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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 4 Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or 5 Bodily injury or property damage arising out of a The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definition 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 preamanged 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 Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you b 3 2 Page 4 of 16 Insurance Services Office Inc. 2012 CG 00010413
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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 Advei ng 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 The CAN SPAM Act of 2003 including any amendment of or addition to such law 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 2 3 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 settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and Our right and duty to defend 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 2. Exclusions This insurance does not apply to a.. Contractual Liabili 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. Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement.. Breach Of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s advertising idea in your advertisement.. Quality Or Performance Of Goods Failure To Conform To Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your advertisement.. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Page 6 of 16 Insurance Services Office Inc. 2012 CG 00010413
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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. 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 at any time. n. Pollution related Any loss cost or expense arising out of any 1 Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. o. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. p. Recording And Distribution Of Material Or Information In Violation Of Law Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or 4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. 3 3 CG 00010413 Insurance Services Office Inc. 2012 Page 7 of 16
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COVERAGE C MEDICAL PAYMENTS. Insuring Agreement a. We will pay medical expenses as described below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that a The accident takes place in the coverage territory and during the policy period b The expenses are incurred and reported to us within one year of the date of the accident and c The injured person submits to examination at our expense by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for 1 First aid administered at the time of an accident 2 Necessary medical surgical X ray and dental services including prosthetic devices and 3 Necessary ambulance hospital professional nursing and funeral services. 2. Exclusions We will not pay expenses for bodily injury a. Any Insured To any insured except volunteer workers. b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d. Workers Compensation And Similar Laws To a person whether or not an employee of any insured if benefits for the bodily injury are payable or must be provided under a workers compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing instructing or participating in any physical exercises or games sports or athletic contests. f. Products Completed Operations Hazard Included within the products completed operations hazard. g. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS COVERAGES A AND B 1. We will pay with respect to any claim we investigate or settle or any suit against an insured we defend a. All expenses we incur. b. Up to 250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. c. The cost of bonds to release attachments but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from work. e. All court costs taxed against the insured in the suit. However these payments do not include attorneys fees or attorneys expenses taxed against the insured. f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment interest based on that period of time after the offer. Page 8 of 16 Insurance Services Office Inc. 2012 CG 00010413
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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 d. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the insured and the indemnitee and f. The indemnitee 1 Agrees in writing to a Cooperate with us in the investigation settlement or defense of the suit o b Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit c Notify any other insurer whose coverage is available to the indemnitee and 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. d 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. QOur 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 injury a To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company to a coemployee while in the course of his or her employment or performing duties related to the conduct of your business or to your other volunteer workers while performing duties related to the conduct of your business To the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of Paragraph 1a above b 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.. 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. 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 Il 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 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 a. Medical expenses under Coverage C member if you are a limited liability b. Damages under Coverage A except damages company. because of bodily injury or property damage b. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. included in the products completed operations hazard and c. Damages under Coverage B. Page 10 of 16 Insurance Services Office Inc. 2012 CG 00010413
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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 Authorize us to obtain records and other information Cooperate with us in the investigation or settlement of the claim or defense against the suit and Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent.. Legal Action Against Us No person or organization has a right under this Coverage Part a. To join us as a party or otherwise bring us into a suit asking for damages from an insured or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us the insured and the claimant or the claimant s legal representative. 2 3 4 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 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 entitled 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 eamned premium we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. 6. Representations By accepting this policy you agree a. The statements in the Declarations are accurate and complete Page 12 of 16 Insurance Services Office Inc. 2012 CG 00010413
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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 To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part those rights are transferred to us. The 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 The activities of a person whose home is in the territory described in Paragraph a. above but is away for a short time on your business or Personal and advertising injury offenses that take place through the Internet or similar electronic means of communication provided the insured s responsibility to pay damages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to.. 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. 2 3. 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 fulfilling 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 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 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. bad 2 10.Leased worker means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker..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. Page 14 of 16 Insurance Services Office Inc. 2012 CG 00010413
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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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18 19. 20. 21. 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 ROMSs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment..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. 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. 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. 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. Page 16 of 16 Insurance Services Office Inc. 2012 CG 00010413
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OLD REPUBLIC GENERAL INSURANCE CORPORATION ANTI STACKING ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM The following is added to SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 4. Other Insurance d. Anti Stacking Provision. If this Coverage Form and any other Coverage Form or policy where vou Anti Stacking Provision. If this Coverage Form and any other Coverage Form or policy where you 1. are a named insured or 2. you are a contractor designated on an Owners and Contractors Protective Liability andor a Special Protective and Highway Liability Policy issued by us or any of our affiliated companies apply to the same occurrence the maximum limit of insurance under all the Coverage Forms or policies will not exceed the highest applicable limit of insurance available under any one Coverage Form or policy. This condition does not apply to any other Coverage Form or policy issued by us or any of our affiliated companies specifically to apply as excess insurance over this Coverage Form. Named Insured OLD CHICAGO STEEL LLC Policy Number A7CG041813 01 Endorsement No. 000 Policy Period 09 01 13to 09 01 14 Endorsement Effective Date 09 01 13 Producer s Name OLD REPUBLIC CONSTRUCTION INSURANCE AGENCY INC. Producer Number 0000007007 AUTHORIZED REPRESENTATIVE DATE CG EN GN 0037 01 12 Page 1 of 1
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OLD REPUBLIC GENERAL INSURANCE CORPORATION AMENDMENT OF INSURANCE AGREEMENT PRIOR DAMAGE OR INJURY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE FORM A. Paragraph 1. Insuring Agreement of Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following 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 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 and B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory The bodily injury or property damage first takes place during the policy period regardless of when such occurrence giving rise to bodily injury or property damage takes place. All bodily injury or property damage caused by or arising out of an occurrence is deemed to first take place at the earliest of when 1 Any bodily injury or property damage first becomes known to anyone or It is alleged that any bodily injury or property damage first manifests or 3 Notification of the alleged existence of a potential or actual claim for any bodily injury or property damage is received by the insured its employees agents subsidiary related entity subcontractor or representatives or 4 The insured its employees agents subsidiary related entity or representatives knew or should have known that any bodily injury or property damage has occurred or CG EN GN 0083 12 08 Page 1 of 2
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5 Any bodily injury or property damage began regardless of whether the bodily injury or property damage results in additional related or unrelated claims is continuous progressive repeated changing or results from exposure to substantially the same general harm. d. Damages for bodily injury includes damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. All other terms and conditions of this policy remain unchanged. Named Insured Policy Number Endorsement No. Policy Period to Endorsement Effective Date Producer s Name Producer Number AUTHORIZED REPRESENTATIVE CG EN GN 0083 12 08 DATE Page 2 of 2
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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 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 Whether the insured may be liable as an em ployer 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. 2 3 B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Per sonal 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 To any obligation to share damages with or repay someone else who must pay damages because of the injury. 3 CG 21471207 ISO Properties Inc. 2006 Page 10of 1 a
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COMMERCIAL GENERAL LIABILITY CG 020012 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ILLINOIS CHANGES CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART. Cancellation Common Policy Conditions is replaced by the following CANCELLATION 1. The first Named Insured shown in the Declara tions may cancel this policy by mailing to us advance written notice of cancellation. 2. We may cancel this policy by mailing to you written notice stating the reason for cancella tion. If we cancel a. For nonpayment of premium we will mail the notice at least 10 days prior to the effec tive date of cancellation. b. For a reason other than nonpayment of premium we will mail the notice at least 1 30 days prior to the effective date of cancellation if the policy has been in ef fect for 60 days or less. 2 60 days prior to the effective date of cancellation if the policy has been in ef fect for more than 60 days. 3. If this policy has been in effect for more than 60 days we may cancel only for one or more of the following reasons a. Nonpayment of premium b. The policy was obtained through a material misrepresentation c. Any insured has violated any of the terms and conditions of the policy d. The risk originally accepted has measurably increased e. Certification to the Director of Insurance of the loss of reinsurance by the insurer that provided coverage to us for all or a sub stantial part of the underlying risk insured or f. A determination by the Director of Insur ance that the continuation of the policy could place us in violation of the insurance laws of this State. 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 will be less than pro rata. The cancellation will be effective even if we have not offered a refund. B. The following is added and supersedes any provi sion to the contrary NONRENEWAL If we decide not to renew or continue this policy we will mail you and your agent or broker written notice stating the reason for nonrenewal at least 60 days before the end of the policy period. If we offer to renew or continue and you do not accept this policy will terminate at the end of the current policy period. Failure to pay the required renewal or continuation premium when due shall mean that you have not accepted our offer. If we fail to mail proper written notice of nonre newal and you obtain other insurance this policy will end on the effective date of that insurance. C. Mailing Of Notices We will mail cancellation and nonrenewal notices to you and the agent or broker at the last ad dresses known to us. Proof of mailing will be suffi cient proof of notice. CG 02001207 ISO Properties Inc. 2006 Page 1 of 1 o
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IL 01 6209 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ILLINOIS CHANGES DEFENSE COSTS This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART LEGAL LIABILITY COVERAGE FORM COMMERCIAL PROPERTY COVERAGE PART MORTGAGEHOLDERS ERRORS AND OMISSIONS COVERAGE FORM EMPLOYMENT RELATED PRACTICES LIABILITY 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 PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK COVERAGE PART. The provisions of Paragraph B. are added to all Insuring Agreements that set forth a duty to de fend under 1. Section of the Commercial General Liability Commercial Liability Umbrella Employment Related Practices Liability Farm Liquor Li ability Owners And Contractors Protective Li ability Pollution Liability Products Completed Operations Liability Product Withdrawal Medical Professional Liability Railroad Pro tective Liability Underground Storage Tank Coverage Parts and the Farm Umbrella Liabil ity Policy 2. Section Il Liability Coverage in Paragraph A. Coverage under the Business Auto Ga rage Motor Carrier and Truckers Coverage Forms 3. Section A. Coverage under the Legal Liability Coverage Form and 4. Coverage C Mortgageholder s Liability under the Mortgageholders Errors And Omis sions Coverage Form. B. If we initially defend an insured insured or pay for an insured s insured s defense but later de termine that the claims is are not covered un der this insurance we will have the right to reim bursement for the defense costs we have incurred. The right to reimbursement for the defense costs under this provision will only apply to defense costs we have incurred after we notify you in writ ing that there may not be coverage and that we are reserving our rights to terminate the defense and seek reimbursement for defense costs. IL 016209 08 ISO Properties Inc. 2007 Page 1 of 1 o
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IL 0147 09 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. The term spouse is replaced by the following C. With respect to coverage for the ownership 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. 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. 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. IL 01470911 Insurance Services Office Inc. 2011 Page 1 of 1
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IL 02720907 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INDIANA CHANGES CANCELLATION AND NONRENEWAL 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 LIABILITY UMBRELLA COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART. Paragraph 2. of the Cancellation Common Policy b. More Than 90 Days Condition is replaced by the following If this policy has been in effect for more 2. Cancellation Of Policies In Effect than 90 days or is a renewal of a policy we a. 90 Days Or Less issued we may cancel this policy only for B. one or more of the reasons listed below by If this policy has been in effect for 90 days mailing or delivering to the first Named or less we may cancel this policy by Insured written notice of cancellation at mailing or delivering to the first Named least Insured written notice of cancellation at ek 1 10 days before the effective date of i. cancellation if we cancel for 10 gy o e tectve st o ropmment of e nonpayment of premium 2 20 days before the effective date of cancellation if you have perpetrated a 2 20 days before the effective date of fraud or material misrepresentation on cancellation if you have perpetrated a us or fraud or material misrepresentation on o al misrep 3 45 days before the effective date of 30 d bef the effective date of cancellation if ays before the effective date of cancellation if we cancel for any other There has been qsubsanllal change reason. in the scale of risk covered by this policy b Reinsurance of the risk associated with this policy has been cancelled or c You have failed to comply with reasonable safety recommendations. IL 02720907 ISO Properties Inc. 2006 Page 1 of 2 o
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B. The following is added to the Common Policy Conditions and supersedes any provision to the contrary. NONRENEWAL 1. If we elect not to renew this policy we will mail or deliver to the first Named Insured written notice of nonrenewal at least 45 days before a. The expiration date of this policy if the policy is written for a term of one year or less or b. The anniversary date of this policy if the policy is written for a term of more than one year. 2. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. If notice is mailed proof of mailing will be sufficient proof of notice. Page 2 of 2 ISO Properties Inc. 2006 IL 02720907 m
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IL 01 58 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INDIANA CHANGES This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL PROPERTY LEGAL LIABILITY COVERAGE FORM COMMERCIAL PROPERTY MORTGAGEHOLDERS ERRORS AND OMISSIONS COVERAGE FORM EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART FARM LIABILITY COVERAGE FORM 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 Under the Mortgageholders Errors And Omis sions Coverage Form the following condition applies only to Coverage C and Coverage D. The following condition is added Notice given by or on behalf of the insured to any of our authorized agents in Indiana with particu lars sufficient to identify the insured shall be considered to be notice to us. IL 01 58 09 08 ISO Properties Inc. 2007 Page 1 of 1 o
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COMMERCIAL GENERAL LIABILITY CG 01230397 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INDIANA CHANGES POLLUTION EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Subparagraph f. Pollution of Paragraph 2. Exclusions of Bodily Injury And Property Damage Liability Coverage Section Coverages and to Paragraph 2. Exclusions of Personal And Advertising Injury Liability Coverage Section Coverages or to any amendment to or replacement thereof This Pollution Exclusion applies whether or not such irritant o contaminant has any function in your business operations premises site or location CG 01230397 Copyright Insurance Services Office Inc. 1996 Page 10f 1
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IL0117 1210 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INDIANA CHANGES WORKERS COMPENSATION EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART FARM LIABILITY COVERAGE FORM FARM UMBRELLA LIABILITY POLICY 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. Forinsurance provided under the Commercial General Liability Coverage Part Commercial Liability Umbrella Coverage Part Employment Related Practices Liability 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 The following is added to the Workers Compensation And Similar Laws Exclusion This exclusion also applies to any obligation of the insured under the Indiana Workers Compensation statutes arising out of the failure of the insured to exact from a contractor or subcontractor if the insured is a contractor a certificate from the workers compensation board showing that the contractor or subcontractor has complied with the applicable workers compensation insurance requirements. B. For insurance provided under the Commercial Automobile Coverage Part the following is added to the Workers Compensation Exclusion This exclusion also applies to any obligation of the insured under the Indiana Workers Compensation statutes arising out of the failure of the insured to exact from a contractor or subcontractor if the insured is a contractor a certificate from the workers compensation board showing that the contractor or subcontractor has complied with the applicable workers compensation insurance requirements.. For insurance provided under the Farm Liability Coverage Form and Farm Umbrella Liability Policy the following is added to the Workers Compensation Or Similar Law Exclusion This exclusion also applies to any obligation of the insured under the Indiana Workers Compensation statutes arising out of the failure of the insured to exact from a contractor or subcontractor if the insured is a contractor a certificate from the workers compensation board showing that the contractor or subcontractor has complied with the applicable workers compensation insurance requirements. B. For insurance provided under the Commercial Automobile Coverage Part the following is added to the Workers Compensation Exclusion This exclusion also applies to any obligation of the insured under the Indiana Workers Compensation statutes arising out of the failure of the insured to exact from a contractor or subcontractor if the insured is a contractor a certificate from the workers compensation board showing that the contractor or subcontractor has complied with the applicable workers compensation insurance requirements. C. For insurance provided under the Farm Liability Coverage Form and Farm Umbrella Liability Policy the following is added to the Workers Compensation Or Similar Law Exclusion This exclusion also applies to any obligation of the insured under the Indiana Workers Compensation statutes arising out of the failure of the insured to exact from a contractor or subcontractor if the insured is a contractor a certificate from the workers compensation board showing that the contractor or subcontractor has complied with the applicable workers compensation insurance requirements. ILo117 1210 Insurance Services Office Inc. 2010 Page 1 of 1 o
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IL 02 83 09 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WISCONSIN CHANGES CANCELLATION AND NONRENEWAL 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 LIABILITY UMBRELLA COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART. Paragraph 2. of the Cancellation Common Policy Condition is replaced by the following 2. We may cancel this policy by mailing or deliv ering to the first Named Insured written notice of cancellation at least 10 days before the ef fective date of cancellation. If this policy has been in effect for less than 60 days and is not a renewal policy we may can cel for any reason. If this policy has been in effect for 60 days or more or is a renewal of a policy we issued ex cept as provided in Paragraph 7. below we may cancel this policy only for one or more of the following reasons a. The policy was obtained by material mis representation b. There has been a substantial change in the risk we originally assumed except to the extent that we should have foreseen the change or considered the risk in writing the policy c. There have been substantial breaches of contractual duties conditions or warranties or d. Nonpayment of premium. If this policy has been in effect for 60 days or more or is a renewal of a policy we issued the notice of cancellation will state the reason for cancellation. B. The following is added to the Cancellation Com mon Policy Condition 7. Anniversary Cancellation If this policy is written for a term of more than one year or has no fixed expiration date we may cancel this policy for any reason by mail ing or delivering to the first Named Insured written notice of cancellation at least 60 days before the anniversary date of the policy. Such cancellation will be effective on the policy s an niversary date. We may cancel this policy because of the ter mination of an insurance marketing intermedi ary s contract with us only if the notice of can cellation contains an offer to continue the policy with us if we receive a written request from the first Named Insured prior to the date of cancellation. IL 02 83 09 07 ISO Properties Inc. 2006 Page 1 of 3 o
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C. The following applies to the Capital Assets Program Output Policy Coverage Part Commercial Inland Marine Coverage Part Commercial Property Coverage Part Crime And Fidelity Coverage Part Equipment Breakdown Coverage Part Farm Coverage Part 1. We may rescind this policy because of the following a. Misrepresentation made by you or on your behalf in the negotiation for or procurement of this Coverage Part if the person knew or should have known that the representation was false b. Breach of affirmative warranty made by you or on your behalf in the negotiation for or procurement of this Coverage Part c. Failure of a condition before a loss if such failure exists at the time of loss or d. Breach of a promissory warranty if such breach exists at the time of loss. 2. We may not rescind this policy a. For the reasons in Paragraphs C. C.1.b. unless 1 We rely on the misrepresentation or affirmative warranty and the misrepre sentation or affirmative warranty is ei ther material or made with intent to de ceive or 2 The facts misrepresented or falsely warranted contribute to the loss. b. For the reasons in Paragraphs C.1.c. and C.1.d. unless such failure or breach 1 Increases the risk at the time of loss or 2 Contributes to the loss. 3. If we elect to rescind this policy we will notify the first Named Insured of our intention within 60 days after acquiring knowledge of sufficient facts to constitute grounds for rescission. D. The following are added and supersede any other provisions to the contrary 1. Nonrenewal a. If we elect not to renew this policy we will mail or deliver written notice of nonrenewal to the first Named Insured s last mailing ad dress known to us. WWe may elect not to re new for any reason the notice will state the reason for nonrenewal. We will mail or de liver the notice at least 60 days before the expiration date of this policy. and We need not mail or deliver the notice if 1 You have insured elsewhere 2 You have accepted replacement cover age 3 You have requested or agreed to non renewal of this policy or 4 This policy is expressly designated as nonrenewable. b. We may refuse to renew this policy be cause of the termination of an insurance marketing intermediary s contract with us only if the notice of nonrenewal contains an offer to renew the policy with us if we re ceive a written request from the first Named Insured prior to the renewal date. c. If you fail to pay the renewal or continuation premium by the premium due date this pol icy will terminate on the policy expiration or anniversary date if we have 1 Given you written notice of the renewal or continuation premium not more than 75 days nor less than 10 days prior to the due date of the premium and 2 Stated clearly in the notice the effect of nonpayment of premium by the due date. 2. Anniversary Alteration If this policy is written for a term of more than one year or has no fixed expiration date we may alter the terms or premiums of this policy by mailing or delivering written notice of less favorable terms or premiums to the first Named Insured s last mailing address known to us. We will mail by first class mail or deliver this no tice at least 60 days prior to the anniversary date. If we notify the first Named Insured within 60 days prior to the anniversary date the new terms or premiums will not take effect until 60 days after the notice was mailed or delivered. The notice will include a statement of the first Named Insured s right to cancel. The first Named Insured may elect to cancel the policy at any time during the 60 day period in accor dance with Paragraph 1. of the Cancellation Common Policy Condition. If the first Named Insured elects to cancel the policy during the 60 day period return premiums or additional premium charges will be calculated proportion ately on the basis of the old premiums. Page 2 of 3 ISO Properties Inc. 2006 IL 02 83 09 07 m
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3. Renewal With Altered Terms If we elect to renew this policy but on less fa vorable terms or at higher premiums we will mail or deliver written notice of the new terms or premiums to the first Named Insured s last mailing address known to us. We will mail by first class mail or deliver this notice at least 60 days prior to the renewal date. If we notify the first Named Insured within 60 days prior to the renewal date the new terms or premiums will not take effect until 60 days after the notice was mailed or delivered. The notice will include a statement of the first Named Insured s right to cancel. The first Named Insured may elect to cancel the re newal policy at any time during the 60 day pe riod in accordance with Paragraph 1. of the Cancellation Common Policy Condition. If the first Named Insured elects to cancel the re newal policy during the 60 day period return premiums or additional premium charges will be calculated proportionately on the basis of the old premiums. We need not mail or deliver this notice if the only change adverse to you is a premium in crease that a. Is less than 25 and is generally applicable to the class of business to which this policy belongs or b. Results from a change based on your ac tion that alters the nature or extent of the risk insured against including but not lim ited to a change in the classification or the units of exposure or increased policy cov erage. E. Special Provision Cancellation And Nonrenewal With respect to insurance provided under the Commercial Automobile Coverage Part we will not cancel or refuse to renew Liability Coverage wholly or partially because of age sex residence race color creed religion national origin ances try marital status or occupation of anyone who is an insured. IL 02 83 09 07 ISO Properties Inc. 2006 Page 3 of 3 o
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COMMERCIAL GENERAL LIABILITY CG 01240193 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WISCONSIN CHANGES AMENDMENT OF POLICY CONDITIONS COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART This endorsement modifies insurance provided under the following PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART. The following is added to CHANGES Common Policy Conditions If one of our agents knows of a fact that breaches a condition of this Coverage Part we will be con sidered to have knowledge of this same fact if a. The agent knows of this fact at the time the Coverage Part is issued or an application is made or b. The agent later learns of this fact in the course of his dealings as an agent with you. Any fact that breaches a condition of this Cover age Part and is known to the agent prior to loss shall not void the Coverage Part or prevent a re covery in the event of loss.. The LEGAL ACTION AGAINST US Condition Section IV does not apply.. The following is added to Condition 6. REPRE SENTATIONS Section IV No misrepresentation or breach of affirmative war ranty made by you or on your behalf in the nego tiation of this Coverage Part affects our obligation under this Coverage Part unless a. We rely on it and it is either material or made with intent to deceive or b. The facts misrepresented or falsely warranted contribute to the loss. No failure of a condition before the loss and no breach of a promissory warranty affects our obli gation under this Coverage Part unless such fail ure or breach a. Exists at the time of the loss and b. Either increases the risk at the time of the loss or contributes to the loss. The provisions of this condition do not apply to nonpayment of premium.. Condition 8. TRANSFER OF RIGHTS OF RE COVERY AGAINST OTHERS TO US Section IV is replaced by the following In the event of any payment under this Coverage Part we will be entitled to the insured s rights of recovery against any person or organization and the insured will do whatever is necessary to se cure such rights. We will be entitled to a recovery only after the insured has been fully compensated for damages.. CONFORMITY TO STATUTE OR RULE Any provision of this policy including endorse ments which modify the policy that is in conflict with a Wisconsin statute or rule is hereby amended to conform to that statute or rule. The term rule means a valid rule promulgated by the Commissioner of Insurance in accordance with the rule making authority conferred under Wis. Stat. Ann. Section 227.112 and published in the Wisconsin Administrative Code. CG 01240193 Copyright Insurance Services Office Inc. 1984 1992 Page 1 of 1 o
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POLICY NUMBER A7CG041813 01 POLICY NUMBER A7CG041813 01 COMMERCIAL GENERAL LIABILITY CG 04351207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYEE BENEFITS LIABILITY COVERAGE THIS ENDORSEMENT PROVIDES CLAIMS MADE COVERAGE. PLEASE READ THE ENTIRE ENDORSEMENT CAREFULLY. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Each Employee Coverage Limit Of Insurance Deductible Premium Employee Benefits 1000000 each employee 1000 INCLUDED Programs 1000000 aggregate 09 01 2012 Information required to complete this Schedule if not shown above will be shown in the Declarations. Retroactive Date A. The following is added to Section Coverages COVERAGE EMPLOYEE BENEFITS LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Sup plementary Payments. b. This insurance applies to damages only if becomes legally obligated to pay as dam ages because of any act error or omission of the insured or of any other person for whose acts the insured is legally liable to which this insurance applies. We 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 dam ages to which this insurance does not ap ply. We may at our discretion investigate any report of an act error or omission and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Paragraph D. Section Il Limits Of Insurance and 2 Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements. 1 The act error or omission is negligently committed in the administration of your employee benefit program 2 The act error or omission did not take place before the Retroactive Date if any shown in the Schedule nor after the end of the policy period and A claim for damages because of an act error or omission is first made against any insured in accordance with Paragraph c. below during the policy period or an Extended Reporting Period we provide under Paragraph F. of this endorsement. 3 c. A claim seeking damages will be deemed to have been made at the earlier of the fol lowing times 1 When notice of such claim is received and recorded by any insured or by us whichever comes first or CG 04351207 ISO Properties Inc. 2006 Page 1 0of 6 o
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2 When we make settlement in accor dance with Paragraph a. above. A claim received and recorded by the in sured within 60 days after the end of the policy period will be considered to have been received within the policy period if no subsequent policy is available to cover the claim.. All claims for damages made by an em ployee because of any act error or omis sion or a series of related acts errors or omissions including damages claimed by such employee s dependents and benefi ciaries will be deemed to have been made at the time the first of those claims is made against any insured.. Exclusions This insurance does not apply to a. Dishonest Fraudulent Criminal Or Malicious Act Damages arising out of any intentional dis honest fraudulent criminal or malicious act error or omission committed by any in sured including the willful or reckless viola tion of any statute.. Bodily Injury Property Damage Or Personal And Advertising Injury Bodily injury property damage or per sonal and advertising injury.. Failure To Perform A Contract Damages arising out of failure of perform ance of contract by any insurer.. Insufficiency Of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the employee benefit pro gram.. Inadequacy Of Performance Of Investment Advice Given With Respect To Participation Any claim based upon 1 Failure of any investment to perform 2 Errors in providing information on past performance of investment vehicles or 3 Advice given to any person with respect to that person s decision to participate or not to participate in any plan included in the employee benefit program. f. Workers Compensation And Similar Laws Any claim arising out of your failure to comply with the mandatory provisions of any workers compensation unemployment compensation insurance social security or disability benefits law or any similar law. g. ERISA Damages for which any insured is liable because of liability imposed on a fiduciary by the Employee Retirement Income Secu rity Act of 1974 as now or hereafter amended or by any similar federal state or local laws. h. Available Benefits Any claim for benefits to the extent that such benefits are available with reasonable effort and cooperation of the insured from the applicable funds accrued or other col lectible insurance.. Taxes Fines Or Penalties Taxes fines or penalties including those imposed under the Internal Revenue Code or any similar state or local law. j. Employment Related Practices Damages arising out of wrongful termina tion of employment discrimination or other employment related practices. B. For the purposes of the coverage provided by this endorsement 1. All references to Supplementary Payments Coverages A and B are replaced by Supple mentary Payments Coverages A B and Em ployee Benefits Liability. 2. Paragraphs 1.b. and 2. of the Supplementary Payments provision do not apply. C. For the purposes of the coverage provided by this endorsement Paragraphs 2. and 3. of Section Il Who Is An Insured are replaced by the following 2. Each of the following is also an insured a. Each of your employees who is or was authorized to administer your employee benefit program. b. Any persons organizations or employees having proper temporary authorization to administer your employee benefit program if you die but only until your legal represen tative is appointed. Page 2 of 6 ISO Properties Inc. 2006 CG 04351207 m
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c. Your legal representative if you die but only with respect to duties as such. That repre sentative will have all your rights and duties under this Endorsement. 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 no other similar insurance applies 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 pol icy period whichever is earlier. b. Coverage under this provision does not apply to any act error or omission that was committed before you acquired or formed the organization. D. For the purposes of the coverage provided by this endorsement Section Il Limits Of Insurance is replaced by the following 1. Limits Of Insurance a. The Limits of Insurance shown in the Sche dule and the rules below fix the most we will pay regardless of the number of 1 Insureds 2 Claims made or suits brought 3 Persons or organizations making claims or bringing suit 4 Acts errors or omissions or 5 Benefits included in your employee benefit program. b. The Aggregate Limit is the most we will pay for all damages because of acts errors or omissions negligently committed in the administration of your employee benefit program. c. Subject to the Aggregate Limit the Each Employee Limit is the most we will pay for all damages sustained by any one em ployee including damages sustained by such employee s dependents and benefi ciaries as a result of 1 An act error or omission or 2 A series of related acts errors or omis sions negligently committed in the administra tion of your employee benefit program. However the amount paid under this en dorsement shall not exceed and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the employee benefit program. The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations of the policy to which this endorsement is attached unless the policy period is extended after issu ance 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 Insur ance. 2. Deductible a. Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of the deductible amount stated in the Schedule as applica ble to Each Employee. The limits of insur ance shall not be reduced by the amount of this deductible. b. The deductible amount stated in the Sche dule applies to all damages sustained by any one employee including such em ployee s dependents and beneficiaries because of all acts errors or omissions to which this insurance applies. c. The terms of this insurance including those with respect to 1 Our right and duty to defend any suits seeking those damages and 2 Your duties and the duties of any other involved insured in the event of an act error or omission or claim apply irrespective of the application of the deductible amount. d. We may pay any part or all of the deducti ble amount to effect settlement of any claim or suit and upon notification of the action taken you shall promptly reimburse us for such part of the deductible amount as we have paid. E. For the purposes of the coverage provided by this endorsement Conditions 2. and 4. of Section IV Commercial General Liability Conditions are replaced by the following 2. Duties In The Event Of An Act Error Or Omission Or Claim Or Suit a. You must see to it that we are notified as soon as practicable of an act error or omis sion which may result in a claim. To the extent possible notice should include 1 What the act error or omission was and when it occurred and CG 04351207 ISO Properties Inc. 2006 Page 3 of 6 o
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2 The names and addresses of anyone who may suffer damages as a result of the act error or omission. 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 Authorize us to obtain records and other information Cooperate with us in the investigation or settlement of the claim or defense against the suit and Assist us upon our request in the en forcement of any right against any per son or organization which may be liable to the insured because of an act error or omission 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 without our consent.. Other Insurance If other valid and collectible insurance is avail able to the insured for a loss we cover under this endorsement our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insur ance is primary our obligations are not af fected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method de scribed in Paragraph c. below. 2 4 b. Excess Insurance 1 This insurance is excess over any of the other insurance whether primary ex cess contingent or on any other basis that is effective prior to the beginning of the policy period shown in the Schedule of this insurance and that applies to an act error or omission on other than a claims made basis if a No Retroactive Date is shown in the Schedule of this insurance or b The other insurance has a policy period which continues after the Ret roactive Date shown in the Schedule of this insurance. 2 When this insurance is excess we will have no duty to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be entitled 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 the total amount that all such other insurance would pay for the loss in absence of this insurance and the total of all deductible and self insured amounts under all that other insurance. We will share the remaining loss if any with any other insurance that is not de scribed in this Excess Insurance provi sion and was not bought specifically to apply in excess of the Limits of Insur ance shown in the Schedule of this en dorsement. 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 fffany of the other insurance does not per mit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limits of insurance to the total applicable limits of insurance of all insurers. 4 Page 4 of 6 ISO Properties Inc. 2006 CG 04351207 m
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F. For the purposes of the coverage provided by this endorsement the following Extended Reporting Period provisions are added or if this endorse ment is attached to a claims made Coverage Part replaces any similar Section in that Coverage Part EXTENDED REPORTING PERIOD 1. You will have the right to purchase an Ex tended Reporting Period as described below if a. This endorsement is canceled or not re newed or b. We renew or replace this endorsement with insurance that 1 Has a Retroactive Date later than the date shown in the Schedule of this en dorsement or 2 Does not apply to an act error or omis sion on a claims made basis. 2. The Extended Reporting Period does not ex tend the policy period or change the scope of coverage provided. It applies only to claims for acts errors or omissions that were first committed before the end of the policy period but not before the Retroactive Date if any shown in the Schedule. Once in effect the Ex tended Reporting Period may not be canceled. 3. An Extended Reporting Period of five years is available but only by an endorsement and for an extra charge. You must give us a written request for the en dorsement within 60 days after the end of the policy period. The Extended Reporting Period will not go into effect unless you pay the addi tional premium promptly when due. We will determine the additional premium in accordance with our rules and rates. In doing so we may take into account the following a. The employee benefit programs insured b. Previous types and amounts of insurance c. Limits of insurance available under this endorsement for future payment of dam ages and d. Other related factors. The additional premium will not exceed 100 of the annual premium for this endorsement. The Extended Reporting Period endorsement applicable to this coverage shall set forth the terms not inconsistent with this Section appli cable to the Extended Reporting Period includ ing a provision to the effect that the insurance afforded for claims first received during such period is excess over any other valid and col lectible insurance available under policies in force after the Extended Reporting Period starts. 4. If the Extended Reporting Period is in effect we will provide an extended reporting period aggregate limit of insurance described below but only for claims first received and recorded during the Extended Reporting Period. The extended reporting period aggregate limit of insurance will be equal to the dollar amount shown in the Schedule of this endorsement under Limits of Insurance. Paragraph D.1.b. of this endorsement will be amended accordingly. The Each Employee Limit shown in the Schedule will then continue to apply as set forth in Paragraph D.1.c. G. For the purposes of the coverage provided by this endorsement the following definitions are added 1. Administration means a. Providing information to employees in cluding their dependents and beneficiaries with respect to eligibility for or scope of employee benefit programs b. Handling records in connection with the employee benefit program or c. Effecting continuing or terminating any employee s participation in any benefit in cluded in the employee benefit program. However administration does not include handling payroll deductions. 2. Cafeteria plans means plans authorized by applicable law to allow employees to elect to pay for certain benefits with pre tax dollars. 3. Claim means any demand or suit made by an employee or an employee s dependents and beneficiaries for damages as the result of an act error or omission. CG 04351207 ISO Properties Inc. 2006 Page 5 of 6 o
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4. Employee benefit program means a program providing some or all of the following benefits to employees whether provided through a cafeteria plan or otherwise a. Group life insurance group accident or health insurance dental vision and hearing plans and flexible spending accounts pro vided that no one other than an employee may subscribe to such benefits and such benefits are made generally available to those employees who satisfy the plan s eligibility requirements b. Profit sharing plans employee savings plans employee stock ownership plans pension plans and stock subscription plans provided that no one other than an em ployee may subscribe to such benefits and such benefits are made generally available to all employees who are eligible under the plan for such benefits c. Unemployment insurance social security benefits workers compensation and dis ability benefits d. Vacation plans including buy and sell pro grams leave of absence programs includ ing military maternity family and civil leave tuition assistance plans transporta tion and health club subsidies and e. Any other similar benefits designated in the Schedule or added thereto by endorse ment. H. For the purposes of the coverage provided by this endorsement Definitions 5. and 18. in the Defini tions Section are replaced by the following 5. Employee means a person actively em ployed formerly employed on leave of ab sence or disabled or retired. Employee in cludes a leased worker. Employee does not include a temporary worker. 18. Suit means a civil proceeding in which dam ages because of an act error or omission to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the in sured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. Page 6 of 6 ISO Properties Inc. 2006 CG 04351207 m
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COMMERCIAL GENERAL LIABILITY CG 2186 1204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION EXTERIOR INSULATION AND FINISH SYSTEMS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. This insurance does not apply to bodily injury property damage or personal and advertising in jury arising out of caused by or attributable to whether in whole or in part the following 1. The design manufacture construction fabrica tion preparation distribution and sale installa tion application maintenance or repair includ ing remodeling service correction or replacement of any exterior insulation and fin B. The following definition is added to the Definitions Section. Exterior insulation and finish system means a non load bearing exterior cladding or finish sys tem and all component parts therein used on any part of any structure and consisting of 1. A rigid or semi rigid insulation board made of expanded polystyrene and other materials ish system or any part thereof or any substan 2. tially similar system or any part thereof includ ing the application or use of conditioners The adhesive andor mechanical fasteners used to attach the insulation board to the sub strate primers accessories flashings coatings 3. Areinforced or unreinforced base coat 039 or sealants in connection with such a 4. A finish coat providing surface texture to which system or color may be added and Your product or your work with respect to 5. Any flashing caulking or sealant used with the any exterior component fixture or feature of any structure if an exterior insulation and finish system or any substantially similar system is used on the part of that structure containing that component fixture or feature. system for any purpose. CG 21861204 ISO Properties Inc. 2003 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 2196 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. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Exclusions of Section Coverage B Per Injury And Property Damage Liability sonal And Advertising Injury Liability 2. Exclusions 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 sus pected inhalation of or ingestion of silica 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. 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 combi nation of silica and other dust or particles. rin part out led or sus n of silica whole or in threatened sure to ex or silica g in whole testing for ng contain izing reme CG 2196 03 05 ISO Properties Inc. 2004 Pagetof1 O
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COMMERCIAL GENERAL LIABILITY CG 2146 07 98 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ABUSE OR MOLESTATION 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 and Para graph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability This insurance does not apply to bodily injury property damage or personal and advertising injury arising out of 1. The actual or threatened abuse or molestation by anyone of any person while in the care custody or control of any insured or e. 2. The negligent a. Employment b. Investigation c. d. Reporting to the proper authorities or failure Supervision to so report or Retention of a person for whom any insured is or ever was legally responsible and whose conduct would be excluded by Paragraph 1. above. CG 2146 07 98 Copyright Insurance Services Office Inc. 1997 Page 1 of 1 o
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COMMERCIAL GENERAL LIABILITY CG 22790413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION CONTRACTORS PROFESSIONAL LIABILITY 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 and Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liabil 1. This insurance does not apply to bodily injury property damage or personal and advertising injury arising out of the rendering of or failure to render any professional services by you or on your behalf but only with respect to either or both of the following operations a. Providing engineering architectural or surveying services to others in your capacity as an engineer architect or surveyor and b. Providing or hiring independent professionals to provide engineering architectural or surveying services in connection with construction work you perform. 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 or the offense which caused the personal and advertising injury involved the rendering of or failure to render any professional services by you or on your behalf with respect to the operations described above. 2. Subject to Paragraph 3. below professional services include a. Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications and b. Supervisory or inspection activities performed as part of any related architectural or engineering activities. 3. Professional services do not include services within construction means methods techniques sequences and procedures employed by you in connection with your operations in your capacity as a construction contractor. CG 22790413 Insurance Services Office Inc. 2012 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 2167 1204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Exclusions of Section Coverage B Per Injury And Property Damage Liability sonal And Advertising Injury Liability 2. Exclusions 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 in halation of ingestion of contact with expo sure 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 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 threat ened 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 con currently or in any sequence to such injury. b. Any loss cost or expense arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. This exclusion does not apply to any fungi or C. The following definition is added to the Definitions bacteria that are are on or are contained in a Section good or product intended for bodily consump Fungi means any type or form of fungus includ tion. ing mold or mildew and any mycotoxins spores scents or byproducts produced or released by fungi. 1age which le or in part reatened in with expo nce of any 2 building or regardless nt material tly or in any ge. 1 g out of the cleaning up detoxifying osing of or sessing the any insured CG 2167 1204 ISO Properties Inc. 2003 Pagetof1 O
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OLD REPUBLIC GENERAL INSURANCE CORPORATION AMENDMENT OF PERSONAL INJURY COVERAGE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section Coverages Coverage B. Personal and Advertising Injury Liability 2. Exclusions e. is deleted in its entirety. Named Insured Policy Number Endorsement No. Policy Period Endorsement Effective Date Producer s Name Producer Number AUTHORIZED REPRESENTATIVE DATE CG EN GN 0030 09 06
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OLD REPUBLIC GENERAL INSURANCE CORPORATION CHANGES ADDITIONAL INSURED PRIMARY WORDING SCHEDULE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM Name of Additional Insured Persons Or Organizations Locations of Covered Operations As required by written contract. Information required to complete this Schedule if not shown above will be shown in the Declarations. The insurance provided by this endorsement is primary insurance and we will not seek contribution from any other insurance of a like kind available to the person or organization shown in the schedule above unless the other insurance is provided by a contractor other than the person or organization shown in the schedule above for the same operation and job location. If so we will share with that other insurance by the method described in paragraph 4.c. of Section IV Commercial General Liability Conditions. All other terms and conditions remain unchanged. Named Insured Policy Number Endorsement No. Policy Period Endorsement Effective Date Producer s Name Producer Number AUTHORIZED REPRESENTATIVE DATE CG EN GN 0029 09 06
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OLD REPUBLIC GENERAL INSURANCE CORPORATION UNINTENTIONAL ERRORS AND OMISSIONS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM The following is added to Section IV Commercial General Liability Conditions Any unintentional error or omission in the description of or failure to completely describe any premises or operations intended to be covered by this Coverage Part will not invalidate or affect coverage for those premises or operations. However you must report such error or omission to us as soon as practicable after its discovery. Named Insured Policy Number Endorsement No. Policy Period Endorsement Effective Date Producer s Name Producer Number AUTHORIZED REPRESENTATIVE DATE CG EN GN 0034 09 06
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OLD REPUBLIC GENERAL INSURANCE CORPORATION KNOWLEDGE AND NOTICE OF AN OCCURRENCE ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM The following is added to Section IV Commercial General Liability Conditions 2. Duties in the Event of Occurrence Offense Claim or Suit e. Knowledge of an occurrence claim or suit by the agent servant or employee of any Insured shall not in itself constitute knowledge by the Insured unless the following individual shall have received such notice from the agent servant or employee Project Manager unless otherwise specified below Knowledge of an occurrence claim or suit by one or more Named Insured or Insured shall not constitute knowledge of such occurrence claim or suit by any other Named Insured and notice of any occurrence claim or suit given to the Company or any of its authorized agents by one Named Insured or Insured shall constitute such notice by all Named Insured and Insureds. For purposes of this endorsement Project Manager shall mean the designee of the Named Insured or Insured exercising on behalf of such Named Insured or Insured chief supervisory or administrative authority at the project site. Named Insured Policy Number Endorsement No. Policy Period Endorsement Effective Date Producer s Name Producer Number AUTHORIZED REPRESENTATIVE DATE CG EN GN 0024 09 06
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OLD REPUBLIC GENERAL INSURANCE CORPORATION AMENDATORY ENDORSEMENT WHEN WE DO NOT RENEW FORM A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE FORM Section IV Commercial General Liability Conditions 9. When We Do Not Renew is replaced by the following 9. 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 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 SIXTY 60 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. Named Insured Policy Number Endorsement No. Policy Period Endorsement Effective Date Producer s Name Producer Number AUTHORIZED REPRESENTATIVE DATE CG EN GN 0047 09 06
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OLD REPUBLIC GENERAL INSURANCE CORPORATION EXTEND EXPECTED AND INTENDED TO PROPERTY DAMAGE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section Coverages Coverage A. Bodily Injury and Property Damage Liability 2. Exclusions a. Expected or Intended Injury is replaced by the following a. Bodily Injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury or property damage resulting from the use of reasonable force to protect person or property. Named Insured Policy Number Endorsement No. Policy Period Endorsement Effective Date Producer s Name Producer Number AUTHORIZED REPRESENTATIVE DATE CG EN GN 0054 09 06
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OLD REPUBLIC GENERAL INSURANCE CORPORATION ASBESTOS EXCLUSION ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE FORM SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY NEW YORK DEPARTMENT OF TRANSPORTATION The coverage afforded by this policy does not apply to bodily injury personal injury or property damage arising out of 1 Inhaling ingesting or prolonged physical exposure to asbestos or goods or products containing asbestos or 2. The use of asbestos in construction or manufacturing any good product or structure or 3. The removal of asbestos from any good product or structure or 4. The manufacture sale transportation storage or disposal of asbestos or goods or products containing asbestos. The coverage afforded by the policy does not apply to payment for the investigation or defense of any loss injury or damage or any cost fine or penalty or for any expenses of claim or suit related to any of the above. Named Insured Policy Number Endorsement No. Policy Period Endorsement Effective Date Producer s Name Producer Number AUTHORIZED REPRESENTATIVE DATE CG EN GN 0019 09 06
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OLD REPUBLIC GENERAL INSURANCE CORPORATION EXCLUSION LEAD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY NEW YORK DEPARTMENT OF TRANSPORTATION This insurance does not apply to 1. Bodily injury or personal injury resulting from exposure to lead or to any product containing lead Property damage resulting from the existence handling processing installing removing disposal sale or distribution of lead or any property containing lead Any loss cost or expense arising out of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing lead or any product containing lead whether done pursuant to government directive or request or for any other reason Any loss cost or expense arising out of the removal replacement repair enclosure or encapsulation of lead or any substance containing lead from a building or structure. Named Insured Policy Number Endorsement No. Policy Period Endorsement Effective Date Producer s Name Producer Number AUTHORIZED REPRESENTATIVE DATE CG EN GN 0025 09 06
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POLICY NUMBER A7CG041813 01 LICY NUMBER A7CG041813 01 COMMERCIAL GENERAL LIABILITY CG 2503 0509 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECTS GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects ALL OF YOUR DESIGNATED CONSTRUCTION PROJECTS. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by occur rences under Section Coverage A and for all medical expenses caused by accidents under Section Coverage C which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above 1. A separate Designated Construction Project General Aggregate Limit applies to each des ignated construction project and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A ex cept damages because of bodily injury or property damage included in the products completed operations hazard and for medi cal expenses under Coverage C regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. damages or under Coverage C for medical expenses shall reduce the Designated Con struction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Ag gregate Limit shown in the Declarations nor shall they reduce any other Designated Con struction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence Damage To Premises Rented To You and Medical Expense continue to apply. However instead of being subject to the General Aggregate Limit shown in the Decla rations such limits will be subject to the appli cable Designated Construction Project Gen eral Aggregate Limit. JCTION PROJECTS. CG 2503 05 09 Insurance Services Office Inc. 2008 Page 1 of 2 o
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B. For all sums which the insured becomes legally obligated to pay as damages caused by occur rences under Section Coverage A and for all medical expenses caused by accidents under Section Coverage C which can not be attrib uted only to ongoing operations at a single des ignated construction project shown in the Sched ule above 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products completed Operations Aggregate Limit whichever is applicable and 2. Such payments shall not reduce any Desig nated Construction Project General Aggre gate Limit. C. When coverage for liability arising out of the products completed operations hazard is pro vided any payments for damages because of bodily injury or property damage included in the products completed operations hazard will reduce the Products completed Operations Ag gregate Limit and not reduce the General Ag gregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned delayed or abandoned and then restarted or if the authorized contract ing parties deviate from plans blueprints de signs specifications or timetables the project will still be deemed to be the same construction pro ject. E. The provisions of Section Il Limits Of Insur ance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 Insurance Services Office Inc. 2008 CG 2503 05 09 o
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POLICY NUMBER A7CG041813 01 POLICY NUMBER A7CG041813 01 COMMERCIAL GENERAL LIABILITY CG 2504 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED LOCATIONS GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Designated Locations ALL LOCATIONS OWNED BY OR RENTED TO YOU. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. For all sums which the insured becomes legally obligated to pay as damages caused by occur rences under Section Coverage A and for all medical expenses caused by accidents under Section Coverage C which can be attributed only to operations at a single designated loca tion shown in the Schedule above 1. A separate Designated Location General Aggregate Limit applies to each designated location and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Location General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A except dam ages because of bodily injury or property damage included in the products completed operations hazard and for medical expenses under Coverage C regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Loca tion General Aggregate Limit for that desig nated location. Such payments shall not re duce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Location General Aggre gate Limit for any other designated location shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence Damage To Premises Rented To You and Medical Expense continue to apply. However instead of being subject to the General Aggregate Limit shown in the Decla rations such limits will be subject to the appli cable Designated Location General Aggre gate Limit. BY OR RENTED TO YOU. CG 2504 05 09 Insurance Services Office Inc. 2008 Page 1 of 2 o
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B. For all sums which the insured becomes legally obligated to pay as damages caused by occur rences under Section Coverage A and for all medical expenses caused by accidents under Section Coverage C which can not be attrib uted only to operations at a single designated location shown in the Schedule above 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products completed Operations Aggregate Limit whichever is applicable and 2. Such payments shall not reduce any Desig nated Location General Aggregate Limit. C. When coverage for liability arising out of the products completed operations hazard is pro vided any payments for damages because of bodily injury or property damage included in the products completed operations hazard will reduce the Products completed Operations Ag gregate Limit and not reduce the General Ag gregate Limit nor the Designated Location Gen eral Aggregate Limit. D. For the purposes of this endorsement the Defi nitions Section is amended by the addition of the following definition Location means premises involving the same or connecting lots or premises whose connection is interrupted only by a street roadway waterway or right of way of a railroad. E. The provisions of Section Il Limits Of Insur ance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 Insurance Services Office Inc. 2008 CG 2504 05 09 o
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POLICY NUMBER A7CG041813 01 POLICY NUMBER A7CG041813 01 COMMERCIAL GENERAL LIABILITY CG 2404 0509 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization WHERE REQUIRED BY WRITTEN CONTRACT. Information required to complete this Schedule if not shown above will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV Conditions We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. DNTRACT. CG 24 04 05 09 Insurance Services Office Inc. 2008 Page 1 of 1 o
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POLICY NUMBER A7CG041813 01 POLICY NUMBER A7CG041813 01 COMMERCIAL GENERAL LIABILITY CG 2404 0509 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization TOPPING OUT INC. DAVIS ERECTION DAVIS J.D. STEEL LLC J.D. STEEL LLC Information required to complete this Schedule if not shown above will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV Conditions We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. IS ERECTION CG 24 04 05 09 Insurance Services Office Inc. 2008 Page 1 of 1 o
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POLICY NUMBER A7CG041813 01 POLICY NUMBER A7CG041813 01 COMMERCIAL GENERAL LIABILITY CG 02241093 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Number of Days Notice 60 If no entry appears above information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement. For any statutorily permitted reason other than nonpayment of premium the number of days required for notice of cancellation as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement is increased to the number of days shown in the Schedule above. CG 02241093 Copyright Insurance Services Office Inc. 1992 Page 1 of 1 o
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OLD REPUBLIC GENERAL INSURANCE CORPORATION WRAP UP EXCLUSION WITH LIMITED EXCEPTIONS FOR CERTAIN ONGOING OPERATIONS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. 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 or property damage arising out of any project that is or was subject to a wrap up insurance program in which you are or were included as an insured. This exclusion does not apply to bodily injury or property damage arising out of your ongoing operations A for work being performed at any location owned by or rented to you that is not within the project site or location as defined in the wrap up insurance program and is not covered by the wrap up insurance program or B for work being performed on a project covered by a wrap up insurance program after such program has terminated or expired. The exceptions A. and B. above do not apply to bodily injury or property damage included in the products completed operations hazard even if you are required to provide such coverage for an additional insured by a written contract or agreement. The following is added to Section V Definitions Wrap up insurance program means an owner or contractor controlled or similar insurance program under which some or all of the contractors and subcontractors working on a specific project or projects are required to participate in a program to obtain insurance that a. Isissued specifically to cover damage or injury arising out of such project or projects and b. Includes the same or similar insurance as is provided by this endorsement. All other terms and conditions of this Policy remain unchanged. Named Insured ouo curcaco steen 1ic Policy Number A7CG041813 01 Endorsement No. 000 Policy Period 09 01 13 to Endorsement Effective Date 09 01 13 09 01 14 Producer s Name OLD REPUBLIC CONSTRUCTION INSURANCE AGENCY INC. Producer Numbet 0000007007 AUTHORIZED REPRESENTATIVE CG EN GN 0090 02 10 Page DATE Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21730108 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. The following exclusion is added This insurance does not apply to TERRORISM Any injury or damage arising directly or indi rectly out of a certified act of terrorism. 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 dam age 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 concurrence with the Secretary of State and the Attorney General of the United States to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria con tained 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 Terror ism Risk Insurance Act and b. The act is a violent act or an act that is dangerous to human life property or infra structure and is committed by an individual or individuals as part of an effort to coerce 2. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in concurrence with the Secretary of State and the Attorney General of the United States to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria con tained 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 Terror ism Risk Insurance Act and b. The act is a violent act or an act that is dangerous to human life property or infra structure 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 con duct of the United States Government by coercion. CG 21730108 ISO Properties Inc. 2007 Page 1 of 1 o
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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 nu clear energy liability policy issued by Nu clear Energy Liability Insurance Associa tion Mutual Atomic Energy Liability Underwriters Nuclear Insurance Associa tion of Canada or any of their successors or would be an insured under any such pol icy 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 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 nu clear 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. 2 3. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source materi 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 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 nu clear 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. 2 3 IL 00 21 09 08 ISO Properties Inc. 2007 Page 1 of 2 o
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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 nu clear 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 proc essing 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 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. d Page 2 of 2 ISO Properties Inc. 2007 IL 00 21 09 08 m
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OLD REPUBLIC GENERAL INSURANCE CORPORATION NONOWNED WATERCRAFT ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE FORM SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2. Exclusions g. Aircraft Auto Or Watercratft 2 is amended to read A watercraft you do not own that is Less than 51 feet long and b Not being used to carry persons or property for a charge. However this exception does not apply to watercraft you do not own that is used in any pre arranged race or speed contest. SECTION Il WHO IS AN INSURED is amended to add the following No person is an insured with respect to any watercraft owned in whole or in part by such person or by a member of his household. Named Insured Policy Number Endorsement No. Policy Period Endorsement Effective Date Producer s Name Producer Number AUTHORIZED REPRESENTATIVE DATE CG EN GN 0039 09 06
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OLD REPUBLIC GENERAL INSURANCE CORPORATION BROAD FORM NAMED INSURED THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART BUSINESS AUTO COVERAGE FORM The Named Insured on the Declarations page is revised to include Named Insured means the person or organization first named as the Named Insured on the Declarations page of this policy the First Named Insured. Named Insured also includes 1 any other person or organization named as a Named Insured on the Declarations page 2 any subsidiary associated affiliated allied or acquired company or corporation including subsidiaries thereof of which any insured named as the Named Insured on the Declarations page has more than 50 ownership interest in or exercises management or financial control over at the inception date of this policy provided such subsidiary associated affiliated allied or acquired company or corporation and their operations have been declared to us prior to the inception date of this policy. Named Insured Policy Number Endorsement No. Policy Period Endorsement Effective Date Producer s Name Producer Number AUTHORIZED REPRESENTATIVE DATE IL EN GN 0001 09 06
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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 in sured or others for the handling storage disposal processing or treatment of waste or b 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 as sessing 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 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 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 as sessing the effects of pollutants CG 21651204 ISO Properties Inc. 2003 Pagetof1 O
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IL 02 59 09 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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. Paragraphs 2. and 3. of the Cancellation Com mon Policy Condition are replaced by the follow ing 2. Cancellation Of Policies In Effect a. 60 Days Or Less If this policy has been in effect for 60 days or less we may cancel this policy for any reason b. More Than 60 Days If this policy has been in effect for more than 60 days or if this is a renewal of a pol icy we issued we may cancel this policy only for one or more of the following rea sons 1 Nonpayment of premium 2 The policy was obtained through mate rial misrepresentation 3 Any insured has submitted a fraudulent claim 4 Any insured has violated the terms and conditions of this policy 5 The risk originally accepted has sub stantially increased 6 Certification to the Director of Insurance of our loss of reinsurance which pro vided coverage to us for all or a sub stantial part of the underlying risk in sured or The determination by the Director of In surance that the continuation of the pol icy could place us in violation of the Ne braska Insurance Laws. c. 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 can cellation if we cancel for nonpayment of premium or 2. 60 days before the effective date of can cellation if we cancel for any other rea son. 7 3. 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. IL 02 59 09 07 ISO Properties Inc. 2006 Page 1 of 2 a
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B. Paragraph 6. of the Cancellation Common Policy Condition does not apply. C. The following is added and supersedes any provi sions 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 In sured at least 60 days prior to the expiration date of this policy. 2. 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 Page 2 of 2 ISO Properties Inc. 2006 IL 02 59 09 07 o
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POLICY NUMBER A7CG041813 01 POLICY NUMBER A7CG041813 01 COMMERCIAL GENERAL LIABILITY CG 20100413 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 WHERE REQUIRED BY WRITTEN CONTRACT. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by 1. Your acts or omissions or 2. The acts or omissions of those acting on your behalf in the performance of your ongoing operations for the additional insureds at the locations designated above. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following additional exclusions apply This insurance does not apply to bodily injury or property damage occurring after 1. Al work including materials parts or equipment furnished in connection with such work on the project other than service maintenance or repairs to be performed by or on behalf of the additional insureds at the location of the covered operations has been completed or 2. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20100413 Insurance Services Office Inc. 2012 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 lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 Insurance Services Office Inc. 2012 CG20100413
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POLICY NUMBER A7CG041813 01 POLICY NUMBER A7CG041813 01 COMMERCIAL GENERAL LIABILITY CG 20370413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS COMPLETED OPERATIONS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Location And Description Of Completed Operations WHERE REQUIRED BY WRITTEN CONTACT BUT ONLY WHEN COVERAGE FOR COMPLETED OPERATIONS IS SPECIFICALLY REQUIRED BY THAT CONTRACT. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury 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 lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20370413 Insurance Services Office Inc. 2012 Page 1 of 1
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POLICY NUMBER A7CG041813 01 POLICY NUMBER A7CG041813 01 COMMERCIAL GENERAL LIABILITY CG 20100413 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 TOPPING OUT INC. DAVIS ERECTION DAVIS J.D. STEEL LLC Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by 1. Your acts or omissions or 2. The acts or omissions of those acting on your behalf in the performance of your ongoing operations for the additional insureds at the locations designated above. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following additional exclusions apply This insurance does not apply to bodily injury or property damage occurring after 1. Al work including materials parts or equipment furnished in connection with such work on the project other than service maintenance or repairs to be performed by or on behalf of the additional insureds at the location of the covered operations has been completed or 2. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. AVIS J.D. STEEL LLC CG 20100413 Insurance Services Office Inc. 2012 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 lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 Insurance Services Office Inc. 2012 CG20100413
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POLICY NUMBER A7CG041813 01 POLICY NUMBER A7CG041813 01 COMMERCIAL GENERAL LIABILITY CG 20370413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS COMPLETED OPERATIONS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Location And Description Of Completed Operations TOPPING OUT INC. DAVIS ERECTION DAVIS J.D. STEEL LLC J.D. STEEL LLC 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 lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. LLC CG 20370413 Insurance Services Office Inc. 2012 Page 1 of 1
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OLD REPUBLIC GENERAL INSURANCE CORPORATION ADDITIONAL PERSONS INSURED INJURY TO A FELLOW EMPLOYEE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART In consideration of the premium charged the following provisions apply to the insurance provided by this policy and supersede any provisions to the contrary. It is agreed that the following language is added to the end of paragraph 2.a.1a of SECTION Il WHO IS AN INSURED. However with respect to the positions designated below the employees in those positions are considered insureds for bodily injury or personal injury to a fellow employee while the fellow employee is in the course of employment. Covered Positions EXECUTIVE OFFICERS SUPERVISORS MANAGERS All other terms and conditions of this Policy remain unchanged. Policy Number A7CG041813 01 Endorsement No. 000 Policy Period 09 01 13 to Endorsement Effective Date 09 01 13 09 01 14 Producer s Name OLD REPUBLIC CONSTRUCTION INSURANCE AGENCY INC. Producer Numbe 0000007007 AUTHORIZED REPRESENTATIVE DATE CG EN GN 009103 10 Page 1 of 1
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POLICY NUMBER A7CG041813 01 POLICY NUMBER A7CG041813 01 COMMERCIAL GENERAL LIABILITY CG 04370413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ELECTRONIC DATA LIABILITY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Loss Of Electronic Data Limit 1000000 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Exclusion 2.p. of Coverage A Bodily Injury And Property Damage Liability in Section Coverages is replaced by the following 2. Exclusions This insurance does not apply to p. 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 that does not result from physical injury to tangible property. However this exclusion does not apply to liability for damages because of bodily injury. B. The following paragraph is added to Section Ill Limits Of Insurance Subject to 5. above the Loss of Electronic Data Limit shown in the Schedule above is the most we will pay under Coverage A for property damage because of all loss of electronic data arising out of any one occurrence. C. The following definition is added to the Definitions section 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 ROMSs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. D. For the purposes of the coverage provided by this endorsement the definition of property damage in the Definitions section is replaced by 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 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 or c. Loss of loss of use of damage to corruption of inability to access or inability to properly manipulate electronic data resulting from physical injury to tangible property. All such loss of electronic data 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 04370413 Insurance Services Office Inc. 2012 Page 1 of 1
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OLD REPUBLIC GENERAL INSURANCE CORPORATION CANCELLATION OR NON RENEWAL TO SPECIFIED PERSONS OR ORGANIZATIONS ENDORSEMENT ILLINOIS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING BUSINESS AUTO COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART We may cancel or non renew this policy. If we cancel or non renew this policy for any reason other than non payment we will deliver notice of the cancellation or non renewal to all Specified Persons or Organizations on file with us THIRTY 30 days prior to the effective date of cancellation or non renewal. We may cancel this policy for non payment. If we do we will deliver notice of the cancellation to all Specified Persons or Organizations on file with us TEN 10 days prior to the effective date of cancellation. If notice is mailed proof of mailing will be sufficient proof of notice. This endorsement does not apply to the Named Insured. Named Insured OLD CHICAGO STEEL LLC Policy Number A7CG041813 01 Endorsement No. 000 Policy Period 09 01 13t0 09 01 14 Endorsement Effective Date 09 01 13 Producer s Name OLD REPUBLIC CONSTRUCTION INSURANCE AGENCY INC. Producer Number 0000007007 AUTHORIZED REPRESENTATIVE DATE IL EN IL 0004 09 11 Page 1 of 1
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INSURANCE IS PROVIDED BY THE COMPANY DESIGNATED ON THE DECLARATIONS PAGE IN WITNESS WHEREOF we have caused this policy to be executed and attested and if required by state law this policy shall not be valid unless countersigned by our authorized representative. OLD REPUBLIC GENERAL INSURANCE CORPORATION 307 N. Michigan Avenue Chicago lllinois 60601 A Stock Company o by Secretary R President X K OLD REPUBLIC couus X K 307 North Michigan Avenue Chicago Illinois 60601 312 346 8100 J02 0812
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IEA 0 COMMERCIAL GENERAL LIABILITY AMCO 5139 TABPAGE 07 02100 nan nan nan nan 72.0 5139.0 LAXA INSURED COPY ACP 72 4 4313823
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MATION Kook Kok dokok POLICIES 3 e streamlined your renewal policy. We have not changed from your expiring policy uniess your prior policies for printed copies of these agent. ACP GLAO 7244313823 955503571 72 0005140 AMCO INSURANCE COMPANY 1100 LOCUST ST DEPT 1100 DES MOINES IA 50391 2000 Named Insured SKYLINE CONSTRUCTION INC Address 9120 FLINT ST OVERLAND PARK KS 66214 1736 IMPORTANT INSURANCE INFORMATION Fodkokok ko ok Fokdok Fok kokok IMPORTANT NOTICE FOR RENEWAL POLICIES In an effort to keep your insurance premium as low as possible we have streamlined your renewal policy. We have not included printed copies of policy forms and endorsements that have not changed from your expiring policy unless they include variable information that is unique to you. Please refer to your prior policies for printed copies of these forms. If you desire copies they are available upon request from your agent. IN 5017 05 93 DIRECT BILL LAXA 13262 INSURED COPY
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IMPORTANT INSURANCE INFORMATION ook Aok ok Raga2.2.2.2.8 4 IMPORTANT NOTICE TO POLICYHOLDERS TEXAS CONTRACTORS The Texas State Board of Insurance requires that insurance companies establish their criteria for the adequacy of insurance limits of subcontractors performing work for you prior to policy inception. Unless otherwise com municated to you for the purposes of issuance of this policy those limits are 300000 Each Occurrence Limit for Bodily Injury and Property Damage 300000 Personal and Advertising Injury Limit 600000 General Aggregate Limit 600000 Products Completed Operations Limit Operations performed by subcontractors who work for you without adequate insurance shall be classified and rated under the specific classification description for each type of work that is performed. IN 72 24 07 02 ACP GLAO 7244313823 DIRECT BILL LAXA1326 INSURED COPY nan nan nan nan 2955503571.0 nan nan nan nan 72.0 5141.0
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IN75841111 Hokok ok ok ok ok IMPORTANT INSURANCE INFORMATION oA Kk kK ok Please read this Notice carefully. No coverage is provided by this notice nor can it be construed to replace any provision of your policy. You should read your policy and review your declarations page for complete information on the coverages you are provided. If there is any conflict between the policy and this notice the provisions of the policy shail prevail. NOTICE TO POLICYHOLDERS COMMERCIAL GENERAL LIABILITY CONTRACTORS ENHANCEMENT OR CONTRACTORS ENHANCEMENT PLUS ENDORSEMENT The purpose of this notice is 1o make you aware of a change to the endorsements listed below. Your policy includes one of the following endorsements e CG 728803 10 Coniractors Enhancement Endorsement CG 72890310 Contractors Enhancement Endorsement CG 73230510 Contractors Enhancement Plus Endorsement e CG 73250510 Contractors Enhancement Plus Endorsement e CG 73300610 New York Contractors Enhancement Endorsement e GG 73310610 Virginia Contractors Enhancement Endorsement e CG 73320610 Virginia Contractors Enhancement Plus Endorsement e CG 73670610 New York Contractors Enhancement Plus Endorsement The additional insured coverage within these endorsements has been revised to specifically require that in order for there 1o be coverage for an additional insured the injury or damage must be caused in whole or in part by the acts or omissions of you or those acling on your behalf. This revision clarifies that coverage is not extended for injuries or damages caused by an additional insured s sole negligence. IN75841111 ACP GLAO 7244313823 DIRECT BILL LAXA1326 Page 1 of 1 72 0005142 INSURED COPY nan nan nan nan 2955503571.0
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COMMERCIAL GENERAL LIABILITY IN76890413 GENERAL LIABILITY FORMS REVISION ADVISORY NOTICE TO POLICYHOLDERS Your General Liability policy is changing but the basic coverages are similar. No coverage is provided by this summary nor can it be construed to replace any provision of your policy. You should read your policy and review your Declarations page 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. If your current policy includes any of the following endorsements the coverage has been broadened clarified or reduced as noted below. This notice does not reference every editorial change made in your policy. We have followed the policy sequence of provisions in setting out this material. CG 70 02 BODILY INJURY TO CO EMPLOYEES COVERAGE Minor corrections were made with no impact to coverage. HIRED AUTO AND NON OWNED AUTO LIABILITY COVERAGE Replacing CG 72 02 with CG 70 03 12 12 in Maryland only. Replacing CG 72 47 with CG 70 03 12 12 in Maine only. Replacing CG 70 48 with CG 70 03 12 12 in Kansas only. Replacing CG 70 50 with CG 70 03 12 12 in Minnesota only. Replacing CG 70 51 with CG 70 03 12 12 in Montana only. Replacing CG70 03 with updated CG 70 03 12 12 edition in all other states. A. REDUCTIONS IN COVERAGE 1. The fellow Employee Exclusion has been modified to exclude bodily injury of people in familial relationships with the insured. 2. WhoIs an Insured has been modified with regard to non owned autos to limit coverage 1o pariners executive officers while non owned autos are being used in your business and employee s if they or those with familial relationships do not own the non owned auto being used in the insured s business. 3. We will no longer provide coverage for liability arising from the maintenance of Non Owned autos. 4. We will no longer provide coverage for attorney fees and litigation expenses assumed through Contractual Liability. 5. We will no longer provide coverage for liability assumed under a sidetrack agreement. B. CLARIFICATIONS IN COVERAGE The Other Insurance Provision has been modified to clarify that coverage will be excess over any primary insurance. CG 70 68 GOLF COURSE ADDITIONAL INSURED ENDORSEMENT IN76890413 Includes copyrighted material of Insurance Services Office Inc. with its permission. ACP GLAO 7244313823 DIRECT BILL LAXA1326 INSURED COPY 2955503571 Page 10f 2 72 0005143
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COMMERCIAL GENERAL LIABILITY IN76890413 A. CLARIFICATIONS IN COVERAGE Who Is An Insured has been modified to remove volunteer workers as this is a defined term within the GG 00 01. B. EXCLUSIONS Coverage C. Medical Payments has been madified to exclude payment of expenses for bodily injury to users of golf carts. CG 70 78 EXCLUSION TOBACCO PRODUCTS Minor corrections were made with no impact to coverage. CG 71 59 DAMAGE TO YOUR PRODUCT AUTO SERVICE A. CLARIFICATIONS IN COVERAGE The title of the form has been modified to clarify that the endorsement only applies to Auto Service risks. COMMERCIAL GENERAL LIABILITY COVERAGE ENHANCEMENT ENDORSEMENT Replacing CG 72 29 with CG 7212 12 11 in New Hampshire only. Replacing CG72 12 with updated CG 72 12 12 11 edition in all other states. A. CLARIFICATIONS IN COVERAGE Clarification added regarding the application of the deductible. GL 2199 EXCLUSION SUBSIDENCE OF LAND Replacing GL 21 99 with CG 74 20 12 11. A. REDUCTIONS IN COVERAGE Definition has been modified 1o include artificial causes and the result of erosion contraction and settling. Page 2 of 2 Includes copyrighted material of Insurance Services Office inc. with ils permission. ACP GLAC72 44313823 LAXA 13262 INSURED COPY IN7689041300 0000 IN 76 89 0413 72 0005144
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COMMERCIAL GENERAL LIABILITY IN76 9504 13 2012 GENERAL LIABILITY KANSAS FORMS REVISION ADVISORY NOTICE TO POLICYHOLDERS This is a summary of the major changes in your policy. No coverage is provided by this summary nor can it be construed to replace any provision of your policy. You should read your policy and review your Declarations page 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. The major areas within the policy that broaden or reduce coverage and other changes are highlighted below. This notice does not reference every editorial change made in your policy. We have followed the policy sequence of provisions in setting out this material. COMMERCIAL GENERAL LIABILITY COVERAGE FORMS CG 00 0104 13 AND CG 00 02 04 13 I. EXCLUSIONS A. BROADENING OF COVERAGE 1. Coverage A Exclusion 2.c. Liquor Liability is revised to provide an exception with respect to allowing a person fo bring alcoholic beverages onto the named insured s premises for consumption on the named insured s premises. 2. Coverage A Exclusion 2.p. Electronic Data is revised to introduce an exception for liability for damages because of bodily injury. B. OTHER CHANGES 1. Coverage A Exclusion 2.c. Liquor Liability 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 o provide transportation with respect to any person that may be under the influence of alcohol. 2. Coverage A Exclusion 2.g. Aircraft Auto Or Walercraft is revised to delete reference to in the state. 3. Coverage A Exclusion 2.q. and Coverage B Exclusion 2.p. Recording And Distribution Of Material Or Information In Violation Of Law were previously added to your policy via mandatory endorsement. The endorsement coniained an exclusion addressing injury or damage arising out of any action or omission that violates or is alleged to violate certain statutes ordinances and regulations. This exclusion has been incorporated directly into your policy. 4. Coverage B Exclusions 2.b. and 2.c. Material Published With Knowledge Of Falsity and Material Published Prior To Policy Period are revised to reference in any manner with respect 1o oral or written publication for consistency with the definition of personal and advertising injury.. CONDITIONS OTHER CHANGES 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. lil. DEFINITIONS OTHER CHANGES 1. Definition 2. Auto is revised o delete reference 1o in the state with respect 1o where a vehicle is licensed or principally garaged. 2. Definition 12. Mobile Equipment is revised to delele reference to in the state with respect fo where a vehicle is licensed or principally garaged. IN76 9504 13 Includes copyrighted material of Insurance Services Office Inc. Page 1 0f 6 with its permission. ACP GLAO 7244313823 DIRECT BILL LAXA1326 INSURED COPY 2055503571 72 0005145
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IN76 9504 13 OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM COVERAGE FOR OPERATIONS OF DESIGNATED CONTRACTOR CG 00090413 I. EXCLUSIONS BROADENING OF COVERAGE Exclusion 2.1. Electronic Data is revised to introduce an exception for liability for damages because of bodily injury. Il. DEFINITIONS OTHER CHANGES 1. Definition 1. Auio is revised fo delete reference to in the state with respect to where a vehicle is licensed or principally garaged. 2. Definition 10. Mobile Equipment is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged. LIQUOR LIABILITY COVERAGE FORMS CG 0033 04 13 AND CG 0033 04 13 WHO IS AN INSURED BROADENING OF COVERAGE We have included trusts as Named Insureds. In addition trustees have been included as insureds but only with respect to their duties as trustees. CG 00 35 04 13 RAILROAD PROTECTIVE LIABILITY COVERAGE FORM EXCLUSIONS BROADENING OF COVERAGE Exclusion 2.f.3a Pollution is amended to expand the exception to the exclusion with respect to bodily injury or property damage arising out of fuel or lubricants for equipment used at the job location not just when they escape from such equipment. PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM CG 0037 04 13 AND CG 00 38 04 13 I. EXCLUSIONS BROADENING OF COVERAGE 1. Exclusion 2.c. Liquor Liability 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 2. Exclusion 2.1. Electronic Data is revised fo introduce an exception for liability for damages because of bodily injury. IN 769504 13 72 0005146 Page 2 of 6 Includes copyrighled material of Insurance Services Office Inc. with its permission. ACP GLAO72 4 4313823 LAXA 13262 INSURED COPY IN7695041300 0000
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IN76 950413 IN76 950413 1. DEFINITIONS OTHER CHANGES 1. Exclusion 2.c. Liquor Liability 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 2. Definition 1. Aulo is revised fo delete reference to in the state with respect 1o where a vehicle is licensed or principally garaged. 3. Definition 10. Mobile Equipment is revised to delete reference to in the state with respect to where a vehicle is licensed or principally garaged. ENDORSEMENTS A. BROADENING OF COVERAGE 1. Electronic Data Liability Endorsement CG 04 37 is revised 1o introduce an exception 1o the electronic data exclusion in order to provide that the exclusion does not apply to liability for damages because of bodily injury. 2. Additional Insured Owners Lessees Or Contractors Automatic Status For Other Parties When Required In Written Construction Agreement Endorsement CG 20 88 is introduced to provide additional insured status to those parties whom 1he named insured is obligated in writing in a contract or agreement to name as an additional insured. 3. Druggists Endorsement CG 22 69 is revised to introduce an exception for the administering of vaccinations. 4. Liquor Liability Bring Your Own Alcohol Establishments Endorsement CG 24 06 is introduced 1o provide coverage to insureds who permit any person to bring any alcoholic beverage on an insured s premises for consumption on the insured s premises. B. REDUCTIONS OF COVERAGE 1. Additional Insured Users Of Golfmobiles Endorsement CG 20 08 is revised 1o include a definition of the term golfmobile. 2. Liquor Liability Exclusion Endorsements The following endorsements are revised to indicate that the liquor liability exclusion will apply if a named insured permits any person fo bring any alcoholic beverages on the named insured s premises for consumption on the named insured s premises CG 21 50 Amendment Of Liquor Liability Exclusion for use with Commercial General Liability Coverage Parl o CG 21 51 Amendment Of Liquor Liability Exclusion Exception For Scheduled Premises Or Activities for use with Commercial General Liability Coverage Part CG 29 52 Amendment Of Liquor Liability Exclusion for use with Products Completed Operations Liability Coverage Part CG 29 53 Amendment Of Liquor Liability Exclusion Exception For Scheduled Premises Or Activities for use with Products Completed Operations Liability Coverage Part 3. Total Pollution Exclusion For Designated Products Or Work Endorsement CG 21 99 is introduced to exclude coverage with respect to bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants which arises out of the product or work scheduled in the endorsement. 4. Amendment Of Personal And Advertising Injury Definition Endorsement CG 24 13 is introduced to remove from the definition of personal and advertising injury the offense of oral and written publication in any manner of material that violates a person s right of privacy. IN769504 13 Includes copyrighted material of Insurance Services Office Inc. with ils permission. ACP GLAO72 4 4313823 LAXA 13262 INSURED COPY IN7695041300 0000 Page 3 of 6 72 0005147
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IN769504 13 C. OTHER CHANGES 1. Limited Product Withdrawal Expense Endorsement CG 04 36 is revised in part to reinforce that the Participation Percentage is indicated in the Schedule and to reflect that the cost of the insured s participation in each product withdrawal will be borne by the named insured when due. 2. Additional Insured Endorsements The following additional insured endorsements are revised to indicate that when these endorsements are altached to a policy if coverage provided to the additional insured is required by contract or agreement coverage 1o the additional insured will be afforded to the extent permissible by law and to the extent the named insured is required by the contract or agreement 1o 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 thal are available to an additional insured will be limited to the extent required by 1he contract or agreement or the amount of insurance available under the applicable Limits of Insurance shown in the Declarations whichever is less CG 20 03 Additional Insured Concessionaires Trading Under Your Name CG 20 05 Additional Insured Controlling Interest CG 20 07 Additional Insured Engineers Architects Or Surveyors replaces CG 32 81 CG 20 10 Additional Insured Owners Lessees Or Contractors Scheduled Person Or Organization replaces CG 32 76 CG 20 11 Additional Insured Managers Or Lessors Of Premises CG 20 12 Additional Insured State Or Governmental Agency Or Subdivision Or Political Subdivision Permits Or Authorizations CG 20 13 Additional Insured Stale Or Governmental Agency Or Subdivision Or Political Subdivision Permits Or Authorizations Relating To Premises CG 20 15 Additional Insured Vendors replaces CG 32 79 CG 20 18 Additional Insured Mortgagee Assignee Or Receiver CG 20 23 Additional Insured Executors Administrators Trustees Or Beneficiaries CG 20 24 Additional Insured Owners Or Other Interest From Whom Land Has Been Leased CG 20 26 Additional Insured Designated Person Or Organization CG 20 27 Additional Insured Co owner Of Insured Premises CG 20 28 Additional Insured Lessor Of Leased Equipment replaces CG 32 84 CG 20 29 Additional Insured Grantor Of Franchise replaces CG 32 80 CG 20 30 Oil Or Gas Operations Nonoperating Working Interests CG 20 31 Additional Insured Engineers Architects Or Surveyors CG 20 32 Additional Insured Engineers Architects Or Surveyors Not Engaged By The Named Insured replaces CG 32 82 CG 20 33 Additional Insured Owners Lessees Or Contractors Automatic Status When Required In Construction Agreement With You replaces CG 32 77 CG 20 34 Additional Insured Lessor Of Leased Equipment Automatic Stalus When Required In Lease Agreement With You replaces CG 32 83 CG 20 35 Additional Insured Grantor Of Licenses Automalic Status When Required By Licensor CG 20 36 Additional Insured Grantor Of Licenses CG 20 37 Additional Insured Owners Lessees Or Contraclors Completed Operations replaces CG 3278 CG 29 35 Additional Insured State Or Governmental Agency Or Subdivision Or Political Subdivision Permits Or Authorizations Page 40f 6 Includes copyrighted material of Insurance Services Office Inc. wilh its permission. ACP GLAO724 4313823 LAXA 13262 INSURED COPY IN7695041300 0000 IN76 9504 13 72 0005148
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IN769504 13 3. Professional Services Endorsements The following 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 CG 21 16 Exclusion Designated Professional Services CG 21 52 Exclusion Financial Services CG 21 56 Exclusion Funeral Services CG 21 57 Exclusion Counseling Services CG 21 58 Exclusion Professional Veterinarian Services CG 21 59 Exclusion Diagnostic Testing Laboratories CG 22 24 Exclusion Inspection Appraisal And Survey Companies CG 22 32 Exclusion Professional Services Blood Banks CG 22 33 Exclusion Testing Or Consulting Errors And Omissions CG 22 34 Exclusion Construction Management Errors And Omissions CG 22 36 Exclusion Products And Professional Services Druggists CG 22 37 Exclusion Products And Professional Services Optical And Hearing Aid Establishments CG 22 39 Exclusion Camps Or Gampgrounds CG 22 43 Exclusion Engineers Architects Or Surveyors Professional Liability CG 22 44 Exclusion Services Furnished By Health Care Providers CG 22 45 Exclusion Specified Therapeutic Or Cosmetic Services CG 22 48 Exclusion Insurance And Related Operations CG 22 69 Druggists CG 22 71 Colleges Or Schools Limited Form CG 22 72 Colleges Or Schools CG 22 75 Professional Liability Exclusion Computer Software CG 22 76 Professional Liability Exclusion Health Or Exercise Clubs Or Commercially Operated Health Or Exercise Facilities CG 2277 Professional Liability Exclusion Computer Data Processing CG 22 79 Exclusion Contractors Professional Liability CG 22 80 Limited Exclusion Contractors Professional Liability CG 22 87 Exclusion Adult Day Care Centers CG 22 88 Professional Liability Exclusion Electronic Data Processing Services And Computer Consulting Or Programming Services CG 22 90 Professional Liability Exclusion Spas or Personal Enhancement Facilities CG 22 91 Exclusion Telecommunication Equipment Or Service Providers Errors And Omissions CG 22 96 Limited Exclusion Personal And Advertising Injury Lawyers CG 22 98 Exclusion Internet Service Providers And Internet Access Providers Errors And Omissions CG 22 99 Professional Liability Exclusion Web Site Designers CG 23 01 Exclusion Real Estate Agents Or Brokers Errors Or Omissions CG 31 15 Construction Project Management Protective Liability Coverage 4. Exclusion Volunteer Workers Endorsement CG 21 66 is revised to delete reference to in the state from Exclusion 2.g. Aircraft Auto Or Watercraft. IN769504 13 ACP GLAO72 4 4313823 Includes copyrighted material of Insurance Services Office Inc. Page50f 6 with its permission. LAXA 13262 INSURED COPY IN7695041300 0000 72 0005149 Page50f 6 72 0005149
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IN 769504 13 5. 6. 10. 1. 12 13. 14. Exclusion Failure To Supply Endorsement CG 22 50 is revised 1o expressly state that the exclusion also applies to the failure of any insured to adequately supply biofuel. Pesticide Or Herbicide Applicator Coverage Endorsements CG 22 64 and CG 28 12 and Lawn Care Services Coverage Endorsement CG 22 93 are revised lo reflect a change in litles to Herbicide Applicator Limited Pollution Coverage endorsements and Lawn Care Services Limited Pollution Coverage.. Real Estale Property Managed Endorsement CG 22 70 is revised to reinforce that the insurance provided is excess over any other insurance available whether such insurance is primary or excess.. Colleges Or Schools Endorsements CG 22 71 and CG 22 72 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.. Waiver Of Governmental Immunily Endorsement CG 24 14 is revised lo reference that the endorsement also applies to the Owners And Contractors Protective Liability Coverage Part and the Railroad Proteclive Liability Coverage Part. Amendment Of Insured Contract Definition Endorsement CG 24 26 and Limited Contractual Liability Railroads Endorsement CG 24 27 are revised to reflect that the defined term insured contract addresses certain liability assumed by the named insured with respect to the fort liability of another party to the extent the assumption of the tort liability is permitted by law. Designated Locationss Aggregate Limit Endorsement CG 25 14 is introduced to make a separate Designaled Location Aggregate Limit available for each location of the insured listed in the Schedule of the endorsement. Supplemental Extended Reporting Period Endorsement CG 27 10 and Supplemental Extended Reporting Period Endorsement For Specific Accidents Products Work Or Locations Endorsement CG 27 11 are revised to amend Condition 4. Other Insurance 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. Principals Protective Liability Coverage Endorsement CG 28 07 is revised to delete reference to in the state from Exclusion 2.c.1ei. Liquor Liability Exclusion Endorsements The following endorsements are 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. CG 21 50 Amendment Of Liquor Liability Exclusion for use with Commercial General Liability Coverage Parl. CG 21 51 Amendment Of Liguor Liability Exclusion Exception For Scheduled Premises Or Activities for use with Commercial General Liability Coverage Part. CG 29 52 Amendment Of Liquor Liability Exclusion for use with Products Completed Operations Liability Coverage Part. CG 29 53 Amendment Of Liquor Liability Exclusion Exception For Scheduled Premises Or Activities for use with Products Completed Operations Liability Coverage Part IN769504 13 72 0005150 Page 6 of 6 Includes copyrighted material of Insurance Services Office Inc. with ils permission. ACP GLAO72 4 4313823 LAXA 13262 INSURED COPY IN7695041300 0000
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02 10 mium es an y vary ssions. an be ium. If wifl be I by audit audit your nce is dise BR 9955 02 10 BR 9955 02 10 The policy you have just received is subject to a premium adjustment When your policy was issued the premium was estimated. When your policy expires the actual premium must be determined. Please take a few minutes to read this information about your premium audit WHY MAKE A PREMIUM ADJUSTMENT HOW WILL THE PREMIUM ADJUSTMENT BE MADE WHAT WILL THE PREMIUM AUDITOR DO PREMIUM BASES BR 9955 02 10 GLAD7244313823 LAXA 13262 This policy was issued with an estimated premium which requires an adjustment after the policy expires. Premium bases for this type of policy vary according to such factors as payroll sales receipts number of admissions contract costs number of units etc. incurred during the term of the policy. After the policy expires and the actual amount of these variables can be determined the estimated premium is adjusted to develop the final premium. If the final premium is less than the estimated premium the difference will be refunded. If it is more you will receive a bill for the additional premium. When the policy expires a final audit will be requested. This will be done by one of the following methods 1 Mailing a Policyholder s Report Audit Inquiry to you or 2 A premium auditor representing our company will call you for an audit of your recordsor 3 A premium auditor representing our company will visit you for an audit of your records. This audit of your records will pertain to the variable factors that apply to your policy. You are assured of complete confidentiality by the auditor and the insurance company personnel. The premium auditor will ask to examine your books of original entry and ledger accounts that pertain to the variable factors on which the premium is based. The auditor will also routinely verify payroll and sales figures by comparison with quarterly tax reports. Insurance rates differ by the type of work performed. The premium auditor must place each employee in the proper insurance occupational classification. In some cases these classifications are assigned by the state. This step of the audit requires your guidance and assistance. When all the different functions of your operation have been identified and the payrolls sales costs and other applicable variables have been assigned to the proper classification the appropriate rates will be applied and the final premium developed. The basis of premium for a Workers Compensation or General Liability policy may be total remuneration including wages and other considerations given to an employee for services rendered. Remuneration includes monies paid out and may also include other considerations such as meals and housing free merchandise or merchandise discounts commissions and bonuses payments for holidays vacations ilinesses and overtime incentive plans or profit sharing agreements. Remuneration does notinclude your contributions to employee benefit plans such as group insurance and pension plans or rewards for individual inventions. Under a General Liability policy remuneration does not include payrolls for clerical office employees sales persons and drivers unless specifically included by a classification wording. Page 10f 3 INSURED COPY 72 0005151 HOW WILL THE PREMIUM ADJUSTMENT BE MADE WHAT WILL THE PREMIUM AUDITOR DO PREMIUM BASES BR 9955 02 10 ACP GLAD7244313823 LAXA 13262 INSURED COPY
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13262 NOTE In most cases there are predetermined payroll amounts which must be used for sole proprietors partners and executive officers. When your policy is audited the auditor will use the predetermined amount rather than actual payroll for individuals in these groups. Contact your agent if you have questions about the amount of payroll which will be used for sole proprietors partners and executive officers. Also included is the payroll of mobile equipment operators and their helpers and drivers of automobiles when such persons are provided under contract at the time the mobile equipment or automobiles are hired. Under a General Liability policy fees paid to employment agencies for temporary personnel provided to you are counted as remuneration. The basis of premium for some classes can include variables such as area number of units admissions to an insured event conducted on your premises or receipts covering your gross earnings for goods or products sold or for operations performed. For subcontracted work the basis of premium is total cost. This means the total cost of all work let or subletin connection with each specific project and includes the cost of all labor materials and equipment furnished used or delivered for use in the performance of the work. Also all fees bonuses or commissions made paid or due are included. It is to your advantage to obtain Certificates of Insurance from your subcontractors and have them available for the premium auditor showing that they have generalliability insurance with an occurrence limit preferably equal to your own occurrence limit. Regardless of the occurrence limit carried by the subcontractor in the event you can not furnish the premium auditor with their Certificate of Insurance their payroll will be attributed to you and your premium will be increased. In most jurisdictions you must have Workers Compensation certificates from each subcontractor as well. When sales or receipts are the basis of premium for a coverage the gross amount of money you or others operating or trading under your name have charged for goods or products sold or operations performed is the figure which should be used. With respect to the ownership andor use of automobiles in connection with your business operations the basis of premium will vary. For owned autos the auditor will need to verify the accuracy of the schedule of autos on your policy plus the date of any sales andor purchases during the policy period. Any premium for the use of nonowned autos will be rated based on the total number of employees at all locations. Any premium for the use of hired autos will be rated based on the cost of hire during the policy period. The best sources of information for a premium audit are the following records. 1. S Payroll journals providing monthly total and division of payroll by type of work performed. Individual earnings records with an indication of work performed. The date hired andor terminated should be indicated. Gross payroll and overtime should be totaled by month and quarter. Cash disbursements journals with monthly totals disbursed to various accounts including materials subcontractors and casual labor. Cash receipts in sales journals totaled by month and assigned to various Page20f 3 INSURED COPY 72 0005152 BR 9955 02 10 RECORD KEEPING AIDS BR 9955 02 10 ACP GLAO7244313823 LAXA 13262 INSURED COPY
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BR 9955 02 10 categories. 5. Vehicle titles registrations or ownership tax receipts. 6. Workers Compensation andor General Liability certificates of insurance indicating coverage for subcontractors. 7. Data processing printouts or computerized records can differ greatly in their value to the auditor depending on the type of records provided. We hope this information will serve as a guide to help you prepare for your premium audit. Our premium auditor is available to help you with any problem or questions you may have with record keeping. Remember for more information contact your agent. FINALLY Page 30f 3 72 0005153 BR 9955 02 10 ACP GLA07244313823 LAXA 13262 INSURED COPY
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AMCO INSURANCE COMPANY 20113 1100 LOCUST ST DEPT 1100 RENEWAL DES MOINES IA 50391 2000 COMMERCIAL GENERAL LIABILITY DECLARATIONS Policy Number ACP GLAO 7244313823 Named Insured SKYLINE CONSTRUCTION INC Address 9120 FLINT ST OVERLAND PARK KS 66214 1736 Agent LOCKTON COMPANIES LLC 15 20113 000 Address KANSAS CITY MO 64112 Policy Period From 092113 to 092114 1201 A.M. standard time at the address of the named insured as stated herein. In return for the payment of the premium and subject to all the terms of this policy we agree with you to provide the insurance as stated in this policy. LIMITS OF INSURANCE GENERAL AGGREGATE LIMIT other than products completed operations 2000000 PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT see classification shown on 2000000 the attached schedule to determine a glicabiliiy of products liability coverage PERSONAL AND ADVERTISING INJURY LIMIT 1000000 EACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT any one premises 100000 MEDICAL EXPENSE LIMIT any one person 5000 20113 RENEWAL 2y Wi W S AR RENLWAL SEEEES DES MOINES 1A 50391 2000 COMMERCIAL GENERAL LIABILITY DECLARATIONS Policy Number ACP GLAO 7244313823 Named Insured SKYLINE CONSTRUCTION INC Address 9120 FLINT ST i OVERLAND PARK KS 66214 1736 Agent LOCKTON COMPANIES LLC 15 20113 000 Address KANSAS CITY MO 64112 Policy Period From 092113 to 092114 1201 A.M. standard time at the address of the named insured as stated herein. In return for the payment of the premium and subject to all the terms of this policy we agree with you to provide the insurance as stated in this policy. LIMITS OF INSURANCE GENERAL AGGREGATE LIMIT other hanroducs com leted operations 2000000 PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT see classification shown on 2000000 the attached schedule to determine a glicabiliiy of products liability coverage PERSONAL AND ADVERTISING INJURY LIMIT 1000000 EACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT any one premises 100000 MEDICAL EXPENSE LIMIT any one person 5000 Retroactive Date CG0002 only The Named Insured is CORPORATION Business of the Named Insured is COUNTERTOP PRODUCTION Audit Period ANNUAL ENDORSEMENTS ATTACHED TO THIS POLICY SEE COMMERCIAL GENERAL LIABILITY FORMS AND ENDORSEMENTS SCHEDULE TOTAL ADVANCE PREMIUM 18132.00 Replacement or Renewal Number ACP GLAQ7234313823 A PACKAGE MODIFICATION FACTOR HAS BEEN APPLIED Countersigned By Authorized Representative GL D 10 8 DIRECT BILL LAXA 13262 INSURED COPY ACP GLAO 7244313823 955503571 72 0005154 Retroactive Date CG0002 only The Named Insured is CORPORATION Business of the Named Insured is COUNTERTOP PRODUCTION Audit Period ANNUAL ENDORSEMENTS ATTACHED TO THIS POLICY SEE COMMERCIAL GENERAL LIABILITY FORMS AND ENDORSEMENTS SCHEDULE TOTAL ADVANCE PREMIUM 18132.00 INSURED COPY
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AMCO INSURANCE COMPANY IN WITNESS WHEREOF the Company has caused this policy to be signed by its president and secretary and countersigned on the declarations page by a duly authorized representative of the company. Gt Hos LVEA M SECRETARY PRESIDENT et Fiu Ao SECRETARY SP 00020108 Page 1 of 1 INSURED COPY ACP GLAO 7244313823 nan nan nan nan 955503571.0 nan nan nan nan 72.0 5155.0
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AMCO INSURANCE COMPANY 1100 LOCUST ST DEPT 1100 DES MOINES IA 50391 2000 COMMERCIAL GENERAL LIABILITY SCHEDULE Policy Number ACP GLAO 7244313823 Item No. Location and Description Premium Rates Advance Premium of Hazards Basis oTHER PR CO OTHER PR CO 001A KS501 91580 PAYROLL PER THOUSAND CONTRACTORS EXEC 130000 8.462 UTIVE SUPERVISORS OR EXECUTIVE SUPERIN TENDENTS PRODUCTSCOMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT 9120 FLINT ST OVERLANDPARK KS662141736 002A Ks501 92338 PAYROLL PER THOUSAND DRY WALL OR 100000 3.166 3.056 WALLBOARD INSTALLATION 9120 FLINT ST OVERLAND PARK KS662141736 003A KS501 91342 PAYROLL PER THOUSAND CARPENTRY IF ANY 9.534 11.949 9120 FLINT ST OVERLAND PARK KS662141736 004A KS501 91341 PAYROLL PER THOUSAND CARPENTRY INTERIOR 175000 8.476 9.666 9120 FLINT ST OVERLAND PARK Ks662141736 005A MO503 91585 COSTOF WORK PER THOUSAND CONTRACTORS SUB 500000 3.108 1.731 CONTRACTED WORK IN CONNECTION WITH CONSTRUCTION RECON STRUCTION REPAIR OR ERECTION OF BUILDINGS 1100 314 1483 1554 306 1692 865 PER THOUSAND 3.166 3.056 nan nan nan nan 92338.0 PAYROLL 100000 314 306 THDUSANI THOUSAND 9.666 1483 1692 THOUSAND 1.731 1554 865 and PR CO TOTAL ADVANCE PREMIUM Proprietor or Partner may be subject to a fixed ACP GLAO 7244313823 955503571 72 0005156 nan nan nan nan 91342.0 PAYROLL IF ANY PER THOUSAND 9.534 11.949 PAYROLL 175000 PER THOUSAND 8.476 9.666 1692 1483 COSTOF WORK PER THOUSAND 500000 3.108 1.731 1554 865 Total Advance Other and PR CO TOTAL ADVANCE PREMIUM NOTE For classes based on payroll each Executive Officer Sole Proprietor or Partner may be subject to a fixed amount. GL DS 12 93 DIRECT BILL LAXA 13262 INSURED COPY ACP GLAO 7244313823 056503571 72 00051 INSURED COPY
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AMCO INSURANCE COMPANY 1100 LOCUST ST DEPT 1100 DES MOINES 1A 50391 2000 1 515 280 4211 COMMERCIAL GENERAL LIABILITY SCHEDULE Policy Number ACP GLAO 7244313823 Item No. Location.. and Description Code Premium Rates Advance Premium of Hazards No. Basis OTHER PRICO OTHER PR CO 1203 MAIN ST GRANDVIEW M0640302458 006A KS501 91585 COST OF WORK PER THOUSAND CONTRACTORS SUB IF ANY 2.604 1.543 CONTRACTED WORK IN CONNECTION WITH CONSTRUCTION RECON STRUCTION REPAIR OR ERECTION OF BUILDINGS 9120 FLINT ST OVERLANDPARK KS662141736 007A KS501 61226 AREA PER THOUSAND SQ. FT. BUILDINGS OR 6000 34.639 207 PREMISES OFFICE PRODUCTS COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT OTHER THAN NOT FOR PROFIT 156440 109TH ST LENEXA KS662191306 008A M0O503 91341 PAYROLL PER THOUSAND CARPENTRY INTERIOR 390000 10.840 8.633 4228 3367 1203 MAIN ST GRANDVIEW M0640302458 009A M0 503 92338 PAYROLL PER THOUSAND DRY WALL OR 215000 4.016 2.760 865 593 WALLBOARD INSTALLATION. 1203 MAIN ST GRANDVIEW M0640302458 Total Advance Other and PR CO TOTAL ADVANCE PREMIUM NOTE For classes based on payroll each Executive Officer Sole Proprietor or Partner may be subject to a fixed amount. GL DS 12 93 DIRECT BILL LAXA 13262 INSURED COPY ACP GLAO 7244313823 955503571 72 0005157 COST OF WORK PER THOUSAND IF ANY 2.604 1.543 PAYROLL PER THOUSAND 390000 10.840 8.633 4228 3367 nan nan nan nan 92338.0 PAYROLL 215000 PER THOUSAND 4.016 2.760 865 593 Total Advance Other and PR CO TOTAL ADVANCE PREMIUM NOTE For classes based on payroll each Executive Officer Sole Proprietor or Partner may be subject to a fixed amount. GL DS 12 93 DIRECT BILL LAXA 13262 INSURED COPY ACP GLAO 7244313823 955503571 72 0005157 INSURED COPY
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AMCO INSURANCE COMPANY 1100 LOCUST ST DEPT 1100 DES MOINES IA 50391 2000 COMMERCIAL GENERAL LIABILITY SCHEDULE Policy Number ACP GLAO 7244313823 Item No. Location. and Description Code Premium Rates Advance Premium of Hazards No. Basis OTHER PRICO OTHER PR CO 011A TX001 91341 PAYROLL PER THOUSAND CARPENTRY INTERIOR IF ANY 9.090 12.113 1500 3RD ST DALLAS TX752010000 012A TX001 91580 PAYROLL PER THOUSAND CONTRACTORS EXEC IF ANY 10.895 UTIVE SUPERVISORS OR EXECUTIVE SUPERIN TENDENTS PRODUCTS COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT 1500 3RD ST DALLAS TX752010000 013A TX001 92338 PAYROLL PER THOUSAND DRY WALL OR IF ANY 3.364 3.111 WALLBOARD INSTALLATION 1500 3RD ST DALLAS TX752010000 014A TX001 91585 COST OF WORK PER THOUSAND CONTRACTORS SUB IF ANY 1.491 1.581 CONTRACTED WORK IN CONNECTION WITH CONSTRUCTION RECON STRUCTION REPAIR OR ERECTION OF BUILDINGS IN7224 1500 3RD ST DALLAS TX752010000 PER THOUSAND 10.895 PAYROLL IF ANY PER THOUSAND 3.364 3.111 nan nan nan nan 92338.0 PAYROLL IF ANY JISAND 1.581 PR CO TAL ADVANCE PREMIUM rietor or Partner may be subject to a fixed ACP GLAO 7244313823 955503571 72 0005158 COST OF WORK PER THOUSAND IF ANY 1.491 1.581 Total Advance Other and PR CO TOTAL ADVANCE PREMIUM NOTE For classes based on payroll each Executive Officer Sole Proprietor or Partner may be subject to a fixed amount. GL DS 12 93 DIRECT BILL LAXA 13262 INSURED COPY ACP GLAO 7244313823 955503571 72 00051 INSURED COPY
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AMCO INSURANCE COMPANY 1100 LOCUST ST DEPT 1100 DES MOINES IA 50391 2000 COMMERCIAL GENERAL LIABILITY SCHEDULE Policy Number ACP GLAO 7244313823 Item No. Location and Description of Hazards Code No. Premium Basis Rates Advance Premium OTHER PR CO OTHER PR CO 008B KS501 CG72646 0308 Ks501 28 oolc Ks501 EMPLOYEE BENEFITS LIABILITY CG0435 CG435D 40 EMPLOYEES 9120 FLINT ST OVERLAND PARK KS 662141736 o002c KS501 CONTRACTORS ENHANCEMENT PLUS 500001 AND ABOVE PAYROLL 49950 464G4 G 77394 77505 EMPLOYEES 40 FLAT CHARGE EMPLOYEE 600 100 258 600 Advance Premium R CO OTHER PR CO 600 100 258 600 PR CO 11309 6823 TAL ADVANCE PREMIUM 18132 rietor or Partner may be subject to a fixed ACP GLAO 7244313823 955503571 72 0005159 EMPLOYEE 600 FLAT CHARGE Total Advance Other and PR CO 11309 6823 TOTAL ADVANCE PREMIUM 18132 NOTE For classes based on payroll each Executive Officer Sole Proprietor or Partner may be subject to a fixed amount. GL DS 12 93 DIRECT BILL LAXA 13262 INSURED COPY ACP GLAO 7244313823 955503571 72 00051 INSURED COPY
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AMCO INSURANCE COMPANY 1100 LOCUST ST DEPT 11 DES MOINES IA 50391 2000 COMMERCIAL GENERAL LIABILITY FORMS AND ENDORSEMENTS Number ACP GLAO 7244313823 Period From 092113 To 092114 Named Insured SKYLINE CONSTRUCTION INC Form Date Title CG0001 0413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM CG0109 1185 KANSAS OKLAHOMA CHANGES TRANSFER OF RIGHTS CG0435 1207 EMPLOYEE BENEFITS LIABILITY COVERAGE CG2147 1207 EMPLOYMENT RELATED PRACTICES EXCLUSION CG2167 1204 FUNGI OR BACTERIA EXCLUSION CG2170 0108 CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM CG2279 0413 EXCLUSION CONTRACTORS PROFESSIONAL LIABILITY CG2642 0105 KANSAS CHANGES BINDING ARBITRATION CG435D 1001 EMPLOYEE BENEFITS ADMINISTRATION LIABILITY COVERAGE PART CG7023 1096 EXCL ASBESTOS ELECTRO MAGNETIC RADIATION LEAD AND RADON CG7033 0393 TWO OR MORE COVERAGE FORMS OR POLICIES ISSUED BY US CG7246 0212 BLANKET ADDITIONAL INSURED ENDORSEMENT COMMERCIAL CONTRACTORS COVERAGE CG7258 0908 EXCLUSION OPERATIONS COVERED BY A CONSOLIDATED WRAP UP INS PROGRAM L0017 1198 COMMON POLICY CONDITIONS L0021 0908 NUCLEAR ENERGY LIABILITY EXCLUSION 1L0261 0907 KANSAS CHANGES CANCELLATION AND NONRENEWAL L7003 0911 ADVANCE NOTICE OF CANCELLATION OR COVERAGE REDUCTION OR RESTRICTION PROVIDED 13614 1185 SPECIAL CONTINUATION PROVISION 28 0186 BLANK ENDORSEMENT IMPORTANT NOTICES IN5017 0593 IMPORTANT NOTICE FOR RENEWAL POLICIES IN7224 0702 IMPORTANT NOTICE TEXAS CONTRACTORS IN7584 1111 NOTICE TO POLICYHOLDERS COMM GL CONTRACTORS ENHANCEMENT OR ENHANCEMENT PLU IN7689 0413 GENERAL LIABILITY FORMS REVISION ADVISORY NOTICE TO POLICYHOLDERS IN7695 0413 2012 GENERAL LIABILITY KANSAS FORMS REVISION ADVISORY NOTICE TO POLICYHOLDERS GLDF 02 93 DIRECT BILL LAXA 13262 INSURED COPY ACP GLAO 7244313823 955503571 72 0005160 IMPORTANT NOTICES GLDF 02 93 DIRECT BILL LAXA 13262 INSURED COPY
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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 fo determine rights duties and what is and is not covered Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under Section I Who Is An Insured. Other words and phrases that appear in guotation 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 il Limits Of Insurance and Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability 1o pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages Aand 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 oceurs 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 fo 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 1o the policy period that the bodily injury or properly 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.. 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 It 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 I 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 properly damage or 3 Becomes aware by any other means that bodily injury or property damage has occurred or has begun 1o occur. e. Damages because of bodily injury include damages clamed 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 ACP GLAC7244313823 LAXA 13262 INSURED COPY Page 1 0f 16 72 0005161
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CG 00010413 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 coniract or agreement. This exclusion does not apply 1o 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 10 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 thal parly against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. b This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in a The supervision hiring employment training or monitoring of others by that insured or b Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol if the occurrence which caused the bodily injury or property damage involved that which is described in Paragraph 1 2 or 3 above. However this exclusion applies only if you are in the business of manufacturing distributing selling serving or furishing 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 brothr 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 musl pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. CG 00010413 72 0005162 Insurance Services Office Inc. 2012 LAXA 13262 INSURED COPY Page 2 of 16 ACP GLAO7244313823
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CG 00010413 d Al 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 fo 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 operaling fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or released as part of the operations being performed by such insured contractor or subcontractor i Bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. 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 confain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. 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 At or from any premises site or location which is or was al any time owned or occupied by or rented or loaned to any insured. However this subparagraph does not apply to i Bodily injury if suslained 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 confractor and the owner or lessee of such premises site or location has been added to your policy as an additional insured with respect 10 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 b arising out of heat smoke or fumes from a hostile fire Al or from any premises site or location which is or was at any time used by or for any insured or others for the handiing 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 Any person or organization for whom you may be legally responsible or CG 00010413 Insurance Services Office Inc. 2012 ACP GLA07244313823 LAXA 13262 INSURED COPY Page 3 0f 16 72 0005163
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CG 00010413 2 Any loss cost or expense arising out of any a Requesl 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 o or assess the effects of poliutants or Claim or suit by or on behalf of a govemmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding 1o 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 properly 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 invoived the ownership maintenance use or entrustment to others of any aircraft auto or walercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply o 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured 4 Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or b 5 Bodily injury or property damage arising out of a The operation of machinery or equipment thal 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 molor vehicle insurance law where it is licensed or principally garaged or b The operation of any of the machinery or equipment listed in Paragraph.2 or 3 of the definiton of mobile equipment. h. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. i. War Bodily injury or property damage however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expecled 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. j Damage To Property Property damage to 1 Property you own rent or occupy including any costs or expenses incurred by you or any other person organization or entity for repair replacement enhancement restoration or maintenance of such property for any reason including prevention of injury to a person or damage to another s property Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you 2 Insurance Services Office Inc. 2012 LAXA 13262 INSURED COPY CG 00010413 72 0005164 Page 4 of 16 ACP GLAO7244313823
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