on behalf of all insureds with re spect to the giving and receiving of notice of claim the acceptance of endorsements the giving or receiving of any other notice provided for in this Coverage Form. and the exercising or declining to exercise any right to an Extend ed Reporting Period and agree that such first Named Insured shall act on all insureds be half. G. Mediation and Allocation 1. Any dispute including but not limited to tort claims or contract claims between an in sured and us arising out of or relating to this Coverage Form shall be submitted to nonbinding mediation prior to com mencement of an action between the par ties. The mediator shall be chosen by agreement. If the parties can not agree upon a mediator. the mediator shall be chosen by the American Arbitration Asso ciation. 2. If both loss covered by this Coverage Form and loss not covered by this Cover age Form are incurred. either because a claim against an insured includes both covered and uncovered matters or be cause a claim is made against both an insured and others. we will pay 100 of reasonable and necessary defense costs and all remaining loss will be allo cated between covered loss and uncov ered loss based upon the relative legal exposure of the parties to such matters. 3. If we and the insured can not agree as to matters in Paragraph 2. of this condition prior to a judgment or finding in the civil or administrative proceeding dealing with claims against the insured. the parties agree that they will to the extent it is with in their control. require that the allocation between covered loss and uncovered loss is made in such civil or administrative proceeding. Such efforts shall include but are not limited to the submission of spe cial interrogatories to the finder of fact in such proceedings. Such efforts shall not require us to become a party to such civil or administrative proceedings. 4. Notwithstanding Paragraph 3. of this con dition if we and the insured can not agree as to matters in Paragraph 2. of this con dition prior to a judgment or finding in any civil or administrative proceeding in which such issues are decided. we may at any time before or after mediation under Par agraph 1. of this condition settle all claims against any or all insureds. Fol lowing such settlement. any dispute be GA 116 05 17 | 2 |
PRACTICES LIABILITY COVERAGE A. In suring Agreement 2. and Exclusion f. Prior Known Acts. Such claims must be reported to us prior to the expiration of the Extended Reporting Period. D. A 90 day Basic Extended Reporting Period is automatically provided without additional charge. The Basic Extended Reporting Period does not reinstate or increase the Limits of Insur ance of this Coverage Form. E. A Supplemental Extended Reporting Period is available but only by endorsement and for an extra charge. This supplemental period starts when the Basic Extended Reporting Period as set forth by Paragraph D. ends. The insured must give us a written request for this endorsement within 60 days of the termi nation of this insurance. The Supplemental Ex tended Reporting Period will not go into effect unless the insured pays the additional premi um promptly when due. We will determine the additional premium in accordance with our rules and rates. In doing 50 we may take into account the following 1. The exposure insured 2. Previous types and amounts of insurance and 3. Other related factors. The additional premium will not exceed 200 of the expiring annual premium of this Cover age Form. The endorsement shall set forth any terms that differ from the basic Coverage Form applica ble to the Supplemental Extended Reporting Period. If the Supplemental Extended Reporting Peri od endorsement is in effect we will provide a Supplemental Aggregate Limit of Insurance described below. but only for claims first made in accordance with SECTION EM PLOYMENT PRACTICES LIABILITY COV ERAGE A. Insuring Agreement 2. and Ex clusion f. Prior Known Acts against any in sured during our Extended Reporting Period. The Supplemental Aggregate Limit of Insur ance will be equal to the dollar amount shown in the Declarations for Aggregate Limit that is in effect at the end of the last policy period. Any Extended Reporting Period will immedi ately terminate on the effective date and hour of any other insurance issued to you which re places this insurance. If you notify us of the ef. fective date of the other insurance we will send you a refund of any pro rata unearned premium. GA 116 0517 SECTION VI DEFINITIONS A Benefits means perquisites fringe benefits payments in connection with an employee benefit plan and any other payment other than salary or wages. to or for the benefit of an employee arising out of the employment rela tionship. Bodily injury means physical injury sickness disease or death of any person. Claim means 1. A written demand for monetary damage or non monetary relief 2. A civil proceeding commenced by filing of a complaint or similar pleading 3. A formal administrative or regulatory pro ceeding commenced by a filing of charg es formal investigative order or similar document 4. An arbitration mediation or similar alter native dispute resolution proceeding if the insured is required or agrees to participate in such proceeding with our written con sent or 5. A written request to toll or waive a statute of limitations relating to a potential claim described above which is brought by or on behalf of any past. present or prospective employees of a Named Insured against any of the insureds including any appeal therefrom. as the result of an alleged wrongful act. Coverage territory means anywhere. Defense costs means reasonable and nec essary fees costs and expenses incurred by us or with our consent on behalf of the insured or reimbursed to any insured by us resulting solely from the investigation adjustment de fense and appeal of any claim. Defense costs includes but is not limited to the cost of expert consultants and witnesses premiums for appeal. attachment or supersedeas bonds but not the obligation to furnish such bonds. Defense costs do not include 1. Expenses explicitly provided for under Supplementary Payments or 2. The salaries. wages. overhead or ex penses of our employees or your direc tors officers or employees other than that portion of our employed attorneys fees salaries and expenses allocated to a specific claim or 3. Any amount covered by the duty to defend obligation of any other insurer or 4. Any pre tender fees costs or expenses. Page 8 of 10 | 2 |
4. Civil or criminal fines or penalties imposed by law. liquidated damages. payroll or other taxes. or damages. penalties or types of relief deemed uninsurable under applicable law or 5. Future compensation. including salary or benefits for an employee who has been or will be hired promoted or rein stated to employment pursuant to a set tlement. court order. judgment award or other resolution of a claim or 6. Medical pension disability. life insurance. stock option or other employee type benefit. Personal injury means injury other than bodily injury. arising out of one or more of the following offenses 1. False arrest. detention or imprisonment 2. Oral or written publication of material that libeis or slanders a past. present or pro spective employee 3. Invasion of a past. present or prospective employee s right of privacy 4. Malicious prosecution or 5. Abuse of process. Pollutants means any solid. liquid. gaseous or thermal irritant or contaminant including smoke vapor soot fumes acid. alkalis chemicals. petroleum products and their by products and waste. Waste includes material to be recycled. reconditioned or reclaimed. Pollutants include but are not limited to sub stances which are generally recognized in in dustry or government to be harmful or toxic to persons property or the environment. Property damage means 1. Physical injury to tangible property includ ing all resulting loss of use of that proper ty. All such loss of use shall be deemed to have taken place at the time of the physi cal injury that caused it or 2. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to have taken place at the time of the incident that caused it. Subsidiary means any organization in which more than 50 of the outstanding securities or voting rights representing the present right to vote for election of directors is owned or con trolled. directly or indirectly. in any combina tion. by one or more of the insureds. Wrongful act means any error misstatement or misleading statement. act or omission or neglect or breach of duty by an insured or any Domestic partner means a natural person who is not otherwise an insured. in a commit ted relationship with an insured person. which is legally recognizable as a marriage. civil un ion or domestic partnership in the state where the claim is made or suit is filed and the legal existence of the refationship is verifiable by le gal government documentation existing prior to the date of the wrongful act complained of in the claim. Employee includes but is not limited to fulk time part time seasonal volunteer. leased or contingent workers as determined by federal. state or local law. Employee does not include independent contractors as determined by federal state or local law. Executive officer means a person holding any of the officer positions created by your charter constitution bylaws or any other simi lar governing document. Interrelated wrongful acts means all causally connected wrongful acts. Loss means defense costs and the total amount of monetary damages which the in sured becomes legally obligated to pay on account of any claim for a wrongful act with respect to which coverage hereunder applies. including damages including back pay and front pay. judgments settlements. prejudg ment and postjudgment interest and punitive or exemplary damages or the multiplied por tion of any multiplied damage award if insura ble under the applicable law most favorable to the insurability of punitive. exemplary or multi plied damages. Loss shall not include any amount for which an insured is not financially liable. compen sation earned in the course of employment but not paid by an insured or matters which are deemed uninsurable under the law pursuant to which this Coverage Form shall be construed. Loss shall not include. other than defense costs 1. Benefits or the equivalent value howev er. this provision does not apply to loss resulting solely from wrongful termination of employment or 2. Amounts which arise out of. are based upon. or are attributable to the employ ment reinstatement of the claimant by an insured or the continued employment of the claimant or 3. Future compensation including salary or benefits for an employee if the in sured is ordered in accordance with a judgment or other final adjudication but fails to reinstate the claimant as an em ployee or Page 9 of 10 GA 1160517 | 2 |
person for whose acts the insured is legally li able for 1 Wmngful discharge or termination of em ployment including constructive dis charge Breach of any oral written or implied em ployment contract or quasi employment contract except for that part of any ex press contract of employment or an ex press obligation to make payments in the event of the termination of employment Employment related misrepresentation Violation of any federal state or local law that concerns employment discrimination or harassment including sexual harass ment involving unwelcome sexual ad vances requests for sexual favors or oth er conduct of a sexual nature or work place bullying or workplace harassment of a nonsexual nature that a. Are made a condition of employment b. Are used as a basis for employment decisions or c. Create awork environment that inter feres with performance Wirongful failure to employ or promote Wrongful discipline Wrongful deprivation of a career oppor tunity. Negligent hiring supervision prormion retention or evaluation Employment related personal injury. Wrongful failure to grant tenure. Employment related wrongful infliction of emotional distress. Violation of the Family Medical Leave Act. Wrongful retaliation. Wrongful denial of training denial or dep rivation of seniority or evaluation or. Failure to adopt. create provide or en force adequate workplace or employment practices and procedures including any actual or alleged assault battery or loss of consortium in connection with Para graphs 1. through 15. above. Page 10 of 10 GA 1160517 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ILLINOIS CHANGES EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM This endorsement modifies insurance provided under the following EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM A. SECTION EMPLOYMENT PRACTICES LIABILITY COVERAGE B. Exclusions e. Pollutant is deleted and replaced by the fol lowing e. Pollutant Where all or part of such claim is based upon. arising out of directly or indirectly resulting from or in consequence of. or in any way involving 1 The actual. alleged. or threatened discharge dispersal seepage. migra tion emission release or escape of pollutants except injury arising out of heat. smoke or fumes from a hos tile fire. Hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be. Or 2 Any direction or request to test for monitor clean up. remove. contain treat detoxify. or neutralize pollu tants including but not limited to claims alleging damage to an in sured. provided. however this exclusion shall not apply to any claim under this Coverage Form for retaliatory treatment of a person with respect to actual or threatened dis closures by such person of matters de scribed in 1 or 2 above. B. The following items are added to SECTION EMPLOYMENT PRACTICES LIABILITY COVERAGE C. Supplementary Payments 3. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the appli cable 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. of fered to pay. or deposited in court the part of the judgment that is within the applica ble fimit of insurance. C. SECTION IV CONDITIONS C. Other Insur ance is deleted and replaced by the following GA 2341L 04 16 C. Other Insurance If the insured has insurance provided by other companies against a loss covered by this policy we shall not be liable under this policy for a greater proportion of such loss and claims expenses than the appli cable limit of insurance stated in the Dec larations bears to the total applicable limit of insurance of all valid and collectible in surance against such loss. D. SECTION IV CONDITIONS K. Office of Foreign Assets Control OFAC Compliance is deleted and replaced by the following K. Office of Foreign Assets Control OFAC Compliance Whenever insurance coverage provided by this policy would be in violation of any United States economic or trade sanc tions. such insurance coverage will not be provided under this policy. E. SECTION IV CONDITIONS I. Cessation of Subsidiaries is deleted and replaced by the following Cessation of Subsidiaries In the event a Named Insured ceases to be a subsidiary on or after the Retroac tive Date shown in the Declarations. cov erage with respect to such subsidiary and its insureds shall continue until termi nation of this Coverage Part. and subject to any applicable Extended Reporting Pe riod. but only with respect to claims for wrongful acts committed. attempted. or allegedly committed or attempted on or after the Retroactive Date shown in the Declarations and prior to the date such organization ceases to be a subsidiary F. SECTION V EXTENDED REPORTING PE RIODS A. is deleted and replaced by the fol lowing A. Upon termination of this insurance for any reason we may provide one or more Ex tended Reporting Periods as described below. Any payments made will be ap plied to any outstanding premium owed Page 10of 2 | 2 |
before being applied to premiums due for any extended reporting periods. G. SECTION Vi DEFINITIONS is amended as follows Definition J. Loss is hereby deleted and re placed by the following J. Loss means defense costs and the to tal amount of monetary damages which the insured becomes legally obligated to pay on account of any claim fora wrongful act with respect to which cov erage hereunder applies including dam ages. judgments settlements and puni tive or exemplary damages or the multi plied portion of any multiplied damage award if insurable under the applicable law most favorable to the insurability of punitive exemplary or multiplied damag es. However in no event will the punitive exemplary damages or the multiplied por tion of any multiplied damages be insura ble under this contract of insurance with respect to a claim brought against an II linois domiciled insured in an lllinois state court except to the extent such damages are insurable under lllinois law. llinois law dictates that an insurer may not reimburse an insured for punitive damages as sessed as a result of the insured s own misconduct. Loss shall not include any amount for which an insured is not financially liable compensation earned in the course of employment but not paid by an insured or matters which are deemed uninsurable under the law pursuant to which this Cov erage Form shall be construed. Loss shall not include other than de fense costs 1. Benefits or the equivalent value however this provision does not ap ply to loss resulting solely from wrongful termination of employment or Amounts which arise out of are based upon or are attributable to the employment reinstatement of the claimant by an insured or the con tinued employment of the claimant or Future compensation including sala ry or benefits for an employee if the insured is ordered in accord ance with a judgment or other final adjudication but fails to reinstate the claimant as an employee or Civil or criminal fines or penalties im posed by law. liquidated damages. payroll or other taxes or damages penalties or types of relief deemed uninsurable under applicable law or Future compensation including sala ry or benefits for an employee who has been or will be hired promoted or reinstated to employment pursuant to a settlement court order judg ment award or other resolution of a claim or Medical pension disability. life insur ance stock option or other employ ee type benefit. Page 2 of 2 GA 2341L 04 16 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAR LIABILITY EXCLUSION This endorsement modifies insurance provided under the following EMPLOYMENT PRACTICES LIABILITY COVERAGE PART The following exclusion is added This insurance does not apply to War Any claim or loss however caused. arising. directly or indirectly. out of 1. War including undeclared or civil war or 2. Warlike action by a military force. includ ing action in hindering or defending against an actual or expected attack. by any government sovereign or other au thority using military personnel or other agents or 3. Insurrection rebellion revolution. usurped power. or action taken by governmental authority in hindering or defending against any of these. Includes copyrighted material of ISO Properties Inc.. with its permission. GA 39107 03 | 2 |
Commission Schedule Effective Date 03 01 2021 Policy Number EPP 060 55 64 Named Insured CARROLL SEATING COMPANY Premium ALL OTHER 102196 ANNUAL INST AUTO GARAGE 11224 ANNUAL EPLI 825 ANNUAL CYBER RISK 274 ANNUAL COMM UMBRELLA 28128 ANNUAL 2 ANNUAL TAXES AND SURCHARGES EPP 060 55 64 Commission 15 15 15 15 15 0 IA 4991 06 17 | 2 |
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X THE CINCINNATI INSURANCE COMPANY 0244 10677 THE CINCINNATI CASUALTY COMPANY 0244 28665 THE CINCINNATI INDEMNITY COMPANY 0244 23280 AUTOMOBILE LIABILITY I.D. CARD State Date Processed b2 03 01 2021 Policy No. Effective Date Expiration Date EBA 060 55 64 03 01 2021 03 01 2022 Insured CARROLL SEATING COMPANY 10 LINCOLN ST RANSAS CITY XS 66103 1906 MOTOR VEHICLE INSURED Year Make 2017 MERCEDES BENZ SPRINTER Vehicle Identification No. WD3PE7CD3IHP568053 Signature I LOCKTON COMPANIES IN CASE YOU HAVE AN ACCIDENT... CALL YOUR AGENT... LLC 24 108 444 W 47TH ST STE 900 KANSAS CITY MO 64112 1906 816 960 9000 The Cincinnati Insurance Company The Cincinnati Casualty Company The Cincinnati Indemnity Company P.O. Box 145496 Cincinnati OH 45250 5496 513 870 2000 AA 4122 IL 1006 KEEP THIS CARD IN YOUR MOTOR VEHICLE WHILE IN OPERATION We can serve you better if you... 1. Report all claims immediately to the police and to your agent. 2. Get the names addresses. and telephone numbers of all drivers. owners and occupants of the other cars in volved. 3. Get the names addresses. and telephone numbers of any witnesses. 4. Do not accept responsibility or discuss the accident with anyone except a police officer or a representative of this Company. SUPPLEMENTARY PAYMENTS This Company agrees. through its Representative or oth erwise to pay premiums or costs on bonds to release at tachments also. the premium on or cost of bail bonds not to exceed the limit per bail bond listed in supplementary payments in the policy. The Company has no obligation to apply for or fumish any such bonds. CONSULT YOUR POLICY FOR ACTUAL COVERAGE IN FORCE ON SPECIFIC VEHICLES. EXAMINE POLICY EXCLUSIONS CAREFULLY. THIS FORM DOES NOT CONSTITUTE ANY PART OF YOUR INSURANCE POL Icy. EXCLUDED DRIVERS SERVICE TO YOU IS OUR MAIN CONCERN cut along line 3A 060 55 64 03 01 2021 03 01 2022 SUred CARROLL SEATING COMPANY LINCOLN ST ANSAS CITY KS 66103 1906 MOTOR VEHICLE INSURED ear Make 17 MERCEDES BENZ SPRINTER ehicle Identification No. Y3PR7CD3IHP568053 DD EMEMTADY DAVMEMTC CALL YOUR AGENT... XKTON COMPANIES LLC 24 108 4 W 47TH ST STE 900 ANSAS CITY MO 64112 1906 L6 960 9000 e Cincinnati Insurance Company e Cincinnati Casualty Company e Cincinnati Indemnity Company M Bac 120408 Fhcienced AL 2RDENA RABE EXCLUDED DRIVERS | 2 |
X THE CINCINNATI INSURANCE COMPANY 024410677 THE CINCINNATI CASUALTY COMPANY 0244 28665 N ngmg czgl e THE CINCINNATI INDEMNITY COMPANY 0244 23280 AUTOMOBILE LIABILITY 1.D. CARD State Date Processed I 03 01 2021 Policy No. Effective Date Expiration Date EBA 060 55 64 03 01 2021 03 01 2022 Insured CARROLL SEATING COMPANY 10 LINCOLN ST RANSAS CITY KS 66103 1906 MOTOR VEHICLE INSURED Year Make 2019 LINCOLN NAUTILUS Vehicle Identification No. 2LMPJBLPXKBLI3715 Signature IN CASE YOU HAVE AN ACCIDENT... CALL YOUR AGENT... LOCKTON COMPANIES LLC 24 108 444 W 47TH ST STE 900 KANSAS CITY MO 64112 1906 816 960 9000 The Cincinnati Insurance Company The Cincinnati Casualty Company The Cincinnati Indemnity Company WHILE IN OPERATION We can serve you better if you... 1. Report all claims immediately to the police and to your agent. 2. Get the names. addresses and telephone numbers of all drivers. owners. and occupants of the other cars in volved. 3. Get the names. addresses and telephone numbers of any witnesses. 4. Do not accept responsibility or discuss the accident with anyone except a police officer or a representative of this Company. SUPPLEMENTARY PAYMENTS This Company agrees through its Representative or oth erwise to pay premiums or costs on bonds to release at tachments also. the premium on or cost of bail bonds not to exceed the limit per bail bond listed in supplementary payments in the policy. The Company has no obligation to apply for or fumish any such bonds. CONSULT YOUR POLICY FOR ACTUAL COVERAGE IN FORCE ON SPECIFIC VEHICLES. EXAMINE POLICY EXCLUSIONS CAREFULLY. THIS FORM DOES NOT CONSTITUTE ANY PART OF YOUR INSURANCE POL Icy. EXCLUDED DRIVERS P.O. Box 145496 Cincinnati OH 45250 5496 513 870 2000 AA 4122 IL 1006 SERVICE TO YOU IS OUR MAIN CONCERN 3A 060 55 64 03 01 2021 03 01 2022 sured CARROLL SEATING COMPANY LINCOLN ST ANSAS CITY KS 66103 1906 MOTOR VEHICLE INSURED ear Make 19 LINCOLN NAUTILUS ehicle Identificaton No. MPJBLPXKBL33715 BB FMEMTADY DAVMEAMTE CALL YOUR AGENT.. CKTON COMPANIES LLC 24 108 14 W 47TH ST STE 900 ANSAS CITY MO 64112 1906 16 960 9000 e Cincinnati Insurance Company e Cincinnati Casualty Company he Cincinnati Indemnity Company A Bas 14RABE Ficcinncsl MLl 4SRN EABR EXCLUDED DRIVERS | 2 |
X THE CINCINNATI INSURANCE COMPANY 0244 10677 THE CINCINNATI CASUALTY COMPANY 0244 28665 THE CINCINNATI INDEMNITY COMPANY 0244 23280 AUTOMOBILE LIABILITY 1.D. CARD State Date Processed Mo 03 01 2021 Policy No. Effective Date Expiration Date EBA 060 55 64 03 01 2021 03 01 2022 insured CARROLL SEATING COMPANY MOTOR VEHICLE INSURED Year Make 2012 FORD ECONOLINE Vebhicle Identification No. 1FTNE2EL3ICDBO6106 Signature IN CASE YOU HAVE AN ACCIDENT... CALL YOURAGENT... LOCKTON COMPANIES LLC 24 108 444 W 47TH ST STE 900 RANSAS CITY MO 64112 1906 816 960 9000 The Cincinnati Insurance Company The Cincinnati Casualty Company The Cincinnati Indemnity Company P.0. Box 145496 Cincinnati OH 45250 5496 513 870 2000 AA 4122 MO 0502 THIS CARD MUST BE CARRIED IN THE INSURED MOTOR VEHICLE FOR PRODUCTION UPON DEMAND We can serve you better if you... 1. Report all claims immediately to the police and to your agent. 2. Get the names addresses. and telephone numbers of all drivers owners and occupants of the other cars in volved. 3. Get the names. addresses. and telephone numbers of any witnesses. 4. Do not accept responsibility or discuss the accident with anyone except a police officer or a representative of this Company. SUPPLEMENTARY PAYMENTS This Company agrees through its Representative or oth erwise to pay premiums or costs on bonds to release at tachments also the premium on or cost of bail bonds not 1o exceed the limit per bail bond listed in supplementary payments in the policy. The Company has no obligation to apply for or fumish any such bonds. CONSULT YOUR POLICY FOR ACTUAL COVERAGE IN FORCE ON SPECIFIC VEHICLES. SERVICE TO YOU IS OUR MAIN CONCERN 3A 060 55 64 03 01 2021 03 01 2022 Sured CARROLL SEATING COMPANY MOTOR VEHICLE INSURED ear Make 12 FORD ECONOLINE ehicle Identification No. TNE2EL3CDBO6106 BA EFRAERMTABY BAVAMEMYE CALL YOURAGENT... CKTON COMPANIES LLC 24 108 14 W 47TH ST STE 900 ANSAS CITY MO 64112 1906 L6 960 9000 e Cincinnati Insurance Company e Cincinnati Casualty Company e Cincinnati Indemnity Company SERVICE TO YOU IS OUR MAIN CONCERN SERVICE TO YOU IS OUR MAIN CONCERN | 2 |
X THE CINCINNATI INSURANCE COMPANY 0244 10677 THE CINCINNATI CASUALTY COMPANY 0244 28665 THE CINCINNATI INDEMNITY COMPANY 0244 23280 AUTOMOBILE LIABILITY 1.D. CARD State Date Processed Mo 03 01 2021 Policy No. Effective Date Expiration Date EBA 060 55 64 03 01 2021 03 01 2022 Insured CARROLL SEATING COMPANY MOTOR VEHICLE INSURED Year Make 2019 LINCOLN CONTINENTAL Vehicle identification No. 1LN6L9NPTR5600463 Signature IN CASE YOU HAVE AN ACCIDENT... CALL YOUR AGENT... LOCKTON COMPANIES LLC 24 108 444 W 47TH ST STE 900 KANSAS CITY MO 64112 1906 816 960 9000 The Cincinnati Insurance Company The Cincinnati Casualty Company The Cincinnati Indemnity Company P.O. Box 145496 Cincinnati OH 45250 5496 513 870 2000 AA 4122 MO 0502 THIS CARD MUST BE CARRIED IN THE INSURED MOTOR VEHICLE FOR PRODUCTION UPON DEMAND We can serve you better if you.. 1. Report all claims immediately to the police and to your agent. 2. Get the names. addresses and telephone numbers of all drivers owners and occupants of the other cars in volved.. Get the names. addresses. and telephone numbers of any witnesses.. Do not accept responsibility or discuss the accident with anyone except a police officer or a representative of this Company. SUPPLEMENTARY PAYMENTS This Company agrees through its Representative or oth erwise to pay premiums or costs on bonds to release at tachments also the premium on or cost of bail bonds not to exceed the limit per bail bond listed in supplementary payments in the policy. The Company has no obligation to apply for or fumish any such bonds. CONSULT YOUR POLICY FOR ACTUAL COVERAGE IN FORCE ON SPECIFIC VEHICLES. SERVICE TO YOU IS OUR MAIN CONCERN s T o A 060 55 64 03 01 2021 03 01 2022 sured CARROLL SEATING COMPANY MOTOR VEHICLE INSURED ear Make 19 LINCOLN CONTINENTAL ehicle Identification No. N6LINPTR5600463 e FAMEATARY B AVAMEMTE CALL YOUR AGENT... XCKTON COMPANTIES LLC 24 108 4 W 47TH ST STE 900 NSAS CITY MO 64112 1906 L6 960 9000 e Cincinnati Insurance Company e Cincinnati Casualty Company ve Cincinnati Indemnity Company SERVICE TO YOU IS OUR MAIN CONCERN SERVICE TO YOU IS OUR MAIN CONCERN | 2 |
A CINCINNATI INSURANCE COMPANIES The Cincinnati Insurance Company The Cincinnati Casualty Company The Cincinnati Indemnity Company Policy Number EPP 060 55 64 Effective Date 03 01 2021 Named Insured CARROLL SEATING COMPANY For professional advice and policy questions or changes. please contact your local independent agency LOCKTON COMPANIES LLC 444 W 47TH ST STE 900 KANSAS CITY MO 64112 1906 816 960 95000 Dear Policyholder Thank you Thank you for trusting The Cincinnati Insurance Companies with your commercial insurance coverage. We recognize that locally based independent agents have the working knowledge to help you choose the right insurance company for your needs. Together with your local independent insurance agency. we are committed to providing you with the highest level of service. Please review your enclosed policy information to verify your coverage details. as well as deductibles and coverage amounts. Should your needs change. your agent is available to review and update your policy. Please promptly report claims If you experience a policy related foss. you may report it by contacting your local professional independent agency representing The Cincinnati Insurance Companies or by directly calling us toll free at 877 242 2544 and providing your policy number and claim related information. Sincerely Sean M. Givler Senior Vice President Commercial Lines I1A 4443 04 14 | 2 |
A. The Cincinnati Insurance Company The Cincinnati Indemni C iil CINNATI The Cincinnau Casualty Company s The Cincinnati Specialty Underwriters Insuran The Cincinnati Life Insuran INSURANCE COMPANIES Notice to Policyholders Cincinnati Data Defender Data breach and identity recovery support and resources included with your insurance policy To. The Cincinnati Insurance Company s The Cincinnati Indemnity Company The Cincinnan Casualty Company The Cincinnati Speciatty Underwriters Insurance Company The Cincinnati Life Insurance Company To CARROLL SEATING COMPANY Policy Number EPP 060 55 64 Expiration Date 03 01 2024 Agency LOCKTON COMPANIES LLC 24 108 Your policy includes Cincinnati Data Defender coverage for an additional premium helping to safeguard your business against the rising costs of a data breach and offering services to assist you in the event of identity theft. Please save this information so you can access all the tools and resources that come with your cyber protection. Refer to Cincinnati Data Defender Coverage Form HC102 for a complete statement of coverages. exclusions and fimits of insurance. Policyholder tools and resources Cyber risk management portal You gain access to www.eriskhub.comycic. a portal that provides you with the comprehensive. on demand resources you need to Create your breach response plan from the template Learn about breach laws that apply to your business Use the compliance reference guide and notification letter examples Locate credit bureau and government agency notification information Learn how to contact data risk management experts for more help The first time you visit eRiskHub please complete new user registration using this information Access code 12116 868 Identity theft services You also receive case management services and reimbursement for covered expenses if you. as a business owner. become the victim of identity theft or account takeover. If you suspect that you may be an identity theft victim or you have guestions. please call our Identity Recovery Help Line 866 219 9831. 2477 claims services If you suspect or know that a data breach may have exposed or compromised your organization s private customer or personal data a swift response is critical for your protection. Please note that the cyber risk management portal and help line provide advice and information. and using them does not satisfy any notice of claim requirement. The only way to report a claim is to contact your independent agent or call us directly. 877 242 2544 for 247 claims service. Your agent and Cincinnati wilt work with you to preserve your company s goodwill. prevent regulatory sanctions or fines avoid civil litigation and safeguard your business reputation. Please contact your agent representing Cincinnati with questions about this valuable coverage. Thank you for trusting your agent and Cincinnati to protect your business. 1A 4463 01 20 Mailing Address.0. Box 145496 Cincinnati. Ohio 45250 5496 Headquarters 6200 S. Gilmore Road Fairfield. Ohio 45014 5141 cinfin.com 513 870 2000 | 2 |
The Cincinnati Insurance Company o The Cincinnati Casualty Company o The Cincinnati Indemnity Company COMMERCIAL LINES DEPARTMENT SPECIAL REQUEST Date 03 01 2021 Insured CARROLL SEATING COMPANY Policy Number EPP 060 55 64 EBA 060 55 64 To Agent LOCKTON COMPANIES LLC 24 108 O 1. Coverage has been issued subject to satisfactory driver information. Please complete the enclosed forms and return promptly. 2. Please retun one signed copy of the enclosed endorsement. CP0157 AA416BIL AP401KS AP401MO 3. Please countersign the enclosed policy and return to the producer of record in the enclosed envelope. O 4 The MVRs for has been returned from the state showing the license number is incorrect. Please forward the correct driver s ticense numbers or Social Security number GA. IN 1A KY CH VA. 5. The state requires us to report the complete VIN. Please supply us with the entire VIN for every vehicle. 6. Please forward a signed Statement of Values. This is required whenever Blanket Insurance or Agreed Valued coverage is written. 00 7. Acompleted application is required. Please submit as soon as possible. We suggest that you send a letter to the insured making them aware of the endorsement and the consequences of its application. 0 9. This policy endorsement has been issued subject to rate. We have ordered the loss costs and we will endorse the policy when we receive them. O 10. Please complete and forward the FA492. Actual Loss Sustained Business Income Worksheet. These are required annually. 11. Please forward a photograph of the building located at. 0 12. The property Loc. Number Item Number does nt appear to be insured to value. Please advise how you determined the current limits. 13. Please let us know when the following were updated for each building over 25 years old Bldg.. built Electrical Heating Plumbing Roof 8ldg. built Electrical Heating Plumbing Roof 14. Please find enclosed an Excess UM UIM Selection Forms to be completed and signed by the insured. Forms attached for Commercial Umbrella and any related Personal Umbrellas Thank you. Cordially. COMMERCIAL LINES DEPARTMENT MI1302 06 11 | 2 |
Date 03 01 2021 Insured CARROLL SEATING COMPANY Policy Number EPP 060 55 64 EBA 060 55 64 Dear Agent The captioned policy has been issued with the following additional liability exclusionsconditionss Exterior Insulation and Finish Systems EIFS and Direct Applied Exterior Finish Systems DEFS Liability Exclusion Fungi or Bacteria Liability Exclusion Bodily Injury and or Property Damage Deductible Lead Liability Exclusion Bodily Injury andor Property Damage Fungi or Bacteria Deductible ooo R B8 Please be sure that the insured understands the above. Cordially Commercial Lines Department Mt 1603 10 03 | 2 |
The Cincinnati Insurance Companies Business Insurance CINCINNATI NETWORK DEFENDER Cyber Risk Coverage for Computer Systems Protecting your business Businesses of all sizes depend on computer systems and the proprictary daca stored on them to keep operations running smoothly. A computer attack may disrupt your operations potentially threatening your business relacionships. causing lost income and increasing your costs. Tor protect your business. consider adequate security for your computer systems and adding Cincinnati Newwork Defender coverage to your commercial or management liability policy. This insurance provides two important types of cyber risk protection computer attack coverage and nerwork seeurity and clectronic media liabi Ty coveragy Responding after a computer attack Compurer attack coverage helps your business recover after a cyberattack and pays for o data restoration services to help you replace lost or corrupted data from clectronic sources data re creation services to rescarch re create and ey ace lost or corrupted data from non clectronic sources system restoration services to replace or reinstall software remove malicious cod and correct the configuration in order to restore your computer system to its pre liey o cyber extortion expenses you incur to retain an investigator due to an extortion attack level of functior threat against your syst s or data. including ransomware. and amounts paid in response to the extortion threat within the limic of insurance business income you lose and extra expenses you incur while your system and data recovery activities take place public relations services to assist with communications about the computer attack and your response Covering your network security and electronic media liability Network security and electronic media liability coverage pays for defense and settlement costs due to claims brought against you by third parties for alleged damage from a security failure in your computer system that leads ro o breach of third party business data o unplanned forwarding or replication of malware o unintentional suppore of a denial of service attack Page 1 0of 2 Adv. 715 120 For information coverage availability in your state quotes or policy service please contact your local independent agent recommending coverage A CINCINNATI INSURANCE COMPANIES Everything Insurance Should Be The Cincinnati Insurance Companies Business Insurance CINCINNATI NETWORK DEFENDER Cyber Risk Coverage for Computer Systems vour computer systems and data Page 1 0of 2 Adv. 715 120 | 2 |
It also pays for defense and serclement costs duc to claims broughr against you by third parties for alleged damages from your clectronic communications that resule in o defamation o violation of a person s right of privacy o interference with a persou s right of publicity o infringement of copyright or trademark To round out your cyber risk insurance you can also add Cincinnati Data Defender insurance thac helps you respond to and recover from a data breach or the theft of personally identifiable information. Businesses of all sizes face potential loss from using technology No matter what size business you opcrae you experience the same vulnerability to cyberattacks and network sccurity liability claims as the biggest encerprises. Your daily operations are vulnerable to the types of attacks described in these hypothetical claims cxamples A customer claimed that a company sent him a damaging virus and it cost 30000 in legal fees to get it resolved. o A disgruntled former employee hacked the employer s computer system which resulted in a 25000 IT bill 0 repair the damage. The costs of defending a network security lawsuit quickly added up to more than 40000. A nasty virus got into a customers computer system and it cost a fortune in out of pocket expenses and downtime before the system was restored. These examples are provided for cducational purposes only and ar not intended t illustrate the value of any claim or any particular type of claim. Every claim is adjusted according to its own specific set of facts. Policyholider tools and resources Your Network Defender coverage includes access for no additional charge to wunw.eriskhub.comeic a portal that provides you with news information and resources you can use to help mitigate a hacking event virus infection or other cyberattack. The eRiskHub also contains an optional section that offers My Tech Support. a technical support service you can subscribe to for a nominal fee for assistance troubleshooting diagnosing and fixing common computer problems including finding and removing viruses. Choosing coverage from the right people Cincinnati s commitment to you is simple. We deliver service from people who know you. your business and your community your local independent insurance agent and our experienced team of insurance professionals. You can count on your agent and Cincinnati Insurance to be there giving you the peace.of mind you descrve. Talk to your local independent agent representing Cincinnati Insurance about adding these valuable coverages o protect you and the modern technology used to keep your business running smoothly. Thank you for trusting your agent and Cincinnati to.protect your business. AM CINCINNATI INSURANCE COMPANIES Everything Insurance Should Be icity e v lawsuit quickly added up to more ter system and it cost a fortune in ore the system was restored. purposes only and arc not intended t icular type of claim. Every claim is adjusted s access for no additional charge to les you with news information and acking event virus infection or other an optional scction that offers My Tech an subscribe to for a nominal fee for d fixing common computer problems For information coverage availability in your state quotes or policy service please contact your local independent agent recommending coverage. This is not a policy. For a complete statement of the coverages and exclusions. please see the policy contract. The Cincinnati insurance Companies. Gincinnat Insurance and Cincinnati refer to member companies of the insurer group providing ind casualty coverages through The Cincinnati Insurance Company or one of its wholly owned subsidiaries The Cincinnat Indemnity Company of The Cincinnati Casualty Company. Each r has sole financial responsibility for its own products. Not all subsidianes operats in al states. Do not reproduce or post online in whole of in part without watten permission. 2020 The Cincinnati Insurance Company. 6200 S. Gilmore Road. Fairfield O 45014.5141 proper Page 2 of 2 e Adv. 715 120 cinfin.com 55 | 2 |
UNINSURED UNDERINSURED MOTORISTS PROTECTION OPTION SELECTION FORM ILLINOIS The laws of lllinois require that automobile liability insurance policies offer Uninsured Underinsured Motorists Coverage limits equal to the Bodily Injury Limits of the policy to which the coverage attaches. You may. however select coverage at a lower limit. YOU ARE ELECTING TO PURCHASE UNINSURED MOTORISTS LIMITS LESS THAN YOUR BODILY INJURY LIABILITY LIMITS WHEN YOU SIGN THIS FORM. Uninsured Motorists Coverage provides for payment of certain benefits for damages caused by owners or operators of uninsured motor vehicles because of bodily injury or death resulting therefrom. Underinsured Motorists Coverage provides for payment of certain benefits for damages caused by owners or operators of underinsured motor vehicles because of bodily injury or death resulting therefrom. An Underinsured mator vehicle is a vehicle to which a bodily injury policy or bond applies at the time of the accident but its limit for bodily injury liability is less than the limit of liability for this coverage. Such benefits may include payments for certain medical expenses lost wages and pain and suffering. subject to fimitations and conditions in the policy. Uninsured Underinsured Motorist options are available for a modest premium PLEASE CONTACT YOUR AGENT for the exact cost. PLEASE SELECT ONE OF THE FOLLOWING select Uninsured Underinsured Motorists Coverage at the following limits which are lower than the Bodily Injury Liability Limits of my policy. Thousand Dollars Split Limit Single Limit LIMITS OF LIABILITY O 2550 50 0O 507100 o 100 100300 O 300 O Other O Other Attached to and forming a part of Policy Number EBA 060 S5 64 and any subsequent renewals. reinstatements reissuance replacements substitutions or amendments of my policy unless request otherwise in writing. 1 intend that my selection will apply to me and all other persons or organizations that may be eligible for coverage under this policy. DATE LIMITS OF LIABILITY INSURED S SIGNATURE NOTE A. Underinsured Motorist Coverage does not apply unless Uninsured Motorist Coverage limits exceed the minimum Financial Responsibility Limits of 25.000 each person50.000 each occurrence or 50.000 Single Limit Liability. B. Please refer to form AA 4046 IL for information regarding Uninsured Motorist Property Damage. AA 4168 IL 01 15 | 2 |
KANSAS UNINSURED UNDERINSURED MOTORISTS COVERAGE INSURANCE EXCESS LIMITS REJECTION Acknowledgment of Coverage Rejection acknowledge that have been provided Uninsured Underinsured Motorists Coverage Insurance and. in addition. have been offered the following in accordance with the law of the State of Kansas have been given the opportunity to purchase Uninsured Motorists Coverage Insurance including Underinsured Motorists Protection equal to my limits of fiability for bodily injury or death. and instead i select lower limits as indicated by the option selected below. Note Limits selected may not be less than 25.00050.000 Split Limits or 50.000 Single Limit. understand and agree that this acknowledgment of the coverage rejection shall be applicable to all vehicles insured under the policy number indicated on this form unless subsequently request such coverage in writing. LIMITS OF LIABILITY Combined Single Limits Selection Split Limits Selection CsL 50.000 25.000 50.000 60.000 50.000 100.000 100.000 100.000 300.000 125.000 250000 500.000 150.000 500000 500.000 200.000 500.0001.000.000 250.000 1.000.0001.000.000 200 00N Selection Combined Single Limits CsL 50.000 60.000 100.000 125.000 150.000 200.000 250.000 300.000 350.000 400.000 500.000 600.000 750.000 1.000.000 2.000.000 Attached to and forming a part of Policy Number thereof. YOUR ACKNOWLEDGMENT acknowledge that Selection Split Limits 25.000 50.000 100000 250000 500000 50.000 100.000 300.000 500.000 500.000 500.0001.000.000 1.000.0001.000.000 Selection EBA 060 55 64 and any Renewal or Replacement 1. lintend that my selection will apply to me and to all other persons or organizations that may be eligible for coverage under this policy. 2. understand that my selection applies to all subsequent renewals. replacements. substitutions or amendments of my policy unless request otherwise in writing. 3. have read and understand the purpose and content of this form and the consequences of my selection. 4. am legally authorized to make decisions concerning the purchase of Uninsured Motorists Coverage. Insured s Signature Date Authorized Representative AP 401KS 1113 | 2 |
UNINSURED UNDERINSURED MOTORISTS COVERAGE OPTION SELECTION FORM MISSOURI Uninsured Motorists Coverage is offered at limits up to limits equal to the Bodily Injury or Single Limit Liability Limits of your policy. You may purchase Uninsured Motorists Coverage at limits lower than the Bodily Injury or Single Limit Liability Limits of your policy but not lower than the limits required under Missouri Financial Responsibility Law. I select Uninsured Motorists Coverage at the limits indicated below which are lower than the Bodily Injury or Single Limit Liability Limits of my policy. l UNINSURED MOTORISTS COVERAGE LIMITS OF LIABILITY Combined Single Limits CSL Selection Split Limits Selection 50.000 LI 25.00050000 60.000 50.000100000 C 100.000 I 100.000300.000 125.000 250000500.000 I 150000 500.000500000 200.000 500000 1000000 250000 1 51000000 1000000 300000 i 350000 400.000 500.000 1 600.000 750.000 1.000000 I 2.000.000 UNDERINSURED MOTORIST COVERAGE An Underinsured motor vehicle is a vehicle to which a Bodily Injury policy or bond applies at the time of the accident but its limit for Bodily Injury liability is less than the Limit of Liability for this coverage. Underinsured Motorists Coverage may be purchased at limits equal to the limits purchased for Uninsured Motorists Coverage. reject Underinsured Motorists Coverage. Attached to and forming part of Policy Number EBA 060 55 64 and any Renewal or Replacement thereof. AP 401 MO 1113 Page 10f2 | 2 |
YOUR ACKNOWLEDGMENT I acknowledge that. s 1. I intend that my selection will apply to me and to all other persons or organizations that may be eligible for coverage under this policy. understand that my selection applies to all subsequent renewals replacements substitutions or amendments of my policy unless request otherwise in writing. have read and understand the purpose and content of this form and the consequences of my selection. am legally authorized to make decisions concerning the purchase of Uninsured Underinsured Motorists Coverage. CARROLL SEATING COMPANY Named Insured Signature of Named Insured s Legal Representative Title Date Please Print or Type Name Above Please Print or Type Title Above Agent s Signature Date Please Print or Type Name Above Page 2 of 2 AP 401MO 1113 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MINNESOTA CHANGES COINSURANCE This endorsement modifies insurance provided under the following COMMERCIAL PROPERTY COVERAGE PART The following is added to the Coinsurance Additional Condition At your request the Coinsurance Condition is made a part of Policy No. EPP 060 55 64 ofthe CINCINNATI INSURANCE COMPANY NAME OF COMPANY issued atits KANSAS CITY MO Agency. Dated 03 01 2021 CITY OR TOWN STATE Agent Insured LOCKTON COMPANIES LLC 24 108 Agent Insured Copyright. Insurance Services Office. Inc.. 1998 CP 01570798 | 2 |
NOTICE TO POLICYHOLDERS DIRECT BILL ACCOUNT CREDIT PROCEDURE This is a notice of how an account credit will be applied to your policy or to all of the policies being billed as single account. Account Credits A. If your account is comprised of a single policy and an endorsement or premium audit results in a credit return premium. the credit is applied to that policy. If your account does not have a future installment due at the time the endorsement or audit is processed. the credit is refunded to the payor listed for your account. If you do not wish for credits to be automatically applied to future unpaid installments. please contact us to request a refund. Please note that the amount of the refund may vary based upon the date you contact us and your billing schedule. B. If your account is comprised of more than one policy and an endorsement or premium audit results in a credit return premium the credit is applied in the following manner Payments previously applied to your account are deferred. The credit that results from the endorsement or audit is applied to the policy generating the credit. The payments that were deferred are then reapplied to the account in order to satisfy the amount due. Any excess payment that results from the credit is applied proportionately to your policies with a future payment or installment due. If you do not wish for credits to be automatically applied to future unpaid installments. please contact us to request a refund. Please note that the amount of the refund may vary based upon the date you contact us and your billing schedule. If your account does not have a future installment or payment due at the time the endorsement or audit is processed. the credit is refunded to the payor listed for your account. Does not apply to audit return premium for payors located in New York Does not apply to premiums due more than 30 days from the date of processing for payors located in New Hampshire. These credits are automatically refunded to the payor To request a refund. contact us at Mailing Address Toll free phone number Electronic mail The Cincinnati Insurance Company 877 942 2455 CinciBillcinfin.com PO Box 14529 Cincinnati OH 45250 0529 Electronic mail CinciBillcinfin.com Toll free phone number 877 942 2455 IA 4407 03 13 | 2 |
A CINCINNATI INSURANCE COMPANIES The Cincinnati Insurance Company A Stock Insurance Company Headquarters 6200 S. Gilmore Road. Fairfield OH 45014 5141 Mailing address P.O. Box 145496 Cincinnati OH 45250 5496 www.cinfin.com 513 870 2000 COMMON POLICY DECLARATIONS Billing Method DIRECT BILL POLICY NUMBER EPP 060 55 64 EBA 060 55 64 NAMED INSURED CARROLL SEATING COMPANY 10 LINCOLN ST ADDRESS KANSAS CITY KS 66103 1906 Number Street. Town. County. State Zip Code Previous Policy Number NEW Policy Period At 1201 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE All coverages except Automobile and or Garage Policy number EPP 060 55 64 FROM 03 01 2021 TO 03 01 2024 Automobile and or Garage Policy number EBA 060 55 64 FROM 03 01 2021 TO 03 01 2022 Agency LOCKTON COMPANIES LLC 24 108 City RANSAS CITY MO Legal Entity Business Description ORGANIZATION ANY OTHER 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. FORMS APPLICABLE TO ALL COVERAGE PARTS IL0017 1198 COMMON POLICY CONDITIONS IA102A 0908 SUMMARY OF PREMIUMS CHARGED IA4500M0 1018 MISSOURI NOTICE TO POLICYHOLDERS IA904 0404 SCHEDULE OF LOCATIONS IA4236 0115 POLICYHOLDER NOTICE TERRORISM INSURANCE COVERAGE IA4399IL 0711 NOTICE TO POLICYHOLDERS ILLINOIS RELIGIOUS FREEDOM PROTECTION AND CIVIL UNION ACT TA4427 0213 NOTICE OF LOSS CONTROL SERVICES IA4433IL 0317 IMPORTANT POLICYHOLDERS NOTICE ILLINOIS IA4521 0320 NOTICE OF PRIVACY PRACTICES IP409IL 0191 IMPORTANT INFORMATION TO POLICYHOLDERS ILLINOIS IP446 0801 NOTICE TO POLICYHOLDERS 1A4006 0710 SPECIAL PER OCCURRENCE DEDUCTIBLE ENDORSEMENT IA4156IL 0118 ILLINOIS CHANGES CANCELLATION AND NONRENEWAL IA4201KS 0116 KANSAS CHANGES CONCEALMENT MISREPRESENTATION OR FRAUD IA4210IL 0118 ILLINOIS CHANGES CANCELLATION AND NONRENEWAL IA4215M0 0214 MISSOURI CHANGES IA4226 0302 NOTICE TO POLICY HOLDERS FUNGI OR BACTERIA EXCLUSION ENDORSEMENTS IA4238 0115 CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM IA4338 0511 SIGNATURE ENDORSEMENT IA4382IL 0717 ILLINOIS CHANGES 1A 509 01 12 Page 1 of 2 EPP 060 S5 64 EBA 060 55 64 03 01 2021 1543 Page 1 of 2 EPP 060 S5 64 EBR 060 55 64 | 2 |
IA4395IL IA481 IP412 FM502 GA532 GA531 MAS559 MAS60 AAS05 USsCs513 HC502 HC503 0417 0108 1292 0708 0708 0708 0510 0607 0306 0510 0118 0118 ILLINOIS CHANGES CIVIL UNION NOTICE CONCERNING POLICYHOLDER RIGHTS IN AN INSOLVENCY UNDER THE MINNESOTA INSURANCE GUARANTY ASSOCIATION LAW IMPORTANT INFORMATION TO POLICYHOLDERS COMMERCIAL PROPERTY COVERAGE PART DECLARATIONS COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS CLAIMS MADE EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM DECLARATIONS CONTRACTORS EQUIPMENT AND TOOLS COVERAGE PART DECLARATIONS INSTALLATION FLOATER COVERAGE PART DECLARATIONS BUSINESS AUTO COVERAGE PART DECLARATIONS COMMERCIAL UMBRELLA LIABILITY COVERAGE PART DECLARATIONS CINCINNATI DATA DEFENDER COVERAGE PART DECLARATIONS CINCINNATI NETWORK DEFENDER COVERAGE PART DECLARATIONS Countersigned By Date Authorized Representative 1A 509 01 12 03 01 2021 1543 Page 2 of 2 EPP 060 55 64 EBA 060 S5 64 | 2 |
COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation b. Give you reports on the conditions we 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured writ ten notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpay ment of premium or b. 30 days before the effective date of cancellation 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 effec tive date of cancellation. The policy pe riod will end on that date. 5. If this policy is cancelled. we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels. the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice. Changes This policy contains all the agreements be tween you and us concerning the insurance af forded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy s terms can be amended or waived only by endorsement issued by us and made a part of this policy. Examination of Your Books and Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. Inspections and Surveys 1. We have the right to a. Make inspections and surveys at any time find and. Recommend changes. 2. We are not obligated to make any inspec tions surveys. reports or recommenda tions and any such actions we do under take relate only to insurability 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 ap ply not only to us. but also to any rating. adwvisory. rate service or similar organiza tion which makes insurance inspections. surveys. reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections surveys reports or recommendations we may make rela tive to certification. under state or munici pal statutes ordinances or regulations. of boilers pressure vessels or elevators. Premiums The first Named Insured shown in the Declara tions 1. s responsible for the payment of all pre miums 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 representative. Until your legal represen tative is appointed. anyone having proper tem porary custody of your property will have your rights and duties but only with respect to that property. Copyright Insurance Services Office. Inc. 1998 IL00 17 11 98 | 2 |
MISSOURI NOTICE TO POLICYHOLDERS As it pertains to your commercial policy This policy may include rates and forms which may not be filed with the Missouri Department of Insurance Financial Institutions and Professional Registration pursuant to MO. REV. STAT. 379.321. IA 4500 MO 10 18 Page 10of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SCHEDULE OF LOCATIONS LOC. STREETADDRESS CITY STATE ZIP CODE 1 2105 LUNT AVE ELK GROVE VILLAGE IL 60007 5607 2 10 LINCOLN ST KANSAS CITY KS 66103 1906 3 2101 LUNT AVE ELK GROVE VILLAGE IL 60007 5607 4 112 WELDON PKWY MARYLAND HEIGHTS MO 63043 3102 5 285 18TH ST SE OWATONNA MN 55060 4003 1A 904 04 04 | 2 |
POLICYHOLDER NOTICE TERRORISM INSURANCE COVERAGE 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. Your policy may contain coverage for certain losses caused by terorism. Premium In accordance with the federal Terrorism Risk insurance Act. we are required to notify you of the portion of the premium. if any. attributable to the coverage for terrorist acts certified under the Terrorism Risk insurance Act. Refer to the SUMMARY OF PREMIUMS CHARGED or DECLARATIONS PAGE for the portion of your premium that is attributable to coverage for terrorist acts certified under the Act. Federal Participation The Act also requires us to provide disclosure of federal participation in payment of terrorism losses. Under your policy. any losses caused by certified acts of terrorism would be partially reimbursed by the United States Government. Department of Treasury. under a formula established by federal law. Under this formula the federal share equals a percentage. as specified in the Schedule below. of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However. if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. Schedule Federal Share of Terrorism Losses Percentage Calendar Year 85 2015 84 2016 83 2017 82 2018 81 2019 80 2020 Cap on Insurer Participation If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act. we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion. and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. NOTE IF YOUR POLICY IS A RENEWAL POLICY THIS NOTICE IS PROVIDED TO SATISFY THE REQUIREMENTS UNDER THE TERRORISM RISK INSURANCE ACT FOR POLICYHOLDER DISCLOSURE 1 AT THE TIME OF OUR OFFER TO RENEW THE POLICY AND 2 AT THE TIME THE RENEWAL IS COMPLETED. IA 4236 01 15 | 2 |
NOTICE OF PRIVACY PRACTICES For additional information on our privacy policies. including state specific information. please visit httpswww.cinfin.comprivacypolicy. IA 4521 03 20 Page 1of 1 | 2 |
IMPORTANT INFORMATION TO POLICYHOLDERS ILLINOIS In the event you need to contact someone about this policy for any reason please contact your agent. If you have additional questions you may contact the insurance company issuing this policy at the following ad dress or telephone collect The Cincinnati Insurance Company P.O. Box 145496 Cincinnati. Ohio 45250 5496 Telephone 513 870 2278 The Cincinnati Casualty Company P.O. Box 145496 Cincinnati Ohio 45250 5496 Telephone 513 870 2278 The Cincinnati Indemnity Company P.O. Box 145496 Cincinnati Ohio 45250 5496 Telephone 513 870 2278 IP 409IL 191 | 2 |
THE CINCINNATI INSURANCE COMPANY THE CINCINNATI CASUALTY COMPANY THE CINCINNATI INDEMNITY COMPANY NOTICE TO POLICYHOLDERS Please be advised that in your application for insurance you disclosed information to The Cincinnati Insurance Company The Cincinnati Casualty Company and The Cincinnati Indemnity Company. The information dis closed in the application and all information subsequently collected by any of these companies may be shared among all three. IP 446 08 01 | 2 |
B. Definition For the purpose of this endorsement only any definition of occurrence is deleted in its entirety and the following definition is added to 1. COMMERCIAL PROPERTY CONDITIONS 2. COMMERCIAL INLAND MARINE CONDITIONS 3. COMMERCIAL CRIME COVERAGE FORM 4. CRIME EXPANDED COVERAGE XC COVERAGE FORM and. v 5. GOVERNMENT CRIME COVERAGE FORM s s Occurrence means all loss damage or a sequence of loss or damage casualties or disasters arising from a single happening or event. v Page 2 of 2 1A 4006 07 10 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ILLINOIS CHANGES CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following COMMERCIAL PROPERTY COVERAGE PART FARM COVERAGE PART A. The Cancellation Common Policy Condition is deleted in its entirety and replaced by the fol lowing CANCELLATION 1. The first Named Insured shown in the 4 Declarations may cancel this policy by. mailing to us advance written notice of cancellation. 2. Ifthis policy has been in effect for 60 days or less. except as provided in Paragraphs 8. and 9. below we may cancel this policy s. by mailing written notice of cancellation at feast a. 10 days before the effective date of 6. cancellation if we cancel for nonpay ment of premium or b. 30 days before the effective date of cancellation if we cancel for any other reason. 3. If this policy has been in effect for more 7. than 60 days. except as provided in Para graphs 8. and 9. below. we may cancel 8. this policy only for one or more of the fol lowing reasons a. Nonpayment of premium b. The policy was obtained through a material misrepresentation. You have violated any of the terms and conditions of the policy d. The risk originally accepted has measurably increased e. Certification to the Director of Insur ance of the loss of reinsurance by the insurer which provided coverage to us for all or a substantial part of the underlying risk insured or f. A determination by the Director that the continuation of the policy could place us in violation of the insurance laws of this State. If we cancel this policy based on one or more of the above reasons except for nonpayment of premium we will mail writ ten notice at least 60 days before the ef fective date of cancellation. When cancel lation is for nonpayment of premium. we will mail written notice at least 10 days be fore the effective date of cancellation. We will mail our notice to you at your last mailing address known to us any mortga gee or lienholder listed on the policy and to the broker. if known. or agent of record. if known. Proof of mailing will be sufficient proof of notice. Notice of cancellation will state the effec tive date of cancellation. The policy period will end on that date. If this policy is cancelled. we will send the first Named Insured any premium refund due. If we or the first Named Insured can cel. the refund will be pro rata. The can cellation will be effective even if we have not made or offered a refund. Our notice of cancellation will state the reason for cancellation. Real Property Other Than Residential Properties Occupied by 4 Families or Less The following applies only if this policy co vers real property other than residential property occupied by 4 families or less If any one or more of the following condi tions exists at any building that is Covered Property in this policy. we may cancel this policy by mailing to you written notice of cancellation if a. After a fire loss. permanent repairs to the building have not started within 60 days of satisfactory adjustment of loss unless the delay is due to a la bor dispute or weather conditions. b. The building has been unoccupied 60 or more consecutive days. This does not apply to 1 Seasonal unoccupancy or 2 Buildings under repair construc tion or reconstruction if properly Includes copyrighted material of Insurance 1A 4156 1L 01 18 Services Office. Inc.. with its permission. Page 10f 2 1A 4156 1L 01 18 Page 10f 2 | 2 |
10. secured against unauthorized entry. c. The building has I 1 An outstanding order to vacate 2 An outstanding demolition order or 3 Been declared unsafe in accord ance with the law. d. Heat water sewer service or public lighting have not been connected to the building for 30 consecutive days or more. The policy will terminate 10 days following receipt of the written notice by the named insureds. Residential Properties Occupied by 4 Families or Less The following applies if this policy covers residential properties occupied by 4 fami lies or less If this policy has been in effect for 60 days. or if this is a renewal policy we may only cancel this policy for one or more of the following reasons Nonpayment of premium b. The policy was obtained by misrepre sentation or fraud or c. Any act that measurably increases the risk originally accepted. If we cancel this policy based on one or more of the above reasons except for nonpayment of premium we will mail writ ten notice at least 30 days before the ef fective date of cancellation. When cancel lation is for nonpayment of premium we will mail written notice at least 10 days be fore the effective date of cancellation. For insurance provided under the Com mercial Property Coverage Part the fol lowing applies GRAIN IN PUBLIC GRAIN WARE HOUSES Not applicable to grain owned by the Commodity Credit Corporation The following applies only with respect to grain in public grain warehouses The first Named Insured or we may can cel this policy at any time by mailing to a. The other and b. The Director of the lliinois Depart ment of Agriculture at its Springfield Office 60 days written notice of cancella tion. B. The following is added and supersedes any provision to the contrary NONRENEWAL 1. If we decide not to renew or continue this policy we will mail you at your last mail ing address known to us your broker if known or your agent of record if known and any mortgagee or lienholder listed on. the policy written notice stating the rea son for nonrenewal at least 60 days be fore the end of the policy period. If we of fer to renew or continue and you do not accept this policy will terminate at the end of the current policy period. Failure to pay the required renewal or continuation pre mium when due shall mean that you have not accepted our offer. Proof of mailing will be sufficient proof of notice. If we fail to mail proper written notice of nonrenewal and you obtain other insur ance. this policy will end on the effective date of that insurance. 2. The following provision applies only if this policy covers residential properties occu pied by 4 families or less a. Ifthis policy has been issued to you and in effect with us for 5 or more years we may not fail to renew this policy unless 1 The policy was obtained by mis representation or fraud 2 The risk originally accepted has measurably increased or 3 You received 60 days notice of our intent not to renew as pro vided in 1. above. b. If this policy has been issued to you and in effect with us for less than 5 years we may not fail to renew this policy unless you received 30 days notice as provided in 1. above. Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 2 of 2 1A 4156 IL 01 18 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. KANSAS CHANGES CONCEALMENT MISREPRESENTATION OR FRAUD This endorsement modifies insurance provided under the following MACHINERY AND EQUIPMENT COVERAGE PART COMMERCIAL CRIME AND FIDELITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART FARM COVERAGE PART STANDARD PROPERTY POLICY When this endorsement is attached to the Standard Property Policy CP 00 99 the term Coverage Part in this endorsement is replaced by the term Policy. The CONCEALMENT MISREPRESENTA TION OR FRAUD Condition is replaced by the following CONCEALMENT MISREPRESENTATION OR FRAUD We will not pay for any loss or damage under this Coverage Part if you or any other insured in relation to an insurance application rating. claim or coverage under this policy knowin and with intent to defraud 1. Presents causes to be presented or pi pares with the knowledge or belief tha will be presented to or by an insurer pt ported insurer broker or any agent thel of. any written electronic. electronic i pulse facsimile magnetic. oral or te phonic communication or statement whi such person knows to contain materia false information concerning any mater fact or 2. Conceals information concerning any terial fact for the purpose of misleadina claim or coverage under this policy knowingly and with intent to defraud 1. Presents causes to be presented or pre pares with the knowledge or belief that it will be presented to or by an insurer pur ported insurer broker or any agent there of any written electronic electronic im pulse facsimile magnetic. oral or tele phonic communication or statement which such person knows to contain materially false information concerning any material fact or Conceals information concerning any ma terial fact for the purpose of misleading. Includes copyrighted material of Insurance Services Office. Inc.. with its permission. 1A 4201 KS 0116 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ILLINOIS CHANGES CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following CHEMICAL DRIFT LIMITED LIABILITY COVERAGE FORM CLAIMS MADE CINCINNATI CYBER DEFENSE COVERAGE PART CINCINNATI DATA DEFENDER COVERAGE PART CINCINNATI NETWORK DEFENDER COVERAGE PART CLAIMS MADE EXCESS UABILITY COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL UMBRELLA LIABILITY COVERAGE PART CONTRACTOR S ERRORS AND OMISSIONS COVERAGE FORM CLAIMS MADE EMPLOYEE BENEFIT LIABILITY COVERAGE FORM EMPLOYMENT PRACTICES LIABILITY COVERAGE PART EXCESS LIABILITY COVERAGE FORM EXCESS WORKERS COMPENSATION AND EMPLOYERS LIABILITY COVERAGE FORM HOLE IN ONE COVERAGE FORM ILLINOIS CONTRACTORS LIMITED WORKSITE POLLUTION LIABILITY COVERAGE FORM LIQUOR LIABILITY COVERAGE PART MANUFACTURER S ERRORS AND OMISSIONS COVERAGE FORM CLAIMS MADE POLLUTION LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART PROFESSIONAL UMBRELLA LIABILITY COVERAGE PART PROFESSIONAL UMBRELLA LIABILITY COVERAGE PART CLAIMS MADE SEPTIC SYSTEMS DESIGN INSPECTION ERRORS AND OMISSIONS COVERAGE PART cy Conditions is placed by the fol ed shown in the el this policy by written notice of licy by mailing to address known to g the reason for ailing will be suffi e cancel premium we will ast 10 days prior of cancellation. than nonpayment mail the notice at to the effective ation if the policy ect for 60 days or 2 60 days prior to the effective date of cancellation if the policy has been in effect for more than 60 days. If this policy has been in effect for more than 60 days. we may cancel only for one or more of the following reasons a. Nonpayment of premium The policy was obtained through a material misrepresentation Any insured has violated any of the terms and conditions of the policy The risk originally accepted has measurably increased Certification to the Director of Insur ance of the loss of reinsurance by the insurer that provided coverage to us for all or a substantial part of the un derlying risk insured or A determination by the Director of In surance that the continuation of the policy could place us in violation of the insurance laws of this State. Includes copyrighted material of Insurance Services Office Inc.. with its permission. Page 10f 2 A. Cancellation Common Policy Conditions is deleted in its entirety and replaced by the fol lowing CANCELLATION 1. The first Named Insured shown in the Declarations may cancel this policy by mailing to us advance written notice of cancellation. 2. We may cancel this policy by mailing to you at your last mailing address known to us. written notice stating the reason for cancellation. Proof of mailing will be suffi cient proof of notice. If we cancel a. For nonpayment of premium. we will mail the notice at least 10 days prior to the effective date of cancellation. b. For a reason other than nonpayment of premium we will mail the notice at least 1 30 days prior to the effective date of cancellation if the policy has been in effect for 60 days or less. 1A 42101L 0118 Page 10of 2 | 2 |
4. Notification of cancellation will also be sent to your broker if known or agent of record. if known. 5. Notice of cancellation will state the effec tive date of cancellation. The policy period will end on that date. 6. If this policy is cancelled we will send the first Named iInsured any premium refund due. If we or the first Named Insured can cels the refund will be pro rata. The can cellation will be effective even if we have not offered a refund. B. The following is added and supersedes any provision to the contrary 1. NONRENEWAL a. If we decide not to renew or continue this policy. we will mail you at your last mailing address known to us written notice stating the reason for the nonrenewal atleast 1 60 days before the end of the policy period. for all policies oth er than that described in a.2 or 2 30 days before the end of the policy period for all commercial excess and umbrella liability pol icies as defined in 215 ILL. COMP. STAT.143.13 h. The nonrenewal shall not become ef fective until at least 30 days from the proof of mailing date of the notice to you. b. Proof of mailing will be sufficient proof of notice. c. Notification of nonrenewal will also be sent to your broker if known. or agent of record if known. d. If we offer to renew or continue and you do not accept this policy will ter minate at the end of the current policy period. Failure to pay the required re newal or continuation premium when due shall mean that you have not ac cepted our offer. e. If we fail to mail proper written notice of nonrenewal and you obtain other insurance this policy will end on the effective date of that insurance. For the purposes of Paragraph a.2. commercial excess and umbrella liability policies are defined in 215 ILL. COMP. STAT. 143.13.h as follows h Commesrcial excess and umbrella lia bility policy means a policy written over one or more underlying policies for an in sured 1 that has at least 25 full time em ployee at the time the commer cial excess and umbrella liability policy is written and. procures the insurance of any risk or risks other than life. accident and health. and annuity contracts as described in clauses a and b of Class 1 of Section 4 and clause a of Class 2 of Section 4 by use of the services of a full time employee acting as an in surance manager or buyer or 2 whose aggregate annual premi ums for all property and casualty insurance on all risks is at least 50000. Includes copyrighted material of Insurance Services Office Inc.. withits permission. 1A42101L 0118 Page 2 of 2 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MISSOURI CHANGES CAUSES OF LOSS FORM FARM PROPERTY COMMERCIAL PROPERTY COVERAGE PART This endorsement modifies insurance provided under the following FARM PROPERTY OTHER FARM PROVISIONS FORM ADDITIONAL COVERAGES CONDITIONS DEFINITIONS LIVESTOCK COVERAGE FORM MOBILE AGRICULTURAL MACHINERY AND EQUIPMENT COVERAGE FORM MORTGAGE HOLDER S COVERAGE PART When this endorsement is attached to the Standard Property Policy CP 00 99 the terms Coverage Form and Coverage Part in this en dorsement are replaced by the term Policy. If partial loss loss or damage to Covered Property is caused by or results from fire Par agraph a.. of the Loss Payment Loss Condi tion is replaced by the following LOSS PAYMENT In the event of partial loss loss or damage caused by or resulting from fire. and covered by this Coverage Part. at your option. we will either 1. Payyou an amount of money equal to the damage done or 2. Repair the damage so that the property is in as good a condition as before the fire. But we will not pay more than the Limit of In surance. The following provision replaces 1. Paragraph c. of the Loss Payment Loss Condition in the Commercial Property Coverage Part and 2. Paragraph d. of the Loss Payment Loss Condition in the Farm Property Other Farm Provisions Form Additional Cover ages. Conditions. Definitions and Para graph c. of the Loss Payment Loss Con dition in the Mobile Agricultural Machinery and Equipment Coverage Form and Live stock Coverage Form In the event of loss loss or damage covered under this Coverage Part. we will give you notice. within 15 working days af ter we receive a properly executed proof of loss. that we 1. Accept your claim 2. Deny your claim or 3. Need more time to determine wheth er your claim should be accepted or denied. If we deny your claim. such notice will be in writing. and will state any policy provi sion condition or exclusion used as a ba sis for the denial. If we need more time to determine wheth er your claim should be accepted or de nied the written notice will state the rea sons why more time is needed. If we have not completed our investiga tion. we will notify you again in writing. within 45 days after the date the initial no tice is sent informing you that we need more time to determine whether your claim should be accepted or denied and thereafter every 45 days. The written no tice shall state why more time is needed to investigate your claim. Except as provided in E. below. the Appraisal Loss Condition is replaced by the following APPRAISAL If we and you disagree on the value of the property or the amount of loss loss either may make written demand for an appraisal of the loss loss. In this event each party will select a competent and impartial appraiser and notify the other of the appraiser selected within 20 days of the written demand for ap praisal. The two appraisers will select an um pire. If they can not agree upon an umpire with in 15 days. then upon your or our request an umpire shall be selected by a judge of a court of record in the state and county or city if the city is not within a county in which the property covered is located. The appraisers will state separately the value of the property and amount of loss loss. If they fail to agree. they will submit their differences to the umpire. The umpire shall make an award within 30 days after the umpire receives the appraisers submissions of their differences. A decision attached to the 00 99 the terms e Part in this en e term Policy. nage to Covered Its from fire Par rent Loss Condi g loss or damage fire. and covered ur option. we will oney equal to the 1at the property is before the fire. n the Limit of In es s Payment Loss mercial Property s Payment Loss Property Other Additional Cover itions and Para yment Loss Con ultural Machinery e Form and Live oss or damage rage Part we will 5 working days af ly executed proof 3. Need more time to determine wheth er your claim should be accepted or denied. If we deny your claim. such notice will be in writing. and will state any policy provi sion condition or exclusion used as a ba sis for the denial. If we need more time to determine wheth er your claim should be accepted or de nied the written notice will state the rea sons why more time is needed. If we have not completed our investiga tion. we will notify you again in writing. within 45 days after the date the initial no tice is sent informing you that we need more time to determine whether your claim should be accepted or denied and thereafter every 45 days. The written no tice shall state why more time is needed to investigate your claim. Except as provided in E. below. the Appraisal Loss Condition is replaced by the following APPRAISAL If we and you disagree on the value of the property or the amount of loss loss either may make written demand for an appraisal of the loss loss. In this event each party will select a competent and impartial appraiser and notify the other of the appraiser selected within 20 days of the written demand for ap praisal. The two appraisers will select an um pire. If they can not agree upon an umpire with in 15 days. then upon your or our request an umpire shall be selected by a judge of a court of record in the state and county or city if the city is not within a county in which the property covered is located. The appraisers will state separately the value of the property and amount of loss loss. If they fail to agree. they will submit their differences to the umpire. The umpire shall make an award within 30 days after the umpire receives the appraisers submissions of their differences. A decision agreed to by any two will be binding. Includes copyrighted material of Insurance Services Office. Inc.. with its permission. Page 10of 4 IA 4215 MO 02 14 | 2 |
IA 4215M0 02 14 Each party will 1. Pay its chosen appraiser and 2. Bear the other expenses of the appraisal and umpire equally. If there is an appraisal we will still retain our right to deny the claim. The Appraisal Condition in 1. Business Income and Extra Expense Coverage Form FA 213 and 2. Business Income Without Extra Ex pense Coverage Form FA 212 is replaced by the following APPRAISAL If we and you disagree on the amount of Net Income and operating expense or the amount of loss either may make written demand for an appraisal of the loss. In this event each party will select a competent and impartial ap praiser and notify the other of the appraiser selected within 20 days of the written demand for appraisal. The two appraisers will select an umpire. If they can not agree upon an umpire within 15 days then upon your or our request. an umpire shall be selected by a judge of a court of record in the state and county or city if the city is not with a county in which the property covered is located. The appraisers will state separately the amount of Net Income and operating expense or the amount of loss. If they fail to agree. they will submit their dif ferences to the umpire. The umpire shall make an award within 30 days after the umpire re ceives the appraisers submissions of their dif ferences. A decision agreed to by any two will be binding. Each party will 1. Pay its chosen appraiser and 2. Bear the other expenses of the appraisal and umpire equally. If there is an appraisal. we will still retain our right to deny the claim. The Legal Action Against Us Condition is replaced by the following LEGAL ACTION AGAINST US No one may bring a legal action against us under this Coverage Part unless 1. There has been full compliance with all of the terms of this Coverage Part and 2. The actionis brought within 10 years after the date on which the direct physical loss loss or damage occurred. G. Paragraph F. above does not apply to the 1. Legal Action Against Us Loss Condition in the Legal Liability Coverage Form or 2. Legal Action Against Us Condition ap plicable to Coverages C and D in the Mortgageholders Errors and Omission Coverage Form. H. Missouri Property and Casualty Insurance Guaranty Association Coverage Limita tions 1. Subject to the provisions of the Missouri Property and Casualty Insurance Guar anty Association Act to be referred to as the Act. if we are a member of the Mis souri Property and Casualty Insurance Guaranty Association to be referred to as the Association. the Association will pay claims covered under the Act if we be come insolvent. 2. The Act contains various exclusions con ditons and limitations that govern a claimant s eligibility to collect payment from the Association and affect the amount of any payment. The following limitations apply subject to all other provi sions of the Act a. Claims covered by the Association do not include a claim by or against an insured of an insolvent insurer if the insured has a net worth of more than 25 million on the later of the end of the insured s most recent fiscal year or the December thirty first of the year next preceding the date the in surer becomes insolvent provided that an insured s net worth on such date shall be deemed to include the aggregate net worth of the insured and all of its affiliates as calculated on a consolidated basis. b. Payments made by the Association for covered claims will include only that amount of each claim which is less than 300000. However the Association will not 1 Pay an amount in excess of the applicable limit of insurance of the policy from which a claim arises or 2 Return to an insured any un eamed premium in excess of 25.000. These limitations have no effect on the coverage we will provide under this policy. For the Commercial Property Coverage Part the following exclusion and related provisions are added to Paragraph B.2. Exclusions in the Causes of Loss Forms and to any cover Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 2 of 4 IA 4215M0 02 14 | 2 |
IA 4215 MO 02 14 age Form or policy to which a Causes of Loss Form is not attached 1. We will not pay for loss or damage arising out of any act committed a. By or at the direction of any insured and b. With the intent to cause a loss. 2. However this exclusion will not apply to deny coverage to an innocent co insured who did not cooperate in or contribute to the creation of the loss. provided the loss is otherwise covered under this Coverage Part and the loss arose out of domestic violence. Such coverage will be provided only if the innocent co insured files a po lice report and completes a sworn affidavit indicating both a. The cause of the loss and b. A pledge to cooperate in any criminal prosecution of the person committing the act causing the loss. 3. If we pay a claim pursuant to Paragraph 1.2.. our payment to the innocent co insured will be limited to that insured s ownership interest in the property as re duced by any payment to a mortgagee or other secured interest however we shall not be required to make any subsequent payment for any loss for which the inno cent co insured has received payment. In no event will we pay more than the Limit of Insurance. The Intentional Loss Exclusion in the Caus es of Loss Form Farm Property. Mobile Agri cultural Machinery and Equipment Coverage Form and Livestock Coverage Form is re placed by the following 1. We will not pay for loss loss or dam age arising out of any act committed a. Byor at the direction of any insured and b. With the intent to cause a loss loss. 2. However this exclusion will not apply to deny coverage to an innocent coinsured who did not cooperate in or contribute to the creation of the loss loss. provided the loss loss is otherwise covered un der this Coverage Form and the loss loss arose out of domestic violence. Such coverage will be provided only if the innocent coinsured files a police report and completes a sworn affidavit indicating both a. The cause of the loss loss and b. A pledge to cooperate in any criminal prosecution of the person committing the act causing the loss loss. 3. If we pay a claim pursuant to Paragraph J.2. our payment to the innocent co insured will be limited to that insured s ownership interest in the property as re duced by any payment to a mortgagee or other secured interest however we shall not be required to make any subsequent payment for any loss loss for which the innocent coinsured has received pay ment. In no event will we pay more than the Limit of Insurance. The following is added to the Transfer of Rights of Recovery Against Others to Us Condition If we pay an innocent coinsured for loss loss arising out of an act of domestic vio lence by another insured. the rights of the in nocent coinsured to recover damages from the abuser are transferred to us to the extent of our payment. Following the loss loss. the innocent coinsured may not waive such right to recover against the abuser. The following is added with respect to the Ad ditional Coverages of Debris Removal and Pollutant Clean Up and Removal and relates only to the requirement to report expenses to us within 180 days of the specified occurrence If you fail to report the expenses to us within the 180 day timeframe such failure will not in validate a claim under Debris Removal or Pol lutant Clean Up and Removal unless such fail ure operates to prejudice our rights. When the 1. Replacement Cost Optional Coverage in the Commercial Property Coverage Part 2. Coverage A Valuation Loss Condition in the Farm Property Farm Dwellings. Ap purtenant Structures and Household Per sonal Property Coverage Form or 3. Valuation Property Other Than Im provements and Betterments Loss Condition in the Farm Property Barns. Outbuildings and Other Farm Structures Coverage Form applies. the following is added with respect to these provisions and relates only to the re quirement to notify us of your intent to submit an additional claim for the difference between the actual cash value and replacement cost within 180 days after the loss or damage oc curs if you fail to notify us of your intent within the 180 day timeframe. such failure will not invali Includes copyrighted material of Insurance Services Office. Inc.. with its permission. Page 3 of 4 Page 3 of 4 IA 4215 MO 02 14 | 2 |
date the claim unless such failure operates to prejudice our rights. The Transfer of Your Rights and Duties Under This Policy Common Policy Condition is replaced by the following 1. Transfer By Beneficiary Deed If you convey real property insured under this policy to a person known as a grantee beneficiary designated under a beneficiary deed which has been properly recorded prior to your death that person will have your rights and duties with respect to the insured real property but only for the pe riod from the date of your death until the first of the following occurs a. A period of 30 days from the date of your death b. The date that alternative coverage is obtained on your property. or c. The end of the policy period as shown in the Declarations. 2. Transfer By Other Means Following Death If you die your rights.and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed an yone having proper temporary custody of your property will have your rights and du ties. but only with respect to that property. 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. 0. Under Debris Removal and Mandated De contamination if any are amended to in clude the following However your failure to report these expenses to us in writing within 180 days from the date the covered peril occurs will not be reason to deny your claim unless your failure to meet the notice requirement operates to prejudice our rights under this policy. P. Under IDENTITY RECOVERY COVERAGE FOR BUSINESS OWNERS WITH CASE MANAGEMENT SERVICES AND EXPENSE REIMBURSEMENT. if any is amended to in clude the following However your failure to report these expenses to us within 30 days from the date the covered peril occurs will not be reason to deny your claim unless your failure to meet the notice re quirements operates to prejudice our rights under this policy. Includes copyrighted material of Insurance Services Office Inc. with its permission. Paged4of 4 IA 4215 MO 02 14 | 2 |
NOTICE TO POLICY HOLDERS FUNGI OR BACTERIA EXCLUSION ENDORSEMENTS RESTRICTIONS OF COVERAGE This is a summary of the new fungi or bacteria liability exclusion endorsements. NO COVERAGE IS PRO VIDED BY THIS SUMMARY. Nor can it be construed to replace any provision of your policy. YOU SHOULD READ YOUR POLICY AND REVIEW YOUR DECLARATIONS PAGE CAREFULLY for complete information on the coverage that you are provided. If there is any conflict between the policy and this summary THE PROVISIONS OF THE POLICY SHALL PREVAIL. Your policy now specifically excludes coverage for fungi including mold and bacteria liability claims. The definition of fungi included within the forms is Fungi means any type or form of fungus and includes but is not limited to any form or type of mold mushroom or mildew and any mycotoxins spores scents or byproducts produced or released by fungi. We are introducing these new endorsements in response to the increasing frequency and severity of claims. Other exclusions and language in the policy may address some elements of injury or damage arising from fungi including mold or bacteria exposure. To avoid any confusion we are introducing separate exclusion ary language. These endorsements vary only with respect to the Coverage Form to which they apply. The endorsements exclude your liability to others arising from Injury or damage caused by fungi or bacteria The treatment of conditions resulting from fungi or bacteria Information given or which should have been given about fungi or bacteria and Any obligation to share damages with or repay anyone due to injury or damage arising from fungi or bacteria. The exclusion applies regardless of any other concurrent cause or the sequence in which injury or damage develops. The only exception to the exclusion of fungi including mold or bacteria is with regard to fungi including mold or bacteria intended for human ingestion. 1A 4226 03 02 | 2 |
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 All Commercial Lines Coverage Parts Coverage Forms Policies and Endorsements subject to the federal Terrorism Risk Insurance Act and any amendments and extensions thereto A. The following definition is added with respect to the provisions of this endorsement Certified act of terrorism means an act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act. to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria contained in the Terrorism Risk Insurance Act for a certi fied act of terrorism include the following 1. The act resulted in insured losses in ex cess of 5 million in the aggregate. attrib utable 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 in frastructure and is committed by an indi vidual or individuals. as part of an effort to coerce the civilian population of the Unit ed States or to influence the policy or af fect the conduct of the United States Government by coercion. B. Cap On Losses from Certified Acts of Ter rorism If aggregate insured losses attributable to ter rorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calen dar year and we have met our insurer deducti ble under the Terrorism Risk Insurance Act. we shall not be liable for the payment of any portion of the amount of such losses that ex ceeds 100 billion. and in such case insured losses up to that amount are subject to pro ra ta allocation in accordance with procedures established by the Secretary of the Treasury. Application of Other Exclusions The terms and limitations of any terrorism ex clusion. or the inapplicability omission or ab sence of a terrorism exclusion does not serve to create coverage for any loss which would otherwise be excluded under this Coverage Part. Coverage Form. Policy or Endorsement such as losses excluded by 1. Exclusions that address war warlike ac tion insurrection rebellion revolution mil itary action. nuclear hazard nuclear mate rials nuclear reaction. radiation. or radio active contamination 2. Exclusions that address pollutants. con tamination. deterioration fungi or bacteria or 3. Any other exclusion regardless if the certified act of terrorism contributes concurrently or in any sequence to the loss. Sunset Clause If the federal Terrorism Risk Insurance Act ex pires or is repealed. then this endorsement is and void for any act of terrorism that takes place after the expiration or repeal of the Act. Includes copyrighted material of 1ISO Properties Inc. and American Association of Insurance Services with their permission. 1A 4238 01 15 | 2 |
SIGNATURE ENDORSEMENT IN WITNESS WHEREOF this policy has been signed by our President and Secretary in the City of Fairfield Ohio but this policy shall not be binding upon us unless countersigned by an authorized representative of ours. The failure to countersign does not void coverage in Arizona. Virginia and Wisconsin. e b S o Secretary President The signature on any form endorsement. policy. declarations. jacket or application other than the signature of the President or Secretary named above is deleted and replaced by the above signatures. 1A 4338 05 11 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ILLINOIS CHANGES This endorsement modifies insurance provided under the following C. COMMERCIAL PROPERTY COVERAGE PART FARM COVERAGE PART STANDARD PROPERTY POLICY When this endorsement is attached to Stand ard Property Policy CP 00 99 the terms Cov erage Part and Coverage Form in this en dorsement are replaced by the term Policy. The following is added to the Legal Action Against Us Condition The 2 year period for legal action against us is extended by the number of days between the date the proof of loss is filed with us and the date we deny the claim in whole or in part. If this policy covers 1. The following in a. and b.. then Para graphs 2. and 3. apply a. Real property used principally for res idential purposes up to and including a four family dwelling or Household or personal property that is usual or incidental to the occupan cy of any premises used for residen tial purposes. The second paragraph of the Appraisal Condition is deleted and replaced by the following Each party will pay its own appraiser and bear the other expenses of the appraisal and umpire equally. except as provided in b. below. We will pay your appraiser s fee and the umpire s appraisal fee. if the fol lowing conditions exist 1 You demanded the appraisal and 2 The full amount of loss. as set by your appraiser is agreed to by our appraiser or by the umpire. The Concealment Misrepresentati or Fraud Condition is replaced by the f lowing CONCEALMENT MISREPRESENT TION OR FRAUD a. This Coverage Part or Covera Form is void if you or any insur insured commit fraud or conc or misrepresent a fact in the proce leading to the issuance of this ins ance. and such fraud. concealme or misrepresentation is stated in t policy or endorsement or in the w ten application for this policy and 1 Was made with actual intent deceive or 2 Materially affected either our cision to provide this insuran or the hazard we assumed. However. this condition will not ser as a reason to void this Covera Part or Coverage Form after Coverage Part or Coverage Fo has been in effect for one year or policy term whichever is less. We do not provide coverage un this Coverage Part or Coverage Fo to you or any other insured sured who. at any time subsequ to the issuance of this insuran commit fraud or intentionally conc or misrepresent a material fact re ing to 1 This Coverage Part or Cover Form 2 The Covered Property 3 Your interest in the Cove tached to Stand the terms Cov orm in this en e term Policy. e Legal Action tion against us is lays between the with us and the le or in part. b.. then Para yrincipally for res to and including or nal property that to the occupan used for residen of the Appraisal replaced by the its own appraiser expenses of the e equally except low. praiser s fee and sal fee. if the fol ist d the appraisal L of loss. as set by is agreed to by r by the umpire. The Concealment Misrepresentation or Fraud Condition is replaced by the fol lowing CONCEALMENT MISREPRESENTA TION OR FRAUD a. This Coverage Part or Coverage Form is void if you or any insured insured commit fraud or conceal or misrepresent a fact in the process leading to the issuance of this insur ance. and such fraud. concealment or misrepresentation is stated in the policy or endorsement or in the writ ten application for this policy and 1 Was made with actual intent to deceive or 2 Materially affected either our de cision to provide this insurance or the hazard we assumed. However this condition will not serve as a reason to void this Coverage Part or Coverage Form after the Coverage Part or Coverage Form has been in effect for one year or one policy term whichever is less. We do not provide coverage under this Coverage Part or Coverage Form to you or any other insured in sured who. at any time subsequent to the issuance of this insurance. commit fraud or intentionally conceal or misrepresent a material fact relat ing to 1 This Coverage Part or Coverage Form 2 The Covered Property 3 Your interest in the Covered Property or 4 A claim under this Coverage Part or Coverage Form. Notwithstanding the limitations stated in 3.a. above we may cancel the Coverage Part or Coverage Form in Includes copyrighted material of Insurance Services Office. Inc.. with its permission. Page 10of 2 Page 10f 2 1A 43821L 07 17 | 2 |
accordance with the terms of the Cancellation Condition. D. For the Commercial Property Coverage.Part and the Standard Property Palicy. the following exclusion and related provisions are added to Paragraph B.2. Exclusions. in the Causes of Loss Forms and to any Coverage Form or pol icy to which a Causes of Loss Form is not at tached 1. We will not pay for toss or damage arising out of any act an insured commits or con spires to commit with the intent to cause a loss. In the event of such loss no insured is en titled to coverage even insureds who did not commit or conspire to commit the act causing the loss. However this exclusion will not apply to deny payment to an innocent co insured who did not cooperate in or contribute to the creation of the loss if a. The loss arose out of a pattern of criminal domestic violence and b. The perpetrator of the loss is crimi nally prosecuted for the act causing the loss. If we pay a claim pursuant to Paragraph D.2. our payment to the insured is limited to that insured s insurable interest in the property less any payments we first made to a mortgagee or other party with a legal secured interest in the property. In no event will we pay more than the Limit of Insurance. The Intentional Loss Exclusion in the Caus es of Loss Form Farm Property. Mobile Agri cultural Machinery And Equipment Coverage Form and Livestock Coverage Form is re placed by the following 1. We will not pay for loss loss or dam age arising out of any act an insured commits or conspires to commit with the intent to cause a loss loss. In the event of such loss loss. no sured is entitled to coverage. even in sureds who did not commit or conspire to commit the act causing the loss loss. However this exclusion will not apply to deny payment to an innocent coinsured who did not cooperate in or contribute to the creation of the loss loss if a. The loss loss arose out of a pat tern of criminal domestic violence and b. The perpetrator of the loss loss is criminally prosecuted for the act causing the loss. If we pay a claim pursuant to Paragraph E.2. our payment to the insured is lim ited to that insured s insurable interest in the property less any payments we first made to a mortgagee or other party with a legal secured interest in the property. In no event will we pay more than the Limit of Insurance. Includes copyrighted material of Insurance Services Office. Inc. withits permission. IA 4382 IL 07 17 Page 2 of 2 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ILLINOIS CHANGES CIVIL UNION This endorsement modifies insurance provided under the following CHEMICAL DRIFT LIMITED LIABILITY COVERAGE FORM COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL UMBRELLA LIABILITY COVERAGE PART CONTRACTOR S ERRORS AND OMISSIONS COVERAGE FORM CLAIMS MADE EMPLOYEE BENEFIT LIABILITY COVERAGE FORM EMPLOYMENT PRACTICES LIABILITY COVERAGE PART EXCESS LIABILITY COVERAGE FORM EXCESS WORKERS COMPENSATION AND EMPLOYERS LIABILITY COVERAGE FORM HOLE IN ONE COVERAGE FORM ILLINOIS CONTRACTORS LIMITED WORKSITE POLLUTION LIABILITY COVERAGE FORM FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MANUFACTURER S ERRORS AND OMISSIONS COVERAGE FORM CLAIMS MADE OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART PROFESSIONAL UMBRELLA LIABILITY COVERAGE PART PROFESSIONAL UMBRELLA LIABILITY COVERAGE PART CLAIMS MADE SEPTIC SYSTEMS DESIGN INSPECTION ERRORS AND OMISSIONS COVERAGE PART UNDERGROUND STORAGE TANK POLICY The term spouse is replaced by the following nized under lllinois law. who is a resident.. the individual s household. including a wa Spouse or party to a civil union recognized un or foster child if the Drive Other Car Cc der llinois flaw. erage Broadened Coverage For Nam Under the Commercial Auto Coverage Part the Individual Endorsement is attached. term family member is replaced by the follow with respect to coverage for the ownersh Ing maintenance or use of covered autos prov Family member means a person related to ed under the Commercial Liability Umbre the y P Coverage Part. the term family member is placed by the following 1. Individual Named Insured by blood. adop tion. marriage or civil union recognized un Family member means a person related der linois law who is a resident of such you by blood. adoption. marriage or civil uni Named Insured s household. including a recognized under lllinois law. who is a reside ward or foster child or o jour household. including a ward or fos child. 2. Individual named in the Schedule by blood. adoption marriage or civil union recog nized under lllinois law. who is a resident of the individual s household. including a ward or foster child. if the Drive Other Car Cov erage Broadened Coverage For Named Individual Endorsement is attached. With respect to coverage for the ownership maintenance or use of covered autos provid ed under the Commercial Liability Umbrella Coverage Part. the term family member is re placed by the following Family member means a person related to you by blood. adoption. marriage or civil union recognized under lllinois law. who is a resident of your household. including a ward or foster child. Includes copyrighted material of Insurance Services Office Inc.. with its permission. IA 4395 IL 04 17 | 2 |
NOTICE CONCERNING POLICYHOLDER RIGHTS IN AN INSOLVENCY UNDER THE MINNESOTA INSURANCE GUARANTY ASSOCIATION LAW Residents of Minnesota who purchase property and casualty or liability insurance from insurance companies licensed to do business in Minnesota are protected SUBJECT TO LIMITS AND EXCLUSIONS in the event the insurer becomes insolvent. This protection is provided by the Minnesota Insurance Guaranty Association. Minnesota Insurance Guaranty Association 4640 West 77 Street Suite 342 Edina Minnesota 55435 952 831 1908 The maximum amount that the Minnesota Insurance Guaranty Association will pay in regard to a claim under all policies issued by the same insurer is limited to 300000. This limit does not apply to workers compensation insurance. Protection by the Guaranty Association is subject to other substantial limitations and exclusions. To be eligible for protection you must at the time the claim under the policy arises be either a Minnesota resident have your principal place of business in Minnesota or if your principal place of business is in Wisconsin lowa North or South Dakota maintain substantial business in Minnesota. If your claim exceeds the Guaranty Association s limits you may still recover a part or all of that amount from the proceeds from the liquidation of the insolvent insurer if any exist. Funds to pay claims may not be immediately available. The Guaranty Association assesses insurers licensed to sell property casualty or liability insurance in Minnesota after the insolvency occurs. Claims are paid from the assessment. THE PROTECTION PROVIDED BY THE GUARANTY ASSOCIATION IS NOT A SUBSTITUTE FOR USING CARE IN SELECTING INSURANCE COMPANIES THAT ARE WELL MANAGED AND FINANCIALLY STABLE. IN SELECTING AN INSURANCE COMPANY OR POLICY YOU SHOULD NOT RELY ON PROTECTION BY THE GUARANTY ASSOCIATION. THIS NOTICE IS REQUIRED BY MINNESOTA STATE LAW TO ADVISE POLICYHOLDERS OF PROPERTY AND CASUALTY OR LIABILITY INSURANCE POLICIES OF THEIR RIGHTS IN THE EVENT THEIR INSURANCE CARRIER BECOMES INSOLVENT. THIS NOTICE IN NO WAY IMPLIES THAT THE COMPANY CURRENTLY HAS ANY TYPE OF FINANCIAL PROBLEMS. ALL PROPERTY AND CASUALTY INSURANCE OR LIABILITY POLICIES ARE REQUIRED TO PROVIDE THIS NOTICE. have read the foregoing notice and received a copy for my records this day of 20 N Applicant IA 4810108 | 2 |
IMPORTANT INFORMATION TO POLICYHOLDERS In the event you need to contact someone about this policy for any reason please contact your agent. If you have additional questions you may contact the insurance company issuing this policy at the following ad dress or telephone collect The Cincinnati Insurance Company P.O. Box 145496 Cincinnati Ohio 45250 5496 Telephone 513 870 2278 The Cincinnati Casualty Company P.O. Box 145496 Cincinnati Ohio 45250 5496 Telephone 513 870 2278 The Cincinnati Indemnity Company P.O. Box 145496 Cincinnati Ohio 45250 5496 Telephone 513 870 2278 The Cincinnati Life Insurance Company P.0. Box 145496 Cincinnati Ohio 45250 5496 Telephone 513 870 2000 IP 4121292 | 2 |
A EMCInsurance Companies EMCASCO INSURANCE COMPANY PRIOR POLICY 4D6 49 78 GENERAL LIABILITY DECLARATIONS POLICY PERIOD FROM 010114 TO 010115 POLICY NUMBER 4D6 49 7 8 15 NAMED INSURED PRODUCER FALEWITCH CONSTRUCTION LOCKTON COMPANIES LLC SERVICES INC. 1015 N 98TH ST STE 101 8720 S 114TH ST STE 90 OMAHA NE 68114 2357 LAVISTA NE 68128 5585 AGENT BB 8210 AGENT PHONE 402 970 6100 AGENCY BILL JACK H. STRUYK JR INSURED IS CORPORATION BUSINESS DESC DRYWALL CONTRACTOR LIMIT S O F INSURANCE EACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT s 100000 ANY ONE PREMISES MEDICAL EXPENSE LIMIT 5000 ANY ONE PERSON PERSONAL AND ADVERTISING INJURY LIMIT 1000000 ANY ONE PERSON OR ORGANIZATION GENERAL AGGREGATE LIMIT 2000000 PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT 2000000 COVERAGES PROVIDED PREMIUM PRODUCTS COMPLETED OPERATIONS 0.00 OTHER THAN PRODUCTS COMPLETED OPERATIONS 21064.00 TOTAL ESTIMATED POLICY PREMIUM s 21064.00 SEE ATTACHED SCHEDULE FOR LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED. ECEIVED JAN D9 20H LOCKTON DATE OF ISSUE 010614 BPP FORM CG7000A ED. 08 99 BPP 101513 007 JO 4D64575 501 GENERAL LIABILITY DE POLICY PERIOD FROM 010114 TO 010115 SERVICES INC. 1015 N 98TH ST STE 101 8720 S 114TH ST STE 90 OMAHA NE 68114 2357 LAVISTA NE 68128 5585 AGENT BB 8210 AGENT PHONE 402 970 6100 N NTANTAY B TT T v Tt Tt e EACH OCCURRENCE LIMIT 1000 00 DAMAGE TO PREMISES RENTED TO YOU LIMIT s 100 00 MEDICAL EXPENSE LIMIT 500 PERSONAL AND ADVERTISING INJURY LIMIT 1000001 GENERAL AGGREGATE LIMIT T T T T O PR ATNT T T TN T R TIT AT R T TV R T T T AR Ty PRODUCTS COMPLETED OPERATIONS 0.00 OTHER THAN PRODUCTS COMPLETED OPERATIONS 21064.00 r 0 Rarsen D LOCKTON Rarsen D LOCKTON | 2 |
AV EMC Insurance Companies PAGE 2 EMCASCO INSURANCE COMPANY POLICY NUMBER 4D6 49 78 FALEWITCH CONSTR EFF DATE 010114 EXP DATE 010115 FORMS APPLICABLE CG00011207 CG03000196 G20370704 CG21671204 G22800798 CG70031008 CG71740108 CG7276 1008 CG75551104 CG8081 0406 IL.0274 0908 IL7131A0401 IL8383.50108 Footnotes G20101001 C AUDIT PERIOD ANNUAL DATE OF ISSUE 010614 BPP CG00680509 CG04371204 CG21471207 CG21700108 CG24171001 CG71400106 CG7174.30108 CG74281198 CG75830106 IL00210502 IL02760908 IL73380512 IL8384A0108 yu G20371001 CG01091185 CG20100704 CG21500989 CG21760108 CG26501298 CG71410590 CG71910113 CG74291198 CG7584 1008 IL02590907 IL70281005 1L73390511 Jx c00134 os o3 CG20280704 CG21540196 G2274 1001 CG7001A101 m CG71660106 CG72531296 675230307 CG7644 0209 IL02610907. IL7130A0401 IL7604 0199 i IL85760909 FORM CG7000A ED. 08 99 BPP 101513 007 Jo 4D64978 1501 EFF DATE 0101 Footnotes G20101001 CG20371001 AUDIT PERIOD ANNUAL | 2 |
AF EMCInsurance Companies EMCASCO INSURANCE COMPANY INSTALLMENT PREMIUM PAYMENT SCHEDULE oo POLICY NUMBER POLICY PERIOD 01012014 TO 01012015 4D6 49 7 8 15 e NAMED INSURED PRODUCER FALEWITCH CONSTRUCTION. LOCKTON COMPANIES LLC SERVICES INC... 1015 N 98TH ST STE 101 8720 S 114TH ST STE 90.. OMAHA NE. LAVISTA NE.. 68114 2357 68128 5585. AGENT NO. BB8210 THE ADVANCE ESTIMATED PREMIUM WILL BE DUE AS FOLLOWS SCHEDULE INSTALLMENT DUE DATE AMOUNT 1 090114 1755.00 1 1 100114 THIS INSTALLMENT SCHEDULE WILL NOT BE REVISED BY ANY FUTURE ENDORSEMENT RESULTING IN PREMIUM CHANGES UNLESS APPROVED BY THE COMPANY. PLACE OF ISSUE OMAHA NE DATE OF ISSUE 01062014 FORM IL7007A ED.03 86 01062014 007 JoO 4D64978 15001 INSTALLMENT PREMIUM PAYMENT SCHEDULE oo POLICY NUMBER POLICY PERIOD 01012014 TO 01012015 4D6 49 78 15 e NAMED INSURED PRODUCER FALEWITCH CONSTRUCTION. LOCKTON COMPANIES LLC SERVICES INC... 1015 N 98TH ST STE 101 8720 S 114TH ST STE 90.. OMAHA NE. LAVISTA NE.. 68114 2357 68128 5585. AGENT NO. BB8210 THE ADVANCE ESTIMATED PREMIUM WILL BE DUE AS FOLLOWS SCHEDULE INSTALLMENT DUE DATE AMOUNT 1 e ettt I e 1 010114 1759.00 Pommmmeaas 1 020114 1755.00 THIS INSTALLMENT SCHEDULE WILL NOT BE REVISED BY ANY FUTURE ENDORSEMENT RESULTING IN PREMIUM CHANGES UNLESS APPROVED BY THE COMPANY. PLACE OF ISSUE OMAHA NE ST STE 101 THE ADVANCE ESTIMATED PREMIUM WILL BE DUE AS FOLLOWS SCHEDULE INSTALLMENT DUE DATE AMOUNT 1 100114 1755.00 110114 1755.00 | 2 |
AV EMC Insurance Companies CG0001 CG0068 CG01l09 CG0134 CG0300 CG0437 CG2010 CG2028 CG2037 CG2147 CG2150 CG2154 CG2167 CG2170 CG2176 CG2274 CG2280 CG2417 DATE OF ISSUE EMCASCO INSURANCE COMPANY DATE 07 04 07 04 07 04 12 07 09 89 01 96 12 04 01 08 01 08 10 01 07 98 10 01 010614 FALEWITCH CONSTRUCTION EFF DATE 010114 EXP DATE ENDORSEMENT SCHEDULE DESCRIPTION ADDITIONAL INFORMATION COMMERCIAL GEN LIABILITY COV FORM RECORD DISTR MATRL INFO VIOL LAW EXC KS OK CHANGES TRANSFER OF RIGHTS MISSOURI CHGS POLLUTION EXCLUSION DEDUCTIBLE LIABILITY INSURANCE APPLICATION OF ENDORSEMENT LIMITATIONS NONE ELECTRONIC DATA LIAB ENDORSEMENT LOSS OF ELECTRONIC DATA LIMIT 50000 AI OWNERS LESSEES OR CONTRACTORS.. NAME MCCARTHY BUILDING COMPANIES INC. AND ALEGENT HEALTH OWNER PREM OPS ADDRESS 1341 NORTH ROCK HILL ROAD ST LOUIS MO 63124 AI LESSOR OF LEASED EQUIPMENT NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. ORIX CREDIT ALLIANCE INC. AI OWNERS LESSEES OR CONT COMP OPS NAME MCCARTHY BUILDING COMPANIES INC. AND ALEGENT HEALTH OWNER PREM OPS ADDRESS 1341 NORTH ROCK HILL ROAD ST LOUIS MO 63124 EXCL EMPLOYMENT RELATED PRACTICES AMENDMENT LIQUOR LIABILITY EXCLUSION EXCL OPER COV BY CONSLDATED INS PROG DESCRIPTION AND LOCATION OF OPERATIONS 7215 NAVAJO COUNCIL BLUFFS IA 51501 PROJECT NO. KVAERNERSONGER PO NO. 16514C1045 FUNGI OR BACTERIA EXCLUSION CAP LOSSES FROM CERT ACTS TERRORISM EXCL PUNITIVE DMGS ACTS OF TERRORISM LTD CONTRACTUAL LIAB COV PERS ADV DESIGNATED CONTRACT OR AGREEMENT ANY CONTRACT LIMITED EXCL CONTRACTOR PROF LIAB CONTRACTUAL LIABILITY RAILROADS CONTINUED PREMIUM POLICY NUMBER 4D6 49 78 15 010115 FORM IL7131A ED. 04 01 007 Jo 4064978 1501 EDITION PR PR T TS T TNTIT AT R TN TS T T ARTR T T AT TAT A AR T AT P CG0068 CGO109 CG0134 CG0300 CG0437 CG2010 CG2028 CG2037 CG2147 CG2150 CG2154 CG2167 CG2170 CG2176 CG2274 CG2280 CG2417 07 04 07 04 07 04 12 07 09 89 01 96 12 04 01 08 01 08 10 01 07 98 10 01 RECORD DISTR MATRL INFO VIOL LAW EXC KS OK CHANGES TRANSFER OF RIGHTS MISSOURI CHGS POLLUTION EXCLUSION DEDUCTIBLE LIABILITY INSURANCE APPLICATION OF ENDORSEMENT LIMITATIONS NONE ELECTRONIC DATA LIAB ENDORSEMENT LOSS OF ELECTRONIC DATA LIMIT 50000 AI OWNERS LESSEES OR CONTRACTORS.. NAME MCCARTHY BUILDING COMPANIES INC. AND ALEGENT HEALTH OWNER PREM OPS ADDRESS 1341 NORTH ROCK HILL ROAD ST LOUIS MO 63124 AI LESSOR OF LEASED EQUIPMENT NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. ORIX CREDIT ALLIANCE INC. AI OWNERS LESSEES OR CONT COMP OPS NAME MCCARTHY BUILDING COMPANIES INC. AND ALEGENT HEALTH OWNER PREM OPS ADDRESS 1341 NORTH ROCK HILL ROAD ST LOUIS MO 63124 EXCL EMPLOYMENT RELATED PRACTICES AMENDMENT LIQUOR LIABILITY EXCLUSION EXCL OPER COV BY CONSLDATED INS PROG DESCRIPTION AND LOCATION OF OPERATIONS 7215 NAVAJO COUNCIL BLUFFS IA 51501 PROJECT NO. KVAERNERSONGER PO NO. 16514C1045 FUNGI OR BACTERIA EXCLUSION CAP LOSSES FROM CERT ACTS TERRORISM EXCL PUNITIVE DMGS ACTS OF TERRORISM LTD CONTRACTUAL LIAB COV PERS ADV DESIGNATED CONTRACT OR AGREEMENT ANY CONTRACT LIMITED EXCL CONTRACTOR PROF LIAB CONTRACTUAL LIABILITY RAILROADS | 2 |
A EMC Insurance Companies PAGE NO 2 EMCASCO INSURANCE COMPANY POLICY NUMBER 4D6 49 78 15 FALEWITCH CONSTRUCTION EFF DATE 010114 EXP DATE 010115 GENERAL POLICY LIABILITY DECLARATIONS ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM ANY AND ALL RAILROADS ANY AND ALL RAILROADS PINNACLE BANK ARENA LINCOLN NE CG2650 12 98 MISSOURI CHANGES MEDICAL PAYMENTS CG7001A 10 12 GENERAL LIABILITY SCHEDULE CG7003 10 08 GL QUICK REFERENCE OCCURRENCE CG7140 01 06 INJ TO CO EMPL OR O VOLUNTEER WKRS NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. ALL MANAGERIAL OR SUPERVISORY EMPLOYEESOR EXCUTIVE OFFICERS CG7141 05 90 EXTENDED PROPERTY DAMAGE COVERAGE CG7166 01 06 AI DESIG PERS ORG PRIM NONCONTRIBTRY NAME BLANKET WHERE REQUIRED BY WRITTEN CONTRACT CG7174 01 08 BLANKET AI CONSTRUCTION CONTRACTS CG7174.3 01 08 BLKT AI CONST CONT INCL COMP OPS CG7191 01 13 COMML GENERAL LIABILITY AMENDMENT CG7253 12 96 CONTRACTORS EXTENDED PROPERTY DAMAGE CG7276 10 08 LIMITED POLLUTION COV WORK SITES 150 CG7428 i 11 98 AMEND AGGREGATE LIMIT PER LOCATION CG7429 AMEND AGGREGATE LIMIT PER PROJECT CG7523 EXCL EXT INSUL FINISH OR DIRECT APP CG7555 11 04 BLKT WAIV SUBRO WRITTEN CONT AGREE CG7583 01 06 MOTOR VEHICLE LAWS I CG7584 10 08 MOBILE EQUIPMENT AUTO AMENDMENT CG7644 02 09 CONTRACTORS OCCURRENCE DEFINITION CGB081 04 06 FUNGI BACTERIA NOTICE TO POLICYHOLDR IL0021 05 02 NUCLEAR ENERGY LIAB EXCL BROAD FORM TIL0259 09 07 NE CHANGES CANCELLATION NONRENEWAL TIL0261 09 07 KS CHANGES CANCELLATION NONRENEWAL IL0274 09 08 MO CHANGES CANCELLATION NONRENEWAL 1L0276 09 08 TIA CHANGES CANCELLATION NONRENEWAL TIL7028 10 05 ASBESTOS EXCLUSION IL7130A 04 01 NAMED INSURED ENDORSEMENT IL7131A 04 01 COMML POLICY ENDORSEMENT SCHEDULE IL7338 05 12 EARLIER NOTICE CANC PROV BY US DESIG NAME GRAHAM CONSTRUCTION INC. ADDRESS 13210 CENTENNIAL RD STE 1 NUMBER OF DAYS ADVANCE NOTICE 45 NAME KIEWIT BUILDING GROUP ATTN KRISTINA PARKER ADDRESS 3921 MASON STREET DATE OF ISSUE 010614 CONTINUED FORM IL7131A ED. 04 01 007 Jo 4D64978 1501 EDITION P P T T T T T ART SR TN T T AN AT TATT D AR T R CG2650 CG7001A CG7003 CG7140 CG7141 CG7166 CG7174 CG7174.3 IL7130A IL7131A IL7338 12 98 10 12 10 08 01 06 05 390 01 06 01 08 01 08 01 13 12 96 10 08 01 06 10 08 02 09 04 06 05 02 09 07 09 07 09 08 09 08 10 05 04 01 04 01 05 12 M AREE A A A AR A A A R e e m e e e ANY AND ALL RAILROADS ANY AND ALL RAILROADS PINNACLE BANK ARENA LINCOLN NE MISSOURI CHANGES MEDICAL PAYMENTS GENERAL LIABILITY SCHEDULE GL QUICK REFERENCE OCCURRENCE INJ TO CO EMPL OR O VOLUNTEER WKRS NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. ALL MANAGERIAL OR SUPERVISORY EMPLOYEESOR EXCUTIVE OFFICERS EXTENDED PROPERTY DAMAGE COVERAGE AI DESIG PERS ORG PRIM NONCONTRIBTRY NAME BLANKET WHERE REQUIRED BY WRITTEN CONTRACT BLANKET AI CONSTRUCTION CONTRACTS BLKT AI CONST CONT INCL COMP OPS COMML GENERAL LIABILITY AMENDMENT CONTRACTORS EXTENDED PROPERTY DAMAGE LIMITED POLLUTION COV WORK SITES AMEND AGGREGATE LIMIT PER LOCATION AMEND AGGREGATE LIMIT PER PROJECT EXCL EXT INSUL FINISH OR DIRECT APP BLKT WAIV SUBRO WRITTEN CONT AGREE MOTOR VEHICLE LAWS MOBILE EQUIPMENT AUTO AMENDMENT CONTRACTORS OCCURRENCE DEFINITION FUNGI BACTERIA NOTICE TO POLICYHOLDR NUCLEAR ENERGY LIAB EXCL BROAD FORM NE CHANGES CANCELLATION NONRENEWAL KS CHANGES CANCELLATION NONRENEWAL MO CHANGES CANCELLATION NONRENEWAL IA CHANGES CANCELLATION NONRENEWAL ASBESTOS EXCLUSION NAMED INSURED ENDORSEMENT COMML POLICY ENDORSEMENT SCHEDULE EARLIER NOTICE CANC PROV BY US DESIG NAME GRAHAM CONSTRUCTION INC. ADDRESS 13210 CENTENNIAL RD STE 1 NUMBER OF DAYS ADVANCE NOTICE 45 NAME KIEWIT BUILDING GROUP ATTN KRISTINA PARKER ADDRESS 3921 MASON STREET 15 CG2650 CG7001A CG7003 CG7140 CG7141 CG7166 CG7174 CG7174.3 CaT191 12 98 10 12 10 08 01 06 05 390 01 06 01 08 01 08 Nn1 12 | 2 |
A EMC Insurance Companies PAGE NO 3 EMCASCO INSURANCE COMPANY POLICY NUMBER 4D6 49 78 15 FALEWITCH CONSTRUCTION EFF DATE 010114 EXP DATE 010115 GENERAL POLICY ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM OMAHA NE 68105 NUMBER OF DAYS ADVANCE NOTICE 30 NAME M. A. MORTENSON COMPANY AND ALL OTH PARTIES AS REQUIRED BY THE OWNER CONTRACT ADDRESS 440 N 8TH ST STE 110 LINCOLN NE 68508 NUMBER OF DAYS ADVANCE NOTICE 30 NAME THE WHITING TURNER CONTRACTING COMPANY ADDRESS SUITE 120 ONE SPEEN STREET FRAMINGHAM MA 01701 NUMBER OF DAYS ADVANCE NOTICE 30 IL7339 05 11 DEFINITION OF YOUR WORK AMEND ENDST T IL7604 01 99 KANSAS COMPANY ELIMINATION IL8383.5 01 08 DISCL PURSUANT TERRSM RISK INS. ACT PREMIUM THROUGH 123114 169 PREMIUM BEYOND 123114 WAIVED IL8384A 01 08 TERRORISM NOTICE IL8576 09 09 MEDICARE IMPT NOTICE TO POLICYHOLDER FOOTNOTES G20101001 CG20371001 DATE OF ISSUE 010614 FORM IL7131A ED. 04 01 007 30 4D64978 1501 EDITION P P et et e e P IL7339 IL7604 IL8383.5 TL8384A IL8576 05 11 01 99 01 08 01 08 09 09 NUMBER NAME ADDRESS NUMBER NAME ADDRESS NUMBER DEFINITION KANSAS COMP DISCL PURSU PREMIUM THI PREMIUM BE TERRORISM N MEDICARE IMI NUMBER OF DAYS ADVANCE NOTICE 30 NAME M. A. MORTENSON COMPANY AND ALL OTH PARTIES AS REQUIRED BY THE OWNER CONTRACT ADDRESS 440 N 8TH ST STE 110 LINCOLN NE 68508 NUMBER OF DAYS ADVANCE NOTICE 30 NAME THE WHITING TURNER CONTRACTING COMPANY ADDRESS SUITE 120 ONE SPEEN STREET FRAMINGHAM MA 01701 NUMBER OF DAYS ADVANCE NOTICE 30 IL7339 05 11 DEFINITION OF YOUR WORK AMEND ENDST IL7604 01 99 KANSAS COMPANY ELIMINATION IL8383.5 01 08 DISCL PURSUANT TERRSM RISK INS. ACT PREMIUM THROUGH 123114 16 PREMIUM BEYOND 123114 WATVE TL8384A 01 08 TERRORISM NOTICE IL8576 09 09 MEDICARE IMPT NOTICE TO POLICYHOLDER FOOTNOTES G20101001 CG20371001 | 2 |
AV EMC Insurance Companies EMCASCO INSURANCE COMPANY POLICY NUMBER 4D6 49 78 15 FALEWITCH CONSTRUCTION EFF DATE 010114 EXP DATE 010115 TERROCRISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent DATE OF ISSUE 010614 FORM IL8384A 01 08 007 Jo 4D64978 1501 FALEWITCH CONSTRUCTION EFF DATE 010114 EXP DATE 0101 TERROCRISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent TERROCRISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent | 2 |
A EMC Insurance Companies EMCASCO INSURANCE COMPANY POLICY NUMBER 4D6 49 78 15 FALEWITCH CONSTRUCTION EFF DATE 010114 EXP DATE 010115 This disclosure is attached to your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This disclosure does not grant any coverage or change the terms and conditions of any coverage under the policy. CLOSURE PURSUANT IsM RISK INSURANC SCHEDULE Terrorism Premium Certified Acts A. Premium through end of year 123114 169.00 B. Premium beyond the date specified above waived. Refer to paragraph D. below A. DISCLOSURE OF PREMIUM In accordance with the Federal Terrorism Risk Insurance Act we are required to provide you with a notice disclosing the portion of your premium if any attributable to coverage for terrorism acts certified under that act. The portion of your premium attributable to such coverage is shown in the schedule of this disclosure or in the policy Declarations. B. DISCLOSURE OF FEDERAL PARTICIPATION IN PAYMENT OF TERRORISM LOSSES The United States Government Department of the Treasury will pay a share of terrorism losses insured under the federal program. 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 Texrrorism 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. D. PREMIUM BEYOND THE YEAR SPECIFIED IN THE SCHEDULE ABOVE The premium for certified acts of terrorism coverage is calculated based in part on the federal participation in payment of terrorism losses as set forth in the Terrorism Risk Insurance Act. The federal program established by the Act is scheduled to terminate at the end of the year specified in the Schedule of this endorsement unless extended by the federal government. If the federal program is extended the premium shown in B in the Schedule shall be attributable to coverage for terrorism acts certified under the act. If the Federal program terminates your policy will still contain coverage for acts of terrorism unless you have elected to exclude the coverage. The premium shown in B of the schedule shall be attributable to that coverage for terrorism. Includes copyrighted material of ISO Properties Inc. with its permission DATE OF ISSUE 010614 continued FORM IL8383.5 01 08 007 Jo 4D64978 1501 o your policy in response to the 1e Terrorism Risk Insurance Act. 1 t any coverage or change the terms je under the policy. R E PURSUANT ISK INSURANC d Acts f year 123114 169.00 e specified above waived. below leral Terrorism Risk Insurance Act we are ith a notice disclosing the portion of ributable to coverage for terrorism acts The portion of your premium attributable in the schedule of this disclosure or in TCIPATION IN PAYMENT OF TERRORISM LOSSES nt Department of the Treasury will pay s insured under the federal program. The f that portion of the amount of such s the applicable insurer retention. ired losses attributable to terrorist acts This disclo disclosure This disclo and conditis A. DISCLOSUJ In accorc required your prer certified to such the polic B. DISCLOSUI The Unite a share federal insured However certifiec in a Prog not make that exce C. CAP ON I If aggrec under the Program 3 insurer not be 1i losses tb up to the with proc D. PREMIUM E The premi based in losses as federal the end c unless ex is extenc attributa If the Fe coverage the cover attributa IN PAYMENT OF TERRORISM LOSSES attributable to terrorist acts certified surance Act exceed 100 billion in a bugh December 31 and we have met our Terrorism Risk Insurance Act we shall 1 t of any portion of the amount of such lion and in such case insured losses t to pro rata allocation in accordance by the Secretary of the Treasury. IFIED IN THE SCHEDULE ABOVE ts of terrorism coverage is calculated participation in payment of terrorism errorism Risk Insurance Act. The by the Act is scheduled to terminate at d in the Schedule of this endorsement al government. If the federal program wn in B in the Schedule shall be terrorism acts certified under the act. nates your policy will still contain sm unless you have elected to exclude shown in B of the schedule shall be je for terrorism. | 2 |
A EMC Insurance Companies Page 2 EMCASCO INSURANCE COMPANY POLICY NUMBER 4D6 49 78 15 FALEWITCH CONSTRUCTION EFF DATE 010114 EXP DATE 010115 This disclosure is attached to your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This disclosure does not grant any coverage or change the terms and conditions of any coverage under the policy. THE FOLLOWING STATEMENT IS REQUIRED TO BE PART OF THE DISCLOSURE NOTICE IN MISSOURI The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your policy carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Includes copyrighted material of ISO Properties Inc. with its permission DATE OF ISSUE 010614 FORM IL8383.5 01 08 007 Jo 4D64978 1501 This disclosure is attached to your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This disclosure does not grant any coverage or change the terms and conditions of any coverage under the policy. THE FOLLOWING STATEMENT IS REQUIRED TO BE PART OF THE DISCLOSURE NOTICE IN MISSOURI The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your policy carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Includes copyrighted material of ISO Properties Inc. with its permission | 2 |
AFEMC Insurance Companies EMCASCO INSURANCE COMPANY NAMED INSURED ENDORSEMENT POLICY PERIOD FROM 010114 TO 010115 POLICY NUMBER 4D6 49 7 8 15 NAMED INSURED PRODUCER FALEWITCH CONSTRUCTION LOCKTON COMPANIES LLC SERVICES INC. 1015 N 98TH ST STE 101 8720 S 114TH ST STE 90 OMAHA NE 68114 2357 LAVISTA NE 68128 5585 AGENT BB 8210 AGENT PHONE 402 970 6100 AGENCY BILL JACK H. STRUYK JR IT IS HEREBY AGREED AND UNDERSTOOD THAT THE NAMED INSURED IS AMENDED TO READ AS FOLLOWS 1ST NAMED INSURED FALEWITCH CONSTRUCTION SERVICES INC. NO. 02 JOHN FALEWITCH NO. 03 FALEWITCH SONS LLC NO. 04 TI CONSTRUCTION SERVICES INC. PLACE OF ISSUE OMAHA NE DATE OF ISSUE 010614 FORM I1L7130A ED. 04 01 007 Jo 4D64978 1501 NAMED INSURED ENDO POLICY PERIOD FROM 010114 TO 010115 SERVICES INC. 1015 N 98TH ST STE 101 8720 S 114TH ST STE 90 OMAHA NE 68114 2357 LAVISTA NE 68128 5585 AGENT BB 8210 AGENT PHONE 402 970 6100 OL ICY. oo IT IS HEREBY AGREED AND UNDERSTOOD THAT THE NAMED INSURED IS AMENDED TO READ AS FOLLOWS 1ST NAMED INSURED FALEWITCH CONSTRUCTION SERVICES INC. NO. 02 JOHN FALEWITCH NO. 03 FALEWITCH SONS LLC NO. 04 TI CONSTRUCTION SERVICES INC. PLACE OF ISSUE OMAHA NE | 2 |
A EMC Insurance Companies EMCASCO INSURANCE COMPANY POLICY NO 4D6 49 78 15 FALEWITCH CONSTR EFF DATE 010114 EXP DATE 010115 GENERAL LIABILITY SCHEDULE PRODUCTS COMPL OPS ALL OTHER RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 001 44444 AMENDMENT OF CONTRACTUAL LIABILITY EXCLUSION FOR PERSONAL INJURY ETC. SEE CG2274 PREMIUM BASIS 1 FLAT CHARG 1 EXPOSURE IF ANY SUBLINE 334 i 61217 BLDGS OR PREM BANK OR OFFICE i MERCANTILE OR MFG.MAINT BY INSURED LESSOR S RISK ONLY 1 4 PREMIUM BASIS THOUSANDS OF AREA EXPOSURE 12500 SUBLINE 334 i 87224 CONTRACTORS EXTENDED PROPERTY DAMAGE ENDORSEMENT SEE FORM CG7253 i PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87509 s 0 PRIMARY ADDITIONAL INSURED CG7166 PREMIUM BASIS EACH EXPOSURE 1 SUBLINE 334 ADDITIONAL INTEREST 1 334 90 1 BLANKET WHERE REQUIRED BY 87511 BLANKET ADDITIONAL INSUREDS I CONSTRUCTION CONTRACTS SEE FORM CG7174 i i PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 DATE OF ISSUE 010614 BPP CONTINUED FORM CG7001A ED.10 12 BPP 101513 007 JO 4D64978 1501 TENDED S PROPERTY TONAL INSURED SIS 334 ITEREST 1 334 ONAL INSUREDS ONTRACTS 4 S. m At | 2 |
A EMC Insurance Companies PAGE 2 EMCASCO INSURANCE COMPANY POLICY NO 4D6 49 78 15 FALEWITCH CONSTR EFF DATE 010114 EXP DATE 010115 GENERAL LIABILITY SCHEDULE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 87604 CARPENTRY NOC 3 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE CTR 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE 87610 4.84718 10501 DRYWALL OR WALLBOARD INSTALLATION 3 1 1 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 2166400 1 SUBLINE CTR i 1 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE ADDITIONAL INTEREST 1 CTR 35 ORIX CREDIT ALLIANCE INC. LESSOR OF LEASED EQUIPMENT C G2028 ADDITIONAL INTEREST 2 CTR 8 MCCARTHY BUILDING COMPANIES 1 1 OWNERS LESSEES OR CONTRACTORS.. CG2010 ADDITIONAL INTEREST 3 CTR 7 MCCARTHY BUILDING COMPANIES OWNERS LESSEES OR CONT COMP OPS CG2037 87625 1 13.5781 2108 PAINTING EXTERIOR 3 6 PREMIUM BASIS 1 1 THOUSANDS OF PAYROLL i EXPOSURE 155250 1 1 SUBLINE CTR 250 DEDUCTIBLE APPLIES TO PD PER OCCUR INCLUDING SPRAY PAINTING OPERATIONS UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE DATE OF ISSUE 010614 BPP CONTINUED FORM CG7001A ED.10 12 BPP 101513 007 Jo 4D64978 1501 ROLL 56400 | 2 |
A EMC Insurance Companies PAGE 3 EMCASCO INSURANCE COMPANY POLICY NO 4D6 49 78 15 FALEWITCH CONSTR EFF DATE 010114 EXP DATE 010115 LITY SCHEDULE NUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 87628 PLASTERING OR STUCCO WORK 3 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE CTR 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE 87639 CONTRACTORS EXECUTIVE SUPERVISORS OR EXECUTIVE SUPERINTENDENTS 3 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 448000 SUBLINE CTR 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE 87654 ADDITIONAL INSURED CO EMPLOYEE BODILY INJURY OR PERSONAL AND ADVERTISING INJURY FORM CG7140 PREMIUM BASIS PER EMP EXPOSURE 10 SUBLINE 334 87741 LIMITED POLLUTION COVERAGE WORKSITES SEE FORM CG7276 PREMIUM BASIS FLAT CHARG EXPOSURE IF ANY SUBLINE 334 87747 AMENDMENT AGGREGATE LIMITS OF INSURANCE PER LOCATION SEE FORM CG7428 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 DATE OF ISSUE 010614 BPP CONTINUED FORM CG7001A ED.10 12 BPP 1015713 007 JO 4D64978 1501 K 3 NJURY FORM CG7140 3IS 10 P COVERAGE GREGATE LIMITS OF LOCATION | 2 |
A EMC Insurance Companies PAGE 4 EMCASCO INSURANCE COMPANY POLICY NO 4D6 49 78 15 FALEWITCH CONSTR EFF DATE 010114 EXP DATE 010115 LITY SCHEDULE NUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 87748 AMENDMENT AGGREGATE LIMITS OF INSURANCE PER PROJECT SEE FORM CG7429 i PREMIUM BASIS 1 FLAT CHARG 1 EXPOSURE 1 SUBLINE 334 87780 1 CONSTRUCTION CONTRACTS INCLUDING COMPLETED OPERATIONS BLANKET ADDL INSUREDS CG7174.3 1 PREMIUM BASIS FLAT CHRGE EXPOSURE 2 SUBLINE 334 87786 BLANKET WAIVER OF SUBROGATION SEE FORM CG7555 PREMIUM BASIS FLAT CHARG 1 EXPOSURE 1 SUBLINE 334 87789 CONTRACTUAL LIABILITY RAILROAD ENDORSEMENT CG2417 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 ADDITIONAL INTEREST 1 334 ANY AND ALL RAILROADS 87808 ELECTRONIC DATA LIABILITY PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 DATE OF ISSUE 010614 BPP CONTINUED FORM CG7001A ED.10 12 BPP 101513 007 J0 4D64978 1501 GREGATE LIMITS OF PROJECT m CG7174.3 S S OF SUBROGATION. IS 334 TEREST 1 334 A LIABILITY S | 2 |
EMC Insurance Companies PAGE 5 EMCASCO INSURANCE COMPANY POLICY NO 4D6 49 78 15 FALEWITCH CONSTR EFF DATE 010114 EXP DATE 010115 GENERAL LIABILITY SCHEDULE CONTINUED PRODUCTS COMPL OPS ALL OTHER RATE ADVANCE PREM RATE ADVANCE PREM CODE NO.EXPOSURE CLASSIFICATION 87830 CONTRACTORS OCCURRENCE DEFINITION PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 1 832 91341 CARPENTRY INTERIOR PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 91590 CONTRACTORS PERMANENT YARDS MAINT OR STORAGE OF EQUIP OR MATERIAL 4 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 121900 SUBLINE 334 I 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE 98449 PLASTERING OR STUCCO WORK PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 LOCATION 002 87610 DRYWALL OR WALLBOARD INSTALLATION 3 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE CTR 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE DATE OF ISSUE 010614 BPP CONTINUED FORM CG7001A ED.10 12 BPP 1015713 007 Jo 4D64978 1501 K ROLL | 2 |
AV EMC Insurance Companies PAGE 6 EMCASCO INSURANCE COMPANY POLICY NO 4D6 49 78 15 FALEWITCH CONSTR EFF DATE 010114 EXP DATE 010115 TY SCHEDULE ED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 87625 PAINTING EXTERIOR 3 6 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE CTR 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE LOCATION 003 H 1 49451 I VACANT LAND 1 4 PREMIUM BASIS ACRE EXPOSURE IF ANY SUBLINE 334 LOCATION 004 87604 CARPENTRY NOC 3 PREMIUM BASIS 1 THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE CTR 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE 87610 DRYWALL OR WALLBOARD INSTALLATION 3 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 140300 SUBLINE CTR 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE DATE OF ISSUE 010614 BPP CONTINUED FORM CG7001A ED.10 12 BPP 101513 007 J0 4D64978 1501 S PAYROLL IF ANY ROLL 10300 | 2 |
A EMC Insurance Companies PAGE 7 EMCASCO INSURANCE COMPANY POLICY NO 4D6 49 78 15 FALEWITCH CONSTR EFF DATE 010114 EXP DATE 010115 PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 87625 PAINTING EXTERIOR 3 6 PREMIUM BASIS THOUSANDS OF PAYROLL 1 1 12.865 260 1 1 EXPOSURE 20200 SUBLINE CTR 250 DEDUCTIBLE APPLIES TO PD UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE 87639 CONTRACTORS EXECUTIVE SUPERVISORS OR EXECUTIVE SUPERINTENDENTS 3 PREMIUM BASIS 1 THOUSANDS OF PAYROLL EXPOSURE 3200 SUBLINE CTR 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE 91590 CONTRACTORS PERMANENT YARDS MAIN OR STORAGE OF EQUIP OR MATERIAL 4 PREMIUM BASIS THOUSANDS OF PAYROLL H EXPOSURE 3100 SUBLINE 334 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE 98449 0 PLASTERING OR STUCCO WORK PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 i DATE OF ISSUE 010614 BPP CONTINUED FORM CG7001A ED.10 12 BPP 101513 007 Jo 4D64978 1501 | 2 |
A EMC Insurance Companies PAGE 8 EMCASCO INSURANCE COMPANY POLICY NO 4D6 49 78 15 FALEWITCH CONSTR EFF DATE 010114 EXP DATE 010115 GENERAL LIABILITY SCHEDULE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 005 87604 CARPENTRY NOC 3 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE CTR 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE 87610 1 DRYWALL OR WALLBOARD INSTALLATION 3 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE CTR i 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE 87625 PAINTING EXTERIOR 3 6 PREMIUM BASIS THOUSANDS OF PAYROLL 1 EXPOSURE IF ANY SUBLINE CTR 250 DEDUCTIBLE APPLIES TO PD PER OCCUR INCLUDING SPRAY PAINTING OPERATIONS UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE 1 91580 I H 16.537 0 CONTRACTORS EXECUTIVE SUPERVISORS 1 OR EXECUTIVE SUPERINTENDENTS 4 1 PREMIUM BASIS 1 1 1 THOUSANDS OF PAYROLL 1 EXPOSURE IF ANY 1 1 b SUBLINE 334 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE DATE OF ISSUE 010614 BPP CONTINUED FORM CG7001A ED.10 12 BPP 1015713 007 Jo 4D64978 1501 PAYROLL IF ANY ROLL ANY | 2 |
A EMC Insurance Companies PAGE k EMCASCO INSURANCE COMPANY POLICY NO 4D6 49 78 15 FALEWITCH CONSTR EFF DATE 010114 EXP DATE 010115 PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 91590 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 334 250 DEDUCTIBLE APPLIES TO PD PER OCCUR UNLESS A LIMITATION IS SHOWN ON THE ENDORSEMENT SCHEDULE PREMIUM FOR CERTIFIED ACTS OF TERRORISM 169.00 TOTAL ESTIMATED POLICY PREMIUM 21064.00 1 OTHER THAN NOT FOR PROFIT 2 NOT FOR PROFIT 3 INCLUDING PRODUCTS AND OR COMPLETED OPERATIONS UNLESS OTHERWISE EXCLUDED 4 PRODUCTS COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT 5 A 250 PD DEDUCTIBLE PER CLAIM APPLIES TO CUSTOMERS AUTOS UNLESS OTHERWISE DESIGNATED BY THIS CLASSIFICATION CODE 6 FOR SPRAY PAINTING OPERATIONS A PD DEDUCTIBLE OF 250 PER CLAIM APPLIES UNLESS A HIGHER DEDUCTIBLE IS OTHERWISE DESIGNATED FOR THIS CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED RATED LOCATIONS LOC 001 8720 S 114TH ST STE 100 LAVISTA NE 68128 5585 LOC 002 NO PHYSICAL ADDRESS WICHITA KS 67201 LOC 003 LOT 29 BROOK VALLEY II LAVISTA NE 68128 LOC 004 NO PHYSICAL ADDRESS COUNCIL BLUFFS IA 51501 LOC 005 NO PHYSICAL ADDRESS KANSAS CITY MO 64112 DATE OF ISSUE 010614 BPP CONTINUED FORM CG7001A ED.10 12 BPP 101513 007 Jo 4D64978 1501 CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED RATED LOCATIONS LOC 001 8720 S 114TH ST STE 100 LAVISTA NE 68128 5585 LOC 002 NO PHYSICAL ADDRESS WICHITA KS 67201 LOC 003 LOT 29 BROOK VALLEY II LAVISTA NE 68128 LOC 004 NO PHYSICAL ADDRESS COUNCIL BLUFFS IA 51501 LOC 005 NO PHYSICAL ADDRESS KANSAS CITY MO 64112 LOC 002 NO PHYSICAL ADDRESS WICHITA KS 67201 LOC 003 LOT 29 BROOK VALLEY II LAVISTA NE 68128 LOC 004 NO PHYSICAL ADDRESS COUNCIL BLUFFS IA 51501 LOC 005 NO PHYSICAL ADDRESS KANSAS CITY MO 64112 | 2 |
A EMC Insurance Companies PAGE 10 EMCASCO INSURANCE COMPANY POLICY NO 4D6 49 78 15 FALEWITCH CONSTR EFF DATE 010114 EXP DATE 010115 GENERAL LIABILITY SCHEDULE CONTINUED ALL OTHER LOCATIONS 221 SUN VALLEY BLVD. SUITE G LINCOLN NE 68528 DATE OF ISSUE 010614 BPP FORM CG7001A ED.10 12 BPP 101513 007 Jo 4D64978 1501 ALL OTHER LOCATIONS 221 SUN VALLEY BLVD. SUITE G LINCOLN NE 68528 | 2 |
POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 20101001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization M.A. MORTENSON COMPANY AND ALL OTHER PARTIES AS REQUESTED BY THE OWNER CONTRACT FOR WEST LINCOLN PINNACLE BANK ARENA PROJECT NO. 10150002 If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. A. Section Il Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds the following exclusion is added 2. Exclusions This insurance does not apply to bodily in Jury or property damage occurring after 1 All work including materials parts or 2 equipment furnished in connection with such work on the project other than service maintenance or repairs to be performed by or on behalf of the addi tional insureds at the site of the cov ered operations has been completed or That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another con tractor or subcontractor engaged in penorrm ations for a principal as. CONTRACT FOR WEST LINCOLN PINNACLE BANK ARENA 1 All work including materials parts or 2 equipment furnished in connection with such work on the project other than service maintenance or repairs to be performed by or on behalf of the addi tional insureds at the site of the cov ered operations has been completed or That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another con tractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20101001 1S0 Properties Inc. 2000 Page 1 of 1 a | 2 |
POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 20371001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS COMPLETED OPERATIONS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization M.A. MORTENSON COMPANY AND ALL OTHER PARTIES AS REQUESTED BY THE OWNER CONTRACT FOR WEST LINCOLN PINNACLE BANK ARENA PROJECT NO. 10150002 Location And Description of Completed Operations WEST LINCOLN PINNACLE BANK ARENA PROJECT NO. 10150002 Additional Premium INCL. L If no entry appears above information required to complete this endorsement wili be shown in the Declarations as applicable to this endorsement. Section Il Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule but only with respect to liability arising out of your work at the location designated and described in the schedule of this endorsement performed for that insured and included in the products completed operations haz ard.. CONTRACT FOR WEST LINCOLN PINNACLE BANK ARENA VEST LINCOLN PINNACLE BANK ARENA PROJECT NO. 10150002 CG 20371001 ISO Properties Inc. 2000 Page 1 of 1 o | 2 |
COMMERCIAL GENERAL LIABILITY QUICK REFERENCE COMMERCIAL GENERAL LIABILITY COVERAGE FORM OCCURRENCE COVERAGE READ YOUR POLICY CAREFULLY DECLARATIONS PAGES Named Insured And Mailing Address Policy Period Description Of Business And Location Coverages And Limits Of Insurance SECTION COVERAGES Coverage A Insuring Agreement................ Bodily Injury And Property Damage Liability Exclusions.................. o i Coverage B Insuring Agreement.. Personal And Advertising Injury Liability Exclusions Coverage C Insuring Agreement.. Medical Payments Exclusions Supplementary Payments..................... SECTIONH WHOISANINSURED....................... it SECTION I LIMITSOF INSURANCE................ i SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS Bankruptcy.. Duties In The Event Of Occurrence Offense Claim OrSuit................................ Legal Action Against Us. Other Insurance Premium Audit................ Representations....... Separation Of Insureds. Transfer Of Rights Of Recovery Against Others To Us When We Do Not Renew.. SECTIONV DEFINITIONS.......... i COMMON POLICY CONDITIONS Cancellation Changes Examination Of Your Books And Records Inspections And Surveys Premiums Transfer Of Your Rights And Duties Under This Policy ENDORSEMENTS If Any Beginning on Page CG700310 08 Page 10f 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG 00011207 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under Section Il Who Is An In sured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured be comes 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 in surance does not apply. We may at our discre tion 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 Nl Limits Of Insurance and 2 Our right and duty to defend ends when we have used up the applicable limit of insur ance in the payment of judgments or set tlements under Coverages A or B or medi cal expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless ex plicitly provided for under Supplementary Pay ments 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 The bodily injury or property damage occurs during the policy period and Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an oc currence or claim knew that the bodily in jury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any con tinuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. c. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have oc curred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or re ceive notice of an occurrence or claim in cludes any continuation change or resumption of that bodily injury or property damage af ter the end of the policy period. d. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed un der Paragraph 1. of Section Il Who Is An In sured or any employee authorized by you to give or receive notice of an occurrence or claim 1 Reports all or any part of the bodily injury or property damage to us or any other in surer 2 Receives a written or verbal demand or claim for damages because of the bodily injury or property damage or Becomes aware by any other means that podily injury or property damage has oc curred or has begun to occur. 2 3 3 Page1of16 O 1SO Propetties Inc. 2006 CG 00011207 | 0 |
e. Damages because of bodily injury include damages claimed by any person or organiza tion for care loss of services or death resulting at any time from the bodily injury. 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 con tract 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 subse quent to the execution of the contract or agreement. Solely for the purposes of liabil ity assumed in an insured contract rea sonable attorney fees and necessary litiga tion expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and Such attorney fees and litigation ex penses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are al leged. b c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or un der the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alco holic 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 unem ployment 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 dam ages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability as sumed by the insured under an insured con tract. CG 00011207 o Page 2 of 16 ISO Properties Inc. 2006 | 1 |
d Ator from any premises site or location on which any insured or any contractors or subcontractors working directly or in directly on any insured s behalf are per forming operations if the poliutants are brought on or to the premises site or lo cation in connection with such opera tions by such insured contractor or sub contractor. However this subparagraph does not apply to i Bodily injury or property damage arising out of the escape of fuels lu bricants or other operating fluids which are needed to perform the normal electrical hydraulic or me chanical 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 re lease of the fuels lubricants or other operating fluids or if such fuels lu bricants 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 per formed by such insured contractor or subcontractor ii Bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connec tion with operations being performed by you or on your behalf by a con tractor or subcontractor or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e At or from any premises site or location on which any insured or any contractors or subcontractors working directly or in directly on any insured s behalf are per forming 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 ef fects of pollutants. f. Pollution. 1 Bodily injury or property damage arising out of the actual alleged or threatened dis charge dispersal seepage migration re lease or escape of poliutants a Atorfrom 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 i 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 pol icy as an additional insured with re spect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not and never was owned or occupied by or rented or loaned to any in sured other than that additional in sured or Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire b At or from any premises site or location which is or was at any time used by or for any insured or others for the han dling storage disposal processing or treatment of waste c Which are or were at any time trans ported handled stored treated dis posed of or processed as waste by or for i Any insured or i Any person or organization for whom you may be legally responsible or Page 3 of 16 u 1SO Properties Inc. 2006 CG 00011207 | 1 |
2 Any loss cost or expense arising out of any a Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up re move contain treat detoxify or neutral ize or in any way respond to or assess the effects of pollutants or b Claim or suit by or on behalf of a gov ermmental authority for damages be cause of testing for monitoring cleaning up removing containing treating de toxifying or neutralizing or in any way responding to or assessing the effects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a govern mental authority. g. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or en trustment to others of any aircraft auto or wa tercraft 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 employ ment 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 entrust ment to others of any aircraft auto or water craft 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 con tract 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 equip ment 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 li censed or principally garaged or the operation of any of the machinery or equipment listed in Paragraph f.2 or.3 of the definition of mobile equip ment. h. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. i. War Bodily injury or property damage however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any govern ment sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental au thority in hindering or defending against any of these. Damage To Property Property damage to 1 Property you own rent or occupy including any costs or expenses incurred by you or any other person organization or entity for repair replacement enhancement restora tion or maintenance of such property for any reason including prevention of injury to a person or damage to another s property Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you 4 Personal property in the care custody or control of the insured b 3 2 Page 4 of 16 ISO Properties Inc. 2006 CG 00011207 | 1 |
This exclusion does not apply to the loss of use of other property arising out of sudden and ac cidental 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 ex pense incurred by you or others for the loss of use withdrawal recall inspection repair re placement adjustment removal or disposal of 1 Your product 2 Your work or 3 impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it.. Personal And Advertising Injury Bodily injury arising out of personal and ad vertising 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 di rectly 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 transmit ting communicating or distribution of mate rial or information. 5 That particular part of real property on which you or any contractors or subcontrac tors working directly or indirectly on your behalf are performing operations if the property damage arises out of those op erations or 6 That particular part of any property that must be restored repaired or replaced be cause your work was incorrectly per formed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the con tents of such premises rented to you for a pe riod of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Prem ises Rented To You as described in Section i 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 exclu sion 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 sub contractor.. 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 danger ous 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. Page 5 of 16 m ISO Properties Inc. 2006 CG 00011207 | 1 |
Exclusions c. through n. do not apply to damage by fire to premises while rented to you or tempo rarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section Ill Limits Of Insurance. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured be comes 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 per sonal and advertising injury to which this in surance does not apply. We may at our discre tion 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 i Limits Of Insurance and 2 Our right and duty to defend end when we have used up the applicable limit of insur ance in the payment of judgments or set tiements under Coverages A or B or medi cal expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless ex plicitly provided for under Supplementary Pay ments Coverages A and B. b. This insurance applies to personal and adver tising injury caused by an offense arising out of your business but only if the offense was committed in the coverage territory during the policy period. 2. Exclusions This insurance does not apply to a. Knowing Violation Of Rights Of Another Personal and advertising injury caused by or at the direction of the insured with the knowl edge that the act would violate the rights of an other and would inflict personal and advertis ing injury. b. 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 knowi edge 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 beginning of the policy period. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured.. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to li ability 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 con tract 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 per formance 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 advertise ment.. Infringement Of Copyright Patent Trademark Or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trade mark trade secret or other intellectual property rights. Under this exclusion such other intellec tual property rights do not include the use of another s advertising idea in your advertise ment. However this exclusion does not apply to in fringement in your advertisement of copy right 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 of web sites for others or Page 6 of 16 1SO Properties inc. 2006 CG 00011207 u | 1 |
3 An Intemet 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 Sec tion. 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 advertis ing broadcasting publishing or telecasting. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the in sured 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 mis lead another s potential customers.. Pollution Personal and advertising injury arising out of the actual alleged or threatened discharge dispersal seepage migration release or es cape 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 govern mental authority for damages because of testing for monitoring cleaning up remov ing containing treating detoxifying or neu tralizing 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 govern ment sovereign or other authority using military personnel or other agents or 3 Insurrection rebellion revolution usurped power or action taken by governmental au thority in hindering or defending against any of these. p. Distribution Of Material In Violation Of Statutes Personal and advertising injury arising di rectly 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 faw or 3 Any statute ordinance or regulation other than the TCPA or CAN SPAM Act of 2003 that prohibits or limits the sending transmit ting communicating or distribution of mate rial or information. COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that a The accident takes place in the cover age territory and during the policy pe riod The expenses are incurred and reported to us within one year of the date of the accident and c The injured person submits to examina tion at our expense by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the ap plicable limit of insurance. We will pay reason able expenses for 1 First aid administered at the time of an accident 2 Necessary medical surgical x ray and dental services including prosthetic de vices and 3 Necessary ambulance hospital sional nursing and funeral services. b profes ISO Properties Inc. 2006 Page 7 of 16 a CG 00011207 | 1 |
2. Exclusions We will not pay expenses for bodily injury a. Any Insured To any insured except volunteer workers. b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occu pies. d. Workers Compensation And Similar Laws To a person whether or not an employee of any insured if benefits for the bodily injury are payable or must be provided under a work ers compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing instructing or participating in any physical exercises or games sports or athletic contests. f. Products Completed Operations Hazard Included within the products completed opera tions hazard. g. Coverage A Exclusions Excluded under Coverage A. f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment in terest based on that period of time after the of fer. g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or depos ited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insur ance.. If we defend an insured against a suit and an indemnitee of the insured is also named as a party to the suit we will defend that indemnitee if all of the following conditions are met a. The suit against the indemnitee seeks dam ages for which the insured has assumed the li ability of the indemnitee in a contract or agree ment that is an insured contract b. This insurance applies to such liability as sumed by the insured c. The obligation to defend or the cost of the defense of that indemnitee has also been as sumed 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 SUPPLEMENTARY PAYMENTS COVERAGES A no conflict appears to exist between the inter AND B ests of the insured and the interests of the in. N... demnitee 1. We will pay with respect to any claim we investi gate or settle or any suit against an insured we defend a. All expenses we incur. b. Up to 250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. c. The cost of bonds to release attachments but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the in sured at our request to assist us in the investi gation or defense of the claim or suit includ ing actual loss of earnings up to 250 a day because of time off from work. e. All court costs taxed against the insured in the suit. However these payments do not include attorneys fees or attorneys expenses taxed against the insured. e. The indemnitee and the insured ask us to conduct and control the defense of that indem nitee 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 settiement or defense of the suit b 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 d Cooperate with us with respect to coor dinating 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 CG 00011207 o Page 8 of 16 1SO Properties Inc. 2006 | 1 |
b Conduct and control the defense of the indemnitee in such suit. So long as the above conditions are met attor neys fees incurred by us in the defense of that in demnitee 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 Cov erage A Bodily Injury And Property Damage Li ability 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 litiga tion expenses as Supplementary Payments ends when we have used up the applicable limit of in surance in the payment of judgments or seftle ments 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 insur eds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an in sured. Your members your partners and their spouses are also insureds but only with re spect to the conduct of your business. c. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their du ties as your officers or directors. Your stock holders are also insureds but only with respect to their liability as stockholders. e. A trust you are an insured. Your trustees are also insureds but only with respect to their du ties as trustees. 2. Each of the following is also an insured a. Your volunteer workers only while performing duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a partnership joint venture or fimited 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 em ployees 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 li ability company to a coemployee while in the course of his or her em ployment or performing duties related to the conduct of your business or to your other volunteer workers while perform ing duties related to the conduct of your business To the spouse child parent brother or sister of that coemployee or volun teer worker as a consequence of Para graph 1a above For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs 1a or b above or Arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b Rented to in the care custody or con trol 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 mem ber if you are a limited liability company. b c d Page 9 of 16 o CG 00011207 1SO Properties Inc. 2006 | 1 |
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 represen tative 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 In sured if there is no other similar insurance avail able to that organization. However a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION lll LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay re gardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. 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 op erations hazard. 4. Subject to Paragraph 2. above the Personal and Advertising Injury Limit is the most we will pay un der Coverage B for the sum of all damages be cause of all personal and advertising injury sus tained 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 dam age arising out of any one occurrence. 6. Subject to Paragraph 5. above the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of property damage to any one premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above the Medical Ex pense Limit is the most we will pay under Cover age C for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptey or insolvency of the insured or of the insured s estate will not relieve us of our obliga tions under this Coverage Part. 2. Duties In The Event Of Occurrence Offense Claim Or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or an offense which may resuilt in a claim. To the extent pos sible notice should include 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured persons and witnesses and CG 00011207 n Page 10 of 16 ISO Properties Inc. 20068 | 1 |
3 The nature and location of any injury or damage arising out of the occurrence or offense. b. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written no tice of the claim or suit as soon as practica ble. c. You and any other involved insured must 1 Immediately send us copies of any de mands notices summonses or legal pa pers received in connection with the claim or suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 Assist us upon our request in the en forcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent.. Legal Action Against Us No person or organization has a right under this Coverage Part a. To join us as a party or otherwise bring us into a suit asking for damages from an insured or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the ap plicable limit of insurance. An agreed settlement means a settiement and release of liability signed by us the insured and the claimant or the claim ant s legal representative. 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Cover ages A or B of this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary except when Para graph b. below applies. If this insurance is pri mary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insur ance by the method described in Paragraph c. below. b. Excess Insurance 1 This insurance is excess over a Any of the other insurance whether primary excess contingent or on any other basis i That is Fire Extended Coverage Builder s Risk Installation Risk or similar coverage for your work ii That is Fire insurance for premises rented to you or temporarily occu pied by you with permission of the owner iii That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occu pied by you with permission of the owner or iv If the loss arises out of the mainte nance or use of aircraft autos or watercraft to the extent not subject to Exclusion g. of Section Coverage A Bodily Injury And Property Dam age Liability. b Any other primary insurance available to you covering liability for damages aris ing 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 against that suit. If no other insurer de fends we will undertake to do so but we will be entitted to the insured s rights against all those other insurers. CG 00011207 ISO Properties Inc. 2006 Page110of16 O | 1 |
3 When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of a The total amount that all such other insurance would pay for the loss in the absence of this insurance and b The total of all deductible and selif insured amounts under all that other in surance. 4 We will share the remaining loss if any with any other insurance that is not de scribed in this Excess insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing if all of the other insurance permits contribution by equal shares we will follow this method also. Under this approach each insurer con tributes equal amounts until it has paid its ap plicable 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 c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this Coverage Part to the first Named Insured this in surance 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 To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part those rights are transferred to us. The in sured 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 expi ration date. If notice is mailed proof of mailing will be sufficient proof of notice. insurance of all insurers. 5. Premium Audit SECTION V DEFINITIONS 1. Advertisement means a notice that is broadcast a. We will compute all premiums for this Cover age Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as ad vance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computa tion and send us copies at such times as we may request. 6. Representations By accepting this policy you agree a. The statements in the Declarations are accu rate and complete b. Those statements are based upon representa tions you made to us and or published to the general public or specific mar ket segments about your goods products or ser vices 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 ser vices for the purposes of attracting customers or supporters is considered an advertisement.. Auto means a. A land motor vehicle trailer or semitrailer de signed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a com pulsory or financial responsibility law or other motor vehicle insurance faw in the state where itis licensed or principally garaged. However auto does not include mobile equip ment CG 00011207 ISO Properties Inc. 2006 Page 12 of 16 | 1 |
3. Bodily injury means bodily injury sickness or disease sustained by a person including death re sulting from any of these at any time.. Coverage territory means a. The United States of America including its territories and possessions Puerto Rico and Canada b. International waters or airspace but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above or c. All other parts of the world if the injury or dam age arises out of 1 Goods or products made or sold by you in the territory described in Paragraph a. above 2 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 3 Personal and advertising injury offenses that take place through the Internet or simi lar electronic means of communication provided the insured s responsibility to pay dam ages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to.. Employee includes a leased worker. Em ployee does not include a temporary worker.. Executive officer means a person holding any of the officer positions created by your charter con stitution by laws or any other similar governing document.. Hostile fire means one which becomes uncon trollable 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. It incorporates your product or your work that is known or thought to be defective defi cient 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 re pair replacement adjustment or removal of your product or your work or your fulfiliing the terms of the contract or agreement. 9. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of prem ises that indemnifies any person or organiza tion for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract b. A sidetrack agreement c. Any easement or license agreement except in connection with construction or demolition op erations 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 That part of any other contract or agreement pertaining to your business including an in demnification 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 dam age to a third person or organization. Tort li ability 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 con struction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing 2 That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to pre pare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifi cations 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 in sured s rendering or failure to render pro fessional services including those listed in 2 above and supervisory inspection ar chitectural or engineering activities. CG 00011207 ISO Properties Inc. 2006 Page 13 of 16 n | 1 |
13. 14. However self propelled vehicles with the fol lowing types of permanently attached equip ment are not mobile equipment but will be considered autos 1 Equipment designed primarily for a Snow removal b Road maintenance but not construction or resurfacing or c Street cleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and Air compressors pumps and generators including spraying welding building clean ing geophysical exploration lighting and well servicing equipment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehi cle 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 con tinuous 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 oc cupies 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 or ganization or disparages a person s or organi zation s goods products or services e. Oral or written publication in any manner of material that violates a person s right of pri vacy 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 10.Leased worker means a person leased to you by 1 1 1. I 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. 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 water craft or auto to the place where it is finally de livered 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 at tached to the aircraft watercraft or auto..Mobile equipment means any of the following types of land vehicles including any attached ma chinery 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 main tained primarily to provide mobility to perma nently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers e. Vehicles not described in Paragraph a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to per manently attached equipment of the following types 1 Air compressors pumps and generators including spraying welding building clean ing geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers Vehicles not described in Paragraph a. b. c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. CG 00011207 o ISO Properties Inc. 2006 Page 14 of 16 | 1 |
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