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COMMERCIAL GENERAL LIABILITY DISTRIBUTION OF MATERIAL IN VIOLATION OF STATUTES AMENDED EXCLUSION CONTINUED 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law or 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transaction Act FACTA or 4 The Fair Debt Collection Practices Act FDCPA including any amendment of or addition to such law or 5 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 FCRA or FDCPA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting cnmmunxcat ng or distribu tion of material or information. All other terms and provisions of this policy remain unchanged. c6 88 39 04 13 Includes copyrighted material of Insurance Services Office Inc. with its permission. LIN 90 15822 03 01 141 10 01 14. Page 002 of 002
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IL 00 21 07 02 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY COMMERCIAL EXCESS UMBRELLA LIABILITY COVERAGE PART 1. The insurance does not apply A. Under any Liability Coverage to bodily injury or property damage 1 With respect to which an insured under the policy is also an insured under a nuclear energy liability policy issued by Nuclear Energy Liability Insurance Association Mutual Atomic Energy Liability Underwriters Nuclear Insurance Association of Canada or any of their successors or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability or 2 Resulting from the hazardous properties of nuclear material and with respect to which a any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954 or any law amendatory thereof or b the insured is or had this policy not been issued would be entitled to indemnity from the United States of America or any agency thereof under any agreement entered into by the United States of America or any agency thereof with any person or organization. B. Under any Medical Payments coverage to expenses incurred with respect to bodily injury resulting from the hazardous properties of nuclear material and arising out of the operation of a nuclear facility by any person or organization. C. Under any Liability Coverage to bodily injury or property damage resulting from hazardous properties of nuclear material if 1 The nuclear material a is at any nuclear facility owned by or operated by or on behalf of an insured or b has been discharged or dispersed therefrom 2 The nuclear material is contained in spent fuel or waste at any time possessed handled used processed stored transported or disposed of by or on behalf of an insured or IL 00 21 07 02 Copyright ISO Properties Inc. 2001 LIN 90 15822 03 01 141 10 01 14 PAGE 001 of 003 o1miBoRG
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NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form CONTINUED 3 The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nuclear facility but if such facility is located within the United States of America its territories or possessions or Canada this exclusion 3 applies only to property damage to such nuclear facility and any property threat. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source material Special nuclear material or by product material. Source material special nuclear material and by product material have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. Spent fuel means any fuel element or fuel component solid or liquidwhich has been used or exposed to radiation in a nuclear reactor. Waste means any waste material a containing by product material other than the tailings or wastes produced by the extraction or concentration of uranium or thorium from any ore processed primarily for its source material content and b resulting from the operation by any person or organization of any nuclear facility inclgd dunder the first two paragraphs of the definition of nuclear facility. Nuclear facility means a Any nuclear reactor b Any equipment or device designed or used for 1 separating the isotopes of uranium or plutonium 2 processing or utilizing spent fuel or 3 handling processing or packaging waste c Any equipment or device used for the processing fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 d Any structure basin excavation premises or place prepared or used for the storage or disposal of waste NUL.. IL 00 21 07 02 Copyright IS0 Properties Inc. 2001 LIN 90 15822 03 01 141 10 01 14 PAGE 002 of 003 oimisonc 14 002 of 003
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NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form CONTINUED and includes the site on which any of the foregoing is located all operations conducted on such site and all premises used for such operations. Nuclear reactor means any apparatus designed or used to sustain nuclear fission in a self supporting chain reaction or to contain a critical mass of fissionable material. Property damage includes all forms of radioactive contamination of property. IL 00 21 07 02 Copyright ISO Properties Inc. 2001 LIN 90 15822 03 01 141 10 01 14 PAGE 003 of 003
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IL 02 59 09 07 NEBRASKA CHANGES CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following CAPITAL ASSETS PROGRAM OUTPUT POLICY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraphs 2. and 3. of the CANCELLATION Common Policy Condition are replaced by the following CANCELLATION OF POLICIES IN EFFECT 60 DAYS OR LESS If this policy has been in effect for 60 days or less we may cancel this policy for any reason. MORE THAN 60 DAYS 2. If this policy has been in effect for more than 60 days or if this is a renewal of a policy we issued we may cancel this policy only for one or more of the following reasons 5 Nonpayment of premium The policy was obtained through material misrepresentation Any insured has submitted a fraudulent claim Any insured has violated the terms and conditions of this policy The risk originally accepted has substantially increased Certification to the Director of Insurance of our loss of reinsurance which provided coverage to us for all or a substantial part of the underlying risk insured or The determination by the Director of Insurance that the continuation of the policy could place us in vioclation of the Nebraska Insurance Laws. If we cancel this policy subject to 2.a. or 2.b. above we will mail to the first Named Insured a written notice of cancellation stating the reasons for cancellation at least 1. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or IL 02 59 09 07 Copyright ISO Properties Inc. 2006 LIN 90 15822 03 01 141 10 01 14 PAGE 001 of 002 o1T160RG
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NEBRASKA CHANGES CANCELLATION AND NONRENEWAL CONTINUED 2.. 60 days before the effective date of cancellatxon if we cancel for any other reason. We will mail our notice by first class mail to the first Named Insured s last mailing address known to us. A United States Postal Service Certificate of Mailing shall be sufficient proof of receipt of notice on the third calendar day after the date of the certificate of mailing. Fargraph 6. of the Cancellationtomman Policy Condition does not apply.. The following is added and supersedes any provisions to the contrary NONRENEWAL 1. If we decide not to renew this policy we will mail written notice of nonrenewal stating the reasons for nonrenewal to the first Named Insured at least 60 days prior to the expiration date of this policy. Any notice of nonrenewal will be mailed by first class mail to the first Named Insured s last mailing address known to us. A United States Postal Service Certificate of Mailing shall be sufficient proof of receipt of notice on the third calendar day after the date of the certificate of mailing. IL 02 59 09 07 Copyright ISO Properties Inc. 2006 nnnmmmm LIN 90 15822 03 01 141 10 01 14 PAGE 002 of 002 nan nan nan nan 102.0
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NAMED INSURED ENDDRSEMENT EFFECTIVE POLICY NUMBER LINCOLN INDUSTRIES INC 01 90 15822 03 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELATION CERTIFICATE HOLDERS This endorsement modifies Insurance provided under the following Business Auto Coverage Part Commercial General Liability Coverage Part The persons or organizations listed or described in the Schedule below have requested that they receive written notice of cancelation when this policy is cancelled by us. We will mail or deliver to the Persons or Organizations listed or described in the Schedule a copy of the written notice of cancelation that we sent to you. Such copies of the notice will be mailed as soon as practicable to the address or addresses provided by your broker or agent. This notification of cancelation of the policy is intended as a courtesy only. Our failure to provide such notification to the persons or organizations shown in the Schedule will not extend any policy cancela tion date nor impact or negate any cancelation of the policy. This endorsement does not entitle the persons or organizations listed or described in the Schedule below to any benefit rights or protection under this policy. Failure by us to provide this notice of cancelation to the persons or organizations listed or described in the Schedule below will not impose liability of any kind upon us. Any of these provisions that conflict with a law that controls the notice of cancelation of the insurance in this endorsement is changed by this statement to comply with the law. SCHEDULE Persons or Organizations including mailing address PERTHE LISTING OF CERTIFICATE HOLDERS PROVIDED BY THE BROKER UPON REQUEST All other terms and conditions of this policy remain unchanged. IL 70 53 09 11 LIN 90 15822 03 01 141 10 01 14 PAGE 001 oiieona
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POLICY NUMBER 90 15822 03 AIRCRAFT PRODUCTS EXCLUSION ENDORSEMENT THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE COMPREHENSIVE GENERAL LIABILITY COVERAGE FORM. IT IS AGREED THAT THE INSURANCE AFFORDED BY THIS POLICY DOES NOT APPLY WITH REPSECT TO LIABILITY ARISING OUT OF AIRCRAFT PRODUCTS. AIRCRAFT PRODUCTS MEANS AIRCRAFT INCLUDING MISSILES OR SPACECRAFT AND ANY GROUND SUPPORT OR CONTROL EQUIPMENT USED THEREWITH OR ANY ARTICLE FURNISHED BY THE INSURED AND INSTALLED IN AIRCRAFT OR USED IN CONNECTION WITH AIRCRAFT OR FOR SPARE PARTS FOR AIRCRAFT OR TOOLING USED FOR THE MANUFACTURE THEREOF INCLUDING GROUND HANDLING TOOLS AND EQUIPMENT AND ALSO MEANS TRAINING AIDS INSTRUCTION MANUALS BLUEPRINTS ENGINEERING OR OTHER DATA AND OR ANY ARTICLE IN RESPECT OF WHICH ENGINEERING OR OTHER ADVICE AND OR SERVICES AND OR LABOR HAVE BEEN GIVEN OR SUPPLIED BY THE INSURED RELATING T0 ANY AIRCRAFT OR AIRCRAFT ARTICLE. SPEC0 G 0786 LIN 90 15822 03 01 141 PAGE 001 10 01 14 04 omisoRe
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POLICY NUMBER 90 15822 03 ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS FORM B CONTRACTORS FORM B THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON OR ORGANIZATION HARLEY DAVIDSON INC. CIF NO ENTRY APPEARS ABOVE INFORMATION REQUIRED TO COMPLETE THIS ENDORSEMENT WILL BE SHOWN IN THE DECLARATIONS AS APPLICABLE TO THIS ENDORSEMENT. WHO IS AN INSURED SECTION II 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 FOR THAT INSURED BY OR FOR YOU. SPEC05 0786 LIN 90 15822 03 01 141 PAGE 001 10 01 16 05 o1ieoRG
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POLICY NUMBER 90 15822 03 GENERAL LIABILITY PREMIUM AND RATE ENDORSEMENT IT IS AGREED THE PREMIUM FOR THIS POLICY SHALL BE COMPUTED IN ACCORDANCE WITH THE FOLLOWING SCHEDULE SCHEDULE PREMIUM BASE ATE PER ANN COVERAGE SALES 1000 SALES PRE GENERAL LIABILITY 140000000.385 5 TERRORISM LIABILITY FLAT CHARGE REJ TOTAL 5 ANNUAL PREMIUM 53900 REJECTED 53900 SALES ARE DEFINED AS TOTAL NET SALES EXCLUDING FOREIGN SALES AND EXCLUDING INTER COMPANY SALES. SALES ARE SUBJECT TO FINAL AUDIT IN ACCORDANCE WITH THE CONDITIONS OF THE CGL POLICY. THE TOTAL ANNUAL PREMIUM IS A 100 MINIMUM ANNUAL PREMIUM. SPEC06 0786 LIN 90 15822 03 01 141 PAGE001 10 01 14 06 o1misoRG
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SENTRY. INSURANCE IMPORTANT NOTICE what You Should Know About. Our Protection of Your Privacy SIERIRINPSEL Protecting the personal information of the individuals we serve is a priority for Sentry Insurance. We collect retain and use personal information about individuals for the purpose of serving their insurance needs and providing services to them. This notice describes how we handle personal information of the individuals we serve. It is only for your information. No action on your part is needed. If you have questions regarding this notice please write to Corporate Compliance Privacy 1800 North Point Drive Stevens Point Wi 54481. What kinds of information are collected and disclosed The types of information we may collect about you include e Information you provide on applications or other forms or in your verbal responses to our questions. This may include identifying information such as name address and information about your assets and income. Information about your transactions with us including policies purchased and premium payment history. Information we receive from a consumer reporting agency that indicates your credit worthiness and credit history. Ne do not sell customer lists or any personal information regarding our customers. We only disclose nonpublic personal information about customers or former customers to other affiliated or nonaffiliated third parties as permitted or required by law. We may share personal financial information about you between affiliated companies within the Sentry Insurance Group in order to make additional services available to you e.g. auto insurance customers may receive information about life insurance products and vice versa. For those clients of Point Insurance Agency LLC andor the Parker Stevens agencies these agencies may disclose your nonpublic personal information to nonaffiliated insurance companies as reasonably necessary to provide you with insurance products and services. How do we safeguard your privacy e We maintain physical electronic and procedural safeguards to protect your personal financial information. e We restrict access to nonpublic personal financial data to those employees who need to know that information in order to provide products or services to you. We communicate to employees in writing the importance of protecting confidential information. e We may amend our privacy policies at any time. If we do we will inform you in writing. This notice applies to each of the following companies. Companies may not be licensed in all states. Sentry Insurance a Mutual Company Parker Stevens Agency L.L.C. Sentry Equity Services Inc. Dairyland County Mutual Insurance Parker Stevens Insurance Agency of Sentry Life Insurance Company Company of Texas Massachusetts Inc. Sentry Life Insurance Company of Dairyland Insurance Company Patriot General Insurance Company New York fiddlesex Insurance Company Peak Property and Casualty Sentry Lioyds of Texas Parker Assurance Ltd. Insurance Corporation Sentry Select Insurance Company Parker Centennial Assurance Company Point Insurance Agency LLC Viking Insurance Company of Parker Services L.L.C. Sentry Casualty Company Wisconsin Y 01778230 0313 any ce
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Sentry Insurance 1800 North Point Drive P.0. Box 8020 Stevens Point WI 54481 8020 OCTOBER 01 2014 LINCOLN INDUSTRIES INC 600 WEST E STREET LINCOLN NE 68522 Your renewal insurance policy excludes losses caused by certified acts of terrorism as classified by the Federal Government. You have the opportunity to purchase coverage for loss resulting from certified acts of terrorism which are defined in the enclosed notice. The offer contained in the enclosed notice pertains only to coverage for certified acts of terrorism. The following lines of business are not subject to the Terrorism Risk Insurance Act and you will not have the option of purchasing coverage for certified acts of terrorism for your Commercial Auto Garage Fidelity or Crime Surety or Errors or Omissions coverages. To preserve the excess nature of your Umbrella insurance you must select coverage for certified acts of terrorism within your primary liability insurance in order to do so within your Umbrella policy. If you wish to purchase coverage for certified acts of terrorism zeasetsign and return the enclosed notice by the date indicated in e notice. If you have any questions regarding your coverage for terrorism please contact our Customer Service unit at 1 800 295 6919. 80 595 05 13 MECH LIN 90 15822 03 01 141 10 01 2014 PAGE 001 XBNAD XX orTisoRe
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SENTRY INSURANCE A MUTUAL COMPANY STEVENS POINT WISCONSIN POLICYHOLDER DISCLOSURE OFFER OF TERRORISM COVERAGE DISCLOSURE OF PREMIUM LINCOLN INDUSTRIES INC 600 WEST E STRE LINCOLN NE 65522 This Notice applies to the following policy Policy Number 90 15822 03 Policy Effective 10 01 2014 TO 10 01 2015 Coverage Provided COMMERCIAL GENERAL LIABILITY POLICY You are hereby notified that under the Terrorism Risk Insurance Act that you have a right to purchase insurance coverage for losses arising out of acts of terrorism as defined in Section 1021 of the Act and amended in 2007. The term act of terrorism means any act that is certified by the Secretary of the Treasury in concurrence with the Secretary of State and the Attorney General of the United States to be an act of terrorism to be a violent act or an act that is dangerous to human life property or infrastructure to have resulted in damage within the United States or outside the United States in the case of an air carrier or vessel or the premises of a United States mission and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. Coverage under your existing policy may be affected as follows YOU SHOULD KNOW THAT COVERAGE WE PROVIDE BY THIS POLICY FOR LOSSES CAUSED BY CERTIFIED ACTS OF TERRORISM IS PARTIALLY REIMBURSED BY THE UNITED STATES UNDER A FORMULA ESTABLISHED BY FEDERAL LAW. HOWEVER YOUR POLICY MAY CONTAIN OTHER EXCLUSIONS WHICH MIGHT AFFECT YOUR COVERAGE SUCH AS AN EXCLUSION FOR NUCLEAR EVENTS. UNDER THIS FORMULA THE UNITED STATES GOVERNMENT GENERALLY REIMBURSES 85 OF COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY ESTABLISHED DEDUCTIBLE PAID BY THE INSURANCE COMPANY PROVIDING THE COVERAGE. YOU SHOULD ALSO KNOW THAT THE TERRORISM RISK INSURANCE ACT CONTAINS A 100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS WELL AS INSURERS LIABILITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS 100 BILLION. IF THE QESSEESTE LOSSES FOR ALL INSURERS EXCEED 100 BILLION YOUR COVERAGE MAY BE THE PREMIUM CHARGED FOR THIS COVERAGE IS PROVIbED BELOW AND DOES NOT INCLUDE az EgRGES FOR THE PORTION OF LOSS COVERED BY THE FEDERAL GOVERNMENT UNDER 80 595 05 13 MECH LIN 90 15822 03 01 141 10 01 2014 PAGE 002 xXBNADX orTimoRG
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If you wish to purchase coverage for loss caused by certified acts of terrorism you must complete this form and return it to us by NOVEMBER 05 2014. I hereby elect to purchase Terrorism coverage for a premium of 54.00 for the period ending on December 31 2014. I understand that an additional premium charge may be required for the remainder of the policy term if the Terrorism Risk Insurance Act is renewed or extended beyond December 31 2014 the amount of the additional premium may be calculated when the disposition of the federal act is determined. Policyholder s signature Date Print name 80 595 05 13 MECH LIN 90 15822 03 01 141 10 01 2014 PAGE 003 xXBNADXXX oimwona
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NOTICE TO POLICYHOLDERS 1 E This is a summary of the major changes to your policy. This notice does not reference every editorial change made in the coverage form or its endorsements. No coverage is provided by this summary nor can it be construed to replace any provision of your policy or endorsements. You should read your policy and review your declaration page for complete information on the coverages vou are provided. If there is any conflict between the policy and this summary THE PROVISIONS OF THE POLICY SHALL PREVAIL. The following is a summary of some of the primary changes that Broaden or Reduce coverage or certain editorial changes that are designed to clarify coverage for the listed coverage forms or endorsements. COMMERCIAL GENERAL LIABILITY COVERAGE FORM CG 00 01 04 13 BROADENING OF COVERAGE. The Liquor Liability Exclusion exclusion 2.c. of Coverage A is revised to provide an exception with respect to allowing a person to bring alcoholic beverages onto the named insured s premises for consumption on the named insured s premises.. The Electronic Data Exclusion exclusion 2.p. of Coverage A is revised to introduce an exception for liability for damages because of bodily injury. OTHER CHANGES. The Liquor Liability Exclusion exclusion 2.c. of Coverage A is revised to reinforce that the exclusion applies even if claims against an insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others or providing or failing to provide transportation with respect to any person that may be under the influence of alcohol.. The Aircraft Auto or Watercraft Exclusion exclusion 2.g. of Coverage A is revised to delete reference to in the state.. The Material Published With Knowledge of Falsity and Material Published Prior to Policy Period Exclusions exclusions 2.b. 2.c. of Coverage B are revised to reference in any manner with respect to oral or written publication for consistency with the definintion of personal and advertising injury.. Condition 4. Other Insurance is generally revised so that the insurance provided is excess over any for which the named insured has been added as an additional insured whether by endorsement or any other means.. Definition 2. Auto is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged.. Definition 12. Mobile Equipment is revised to delete reference to in the state with respect to where a vehicle is licensed or v principally garaged. nan nan nan nan 80.0 489.0 13.0 4.0 13.0 LIN 90 15822 03 01 141 10 10 14 PAGE 001 OF 006 o1T1B0RG
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NOTICE TO POLICYHOLDERS COMMERCIAL GENERAL LIABILITY POLICY CHANGES CONTINUED PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM CG 00 37 04 13 BROADENING OF COVERAGE The Liquor Liability Exclusion exclusion 2.c. is revised to provide an exception with respect to allowing aperson to bring alcoholic beverages onto the named insured s premises for consumption on the named insured s premises.. The Electronic Data Exclusion exclusion 2.1. is revised to introduce an exception for liability for damages because of bodily injury. OTHER CHANGES. The Liquor Liability Exclusion exclusion 2.c. is revised to reinforce that the exclusion applies even if claims against an insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others or providing or failing to provide transportation with respect to any person that may be under the influence of alcohol.. Definition 1. Auto is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged. Definition 10. Mobile Equipment is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged. ENDORSEMENT CHANGES The following endorsement changes only apply if the andxcated endorsement is part of your policy CG 21 50 Amendment Of Liquor Liability Exclusion Commercial General Liability Coverage Part C6 21 51 Amendment Of Liquor Liability Exclusion Exception For chedulad Premises Or Activities Commercial General Liability Coverage Part C6 29 52 Amendment Of Liquor Liability Exclusion Products Completed Operations Coverage Part C6 29 53 Amendment Of Liquor Liability Exclusion Exception For Scheduled Premises Or Activities Products Completed Operations Coverage Part Coverage restricted by revising to indicate that the liquor liability exclusion will apply if a named insured permits any person to bring any alcoholic beverages on the named insured s premises for consumption on the named insured s premises. Revised to reinforce that the exclusion applies even if claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others or providing or failing to provide transportation with respect to any person that may be under the influence of alcohol. 6 20 05 Additional Insured Controlling Interest C6 20 10 Addltlonal Insured Owners Lessees or Contractors Scheduled Person Or Organization C6 20 11 Additional Insured Managers Or Lessors Of Premises 80 489 13 04 13 LIN 90 15822 03 01 1641 10 10 14 PAGE 002 OF 006 o11908G. EobaMs VIl NALLA QpFiy AT 8 Tlameud Allsureu petiiiis afly poisuil Piaily aly alcoholic beverages on the named insured s premises for consumption on the named insured s premises. Revised to reinforce that the exclusion applies even if claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others or providing or failing to provide transportation with respect to any person that may be under the influence of alcohol. 6 20 05 Additional Insured Controlling Interest C6 20 10 Addltlonal Insured Owners Lessees or Contractors Scheduled Person Or Organization C6 20 11 Additional Insured Managers Or Lessors Of Premises 80 489 13 04 13 LIN 90 15822 03 01 1641 10 10 14 PAGE 002 OF 006
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NOTICE TO POLICYHOLDERS COMMERCIAL GENERAL LTABILITY POLICY CHANGES CONTINUED C6 20 12 Additional Insured State Or Governmental Agency Or Subdivision Or Political Subdivision Permits or Authorizations C6 20 13 Additional Insureds State Or Governmental Agency Or Subdivision Or Subdivision Or Political Subdivision Permits or Authorizations Relating To Premises C6 20 15 Additional Insured Vendors C6 20 18 Additional Insured Mortgagee Assignee Or Receiver C6 20 24 Additional Insured Owners Or Other Interests From Whom Land Has Been Leased CG 20 26 Additional Insured Designated Person Or Organization CG 20 28 Additional Insured Lessor Of Leased Equipment CG 20 29 Additional Insured Grantor Of Franchise CG 20 32 Additional Insured Engineers Architects Or Surveyors Not Engaged By The Named Insured C6 20 33 Additional Insured Owners Lessees Or Contractors Automatic Status When Required In Construction Agreement With You CG 20 34 Additional Insured Lessor Of Leased Equipment Automatic Status When Required In Lease Agreement With You CG 20 35 Additional Insured Grantor Of Licenses Automatic Status When Required By Licensor CG 20 36 Additional Insured Grantor Of Licenses CG 20 37 Additional Insured Owners Lessees Or Contractors Completed Operations CG 29 35 Additional Insured State Or Governmental Agency Or Subdivision Or Political Subdivision Permits or Authorizations These additional insured endorsements are revised to indicate that when these endorsements are attached to a policy if coverage provided to the additional insured is required by contract or agreement coverage to the additional insured will be afforded to the extent permissible by law or to the extent the named insured is required by the contract or agreement to provide insurance for the additional insured. Additionally if coverage provided to the additional insured is required by contract or agreement the limits of insurance of the named insured s policy that are available to an additional insured will be limited to the extent required by the contract or agreement or the amount of insurance available under the applicable Limits Of Insurance shown in the Declarations whichever is less. CG 21 16 Exclusion Designated Professional Services CG 21 52 Exclusion Financial Services C6 21 56 Exclusion Funeral Services C6 21 59 Exclusion Diagnostic Testing Laboratories CG 22 24 Exclusion Inspection Appraisal And Survey Companies C6 22 33 Exclusion Testing Or Consulting Errors And Omissions CG 22 37 Exclusion Products And Professional Services Optical And Hearing Aid Establishments C6 22 43 Exclusion Engineers Architects Or Surveyors Professional Liability C6 22 44 Exclusion Services Furnished By Health Care Providers CG 22 45 Exclusion Specifiec Theraputic Or Cosmetic Services C6 22 48 Exclusion Insurance And Related Operations C6 22 71 Colleges Or Schools Limited Form CG 22 75 Professional Liaiblity Exclusion Computer Software nan nan nan nan 80.0 489.0 13.0 4.0 13.0 e LIN 90 15822 03 01 141 10 10 14 PAGE 003 OF 006 o1m10RG.
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NOTICETO POLICYHOLDERS CL IAB Y CHANGES C6 22 77 Professional Liability Exclusion Computer Data Processing C6 22 79 Exclusion Contractors Professional Liability CG 22 80 Limited Exclusion Contractors Professional Liability C6 22 88 Professional Liability Exclusion Electronic Data Processing Services And Computer Consulting or Programming Services C6 22 91 Exclusion Telecommunication Equipment Or Service Providers Errors And Omissions C6 22 98 Exclusion Internet Service Providers And Internet Access Providers Errors And Omissions C6 23 01 Exclusion Real Estate Agents Or Brokers Errors And Omissions These exclusion endorsements are revised to expressly address in part claims alleging negligence or other wrongdoing in the hiring employment training supervision or monitoring of others by any insured. 6 22 50 Exclusion Failure to Supply is revised to expressly state that the exclusion also applies to the failure of any insured. to adequately supply biofuel. CG 24 26 Amendment of Insured Contract Endorsement C6 24 26 is revised to reflect that the defined term insured contract addresses certain liability assumed by the named insured with respect to the tort liability of another party to the extent the assumption is permitted by law. CG 70 01 Emplovee Benefits Liability Endnrssmnt CG 70 05 New York Employee Benefits Liability Endorsement The exclusion for computer related losses due to the inability to read a time or date has been deleted. Also we have clarified coverage that this additional coverage is subject to the General Liability Conditions. C6 70 17 Special Broad Form General Liability Endorsement CG 70 21 Special Broad Form General Liability Endorsement CG 70 74 Special Broad Form General Liability Endorsement CG 80 53 Special Broad Form General Liability Endorsement CG 80 55 Special Broad Form General Liability Endorsement The Employee Benefits Liability exclusion for computer related losses due to the inability to read a time or date has been deleted. Changes That Effect the General Liability Declarations Page The standard Damaged to Premises Rented tn You limit of insurance is increased from 150000 to 500000. The standard Medical Payments limit of insurance is increased from 10000 to 15000 The Products and Completed Operations Aggregate Limit will be set at two times the occurrence limit selected. cl S i Broade The dollar amount available for the cost of bail bonds is increased from 1000 to 3000 80 489 13 06 13 mmm LIN 90 15822 03 01 141 10 10 14 PAGE 004 OF 006 nan nan nan nan 89.0 13.0 6.0 13.0 10 10 14 PAGE 004 OF 006
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NOTICE TO POLICYHOLDERS 0 COMMERCIALGE NUED The dollar amount available per day for loss of earnings is increased from 300 to 750. Automatic Additional Insureds Subject to the terms of the endorsement and General Liability policy the following interests are added as Additional Insureds Any Person or Organization You Are Performing Work For. Lessor of Leased Equipment. Lessor of Leased Land Managers or Lessors of Premises Owners Lessees or Contractors State or Political Subdivisions Mental Anguish The definition of bodily injury is amended to include mental anguish. Non Employment Relat Discrimi io The definition of personal and advertising injury is amended to include non employment related discrimination which is discrimination against or harassment of a third party by an employee of the insured. CG 70 39 Printing And Graphic Arts Errors And Omissions C6 70 41 New York Printing And Graphic Arts Errors And Omissions The exclusion for computer related losses due to the inability to read a time or date has been deleted. CG 70 63 Manufacturer s Errors And Omissions C6 70 88 New York Manufacturer s Errors And Omissions. The exclusion for computer related losses due to the inability to read a time or date has been deleted.. Certain format changes which will not impact the coverage provided.. The word willful has been deleted from the fraud criminal acts exclusion and a separate exclusion has been added for willful or intentional acts by an insured.. The deductible provision has been amended to clarify how the deductible applies. CG 70 67 Product Withdrawal Expense Endorsement Including Product Retrofit nan nan nan nan 80.0 489.0 13.0 4.0 13.0 LIN 90 15822 03 01 1641 10 10 14 PAGE 005 OF 006 o1T180RG
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NOTICE TO POLICYHOLDERS COMMERCIAL GENERAL LTABILITY POLICY CHANGES CONTINUED The exclusion for computer related losses due to the 1nablllty to read a time or date has been deleted. CG 80 58 Texas Product Withdrawal Expense Endorsement Including Product Retrofit The exclusion for computer related losses due to the inability to read a time or date has been deleted. The title of Section III Limits of Insurance has been amended to Limits of Insurance Deductible and Participation to clarify intent. CG 88 39 gisripufinn 0f Material In Violation of Statutes Amended xclusion CG 88 38 Alaska Distribution Of Material In Violation Of Statutes Amended Exclusion We have amended the endorsement to be compatible withthe format of the updated Commercial General Liability Coverage Form. This will not change coverage intent. 80 489 13 04 13 LIN 90 15822 03 01 141 10 10 16 PAGE 006 OF 006 o1riRoRG 80 489 13 04 13 LIN 90 15822 03 01 141 10 10 16 PAGE 006 OF 006
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NOTICE TO POLICYHOLDERS COMMERCIAL GENERAL LIABILITY POLICY CHANGES This is a description of the changes to your policy. This notice does not reference every editorial change made in the coverage form or its endorsements. No coverage is provided by this summary nor can it be construed to replace any provision of your policy or endorsements. You should read your policy and review your declaration page for complete information on the coverages you are provided. If there is any conflict between the policy and this summary THE PROVISIONS OF THE POLICY SHALL PREVAIL. One of the following new endorsements has been added to your policy. Refer to your policy to determine the endorsement that applies. The purpose of this notice is to describe the resulting changes in coverage CG 21 06 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information And Data related Liability With Limited Bodily Injury Exception For Use With the Commamal General Liability Coverage Part If this endorsement is attached to your policy e Under Coverage A Bodily Injury And Property Damage Liability coverage is excluded for damages arising out of any access to or disclosure of confidential or personal information. This exclusion replaces the current Electronic Data exclusion and clarifies that the exclusion also applies to the disclosure or access to confidential or personal information. Under Coverage B Personal And Advertising Injury an exclusion has been added. Coverage is now excluded for personal and advertising injury arising out of any access to or disclosure of confidential or personal information that results in an oral or written publication that violates a person s right of privacy. This is a reduction in coverage. CG 21 07 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information And Data related Liability Limited Bodily Injury Exception Not Included For Use With The Comprehensive General Liability Coverage Part If this endorsement is attached to your policy e Under Coverage A Bodily Injury And Property Damage Liability Coverage is excluded for damages arising out of any access to or disclosure of confidential or personal information. This exclusion replaces the current Electronic Data exclusion. The endorsement clarifies that the exclusion also applies to the disclosure or access to confidential or personal information. In addition we have a restriction in coverage as this exclusion will now apply to claims alleging bodily injury arising out of loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. e Under Coverage B Personal And Advertising Injury an exclusion has been added. Coverage is now excluded for personal and advertising injury arising out of any access to or disclosure of confidential or personal information that results in an oral or written publication that violates a person s right of privacy. This is a reduction in coverage. CG 21 08 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information Coverage B Only For Use With The Commercial General Liability Coverage Part If this endorsement is attached to your policy coverage is excluded for personal and advertising injury arising out of any access to or disclosure of confidential or personal information. To the extent that any access or disclosure of confidential or personal information results in the oral or written publication that violates a person s right of privacy this would be a restriction in coverage. Page 10f2 10102014 CG P 01605 14 LIN 90 15822 03 01 141 100001 0000000014 14284 0 N 83CB4CA9 DBF1 44CD98C4 DCEAS4120651
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CG 33 53 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information And Data related Liability With Limited Bodily Injury Exception For Use With the Owners And Contractors Protective Liability Coverage Part and Products Completed Operations Coverage Part If this endorsement is attached to your policy coverage is excluded for damages arising out of any access to or disclosure of confidential information. This is a reinforcement of coverage. CG 33 59 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information And Data related Liability Limited Bodily Injury Exception Not Included For Use With the Owners And Contractors Protective Liability Coverage Part and Products Completed Operations Coverage Part If this endorsement is attached to your policy doverage is excluded for damages arising out of any access to or disclosure of confidential or personal information. This is a reinforcement of coverage. However when this endorsement is attached it will result in a reduction of coverage due to the deletion of an exception with respect to damages because of bodily injury arising out of loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. Page 2 of 2 LINEJRZZ OJU 141 Page 2 of 2 CG P 016 0514 LIN 90 15822 03 01 141. 10102014
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United Specialty Insurance Company 550 POLARIS PARKWAY SUITE 300 WESTERVILLE OH 43082 A STOCK COMPANY COMMERCIAL LINES POLICY THIS POLICY JACKET WITH COMMON POLICY CONDITIONS THE DECLARATIONS PAGE COVERAGE PARTS COVERAGE FORMS AND APPLICABLE FORMS AND ENDORSEMENTS COMPLETE THIS POLICY. USCP 1000 1113
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NO FLAT CANCELLATION United Specialty Insurance Company 550 Polaris Parkway Suite 300 Westerville Ohio 43082 614 895 2000 www.centurysurety.com COMMERCIAL LINES POLICY COMMON POLICY DECLARATIONS POLICY NO. USA 4160538 New NAMED INSURED AND ADDRESS CODE NO.5755 G L J Broggi Transportation Inc. INSUREDS AGENT 14 E. Hattendorf Ave. King Forman Insurance Agency 2604 E. Dempster St. 501 Roselle IL 60172 Park Ridge IL 60068 POLICY PERIOD From03 25 2017 T003 25 2018 at 1201 A.M. Standard time at your mailing address shown above. Business Description Taxicab Company O ndividual O Joint Venture O Partnership O Limited Liability Company LLC Organization Other than Partnership LLC or Joint Venture IN RETURN FOR THE PAYMENT OF THE PREMIUM AND SUBJECT TO ALL THE TERMS OF THIS POLICY WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. PREMIUM Commercial General Liability Coverage Part 2500.00 NOTICE TO POLICYHOLDER This contract is issued pursuant to Section 445 of the Tlinois Insurance Code by a company not authorized and licensed to transact business in Hlinois and as such is not covered by the llinois Insurance Guaranty Fund. 175.00 125.00 88.00 5.00 2893.00 Policy Fee 175.00 Inspection Fee 125.00 IL Tax 88.00 Stamping Fee 5.00 25 of the Policy Premium is fully earned as of the effective TOTAL 2893.00 date of this policy and is not subject to return or refund. Service of Suit if form CCP 20 10 is attached may be made upon USG Insurance Services Inc. 579 First Bank Drive Suite 260 Palatine IL 60067 Forms and Endorsements made a part of this policy at time of issue Omits applicable Forms and Endorsements if shown in specific Coverage Part Coverage Form Declarations. See Attached Schedule of Forms CIL 15 00b 02 02 Any person who with intent to defraud or knowing that he is facilitating a fraud against an insurer submits an application or files a claim containing false or deceptive statement is uilty of insurance fraud COMPANY REPRESENTATIVE USG Insurance Services Inc. 579 First Bank Drive Countersigned By Suite 260 Auth epresentatve Palatine IL 60067 03302017 kms IN WITNESS WHEREOF this Company has executed and attested these presents but this policy shall not be valid unless countersigned by the duly Authorized Agent of this Company at the Agency hereinbefore mentioned. Gcprhlles N Secretary President TOTAL USCP 10 01 0314 Page 1 of 1
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Accepted on 3242017 112400 AM SLA Countersignature 11.20170032887. Notice to Policyholder This contract is issued pursuant to Section 445 of the Illinois Insurance Code by a company not authorized and licensed to transact business in Illinois and as such is not covered by the Illinois Insurance Guaranty Fund. Service of process under this contract may be made upon the Director pursuant to paragraph 10 of Section 445 of the Code. Policy I d Filing Type Insurance Company United Specialty Insurance Co TOTALS COUNT 1 Policy Number Insured Address 1 City State Zip Effective Date Term months Amount Coverage Code Umbrella All including excess TOTALS COUNT 1 Surplus Line Tax Stamping Fee Last Update 120170032887 Policy USA4160538 LIBROGGI TRANSPORTATION INC 14 E HATTENDORF AVE ROSELLE L 60172 3252017 12 2000000 88 a 3242017 112400 AM Percent 100.000000 100.000000 Premium Fire Marshal Tax 2500 2500 Policy I d iling Type Insurance Company United Specialty Insurance Co TOTALS COUNT 1 Yolicy Number nsured Address 1 City State Zip iffective Date erm months Amount Coverage Code Umbrella All including excess TOTALS COUNT 1 Surplus Line Tax Stamping Fee ast Update 120170032887 Policy USA4160538 LIBROGGI TRANSPORTATION INC 14 E HATTENDORF AVE ROSELLE L 60172 3252017 12 2000000 88 5 3242017 112400 AM Percent 100.000000 100.000000 Premium Fire Marshal Tax 2500 0 2500 0 120170032887 Policy USA4160538 LIBROGGI TRANSPORTATION INC 14 E HATTENDORF AVE ROSELLE L 60172 3252017 12 2000000 88 5 3242017 112400 AM
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Policy Number USA 4160538 CIL 15 00b 02 02 SCHEDULE OF FORMS AND ENDORSEMENTS other than applicable forms and endorsements shown elsewhere in the policy Forms and Endorsements applying to the Coverage Parts listed below and made a part of this policy at time of issue Form Edition Endt. Date Title Total of Forms Selected 24 Forms Applicable to this Coverage part INTERLINE ALL COVERAGE PARTS ccp 2010 15008 0003 0017 P001 0002 0001 1000 1001 0508 0202 0908 1198 0104 0713 0115 113 0314 Service of Suit Clause Schedule of Forms and Endorsements Calculation of Premium Common Policy Conditions U.S. Treasury Department s Office of Foreign Assets Control OFAC Advisory Notice to Policyholders United Specialty Insurance Company Policy Holder Privacy Statement Policyholder Disclosure Notice of Terrorism Insurance Coverage United Specialty Insurance Company Commercial Lines Policy Jacket United Specialty Insurance Company Commercial Lines Policy Common Policy Declarations 9 Forms Forms Applicable to this Coverage part GENERAL LIABILITY cG G G G G G 0001 0300 2107 2147 2165 2176 2184 2196 1701 1711a 1793 1507 0021 0147 1500 0413 0196 0514 1207 1204 0115 0115 0305 0316 0416 0114 0713 0908 0911 0713 Commercial General Liability Coverage Form Deductible Liability Insurance Exclusion Access or Disclosure of Confidential or Personal Information and Data Related Liability Limited Bodily Injury Exception Not Included Employment Related Practices Exclusion Total Pollution Exclusion With A Building Heating Cooling and Dehumidifying Equipment Exception and A Hostile Fire Exception Exclusion of Punitive Damages Related to Certified Act of Terrorism Exclusion of Certified Nuclear Biological Chemical or Radiological Acts of Terrorism Cap on Losses from Certified Acts of Terrorism Silica or Silica Related Dust Exclusion Special Exclusions and Limitations Endorsement Classification and Location Limitation Endorsement Exclusion Aircraft Auto or Watercraft Changes Defense Costs and Indemnity Payments Nuclear Energy Liability Exclusion Endorsement Broad Form lllinois Changes Civil Union United Specialty Insurance Company Commercial General Liability Coverage Part Declarations 15 Forms CIL 15 00b 02 02 Page 1 of 1
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CCP 2010 0508 SERVICE OF SUIT CLAUSE This endorsement modifies insurance provided by the policy to which this form is attached. It is agreed that in the event of the failure by us to pay any amount claimed to be due hereunder we will at your request submit to the jurisdiction of a court of competent jurisdiction within the United States of America. Nothing in this clause constitutes or should be understood to constitute a waiver of our rights to commence an action in a court of competent jurisdiction in the United States of America to remove an action to a United States District Court or to seek a transfer of a case to another court as permitted by the laws of the United States of America or of any state in the United States of America. In any such suit against us we will abide by the final decision of such court or of any Appellate Court in the event of an appeal. It is further agreed that service of process in such suit may be made upon the person or organization shown in the Policy Declarations or upon us at the address shown in the policy jacket. The above named are authorized and directed to accept service of process on behalf of us in any such suit andor upon your request to give a written undertaking to you that we will enter a general appearance upon our behalf in the event such a suit shall be instituted. Further pursuant to any statute of any state territory or district of the United States of America which makes provision therefore we hereby designate the Superintendent Commissioner or Directors of Insurance or other officer specified for that purpose in the statute or his successor or successors in office as their true and lawful attorney upon whom may be served any lawful process in any action suit or proceeding instituted by or on your behalf or any beneficiary hereunder arising out of this contract of insurance and hereby designates the above named as the person to whom the said officer is authorized to mail such process or a true copy thereof. CCP 2010 0508 Page 1 of 1
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IL 00 03 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALCULATION OF PREMIUM This endorsement modifies insurance provided under the following CAPITAL ASSETS PROGRAM OUTPUT POLICY COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART The following is added The premium shown in the Declarations was com puted based on rates in effect at the time the policy was issued. On each renewal continuation or anni versary of the effective date of this policy we will compute the premium in accordance with our rates and rules then in effect. IL 00 03 09 08 ISO Properties Inc. 2007 Page 1 of 1 m
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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 advanced written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment 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 tous. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy s terms can be amended or waived only by endorsement issued by us and made a part of this policy.. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. D. 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 inspections surveys reports or recom mendations and any such actions we do undertake relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions a. Are safe or healthful or b. Comply with laws regulations codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us but also to any rating advisory rate services or similar organization which makes insurance inspections surveys reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections surveys reports or recommendations we may make relative to certification under state or municipal statutes ordinances or regulations of boilers pressure vessels or elevators. E. Premiums The first Named Insured shown in the Declarations 1. Is responsible for the payment of all premiums and 2. Will be the payee for any return premiums we pay. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal repre sentative is appointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. Copyright Insurance Services Office Inc. 1998 Page 1 of 1 IL 00171198
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IL P 001 0104 U.S. TREASURY DEPARTMENT S OFFICE OF FOREIGN ASSETS CONTROL OFAC ADVISORY NOTICE TO POLICYHOLDERS No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. This Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC. Please read this Notice carefully. The Office of Foreign Assets Control OFAC administers and enforces sanctions policy based on Presidential declarations of national emergency. OFAC has identified and listed numerous Foreign agents Front organizations Terrorists Terrorist organizations and Narcotics traffickers as Specially Designated Nationals and Blocked Persons. This list can be located on the United States Treas ury s web site httpwww.treas.gov ofac. In accordance with OFAC regulations if it is determined that you or any other insured or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person as identified by OFAC this insurance will be considered a blocked or frozen contract and all provisions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract no payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. IL P 0010104 ISO Properties Inc. 2004 Page 1 0of 1
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United Specialty Insurance Company Policy Holder Privacy Statement As a policyholder of United Specialty Insurance Company you may remember that you purchased your United Specialty Insurance Company policy from an insurance agent. Please understand that the agent from whom you purchased your United Specialty Insurance Company policy is not affiliated with United Specialty Insurance Company but rather is a separate legal entity. In the process of purchasing your United Specialty Insurance Company policy you may have provided your insurance agent with various information including nonpublic personal information about yourself. You did not provide any such information directly to United Specialty Insurance Company but on occasion we may receive such information from your insurance agent. This statement is intended to explain and disclose United Specialty Insurance Company s policies and practices regarding the collection disclosure and protection of such information. United Specialty Insurance Company will provide customers like yourself with a copy of our privacy policy at the beginning of our relationship and annually thereafter unless and until our relationship ends. As our products and services continue to evolve it may be necessary to review and revise our privacy policies in which case we will provide you with an updated privacy notice. L Financial Information Collected. During the ordinary course of our business United Specialty Insurance Company may as explained above collect information about you from the following sources Information the insurance agent receives from you on applications or other forms Information about your transactions including claims with us our affiliates and others and Information we receive from other agents brokers administrators insurance support agencies legal counsel consumer reporting agencies and government reporting agencies. nan nan nan nan 1.0 1. Financial Information Di sed. We do not disclose any information about our customers or former customers to anyone except as permitted by law to service your business. 1L Parties To Whom Information is Disclosed. We do not disclose any information about our customers or former customers to anyone except as permitted by law to service your business.. Confidentiality and Security of Information. We restrict access to information about you to those employees who need to know that information to provide products or services to you. We maintain physical electronic and procedural safeguards to guard your information. A Access to and Correction of Your Information. You may write to us if you have any questions about the information that we may have in our records about you. We will respond within 30 business days from the date such request is received to your inquiry. If you wish you may review this information in person or receive a copy at a reasonable charge. You can notify us in writing if you believe any information should be corrected amended or deleted and we will review your request. We will either make the requested change or explain why we did not do so. If we do not make the requested change you may submit a short written statement identifying the disputed information which will be included in all future disclosures of your information. We value your business. This statement is for your information. No response is necessary. PRIV 0002 0713 Page 1 of 1
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NOTE TO AGENT It is required by federal law that you provide this document to the insured. POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE Coverage for acts of terrorism is included in your policy. You are hereby notified that under the Terrorism Risk Insurance Act as amended in 2015 the definition of act of terrorism has changed. As defined in Section 1021 of the Act The term act of terrorism means any act that is certified by the Secretary of the Treasury in consultation with the Secretary of Homeland Security and the Attorney General of the United States to be an act of terrorism to be a violent act or an act that is dangerous to human life property or infrastructure to have resulted in damage within the United States or outside the United States in the case of certain air carriers or vessels or the premises of a United States mission and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. Under your coverage any losses resulting from certified acts of terrorism may be partially reimbursed by the United States Government under a formula established by the Terrorism Risk Insurance Act as amended. However your policy may contain other exclusions which might affect your coverage such as an exclusion for nuclear events. Under the formula the United States Government generally reimburses 85 through 2015 84 beginning on January 1 2016 83 beginning January 1 2017 82 beginning January 1 2018 81 beginning January 1 2019 and 80 beginning January 1 2020 of covered terrorism losses exceeding the statutorily established deductible paid by the insurance company providing the coverage. The Terrorism Risk Insurance Act as amended contains a 100 billion cap that limits U.S. Government reimbursement as well as insurers liability for losses resulting from certified acts of terrorism when the amount of such losses exceeds 100 billion in any one calendar year. If the aggregate insured losses for all insurers exceed 100 billion your coverage may be reduced The portion of your annual premium that is attributable to coverage for acts of terrorism is as shown below. This premium does not include any charges for the portion of losses covered by the United States government under the Act. Property Inland Marine Crime Excluded General Liability 0 Garage Excluded Total 0 Name of Insurer United Specialty Insurance Company Policy Number USA 4160538 TRIA 0001 0115 NOTE TO AGENT It is required by federal law that you provide this document to the insured. POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE I0SSES 101 all INSUrers exceed o100 DIToN your coverage may be reauced The portion of your annual premium that is attributable to coverage for acts of terrorism is as shown below. This premium does not include any charges for the portion of losses covered by the United States government under the Act. Property Inland Marine Crime Excluded General Liability 0 Garage Excluded Total 0 Name of Insurer United Specialty Insurance Company Paliru Niimbhar 1ICA A1ANE2Q Excluded 0 Excluded Total
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United Specialty Insurance Company COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS Policy No USA 4160538 Effective Date 03252017 1201 A.M. Standard Time NAMED INSURED L J Broggi Transportation Inc LIMITS OF INSURANCE General Aggregate Limit Other than Product Completed Operations 2000000 Products Completed Operations Aggregate Limit Included in the General Aggregate Personal and Advertising Injury Limit 1000000 Each Occurrence Limit 1000000 Damage to Premises Rented to You 100000 Any one Fire Occurrence Medical Expense Limit 3 5000 Any one Person RETROACTIVE DATE CG 00 02 CGL 0002 CGL 1551 or CGL 1553 Coverage A and B of this insurance does not apply to bodily injury property damage personal and advertising injury personal injury or advertising injury which occurs before the retroactive date shown here DEDUCTIBLE Per Claim 500 Bodily Injury Liability Property Damage Liability Combined this deductible also applies to Personal and Advertising Injury Liability. Deductible also applies to Supplementary Payments Coverages A and B Defense Expenses Coverages A and B form CGL 0002 only X Yes No LOCATION OF ALL PREMISES YOU OWN RENT OR OCCUPY 4 E. Hattendorf. Roselle IL 60172 PREMIUM RATE ADVANCED PREMIUM St Terr Code Classification Prem. Basis Prem. Ops. Pr Co Pr Co All Other IL 509 68001 Taxicab Companies a 500 280.291 Incl Incl 2500 MP Audit period is Annual Unless Otherwise Stated Total Advance Premium 2500 TRIA Coverage 4 Minimum Premium for This Coverage Part 2500 FORMS AND ENDORSEMENTS other than applicable Forms and Endorsements shown elsewhere in the policy Forms and Endorsements applying to this Coverage Part and made part of this policy at time of issue See Attached Schedule of Forms CIL 15 00B 02 02 Thclusion of Date Optional THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THIS INSURED AND THE POLICY PERIOD Other than Product Completed Operations rations Aggregate Limit Injury Limit ted to You ggregate Any one Fire Occurrence Any one Person Property Damage Liability Combined iability. s Aand B X Yes No E. Hattendorf. Roselle IL 60172 dit period is Annual Unless Otherwise Stated Total Advance Premium 2500 TRIA Coverage 0 USGL 1500 0713 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under Section Il Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section Hll Limits Of Insurance and 2 Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 The bodily injury or property damage occurs during the policy period and 3 Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. c. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. d. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim 1 Reports all or any part of the bodily injury or property damage to us or any other insurer 2 Receives a written or verbal demand or claim for damages because of the bodily injury or property damage or 3 Becomes aware by any other means that bodily injury or property damage has occurred or has begun to occur. e. Damages because of bodily injury include damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. CG 00010413 Insurance Services Office Inc. 2012 Page 1 of 16
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2. Exclusions This insurance does not apply to a. Expected Or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Contractual Liability Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the absence of the contract or agreement or 2 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorneys fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and Such attorneys fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. b This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in a The supervision hiring employment training or monitoring of others by that insured or b Providing or faiing to provide transportation with respect to any person that may be under the influence of alcohol if the occurrence which caused the bodily injury or property damage involved that which is described in Paragraph 1 2 or 3 above. However this exclusion applies only if you are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages. For the purposes of this exclusion permitting a person to bring alcoholic beverages on your premises for consumption on your premises whether or not a fee is charged or a license is required for such activity is not by itself considered the business of selling serving or furnishing alcoholic beverages.. Workers Compensation And Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law.. Employer s Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a Employment by the insured or b Performing duties related to the conduct of the insured s business or 2 The spouse child parent brother or sister of that employee as a consequence of Paragraph 1 above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. Insurance Services Office Inc. 2012 CG 00010413 Page 2 of 16
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f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a At orfrom any premises site or location which is or was at any time owned or occupied by or rented or loaned to any insured. However this subparagraph does not apply to i Bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or originating from equipment that is used to heat cool or dehumidify the building or equipment that is used to heat water for personal use by the building s occupants or their guests ii Bodily injury or property damage for which you may be held liable if you are a contractor and the owner or lessee of such premises site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not and never was owned or occupied by or rented or loaned to any insured other than that additional insured or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire b At or from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste c Which are or were at any time transported handled stored treated disposed of or processed as waste by or for i Any insured or ii Any person or organization for whom you may be legally responsible or d At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by such insured contractor or subcontractor. However this subparagraph does not apply to i Bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or released as part of the operations being performed by such insured contractor or subcontractor ii Bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor or 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 indirectly on any insured s behalf are performing operations if the operations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. CG 00010413 Insurance Services Office Inc. 2012 Page 3 of 16
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2 Any loss cost or expense arising out of any a Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or b Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a governmental authority. g. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or 4 5 Bodily injury or property damage arising out of a The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or b The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definiion of mobile equipment. h. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. i. War Bodily injury or property damage however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these.. Damage To Property Property damage to 1 Property you own rent or occupy including any costs or expenses incurred by you or any other person organization or entity for repair replacement enhancement restoration or maintenance of such property for any reason including prevention of injury to a person or damage to another s property 2 Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you 3 Insurance Services Office Inc. 2012 CG 00010413 Page 4 of 16
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4 Personal property in the care custody or control of the insured 5 That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the property damage arises out of those operations or That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section Il Limits Of Insurance. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard. 6. Damage To Your Product Property damage to your product arising out of it or any part of it.. Damage To Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor.. Damage To Impaired Property Or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 A defect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use.. Recall Of Products Work Or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it.. Personal And Advertising Injury Bodily injury arising out of personal and advertising injury.. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. However this exclusion does not apply to liability for damages because of bodily injury. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment.. Recording And Distribution Of Material Or Information In Violation Of Law Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or CG 00010413 Insurance Services Office Inc. 2012 Page 5 of 16
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4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section Il Limits Of Insurance. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of personal and advertising injury to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for personal and advertising injury to which this insurance does not apply. We may at our discretion investigate any offense and settie any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section Il Limits Of Insurance and 2 Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to personal and advertising injury caused by an offense arising out of your business but only if the offense was committed in the coverage territory during the policy period. 2. Exclusions This insurance does not apply to Knowing Violation Of Rights Of Another Personal and advertising injury caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising injury.. Material Published With Knowledge Of Falsity Personal and advertising injury arising out of oral or written publication in any manner of material if done by or at the direction of the insured with knowledge of its falsity.. Material Published Prior To Policy Period Personal and advertising injury arising out of oral or written publication in any manner of material whose first publication took place before the beginning of the policy period.. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured.. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement.. Breach Of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s advertising idea in your advertisement.. Quality Or Performance Of Goods Failure To Conform To Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your advertisement.. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Insurance Services Office Inc. 2012 CG 00010413 Page 6 of 16
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i. Infringement Of Copyright Patent Trademark Or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trademark trade secret or other intellectual property rights. Under this exclusion such other intellectual property rights do not include the use of another s advertising idea in your advertisement. However this exclusion does not apply to infringement in your advertisement of copyright trade dress or slogan. Insureds In Media And Internet Type Businesses Personal and advertising injury committed by an insured whose business is 1 Advertising broadcasting publishing or telecasting 2 Designing or determining content of web sites for others or 3 An Internet search access content or service provider. However this exclusion does not apply to Paragraphs 14.a. b. and c. of personal and advertising injury under the Definitions section. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the insured hosts owns or over which the insured exercises control. Unauthorized Use Of Another s Name Or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain name or metatag or any other similar tactics to mislead another s potential customers. m. Pollution Personal and advertising injury arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants at any time. x n. Pollution related Any loss cost or expense arising out of any 1 Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of poliutants. 0. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. p. Recording And Distribution Of Material Or Information In Violation Of Law Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. C CG 00010413 Insurance Services Office Inc. 2012 Page 7 of 16
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COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that a The accident takes place in the coverage territory and during the policy period b The expenses are incurred and reported to us within one year of the date of the accident and d. Workers Compensation And Similar Laws To a person whether or not an employee of any insured if benefits for the bodily injury are payable or must be provided under a workers compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing instructing or participating in any physical exercises or games sports or athletic contests. f. Products Completed Operations Hazard Included within the products completed operations hazard. g. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS COVERAGES A c The injured person submits to AND B examination at our expense by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for 1 First aid administered at the time of an accident 2 Necessary medical surgical X ray and dental services including prosthetic devices and 3 Necessary ambulance hospital professional nursing and funeral services. 2. Exclusions We will not pay expenses for bodily injury a. Any Insured To any insured except volunteer workers. b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. 1. We will pay with respect to any claim we investigate or settle or any suit against an insured we defend a. All expenses we incur. b. Up to 250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. c. The cost of bonds to release attachments but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from work. e. All court costs taxed against the insured in the suit. However these payments do not include attorneys fees or attomneys expenses taxed against the insured. f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment interest based on that period of time after the offer. Insurance Services Office Inc. 2012 CG 00010413 Page 8 of 16
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g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance.. If we defend an insured against a suit and an indemnitee of the insured is also named as a party to the suit we will defend that indemnitee if all of the following conditions are met a. The suit against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an insured contract b. This insurance applies to such liability assumed by the insured. The obligation to defend or the cost of the defense of that indemnitee has also been assumed by the insured in the same insured contract. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the insured and the indemnitee and f. The indemnitee 1 Agrees in writing to a Cooperate with us in the investigation settiement or defense of the suit Immediately send us copies of any demands notices summonses or legal papers received in connection with the o a b c Notify any other insurer whose coverage is available to the indemnitee and d Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee and 2 Provides us with written authorization to a Obtain records and other information related to the suit and b Conduct and control the defense of the indemnitee in such suit. So long as the above conditions are met attorneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.2 of Section Coverage A Bodily Injury And Property Damage Liability such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the limits of insurance. Our obligation to defend an insured s indemnitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above or the terms of the agreement described in Paragraph f. above are no longer met. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. c. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. CG 00010413 Insurance Services Office Inc. 2012 Page 9 of 16
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2. Each of the following is also an insured a. Your volunteer workers only while performing duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a partnership joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees or volunteer workers are insureds for 1 Bodily injury or personal and advertising c. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that property and 2 Until your legal representative has been appointed. d. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership injury JTY 1 b f or majority interest will qualify as a Named a To you to your partners or members i Insured if there is no other similar insurance you are a partnership or joint venture available to that organization. However lo your members if you are a limited a. Coverage under this provision is afforded only iabil empl. Cov 3 jabiity company. 1o a co employee until the 90th day after you acquire or form the while in the course of his or her employment or performing duties related organization or the end of the policy period whichever is earlier to the conduct of your business or to your other volunteer workers while b. Coverage A does not apply to bodily injury or performing duties related to the conduct property damage that occurred before you of your business acquired or formed the organization and b To the spouse child parent brother or c. Coverage B does not apply to personal and sister of that coemployee or advertising injury arising out of an offense volunteer worker as a consequence of committed before you acquired or formed the Paragraph 1a above organization. c For which there is any obligation to No person or organization is an insured with respect share damages with or repay someone to the conduct of any current or past partnership joint else who must pay damages because of venture or limited liability company that is not shown the injury described in Paragraph 1a as a Named Insured in the Declarations. or b above or SECTION Iil LIMITS OF INSURANCE d Arising out of his or her providing or 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b Rented to in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees volunteer workers any partner or member if you are a partnership or joint venture or any member if you are a limited liability company. b. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. Insurance Services Office Inc. 2012 CG 00010413 Page 10 of 16
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3. The Products Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. 4. Subject to Paragraph 2. above the Personal And Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all personal and advertising injury sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above whichever applies the Each Occurrence Limit is the most we will pay for the sum of a. Damages under Coverage A and b. Medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to Paragraph 5. above the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of property damage to any one premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence Offense Claim Or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or an offense which may result in a claim. To the extent possible notice should include 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured persons and witnesses and 3 The nature and location of any injury or damage arising out of the occurrence or offense. b. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part a. To join us as a party or otherwise bring us into a suit asking for damages from an insured or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settiement means a settlement and release of liability signed by us the insured and the claimant or the claimant s legal representative. CG 00010413 Insurance Services Office Inc. 2012 Page 11 of 16
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4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance 1 This insurance is excess over a Any of the other insurance whether primary excess contingent or on any other basis i That is Fire Extended Coverage Builder s Risk Installation Risk or similar coverage for your work ii That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner iii That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner or iv If the loss arises out of the maintenance or use of aircraft autos or watercraft to the extent not subject to Exclusion g. of Section I Coverage A Bodily Injury And Property Damage Liability. b Any other primary insurance available to you covering liability for damages arising out of the premises or operations or the products and completed operations for which you have been added as an additional insured. 2 When this insurance is excess we will have no duty under Coverages A or B to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be entited to the insured s rights against all those other insurers. 3 When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of a The total amount that all such other insurance would pay for the loss in the absence of this insurance and b The total of all deductible and self insured amounts under all that other insurance. 4 We will share the remaining loss if any with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. 6. Representations By accepting this policy you agree a. The statements in the Declarations are accurate and complete Insurance Services Office Inc. 2012 CG 00010413 Page 12 of 16
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b. Those statements are based upon representations you made to us and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this Coverage Part to the first Named Insured this insurance applies a. As if each Named Insured were the only Named Insured and b. Separately to each insured against whom claim is made or suit is brought. 8. Transfer Of Rights Of Recovery Against Others ToUs If the insured has rights to recover all or part of any payment we have made under this Coverage Part those rights are transferred to us. The insured must do nothing after loss to impair them. At our request the insured will bring suit or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. SECTION V DEFINITIONS 1. Advertisement means a notice that is broadcast or published to the general public or specific market segments about your goods products or services for the purpose of attracting customers or supporters. For the purposes of this definition a. Notices that are published include material placed on the Internet or on similar electronic means of communication and b. Regarding web sites only that part of a web site that is about your goods products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. Auto means a. A land motor vehicle trailer or semitrailer designed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However auto does not include mobile equipment.. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time.. Coverage territory means a. The United States of America including its territories and possessions Puerto Rico and Canada b. International waters or airspace but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above or c. All other parts of the world if the injury or damage arises out of 1 Goods or products made or sold by you in the territory described in Paragraph a. above 2 The activities of a person whose home is in the fterritory 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 similar electronic means of communication provided the insured s responsibility to pay damages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to.. Employee includes a leased worker. Employee does not include a temporary worker.. Executive officer means a person holding any of the officer positions created by your charter constitution bylaws or any other similar governing document.. Hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be.. 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 deficient inadequate or dangerous or b. You have failed to fulfill the terms of a contract or agreement if such property can be restored to use by the repair replacement adjustment or removal of your product or your work or your fulfiling the terms of the contract or agreement. CG 00010413 Insurance Services Office Inc. 2012 Page 13 of 16
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9. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract A sidetrack agreement Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality An elevator maintenance agreement That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or 3 Under which the insured if an architect engineer or surveyor assumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. e e 2 10. 1 12 Leased worker means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker..Loading or unloading means the handling of property a. After it is moved from the place where it is accepted for movement into or onto an aircraft watercraft or auto b. While it is in or on an aircraft watercraft or auto or c. While it is being moved from an aircraft watercraft or auto to the place where it is finally delivered but loading or unloading does not include the movement of property by means of a mechanical device other than a hand truck that is not attached to the aircraft watercraft or auto. Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment a. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads b. Vehicles maintained for use solely on or next to premises you own or rent c. Vehicles that travel on crawler treads d. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers e. Vehicles not described in Paragraph a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types 1 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers. Vehicles not described in Paragraph a. b. c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. Insurance Services Office Inc. 2012 CG 00010413 Page 14 of 16
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13. 14. 15. However self propelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos 1 Equipment designed primarily for a Snow removal b Road maintenance but not construction or resurfacing or c Street cleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and 3 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered autos. Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution c. The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies committed by or on behalf of its owner landlord or lessor d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services e. Oral or written publication in any manner of material that violates a person s right of privacy f. The use of another s advertising idea in your advertisement or g. Infringing upon another s copyright trade dress or slogan in your advertisement. Pollutants mean any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals and waste. Waste includes materials to be recycled reconditioned or reclaimed. 16.Products completed operations hazard a. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 Products that are still in your physical possession or 2 Work that has not yet been completed or abandoned. However your work will be deemed completed at the earliest of the following times a When all of the work called for in your contract has been completed. b When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. c When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. b. Does not include bodily injury or property damage arising out of 1 The transportation of property unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you and that condition was created by the loading or unloading of that vehicle by any insured 2 The existence of tools uninstalled equipment or abandoned or unused materials or 3 Products or operations for which the classification listed in the Declarations or in a policy Schedule states that products completed operations are subject to the General Aggregate Limit. 17.Property damage means a. Physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance electronic data is not tangible property. CG 00010413 Insurance Services Office Inc. 2012 Page 15 of 16
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As used in this definition electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. 18.Suit means a civil proceeding in which damages because of bodily injury property damage or personal and advertising injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 19.Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. 20.Volunteer worker means a person who is not your employee and who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other compensation by you or anyone else for their work performed for you. 21.Your product a. Means 1 Any goods or products other than real property manufactured sold handled distributed or disposed of by a You b Others trading under your name or c A person or organization whose business or assets you have acquired and 2 Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 22.Your work a. Means 1 Work or operations performed by you or on your behalf and 2 Materials parts or equipment furnished in connection with such work or operations. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your work and 2 The providing of or failure to provide warnings or instructions. Insurance Services Office Inc. 2012 CG 00010413 Page 16 of 16
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COMMERCIAL GENERAL LIABILITY CG 03 00 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE.. Coverage Amount and Basis of Deductible Amount and Basis of Deductible PER CLAIM or PER OCCURRENCE Coverage Bodily Injury Liability OR Property Damage Liability OR Bodily Injury Liability andor Property Damage Liability Combined APPLICATION OF ENDORSEMENT Enter below any limitations on the application of this endorsement. If no limitation is entered the deductibles apply to damages for all bodily injury and property damage however caused A.Our obligation under the Bodily Injury Liability and Property Damage Liability Coverages to pay dam ages on your behalf applies only to the amount of damages in excess of any deductible amounts stated in the Schedule above as applicable to such coverages. B.You may select a deductible amount on either a per claim or a per occurrence basis. Your se lected deductible applies to the coverage option and to the basis of the deductible indicated by the placement of the deductible amount in the Sched ule above. The deductible amount stated in the Schedule above applies as follows 1. PER CLAIM BASIS. f the deductible amount indicated in the Schedule above is on a per claim basis that deductible applies as follows a. Under Bodily Injury Liability Coverage to all damages sustained by any one person be cause of bodily injury b. Under Property Damage Liability Coverage to all damages sustained by any one person because of property damage or. Under Bodily Injury Liability andor Property Damage Liability Coverage Combined to all damages sustained by any one person because of 1 Bodily injury 2 Property damage or 3 Bodily injury and property damage combined as the result of any one occurrence. If damages are claimed for care loss of ser vices or death resulting at any time from bodily injury a separate deductible amount will be applied to each person making a claim for such damages With respect to property damage person in cludes an organization CG 03 00 01 96 Copyright Insurance Services Office Inc. 1994 Page10of2
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2. PER OCCURRENCE BASIS. If the deductible amount indicated in the Schedule above is on a per occurrence basis that deductible amount applies as follows a. Under Bodily Injury Liability Coverage to all damages because of bodily injury b. Under Property Damage Liability Coverage to all damages because of property dam age or. Under Bodily Injury Liability andor Property Damage Liability Coverage Combined to all damages because of 1 Bodily injury 2 Property damage or 3 Bodily injury and property damage combined as the result of any one occurrence regard less of the number of persons or organizations who sustain damages because of that occur rence C. The terms of this insurance including those with respect to 1.0ur right and duty to defend the insured against any suits seeking those damages and 2.Your duties in the event of an occurrence claim or suit apply irrespective of the application of the de ductible amount. D.We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification of the action taken you shall promptly reimburse us for such part of the de ductible amount as has been paid by us. CG 03 00 01 96 Copyright Insurance Services Office Inc. 1994 Page2of2
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COMMERCIAL GENERAL LIABILITY CG 21070514 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA RELATED LIABILITY LIMITED BODILY INJURY EXCEPTION NOT INCLUDED COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.p. of Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following 2. Exclusions This insurance does not apply to p. Access Or Disclosure Of Confidential Or Personal Information And Data related Liability Damages arising out of 1 Any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information or The loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of that which is described in Paragraph 1 or 2 above 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. 2 This endorsement modifies insurance provided under the following B. The following is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or organization s confidential or personal information. CG 21070514 Insurance Services Office Inc. 2013 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21471207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYMENT RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability This insurance does not apply to Bodily injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demo tion evaluation reassignment discipline defamation harassment humiliation dis crimination or malicious prosecution di rected at that person or 2 The spouse child parent brother or sister of that person as a consequence of bodily injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after em ployment of that person 2 Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Person al And Advertising Injury Liability This insurance does not apply to Personal and advertising injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demo tion evaluation reassignment discipline defamation harassment humiliation dis crimination or malicious prosecution di rected at that person or 2 The spouse child parent brother or sister of that person as a consequence of personal and advertising injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after em ployment of that person 2 Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. CG 21471207 ISO Properties Inc. 2006 Page 1 of 1 m
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COMMERCIAL GENERAL LIABILITY CG 21651204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION WITH A BUILDING HEATING COOLING AND DEHUMIDIFYING EQUIPMENT EXCEPTION AND A HOSTILE FIRE EXCEPTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion f. under Paragraph 2. Exclusions of Sec tion Coverage A Bodily Injury And Property Damage Liability is replaced by the following This insurance does not apply to f. Pollution 1 Bodily injury or property damage which would not have occurred in whole or part but for the actual alleged or threatened discharge. dispersal seepage migration release or es cape of pollutants at any time. This exclusion does not apply to a Bodily injury if sustained within a building which is or was at any time owned or occu pied by or rented or loaned to any insured 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 oc cupants or their guests or Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire unless that hostile fire occurred or originated i At any premises site or location which is or was at any time used by or for any insured or others for the handling stor age disposal processing or treatment of waste or b i At any premises site or location on which any insured or any contractors or subcontractors working directly or indi rectly on any insured s behalf are per forming operations to test for monitor clean up remove contain treat detox ify neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a Request demand order or statutory or b regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a 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. ii At any premises site or location on which any insured or any contractors or subcontractors working directly or indi rectly on any insured s behalf are per forming operations to test for monitor clean up remove contain treat detox ify neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a Request demand order or statutory or b regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a 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. CG 21651204 ISO Properties Inc. 2003 Page 1 of 1 m
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COMMERCIAL GENERAL LIABILITY CG 21760115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF PUNITIVE DAMAGES RELATED TO A CERTIFIED ACT OF TERRORISM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. The following exclusion is added This insurance does not apply to TERRORISM PUNITIVE DAMAGES Damages arising directly or indirectly out of a certified act of terrorism that are awarded as punitive damages. B. The following definition is added Certified act of terrorism means an act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following 1. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. C. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. CG21760115 Insurance Services Office Inc. 2015 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG21840115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF CERTIFIED NUCLEAR BIOLOGICAL CHEMICAL OR RADIOLOGICAL ACTS OF TERRORISM CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART This endorsement modifies insurance provided under the following OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY. The following exclusion is added This insurance does not apply to TERRORISM Any injury or damage arising directly or indirectly out of a certified act of terrorism. However this exclusion applies only when one or more of the following are attributed to such act 1. The terrorism involves the use release or escape of nuclear materials or directly or indirectly results in nuclear reaction or radiation or radioactive contamination or 2. The terrorism is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemical materials or 3. Pathogenic or poisonous biological or chemical materials are released and it appears that one purpose of the terrorism was to release such materials. B. The following definitions are added 1. For the purposes of this endorsement any injury or damage means any injury or damage covered under any Coverage Part to which this endorsement is applicable and includes but is not limited to bodily injury property damage personal and advertising injury injury or environmental damage as may be defined in any applicable Coverage Part. 2. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following a. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and b. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. C. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. CG21840115 Insurance Services Office Inc. 2015 Page 1 of 2
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D. If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. Page 2 of 2 Insurance Services Office Inc. 2015 CG21840115
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COMMERCIAL GENERAL LIABILITY CG 21 96 03 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SILICA OR SILICA RELATED DUST EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Silica Or Silica Related Dust a. Bodily injury arising in whole or in part out of the actual alleged threatened or suspected inhalation of or ingestion of sil ica or silica related dust b. Property damage arising in whole or in part out of the actual alleged threatened or suspected contact with exposure to ex istence of or presence of silica or silica related dust. c. Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing contain ing treating detoxifying neutralizing reme diating or disposing of or in any way re sponding to or assessing the effects of silica or silica related dust by any in sured or by any other person or entity.. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Per sonal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Silica Or Silica Related Dust a. Personal and advertising injury arising in whole or in part out of the actual alleged threatened or suspected inhalation of in gestion of contact with exposure to exis tence of or presence of silica or silica related dust b. Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing contain ing treating detoxifying neutralizing reme diating or disposing of or in any way re sponding to or assessing the effects of silica or silica related dust by any in sured or by any other person or entity. C. The following definitions are added to the Defini tions Section 1. Silica means silicon dioxide occurring in crystalline amorphous and impure forms sil ica particles silica dust or silica compounds. 2. Silica related dust means a mixture or com bination of silica and other dust or particles. y son 2. E. or in part eatened or stion of sil whole or in threatened sure to ex k 2 or silica 1 g in whole testing for ng contain izing reme CG 21 96 03 05 ISO Properties Inc. 2004 Page 1 of 1 m
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CGL 1701 0316 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPECIAL EXCLUSIONS AND LIMITATIONS ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A In consideration of the premium charged this policy has been issued subject to the following exclusions being added to Coverages A B This insurance does not apply to 1 Asbestos or Lead Bodily injury property damage or personal and advertising injury arising out of or resulting from the disposal existence handling ingestion inhalation removal sale storage transportation or use of a. Asbestos or any material containing asbestos or b. Lead lead based paint lead compounds or any material containing lead. Athletic or Sports Participants Spectators or Officials Bodily injury to any person while practicing for promoting participating in watching or officiating at a. Any sports or athletic contest or b. Any athletic endeavor or c. Any sports or athletic exhibition. Communicable Disease or Diseases Bodily injury or personal and advertising injury arising directly or indirectly out of or resulting from the transmission or alleged transmission of any communicable disease including but not limited to any sexually transmitted disease or any other disease transmitted by bodily fluids or excretions. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the a. Supervising hiring employing training or monitoring of others that may be infected with and spread a communicable disease or b. Testing for a communicable disease or c. Failure to prevent the spread of the disease or d. Falilure to report the disease to authorities. Criminal Acts a. Bodily injury or property damage arising directly or indirectly out of or resulting from a criminal act committed by any insured including any additional insureds or b. Bodily injury or property damage arising directly or indirectly out of or resulting from a criminal act at the direction of any insured including any additional insureds. Punitive Exemplary Treble Damages or Multipliers of Attorneys Fees Claims or demands for payment of punitive exemplary or treble damages whether arising from the acts of any insured or by anyone else for whom or which any insured or additional insured is legally liable including any multiplier of attorney s fees statutorily awarded to the prevailing party. CGL 1701 0316 Includes copyrighted material of Insurance Services Office Inc. used with its permission. Page 10of 5
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CGL 1701 0316 6. Mold Fungi Virus Bacteria Air Quality Contaminants Minerals or Other Harmful Materials a. Bodily injury property damage or personal and advertising injury arising out of caused by or contributed to in any way by the existence growth spread dispersal release or escape of any mold fungi lichen virus bacteria algae or other growing organism that has toxic hazardous noxious pathogenic irritating or allergen qualities or characteristics. This exclusion applies to all such claims or causes of action including allegations that any insured caused or contributed to conditions that encouraged the growth depositing or establishment of such colonies of mold lichen fungi virus bacteria algae or other living or dead organism or b. Bodily injury property damage or personal and advertising injury arising out of caused by or alleged to be contributed to in any way by any toxic hazardous noxious irritating pathogenic or allergen qualities or characteristics of indoor air regardless of cause or c. Bodily injury property damage or personal and advertising injury arising out of caused by or alleged to be contributed to in any way by any insured s use sale installation or removal of any substance material or other product that is either alleged or deemed to be hazardous toxic irritating pathogenic or noxious in any way or contributes in any way to an allergic reaction or d. Bodily injury property damage or personal and advertising injury arising out of caused by or alleged to be contributed to in any way by toxic or hazardous properties of minerals or other substances. 7. Work or Premises Specifically Insured Elsewhere Claims demands requests for defense payment or any other cost arising out of caused by or occurring at premises or your work covered under any insurance purchased by you or others on your behalf specifically for that premises or project under a Consolidated Insurance Program CIP Owner Controlled Insurance Program OCIP Contractor Controlled Insurance Program CCIP Wrap Up or similar insurance program. 8. Failure To Complete Your Work Bodily injury or property damage arising directly or indirectly out of caused by resulting from or alleged to be related to any insured s failure to complete your work. 9. Loss Cost or Damages Prior To Tendered Claim Any claim loss cost or damages that are projected estimated or otherwise assessed or adjudicated to be likely before such claims are actually made against the insured by the claimant or their representatives actually suffering the alleged bodily injury or property damage. 10. Insured versus Insured Any claim for damages by any insured that qualifies as an insured in paragraph 1. of Section Il Who Is An Insured against any other insured that qualifies as an insured in paragraph 1. of Section Il Who Is An Insured arising directly or indirectly out of bodily injury property damage or personal and advertising injury sustained by any such insured. B. In consideration of the premium charged this policy has been issued subject to the following changes to item 2. Exclusions in Coverage C Exclusion 2. a. Any Insured is deleted in its entirety and replaced with the following a. Any Insured To any insured. CGL 1701 0316 Includes copyrighted material of Insurance Services Office Inc. used with its permission. Page 2 of 5
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CGL 1701 0316 C. Itis agreed that the following exclusions from Section Coverages are changed as shown below 1. Liquor Liability Exclusion. Liquor Liability of Section Coverages Coverage A 2. Exclusions is deleted and entirely replaced with the following c. Liquor Liability 1. Bodily injury or property damage for which any insured may be held liable by reason of a. Causing or contributing to the intoxication of any person or b. The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or. Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. 2. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in a. The Supervision hiring employment training or monitoring of others by that insured or b. Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol or c. Failing to protect or safeguard any person if the occurrence which caused the bodily injury or property damage involved that which is described in Paragraph 1.a. b. or c. above. 3. This exclusion applies only if you a. Are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages or b. Otherwise provide or permit a person to bring alcoholic beverages on your premises for consumption on your premises or make available alcoholic beverages as a regular part of your business or operations otherwise covered by this policy. Infringement Of Copyright Patent Trademark or Trade Secret Exclusion i. Infringement of Copyright Patent Trademark or Trade Secret of Section Coverages Coverage B. 2. Exclusions is deleted and entirely replaced with the following i. Infringement Of Copyright Patent Trademark or Trade Secret Claims arising out of the infringement of copyright patent trademark trade name trade dress trade secret or other intellectual property rights. D. Itis agreed that SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS is changed as follows 1. Item 4. Other Insurance is deleted and entirely replaced by the following 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages Aor B of this Coverage Part our obligations are limited as follows a. This insurance is excess over any other insurance whether the other insurance is stated to be primary pro rata contributory excess contingent umbrella or on any other basis unless the other insurance is issued to the named insured shown in the Declarations of this Coverage Part and is written explicitly to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. b. When this insurance is excess we will have no duty under Coverage A or B to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be entitled to the insured s rights against all those other insurers. c. When this insurance is excess over other insurance we will pay only our share of the amount of loss if any that exceeds the sum of 1 The total amount that all such other insurance would pay for the loss in the absence of this insurance and CGL 1701 0316 Page 3 of 5 Includes copyrighted material of Insurance Services Office Inc. used with its permission.
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CGL 1701 0316 2 The total of all deductible and self insured amounts under all that other insurance. 2. Item 5. Premium Audit is deleted and entirely replaced by the following 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period. Audit premiums are due and payable on notice to the first Named Insured. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium we will return the excess to the first Named Insured.. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. d. Any premium to be returned under b. above is subject to the minimum premium shown in the Declarations page as applicable to this Coverage Part. 3. Item 9. When We Do Not Renew is deleted in its entirety and is not replaced. E. ltis agreed that the following changes are made to SECTION V DEFINITIONS The following definitions are deleted and entirely replaced 1. Item 5. Employee is deleted in its entirety and replaced by the following 5. Employee includes a leased worker a temporary worker and a volunteer worker. 2. Item 9. Insured contract is deleted in its entirety and replaced by the following 9. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract b. A sidetrack agreement c. Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality e. An elevator maintenance agreement f. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 Thatindemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing 2 That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or 3 Under which the insured if an architect engineer or surveyor assumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. 4 That indemnifies another for the sole negligence of such other person or organization. CGL 1701 0316 Includes copyrighted material of Insurance Services Office Inc. used with its permission. Page 4 of 5
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CGL 1701 0316 3. Iltem 13 Occurrence is deleted in its entirety and replaced with the following 13. Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. All bodily injury or property damage arising out of an occurrence or series of related occurrences is deemed to take place at the time of the first such damage or injury even though the nature and extent of such damage or injury may change and even though the damage may be continuous progressive cumulative changing or evolving and even though the occurrence causing such bodily injury or property damage may be continuous or repeated exposure to substantially the same general harmful conditions. 4. Iltem 14. Personal and advertising injury is deleted in its entirety and replaced with the following 14. Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution c. The wrongful eviction from or the wrongful entry into or the invasion of the right of private occupancy of a room dwelling or premises that a person occupies provided that such wrongful eviction wrongful entry or invasion of the right of private occupancy was committed by or on behalf of the room s dwelling s or premises owner landlord or lessor. d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services. 5. Item 17. Property Damage is deleted in its entirety and replaced with the following. 17. Property damage means a. Physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance electronic data is not tangible property. As used in this definition electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMS tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. For the purposes of this insurance property damage is not physical injury to tangible property any resultant loss of use of tangible property nor loss of use of tangible property that is not physically injured that arises out of failure to complete or abandonment of your work. 6. Item 20. Volunteer worker is deleted in its entirety and replaced with the following 20. Volunteer worker means a person who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other compensation by you or anyone else for their work performed for you. All other terms and conditions of this policy remain unchanged. CGL 1701 0316 Includes copyrighted material of Insurance Services Office Inc. used with its permission. Page 50f 5
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CGL 1711a 0416 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CLASSIFICATION AND LOCATION LIMITATION ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. The following is added to Section Coverages Coverage A Bodily Injury and Property Damage Liability paragraph 1. Insuring Agreement paragraph b. The bodily injury or property damage coverage under this insurance is strictly limited to the classifications codes and scheduled locations listed on the Commercial General Liability Coverage Declarations page and its endorsements or supplements. B. The following is added to Section Coverages Coverage B Personal and Advertising Injury Liability paragraph 1. Insuring Agreement sub paragraph b. The personal and advertising injury coverage under this insurance is strictly limited to the classifications and codes and scheduled locations listed on the Commercial General Liability Coverage Declarations page and its endorsements or supplements. No coverage is provided for operations not included within the classification shown on the Commercial General Liability Declarations its endorsements or supplements for bodily injury property damage personal and advertising injury or medical payments. No coverage is provided for locations which are not shown on the Commercial General Liability Coverage Declarations page its endorsements or supplements for bodily injury property damage personal and advertising injury or medical expenses. This limitation does not apply to bodily injury property damage personal and advertising injury or medical expenses resulting from 1. Work done at your customers location if the operations are shown on the Commercial General Liability Coverage Declarations its endorsements or supplements or 2. Necessary and incidental operations that are directly related to the operations shown on the Commercial General Liability Coverage Declarations its endorsements or supplements. C. Paragraph 3. of Section Il Who is an Insured is deleted in its entirety and is not replaced. All other terms and conditions of this policy remain unchanged. CGL 1711a 0416 Page 1 of 1
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CGL 1793 0114 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION AIRCRAFT AUTO OR WATERCRAFT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM Item g. Aircraft Auto or Watercraft of paragraph 2. Exclusions of Section Coverages Coverage A Bodily Injury or Property Damage Liability is deleted in its entirety and replaced with the following This insurance does not apply to g. Aircraft Auto Or Watercraft 1 Bodily injury or property damage arising out of a Ownership maintenance use or entrustment to others of any aircraft auto or watercraft or b Liability of any insured for the acts of another whether or not statutorily imposed that arise from the actions of any entity s use of an aircraft auto or watercraft Use includes operation and loading and unloading 2 This exclusion applies even if the claim alleges negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by any insured or any other entity working on behalf of any insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft. 3 This exclusion does not apply to a A watercraft while ashore on premises you own or rent or b Bodily injury or property damage arising out of i. The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged or ii. The operation of any of the machinery or equipment listed in paragraph f.2 or f.3 of the definition of mobile equipment Al other terms and conditions of this policy remain unchanged. CGL 1793 0114 Page 1 of 1 Includes copyrighted material of Insurance Services Office Inc. used with its permission.
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CIL 1507 0713 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CHANGES DEFENSE COSTS AND INDEMNITY PAYMENTS This endorsement modifies insurance provided under the following AUTO DEALERS COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL LIABILITY UMBRELLA COVERAGE FORM COMMERCIAL PROPERTY COVERAGE PART LEGAL LIABILITY COVERAGE FORM GARAGE COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM A. The provisions of Paragraph B. are added to all Insuring Agreements that set forth a duty to defend under 1. 2. 3. 4 5. Section of the Commercial General Liability Coverage Form Commercial Liability Umbrella Coverage Form Liquor Liability Coverage Form Owners and Contractors Protective Liability Coverage Form Products Completed Operations Coverage Form and Railroad Protective Liability Coverage Form Section Il under the Auto Dealers Coverage Form and the Garage Coverage Form Section Ill under the Auto Dealers Coverage Form Section Ill A. Coverage under the Garage Coverage Form and Section A. Coverage under the Legal Liability Coverage Form B. If we initially defend an insured insured or pay an insured s insured s defense but later determine that the claims is are not covered under this insurance we will have the right to reimbursement for the defense costs and any uncovered indemnity payments we have incurred when permitted by state law. The right to reimbursement for the defense costs and any uncovered indemnity payments under this provision will only apply to defense costs we have incurred after we notify you in writing that there may not be coverage and that we are reserving our rights to terminate the defense and seek reimbursement for defense costs and any uncovered indemnity payments when permitted by state law. All other terms and conditions of this policy remain unchanged. CIL 1507 0713 Page 1 of 1 Includes copyrighted material of Insurance Services Office Inc. used with its permission.
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IL 00 21 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply A. Under any Liability Coverage to bodily injury or property damage 1 With respect to which an insured under 2 the policy is also an insured under a nuc lear energy liability policy issued by Nuclear Energy Liability Insurance Association Mu tual Atomic Energy Liability Underwriters Nuclear Insurance Association of Canada or any of their successors or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability or Resulting from the hazardous properties of nuclear material and with respect to which a any person or organization is re quired to maintain financial protection pur suant to the Atomic Energy Act of 1954 or any law amendatory thereof or b the in sured is or had this policy not been issued would be entitled to indemnity from the United States of America or any agency thereof under any agreement entered into by the United States of America or any agency thereof with any person or organi zation B. Under any Medical Payments coverage to expenses incurred with respect to bodily in jury resulting from the hazardous properties of nuclear material and arising out of the op eration of a nuclear facility by any person or organization. C. Under any Liability Coverage to bodily injury or property damage resulting from hazard ous properties of nuclear material if 1 The nuclear material a is at any nuclear facility owned by or operated by or on be half of an insured or b has been dis charged or dispersed therefrom 2 The nuclear material is contained in spent fuel or waste at any time pos sessed handled used processed stored transported or disposed of by or on behalf of an insured or The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nuc lear facility but if such facility is located within the United States of America its terri tories or possessions or Canada this ex clusion 3 applies only to property dam age to such nuclear facility and any property thereat. 3. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source material spe cial nuclear material or by product material. C. Under any Liability Coverage to bodily injury or property damage resulting from hazard ous properties of nuclear material if 1 The nuclear material a is at any nuclear facility owned by or operated by or on be half of an insured or b has been dis charged or dispersed therefrom 2 The nuclear material is contained in spent fuel or waste at any time pos sessed handled used processed stored transported or disposed of by or on behalf of an insured or 3 The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nuc lear facility but if such facility is located within the United States of America its terri tories or possessions or Canada this ex clusion 3 applies only to property dam age to such nuclear facility and any property thereat.. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source material spe cial nuclear material or by product material. IL 00 21 09 08 ISO Properties Inc. 2007 Page 1 of 2 m
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Source material special nuclear material and by product material have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. Spent fuel means any fuel element or fuel com ponent solid or liquid which has been used or ex posed to radiation in a nuclear reactor Waste means any waste material a containing by product material other than the tailings or wastes produced by the extraction or concentra tion of uranium or thorium from any ore processed primarily for its source material content and b resulting from the operation by any person or or ganization of any nuclear facility included under the first two paragraphs of the definition of nuc lear facility. Nuclear facility means a Any nuclear reactor b Any equipment or device designed or used for 1 separating the isotopes of uranium or plutonium 2 processing or utilizing spent fuel or 3 handling processing or packag ing waste c Any equipment or device used for the processing fabricating or alloying of spe cial nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of pluto nium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 Any structure basin excavation premises or place prepared or used for the storage or disposal of waste and includes the site on which any of the foregoing is located all operations conducted on such site and all premises used for such operations. Nuclear reactor means any apparatus designed or used to sustain nuclear fission in a self supporting chain reaction or to contain a critical mass of fissionable material Property damage includes all forms of radioac tive contamination of property. Page 2 of 2 ISO Properties Inc. 2007 IL 00 21 09 08 m
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IL014709 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ILLINOIS CHANGES CIVIL UNION This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. The term spouse is replaced by the following Spouse or party to a civil union recognized under lllinois law. B. Under the Commercial Auto Coverage Part the term family member is replaced by the following Family member means a person related to the 1. Individual Named Insured by blood adoption marriage or civil union recognized under lllinois law who is a resident of such Named Insured s household including a ward or foster child or 2. Individual named in the Schedule by blood adoption marriage or civil union recognized under lllinois law who is a resident of the individual s household including a ward or foster child if the Drive Other Car Coverage Broadened Coverage For Named Individual Endorsement is attached. C. With respect to coverage for the ownership maintenance or use of covered autos provided under the Commercial Liability Umbrella Coverage Part the term family member is replaced 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. IL014709 11 Insurance Services Office Inc. 2011 Page 10f 1
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FIRST MERCURY INSURANCE COMPANY ASTOCK COMPANY STATUTORY HOME OFFICE 200 SOUTH WACKER DRIVE SUITE 2390 CHICAGO IL 60606 ADMINISTRATIVE OFFICE 26600 TELEGRAPH RD. SOUTHFIELD MI 48033 GENERAL LIABILITY POLICY DECLARATIONS Serviced by CoverX Specialty POLICY NUMBER IL CGL0000044657 01 RENEWAL OF NEW NAMED INSURED AND MAILING ADDRESS BROKER NAME AND ADDRESS Kinseth Construction Services LLC R T Specialty LLC Kansas City 808 Hwy 18 East PO Box 25 1100 Walnut Street Suite 3200 Clear Lake IA 50428 Kansas City MO 64106 POLICY PERIOD From 6172014 To 6172015 AT 1201 AM. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE IN RETURN FOR THE PAYMENT OF THE PREMIUM AND SUBJECT TO ALL THE TERMS OF THIS POLICY WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. LIMITS OF INSURANCE Defense Costs are outside the limits of Liability Each Occurrence Limit 1000000 Employee Benefits Liability Excluded Personal Advertising Injury Limit 1000000 Employee Benefits Aggregate Limit Excluded General Aggregate Limit 2000000 Liquor Liability Limit Excluded Products Completed Operations Aggregate Limit 2000000 Liquor Liability Aggregate Excluded Damage To Premises Rented To You 50000 Medical Payment Limit Excluded Employee Benefits Liability Excluded Employee Benefits Aggregate Limit Excluded Liquor Liability Limit Excluded Liquor Liability Aggregate Excluded RETAINED LIMIT See form FMIC GL 2015 0114 PREMIUM COMPUTATION Premium 23700 Inspection Fee 250 Coverage for certified acts of terrorism has been rejected exclusion attached. X Per TRIA Disclosure Notice. DEPOSIT PREMIUM 23700 DESCRIPTION OF BUSINESS Contrs sub work in connect w cnstr recnstr repair or erection of bldg FORM OF BUSINESS INDIVIDUAL PARTNERSHIP ORGANIZATION INCLUDING A CORPORATION BUT NOT JOINT VENTURE LIMITED PARTNERSHIP INCLUDING A PARTNERSHIP JOINT VENTURE OR LIMITED X LIMITED LIABILITY COMPANY LIABILITY COMPANY ENDORSEMENTS ATTACHED TO THIS POLICY See Schedule FMIC END Schedule of Forms and Endorsements This policy is issued pursuant to lowa Code section 515.120 by a nonadmitted company in lowa and as such is not covered by the lowa Insurance Guaranty Association. Inspection Fee 250 RSHIP A ADA NI nan nan nan nan 11.0 1.0 IMPORTANT Please carefully examine your policy as it may contain significant coverage modifications or exclusions. If this policy is a renewal it may not contain the same precise terms and conditions as the prior policy. Date 6302014 Authorized Representative THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS AND COVERAGE FORMS AND ANY ENDORSEMENTS COMPLETE THE ABOVE NUMBERED POLICY. FMIC GL DS0001 1210 NO FLAT CANCELLATIONS
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EXTENSION OF DECLARATIONS Policy Number IL CGL0000044657 01 Location of Premises 1 6620 STAGECOACH DRIVE WEST DES MOINES IOWA 50266 Classification and Premium Exposure Basis Exposure Amr Subcontracted Cost 7900000 Exposure Amount 7900000 Rate Deposit Premium 3.0000 Per 1000 23700 of Subcontracted subject to 23700 Cost minimum premium FMIC GL DS EXT 1210
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Insured Kinseth Construction Services LLC Policy Number IL CGL0000044657 01 SCHEDULE OF FORMS AND ENDORSEMENTS other than applicable forms shown elsewhere in the policy Forms and Endorsements applying to and made part of this policy at the time of issuance CG 0001 1207 COMMON POLICY CONDITIONS IL.00 17 1198 COMMERCIAL GENERAL LIABILITY COVERAGE FORM FMIC LEGAL 0414 SERVICE OF SUIT CG 00 68 0509 CG 20 10 0413 CG 20 37 0413 CG 2135 1001 CG 21 44 0798 CG 2147 1207 CG 21 49 0999 CG 2154 0196 CG 2167 1204 CG 2186 1204 CG 22 43 0798 CG 24 04 1093 CG 24 26 0413 RECORD AND DISTRIBUTE OF MATERIAL IN VIOLATION Al OWNERS LESSEES OR CONTRACTORS SCHED PERSON ORG Al OWNERS LESSEES OR CONTRACTORS COMP OPS EXCLUSION COVERAGE C MEDICAL PAYMENTS LIMITATION OF COVERAGE TO DESIGNATED PREMISES OR PROJECT EMPLOYMENT RELATED PRACTICES EXCLUSION TOTAL POLLUTION EXCLUSION ENDORSEMENT EXCL DESG OP COVERED BY CONSOLIDATED WRAP UPS FUNGI OR BACTERIA EXCLUSION EXCLUSION EXTERIOR INSULATION AND FINISH SYSTEMS EXCL ENGINEERS ARCHITECTS OR SURVEYORS PROFESSIONAL WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS AMENDMENT OF INSURED CONTRACT DEFINITION FMIC GL 2009 0514 SPECIAL CONDITIONS FOR SUBCONTRACTORS INCL DED FMIC GL 2010 FMIC GL 2011 FMIC GL 2015 FMIC GL 2077 FMIC GL 2088 FMIC GL 2138 FMIC GL 2163 FMIC GL 2172 FMIC GL 2203 FMIC GL 2337 IL 00 21 0908 0512 0711 0514 0812 EXTENDED REPAIR WORK COVERAGE ENDORSEMENT NUCLEAR ENERGY LIAB EXCL ENDST 0114 CROSS SUITS ENDORSEMENT 0411 CONTINUOUS OR PROGRESSIVE INJURY AND DAMAGE EXCL 0114 POLICY DEDUCTIBLE ENDORSEMENT 0411 0212 0812 EXTENSION OF COVERAGE PRODUCTS COMPLETED OPS HAZARDOUS MATERIALS EXCLUSION EXCLUSION PUNITIVE OR EXEMPLARY DAMAGES MINIMUM EARNED PREMIUM ENDORSEMENT EXCLUSION OF TERRORISM BASIS OF PREMIUM ENDORSEMENT FMIC CLAIM NOTIFICATION 122006 Schedule FMIC END 1210 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 0001 1207 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 Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section Ill Limits Of Insurance and 2 Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 The bodily injury or property damage occurs during the policy period and Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. c. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. d. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim 1 Reports all or any part of the bodily injury or property damage to us or any other insurer 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 bodily injury or property damage has occurred or has begun to occur. 3 3 CG 00011207 1SO Properties Inc. 2006 Page1 of 16
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e. Damages because of bodily injury include damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. 2. Exclusions This insurance does not apply to a. Expected Or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Contractual Liability Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the absence of the contract or agreement or 2 Assumed ina contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that partys defense has aso been assumed in the same insured contract and Such altome fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. 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 under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribuon or use of alcoholic beverages. This exclusion applies only if you are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages. d. Workers Compensation And Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law. e. Employer s Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a Employmentby the insured or b Performing duties related to the conduct of the insured s business or 2 The spouse child parent brother or sister of that employee as a consequence of Paragraph 1 above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. CG 00011207 1SO Properties Inc. 2006 Page2 of 16
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f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a At or from any premises site or location which is or was at any time owned or occupied by or rented or loaned to any insured. However this subparagraph does notapply 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 policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not and never was owned or occupied by or rented or loaned to any insured other than that additional insured or Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire b Ator from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste Which are or were at any time transported handled stored treated disposed of or processed as waste by or for i Anyinsured or ii Any person or organization for whom you may be legally responsible or c d At or fom any premises site or location on which any insured or any contractors or subcontractors working directly or indirecty on any insured s behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by such insured contractor or subcontractor. However this subparagraph does not apply to Bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or released as part of the operations being performed by such insured contractor or subcontractor i Bodily injury or property damage sustained within a buildng and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by acontractor or subcontractor or i Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e At or fom any premises site or location on which any insured or any contractors or subcontractors working directly or indirecty on any insured s behalf are performing operations if the operations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. CG 00011207 1SO Properties Inc. 2006 Page3 of 16
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2Any loss cost or expense arising out of any a Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such clam or suit by or on behalf of a govemnmental authority. g. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for acharge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or b utof any r or statutory or hat any insured iitor clean up t detoxify or y respond to or llutants or on behalf of a for damages or monitoring g containing eutralizing or in or assessing the es not apply to 1se of property ould have in the emand order or rement or such n behalf of a age arising out ance use or ircraft auto or by or rented or ludes operation if the claims ligence or other ision hiring ring of others by which caused perty damage enance use or ircraft auto or operated by or o n premises you that is nd rry persons or 1 the ways next nt provided the ented or loaned any insured maintenance or or 3 5 Budlly injury or property damage arising out of The operaton of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged or the operation of any of the machinery or equipment listed in Paragraph f2 or f.3 of the definition of mobile equipment. b h. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. i. War Bodily injury or property damage however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. j. Damage To Property Property damageto 1 Property you own rent or occupy including any costs or expenses incurred by you or any other person organization or entity for repair replacement enhancement restoration or maintenance of such property for any reason including prevention of injury to a person or damage to another s property 2 Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Propertyloaned to you 4 Personal property in the care custody or control of the insured 1SO Properties Inc. 2006 Page40f 16 CG 00011207 Page40f 16
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5That particular partof real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the property damage arises out of those operations or That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section Il Limits Of Insurance. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard. Damage To Your Product Property damage to your product arising out ofit or any part of it. Damage To Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. 6. Damage To Impaired Property Or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 A defect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use.. Recall Of Products Work Or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition init.. Personal And Advertising Injury Bodily injury arising out of personal and advertising injury.. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMS tapes drives cells data processing devices or any other media which are used with electronically controlled equipment.. Distribution Of Material In Violation Of Statutes Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law or 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law or 3 Any statute ordinance or regulation other than the TCPA or CAN SPAM Act of 2003 that prohibits or limits the sending transmitting communicating or distribution of material or information. CG 00011207 1SO Properties Inc. 2006 Page50f16
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Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section Il Limits Of Insurance. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of personal and advertising injury to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for personal and advertising injury to which this insurance does not apply. We may at our discretion investigate any offense and settle any claimor suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and 2 Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or setlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to personal and advertising injury caused by an offense arising out of your business butonly 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 knowledge that the act would violate the rights of another and would inflict personal and advertising 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 knowledge of its falsity. c. 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. d. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured e. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement. f. Breach Of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s advertising idea in your advertisement. g. Quality Or Performance Of Goods Failure To Conform To Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your advertisement. h. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. i. Infringement Of Copyright Patent Trademark Or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trademark trade secret or other intellectual property rights. Under this exclusion such other intellectual property rights do not include the use of another s advertising idea in your advertisement. However this exclusion does not apply to infringement in your advertisement of copyright trace dress or slogan. j Insureds In Media And Internet Type Businesses Personal and advertising injury committed by an insured whose businessiis 1 Advertising broadcasting publishing or telecasting 2 Designing or determining content of web sites for others or CG 00011207 1SO Properties Inc. 2006 Page 6 of 16
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3 An Internet search access content or service provider. However this exclusion does not apply to Paragraphs 14.a. b. and c. of personal and advertising injury under the Definitions Section. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the insured hosts owns or over which the insured exercises control. Unauthorized Use Of Another s Name Or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain name or metatag or any other similar tactics to mislead another s potential customers. m. Pollution Personal and advertising injury arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants atany time. n. Pollution Related Any loss cost or expense arising out of any 1 Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. o. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or 3 Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. p. Distribution Of Material In Violation Of Statutes Personal and advertising injury arising directly or indirectly out of any action or omission thatviolates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law or 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law or 3 Any statute ordinance or regulation other than the TCPA or CAN SPAM Act of 2003 that prohibits or limits the sending transmitting communicating or distribution of material or information. COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for bodly injury caused by an accident 1 On premises you own or rent 2 On ways rext to premises you own or rent or 3 Because do your operations provided that The accident takes place in the coverage territory and during the policy period b The expenses are incurred and reported to us within one year of the date of the accident and c The injured person submits to examimation at our expense by physicians of our choice as often as we reasorably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for 1 First aid administered at the time of an accident 2 Necessary medical surgical x ray and dental services including prosthetic devices and 3 Necessary ambulance hospital professional nursing and funeral services. CG 00011207 1SO Properties Inc. 2006 Page 7 of 16
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2. Exclusions We will not pay expenses for bodily injury a. Any Insured To any insured except volunteer workers. b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d. Workers Compensation And Similar Laws To a person whether or not an employee of any insured if benefits for the bodily injury are payable or must be provided under a workers compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing instructing or participating in any physical exercises or games sports or athletic contests. f. Products Completed Operations Hazard Included within the products completed operations hazard. g. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS COVERAGES A AND B 1. We will pay with respect to any claim we investigate or setle 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 fumish 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 fumish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit including actual loss of eamings up to 250 a day because of time off from work. e. All court costs taxed against the insured in the suit. However these payments do not include attorneys fees or attorneys expenses taxed against the insured. f. Prejudgment irterest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment interest based on that period of time after the offer. g. Al interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or deposited in cout the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance.. If we defend an irsured 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 aginst the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement thatis an insured contract b. This insurance applies to such liability assumed by theinsured c. The obligation to defend or the cost of the defense of tha indemnitee has also been assumed by the insured in the same insured contract. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee e. The indemnitee and the insured ask us to conduct and contol the defense of that indemnitee against such suit and agree that we can assign he same counsel to defend the insured and the indemnitee and f. The indemnitee 1 Agrees in witing to a Cooperate with us in the investigation settlement or defense of the suit Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit c Notify any other insurer whose coverage is available to the indemnitee and d Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee and 2 Provides us with written authorization to a Obtain records and other information related to the suit and b CG 00011207 1SO Properties Inc. 2006 Page 8of 16
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bConduct and control the defense of the indemnitee in such suit. So long as the above condtions are met attomeys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2b.2 of Section Coverage A Bodily Injury And Property Damage Liability such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the limits of insurance. Our obligation to defend an insured s indemnitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or setflements or the conditions set forth above or the terms of the agreement described in Paragraph f. above are no longer met. SECTION Il WHOIS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. g 2. Each ofthe following is also an insured a. Your volunteerworkers only while performing duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a partnership joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees or volunteer workers are insureds for 1 Bodily injury or personal and advertising injury a To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company to a coemployee while in the course of his or her employment or performing duties related to the conduct of your business or to your other volunteer workers while performing duties related to the conduct of your bisiness To the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of Paragraph 1a above For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in 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 control of or over which physical control is being exercised for any purpose by you any of your employees volunteer workers any partner or member if you are a partnership or joint venture or any member if you are a limited liability company. b c CG 00011207 1S0 Properties Inc. 2006 Page 9 of 16
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b. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that property and 2 Until your legal representative has been appointed. d. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown asa Named Insured in the Declarations. SECTION lIl LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. 3. The Products Conpleted Operations Aggregate Limit is the most we will pay under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. 4. Subject to Paragrgph 2. above the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all personal and advertising injury sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above whichever applies the Each Qccurrence Limit is the most we will pay for the sumof a. Damages under Coverage A and b. Medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to Paragraph 5. above the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of property damage to any one premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with permission of he owner. 7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustaned by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insdvency of the insured or of the insured s estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence Offense Claim Or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or an offense which may result in a claim. To the extent possible notice should include 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured persons and witnesses and CG 00011207 1SO Properties Inc. 2006 Page 100f 16
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3The nature and location of any injury or damage arising out of the occurrence or offense. b. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent. 3. Legal Action AgainstUs No person or organization has a right under this Coverage Part a. To join us as a party or otherwise bring us into asuit 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 settiement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed setiement means a setfement and release of liability signed by us the insured and the claimant or the claimants legal representative. 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then we wil share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance 1 This insurance is excess over Any of the other insurance whether primary excess contingent or on any other basis i That is Fire Extended Coverage Builder s Risk Installation Risk or similar coverage for your work ii That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner i That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner or iv If the loss arises out of the maintenance or use of aircraft autos or watercraft to the extent not subject to Exclusion g. of Section I Coverage A Bodily Injury And Property Damage Liability. b Any other primarl insurance available to you covering liability for damages arising out of the premises or operations or the products and completed operations for which you have been added as an additional insured by attachment of an endorsement. 2 When this insurance is excess we will have no duty under Coverages A or B to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be entitled to the insured s rights against all those other insurers. Inc. 2006 Page110f16 CG 0001 12 07 1S0 Properties Inc. 2006
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3When this insurance is excess over other c. We insurance we will pay only our share of the your amount of the loss if any that exceeds the 7. Separat sum of Exceptw a The total amount that all such other insurance would pay for the loss in the grg er gg absence of this insurance and insuranc b The total of all deductible and self a. As if insured amounts under all that other Name insurance. b. Seps 4 We will share the remaining loss if any is r1a with any other insurance that is not described in this Excess Insurance 8. Transfe provision and was not bought specifically to To Us apply in excess of the Limits of Insurance If the in shown in the Declarations of this Coverage any payr Part. Part the c. Method Of Sharing insured N. At our If all of the other insurance permits contribution transfer by equal shares we will follow this method them. also. Under this approach each insurer contributes equal amounts until it has paid its 9. WhenW applicable limit of insurance or none of the loss If we dei remains whichever comes first. will mail If any of the other insurance does not permit shown il contribution by equal shares we will contribute nonrene by limits. Under this method each insurer s expiratio share is based on the ratio of its applicable If notice limit of insurance to the total applicable limits of proof of ns.urance of all insurers. SECTION V 5. Premium Audit 1. Adverti a. We will compute all premiums for this or publ Coverage Part in accordance with our rules market and rates. services b. Premium shown in this Coverage Part as supporte advance premium is a deposit premium only. a. Notic At the close of each audit period we wil place compute the earned premium for that period mear and send notice to the first Named Insured. b. Rega The due date for audit and retrospective.. ite premiums is the date shown as the due date gvk on the bill. If the sum of the advance and audit custo premiums paid for the policy period is greater advel than the earned premium we wil return the.. excess to the first Named Insured. 2. Autom c. The first Named Insured must keep records of a. A la the information we need for premium desig computation and send us copies at such imes any as we may request. b. Any 6. Representations COrF By accepting this policy you agree Svtheerr a. Zzzurafteaiengig Ilente the Declarations are Howeve al plete equipme b. Those stattments are based upon representations you made to us and CG 00011207 1SO Properties Inc. 2006 c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this Coverage Part to the first Named Insured this insurance applies a. As if each Named Insured were the only Named Insured and b. Separately to each insured againstwhom claim is made or suit is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover al or part of any payment we have made under this Coverage Part those rights are transferred to us. The insured must do nathing after loss to impair them. At our request the insured will bring suit or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. SECTION V DEFINITIONS 1. Advertisement means a notice that is broadcast or published to the general public or specific market segments aout your goods products or services for the purpose of attracting customers or supporters. For the purposes of this definition a. Notices that are published include material placed on the Internet or on similar electronic means of communication and b. Regarding web sites only that part of a web site that is about your goods products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. Auto means a. A land motor vehicle trailer or semitrailer designed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where itis licensed or principally garaged. However auto does not include mobile equipment. Page 120f 16
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. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time.. Coverage territory means a. The United States of America including its territories and possessions Puerto Rico and Canada b. International waters or airspace but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. aboveor c. All other parts of the world if the injury or damage arises out of 1 Goods or products made or sold by you in the teritory described in Paragraph a. above 2 The activities of a person whose home is in the teritory described in Paragraph a. above but is away for a short time on your businessor 3 Personal and advertising injury offenses that take place through the Internet or similar el ectronic means of communication provided the insured s responsibility to pay damages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to.. Employee includes a leased worker. Employee does not include a temporary worker.. Executive officer means a person holding any of the officer positions created by your charter constitution by laws or any other similar governing document.. Hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be.. Impaired property means tangible property other than your product or your work that can not be usedor is less useful because a. It incorporates your product or your work that is known or thought to be defective deficient inadequate or dangerous or b. You have failed to fulfill the terms of a contract oragreement if such property can be restored to use by the repair replacement adjustment or removal of your product or your work or your fulfilling the terms of the contract or agreement. 9. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract b. Asidetrack agreement c. Any easement o license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality e. An elevator maintenance agreement f. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any rairoad bridge or trestle tracks roadbeds tunnel underpass or crossing That indemnifies an architect engineer or surveyor forinjury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and spedfications or b Giving drections or instructions or failing to give them if that is the primary cause of the injury or damage or 3 Under which the insured if an architect engineer or surveyor assumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. 2 CG 00011207 1SO Properties Inc. 2006 Page 130of 16
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10.Leased worker means a person leased to you by 1 1 oy N 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 watercraft or auto to the place where it is finally delivered but loading or unloading does not include the movement of property by means of a mechanical device other than a hand truck that is not attached to the aircraft watercraft or auto.. Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment a. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads b. Vehicles maintained for use solely on or nextto premises you own or rent c. Vehicles thattravel on crawler treads d. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes showels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers e. Vehicles not described in Paragraph a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types 1 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers Vehicles not described in Paragraph a. b. c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. 13. 14 However selfpropelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos 1 Equipmentdesigned primarily for a Snow removal b Road mantenance but not construction or resurfacing or c Streetcleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and 3 Air compressors pumps and generafors including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered autos. Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution c. The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies committed by or on behalf of its owner landlordor lessor d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services e. Oral or written publication in any manner of material that violates a person s right of privacy f. The use of ancther s advertising idea in your advertisement or g. Infringing upon another s copyright trade dress or slogan in you advertisement. CG 00011207 1SO Properties Inc. 2006 Page 140f 16
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15.Pollutants mean any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals and waste. Waste includes materials to be recycled reconditioned or reclaimed. 16.Products completed operations hazard a. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 Products that are still in your physical possession or 2 Work that has not yet been completed or abandoned. However your work will be deemed completed at the earliest of the following times a When all of the work called for in your contract has been completed. b When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. c When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. b. Does not include bodily injury or property damage arising out of 1 The transportation of property unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you and that condition was created by the loading or unloading of that vehicle by any insured 2 The existence of tools uninstalled equipment or abandoned or unused materials or Products or operations for which the classification listed in the Declarations or in a policy schedule states that products completed operations are subject to the General Aggregate Limit. 17.Property damage means a. Physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or i d gaseous or icluding smoke chemicals and to be recycled izard and property 1 premises you your product or your physical n completed or r work will be earliest of the alled for in your eted. be done at the npleted if your t more than one rk done ata job ntended use by tion other than subcontractor ject. e maintenance ment but which be treated as y or property erty unless the of a condition in or operated by created by the t vehicle by any s uninstalled d or unused for which the eclarations or in that products subject to the perty including at property. All med to occur at at caused it or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. For the purposes d this insurance electronic data is not tangible property. As used in this definifion 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 contraled equipment. 18.Suit means a civil proceeding in which damages because of bodily injury property damage or personal and advertising injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 19.Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. 20.Volunteer worker means a person who is not your employee and who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other compensation by you or anyone else for their work performed for you. 21.Your product a. Means 1 Any goods or products other than real property manufactured sold handled distributed or disposed of by a You b Others trading under your name or A person or organization whose business or assets you have acquired and 2 Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 1SO Properties Inc. 2006 Page 150f 16 CG 00011207 Page 150f 16
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2 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 22.Your work a. Means 1 Work or operations performed by you or on your behalf and 2 Materials parts or equipment fumished in connection with such work or operations. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your work and 2 The providing of or failure to provide warnings or instructions. CG 00011207 1SO Properties Inc. 2006 Page 160f 16
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IL00 171198 A. D. COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. Cancellation 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 written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment 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 effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy s terms can be amended or waived only by endorsement issued by us and made a part of this policy. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. Inspections And Surveys 1. Wehave the right to a. Make inspections and surveys at any time b. Give you reports on the conditions we find and c. Recommend changes. 2. We are not obligated to make any inspections surveys reports or recommendations and any such actions we do undertake relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions a. Are safe or healthful or b. Comply with laws regulations codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us but also to any rating advisory rate service or similar organization which makes insurance inspections surveys reports or recommendations.. 4. Paragraph 2. of this condition does not apply to any inspections surveys reports or recommendations we may make relative to certification under state or municipal statutes ordinances or regulations of boilers pressure vessels or elevators. E. Premiums The first Named Insured shown in the Declarations 1. Is responsible for the payment of all premiums and 2. Wil be the payee for any return premiums we pay. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. sements between you ce afforded The stt 1L0017 1198 Page1of1 Copyright Insurance Services Office Inc. 1998
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SERVICE OF SUIT The Company agrees that in the event of its failure to pay any amount claimed to be due hereunder the Company at the request of the Insured will submit to the jurisdiction of any court of competent jurisdiction within the United States of America and will comply with all requirements necessary to give such Court jurisdiction and all matters arising hereunder shall be determined in accordance with the law and practice of such Court. The Company hereby designates the Commissioner Director or Superintendent of Insurance or other officer specified by law for that purpose or his successor or successors in office or the person designated below in the space indicated as its true and lawful attorney upon whom may be served any lawful process in any action suit or proceeding instituted by or on behalf of the Insured arising out of this contract of insurance. It is further agreed that the Company shall abide by the final decision of any court having jurisdiction in which such action is filed or by the decision of any appellate court in the event of an appeal. Upon receipt of process served hereunder the Company hereby designates Wendy Drum Legal Department 26600 Telegraph Road Southfield Michigan 48033 as the person to whom the officer designated above is authorized to mail such process. In the alternative process may be served upon the authorized agent of the Company whose name and address are FIRST MERCURY INSURANCE COMPANY 26600 TELEGRAPH RD. SOUTHFIELD MICHIGAN 48033 FMIC LEGAL 042014
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RECORDING AND DISTRIBUTION OF MATERIAL OR INFORMATION IN VIOLATION OF LAW EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion q. of Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following 2. Exclusions This insurance does not apply to q. Recording And Distribution Of Material Or Information In Violation Of Law Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or additon to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transaction Act FACTA or Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collect ing recording sending transmitting communicating or distribution of material or information. B. Exclusion p. of Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability is replaced by the following 2. Exclusions This insurance does not apply to p. Recording And Distribution Of Material Or Information In Violation Of Law Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to violate The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law The CAN SPAM Act of 2003 including any amendment of or additon to such law The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transaction Act FACTA or Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collect ing recording sending transmiting communicating or distribution of material or information. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. This endorsement forms a part of the Policy to which attached effective on the inception date of the Policy unless otherwise stated herein. The following information s required only when this endorsement is issued subsequent to preparation of the Policy. Endorsement effective Policy No. Endorsement No. Named Insured Countersigned by CG 00 68 05 09
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POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Locations Of Covered Operations Mills Civic Hotel Associates LLC 2 Quail Creek Cir North Liberty 1A 52317 Information required to complete this Schedule if notshown above will be shown in the Declarations. A. Sectionll WhoIs An Insured is amended to include as an add itional insured the person s or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by 1. Your acts or omissions or 2. The acts or omissions of those acting on your behalf inthe performance of your ongoing operations for the additional insureds at the locations designated above. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. Ifcoverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will notbe broader thanthat which you are required by the contract or agreement to provide for such add itional insured. CG20100413 Insurance Services Office Inc. 2012 B. With respectto the insurance afforded to these additional insureds the following additional exclusions apply This insurance does not apply to bodily injury or property damage occurring after 1. Allwork including materials parts or equipment furnished in connection with such work on the project other than service maintenance or repairs to be performed by or on behalf of the additional insureds at the location of the covered operations has been completed or 2. That portion of your wo rk out of which the injury or damage arises has been put to its intended use by any person or organiz ation other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Page 1 of 2 Quail Creek Cir rth Liberty I1A 52317 Page 1 of 2
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C. With respect to the insurance afforded to these additional insureds the following is added to Section Ill Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG20100413 Insurance Services Office Inc. 2012 Page 2of 2
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POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 20370413 ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS COMPLETED OPERATIONS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Location And Description Of Completed Operations IAs required by written contract signed by both parties lprior to the loss. overage under this endorsement applies only to Commercial onstruction. Commercial Construction means all construction activity that s ot Residential Construction. Residential Construction means all construction activity erformed on townhouses condominiums cooperatives uplexes triplexes fourplexes and single family detached ousing that is intended to be will be or is maintained or sold or the purpose of being used by natural persons as a dwelling. ind includes any associated improvements to real property infrastructure improvements grading excavating utility work oad paving curb or sidewalk work. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury or property damage caused in whole or in part by your work at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the products completed operations hazard. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following is added to Section Il Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the addtional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. CG20370413 Insurance Services Office Inc. 2012 Page 10f 1
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POLICY NUMBER IL CGL0000044657 01 COMMERCIAL GENERAL LIABILITY CG 213510 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION COVERAGE C MEDICAL PAYMENTS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description And Location Of Premises Or Classification All Locations and All Operations If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. 2. The following is added to Section Supplementary Payments h. Eaenses incurred the insured for first aid administered to others at the time of an accident for bodily injury to which this insurance applies. With respect to any premises or classification shown in the Schedule 1. Section Coverage C Medical Payments does not apply and none of the references to it in the Coverage Part apply and Loctons and All Operations 2. The following is added to Section Supplementary Payments h. Eaenses incurred the insured for first aid administered to others at the time of an accident for bodily injury to which this insurance applies. CG 21351001 SO Properties Inc. 2000 Page 10f 1
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POLICY NUMBER IL CGL0000044657 01 COMMERQAL GENERAL LIABILITY CG 2144 0798 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITATION OF COVERAGE TO DESIGNATED PREMISES OR PROJECT This endorsement modifies nsurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Premises 6620 Stagecoach Drive West Des Moines IA 50266 Project Construction of a 5 story 102 unit hotel building If no entry appears aboe information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. This insurance applies only to bodily injury property damage personal and advertising injury and medical expensesarising out of 1. The ownership maintenance or use of the premises shown in the Schedule and operations necessary or incidental to those premises or 2. Theproject shown inthe Schedule. CG 214407 98Copyright Insurance Services Office Inc. 1997 Page 10f 1 Page 10f 1
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COMMERCIAL GENERAL LIABILITY CG 21471207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYMENT RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability This insurance does not apply to Bodily injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demotion evaluation reassignment discipline defamation harassment humiliation discrimination or malicious prosecution directed at that person or 2 The spouse child parent brother or sister of that person as a consequence of bodily injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after employment of that person Whether the insured may be liable as an employer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability This insurance does not apply to Personal and advertising injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demotion evaluation reassignment discipline defamation harassment humiliation discrimination or malicious prosecution directed at that person or 2 The spouse child parent brother or sister of that person as a consequence of personal and advertising injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after employment of that person 2 Whether the insured may be liable as an employer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. CG 21471207 ISO Properties Inc. 2006 Page1of1
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COMMERCIAL GENERAL LIABILITY CG 2149 09 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion f. under Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following This insurance does not apply to f. Pollution 1 Bodily injury or property damage which would not have occurred in whole or part but for the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants at any time. 2 Any loss cost or expense arising out of any a b Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. CG 2149 09 99 Copyright Insurance Services Office Inc. 1998 Page1of1
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POLICY NUMBER IL CGL0000044657 01 COMMERCIAL GENERAL LIABILITY CG 21540196 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION DESIGNATED OPERATIONS COVERED BY A CONSOLIDATED WRAP UP INSURANCE PROGRAM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description and Location of Operations Every project where coverage is being provided under a consolidated or wrap up program If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. The following exclusion is added to paragraph 2. Exclusions of COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY Section 1 Coverages This insurance does not apply to bodily injury or property damage arising out of either your ongoing operations or operations included within the products completed operations hazard at the location described in the Schedule of this endorsement as a consolidated wrap up insurance program has been provided by the prime contractor project manager or owner of the construction project in which you are involved. This exclusion applies whether or not the consolidated wrap up insurance program 1 Provides coverage identical to that provided by this Coverage Part 2 Has limits adequate to cover all claims or 3 Remains in effect. This exclusion applies whether or not the consolidated wrap up insurance program 1 Provides coverage identical to that provided by this Coverage Part 2 Has limits adequate to cover all claims or 3 Remains in effect. CG 21 54 0196 Copyright Insurance Services Office Inc. 1994 Page 10of 1
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COMMERCIAL GENERAL LIABILITY CG 21671204 FUNGI OR BACTERIA EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Bodily injury or property damage which would not have occurred in whole or in part but for the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed concurrently or in any sequence to such injury or damage. b. Any loss cost or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. This exclusion does not apply to any fungi or bacteria that are are on or are contained in a good or product intended for bodily consumption. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Personal and advertising injury which would not have taken place in whole or in part but for the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed concurently or in any sequence to such injury. b. Any loss cost or expense arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing reme diating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. C. The following definition is added to the Definitions Section Fungi means any type or form of fungus including mold or midew and any mycotoxins spores scents or byproducts produced or released by fungi. aragraph 2. A Bodily 1age which vhole or in alleged or gestion of tence of or cteria on or ncluding its r any other r product y sequence ising out of ng cleaning treating ediating or y any other B. The Excl Pers 2. E PR CG 21 67 1204 ISO Propetties Inc. 2003 Page 1of 1
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