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COMMERCIAL GENERAL LIABILITY CG 21550999 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION WITH A HOSTILE FIRE EXCEPTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion f. under Paragraph 2. Exclusions of Section I Coverage A Bodily Injury And Property Damage Liability is replaced by the foliowing 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 scepage migration release or es cape of pollutants at any time. This exclusion does not apply tobodily injury or property damage arising out of heat smoke or fumes from a hostile fire unless that hostile fire occurred or originated a 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 At any premises site or location on which any insured or any contractors or subcon tractors working directly or indirectly on any insured s behalf are performing opera tions to test for monitor clean up remove contain treat detoxify 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 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 govern mental authority for damages because of testing for monitoring cleaning up re moving containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. Page 1of 1 CG 215509 99 Copyright Insurance Services Office Inc. 1998 | 2 |
COMMERCIAL GENERAL LIABILITY CG227004 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. REAL ESTATE PROPERTY MANAGED This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to Exclusion j. Damage To B. The following is added to Paragraph 4.b.1 of Property of Paragraph 2. Exclusions of Section Other Insurance of Section IV Commercial Coverage A Bodily Injury And Property Damage General Liability Conditions Liability 4. Other Insurance 2. Exclusions b. Excess Insurance This insurance does not apply to With respect to your liability arising out of j Damage To Property Property damage to Property you operate or manage or as to which you act as agent for the collection of rents or in any other supervisory capacity. your management of property for which you are acting as real estate manager this insurance is excess over any other valid and collectible insurance available to you whether such insurance is primary or excess. CG227004 13 Insurance Services Office Inc. 2012 Page 1 of 1 | 2 |
IL 00 03 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALCULATION OF PREMIUM This endorsement modifies insurance provided under the following CAPITAL ASSETS PROGRAM OUTPUT POLICY COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART The following is added The premium shown in the Declarations was com puted based on rates in effect at the time the policy was issued. On each renewal continuation or anni versary of the effective date of this policy we will compute the premium in accordance with our rates and rules then in effect. IL 00 03 09 08 ISO Properties Inc. 2007 Page 10f 1 m | 2 |
IL01231113 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON 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 MORTGAGEHOLDER S ERRORS AND OMISSIONS COVERAGE FORM ELECTRONIC DATA 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 PRODUCT WITHDRAWAL COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY 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 defend under 1. Section of the Commercial General Liability Commercial Liability Umbrella Electronic Data Liability Farm Liquor Liability Owners And Contractors Protective Liability Pollution Liability Products Completed Operations Liability Product Withdrawal Medical Professional Liability Railroad Protective Liability and Underground Storage Tank Coverage Parts Auto Dealers Coverage Form and the Farm Umbrella Liability Policy 2. Section Il under the Auto Dealers Business Auto and Motor Carrier Coverage Forms 3. Section Il under the Auto Dealers and Motor Carrier Coverage Forms 4. Section A. Coverage under the Legal Liability Coverage Form and 5. Coverage C Mortgageholder s Liability under the Mortgageholder s Errors And Omissions Coverage Form. Paragraph B. also applies to any other provision in the policy that sets forth a duty to defend.. If we initially defend an insured insured or pay for an insured s insured s defense but later determine that none of the claims claims for which we provided a defense or defense costs are covered under this insurance we have the right to reimbursement for the defense costs we have incurred. The right to reimbursement under this provision will only apply to the costs we have incurred after we notify you in writing that there may not be coverage and that we are reserving our rights to terminate the defense or the payment of defense costs and to seek reimbursement for defense costs. IL01231113 Insurance Services Office Inc. 2013 Page 1of 1 | 2 |
IL 01 46 08 10 WASHINGTON COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. The conditions in this endorsement replace any similar conditions in the policy that are less favorable to the insured. A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by notifying us or the insurance producer in one of the following ways a. Written notice by mail fax or e mail b. Surrender of the policy or binder or c. Verbal notice. Upon receipt of such notice we will cancel this policy or any binder issued as evidence of coverage effective on the later of the following a. The date on which notice is received or the policy or binder is surrendered or b. The date of cancellation requested by the first Named Insured. 2. We may cancel this policy by mailing or delivering to the first Named Insured and the first Named Insured s agent or broker written notice of cancellation including the actual reason for the cancellation to the last mailing address known to us at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 45 days before the effective date of cancellation if we cancel for any other reason except as provided in Paragraphs 3. and 4. below. 3. We may cancel the Commercial Property Coverage Part and the Capital Assets Program Output Policy Coverage Part if made a part of this policy by mailing or delivering to the first Named Insured and the first Named Insured s agent or broker written notice of cancellation at least five days before the effective date of cancellation for any structure where two or more of the following conditions exist a. Without reasonable explanation the structure is unoccupied for more than 60 consecutive days or at least 65 of the rental units are unoccupied for more than 120 consecutive days unless the structure is maintained for seasonal occupancy or is under construction or repair b. Without reasonable explanation progress toward completion of permanent repairs to the structure has not occurred within 60 days after receipt of funds following satisfactory adjustment or adjudication of loss resulting from a fire c. Because of its physical condition the structure is in danger of collapse d. Because of its physical condition a vacation or demolition order has been issued for the structure or it has been declared unsafe in accordance with applicable law e. Fixed and salvageable items have been removed from the structure indicating an intent to vacate the structure f. Without reasonable explanation heat water sewer and electricity are not furnished for the structure for 60 consecutive days or g. The structure is not maintained in substantial compliance with fire safety and building codes. IL 01 46 08 10 Insurance Services Office Inc. 2010 Page 1of 4 m | 2 |
a. You are an individual b. A covered auto you own is of the private passenger type and c. The policy does not cover garage automobile sales agency repair shop service station or public parking place operations hazards we may cancel the Commercial Automobile Coverage Part by mailing or delivering to the first Named Insured and the first Named Insured s agent or broker written notice of cancellation including the actual reason for cancellation to the last mailing address known to us a. At least 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. At least 10 days before the effective date of cancellation for any other reason if the policy is in effect less than 30 days or c. At least 20 days before the effective date of cancellation for other than nonpayment if the policy is in effect 30 days or more or d. At least 20 days before the effective date of cancellation if the policy is in effect for 60 days or more or is a renewal or continuation policy and the reason for cancellation is that your driver s license or that of any driver who customarily uses a covered auto has been suspended or revoked during policy period.. We will also mail or deliver to any mortgage holder pledgee or other person shown in this policy to have an interest in any loss which may occur under this policy at their last mailing address known to us written notice of cancellation prior to the effective date of cancellation. If cancellation is for reasons other than those contained in Paragraph A.3.above this notice will be the same as that mailed or delivered to the first Named Insured. If cancellation is for a reason contained in Paragraph A.3. above we will mail or deliver this notice at least 20 days prior to the effective date of cancellation.. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 7. 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 at least 90 of the pro rata refund unless the following applies a. For Division Two Equipment Breakdown if the first Named Insured cancels the refund will be at least 75 of the pro rata refund. b. If 1 You are an individual 2 A covered auto you own is of the private passenger type 3 The policy does not cover garage automobile sales agency repair shop service station or public parking place operations hazards and 4 The first Named Insured cancels the refund will be not less than 90 of any unearned portion not exceeding 100 plus 95 of any unearned portion over 100 but not exceeding 500 and not less than 97 of any unearned portion in excess of 500. The cancellation will be effective even if we have not made or offered a refund. 8. If notice is mailed proof of mailing will be sufficient proof of notice. B. Changes The policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy s terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspection And Surveys 1. We have the right to a. Make inspections and surveys at any time b. Give you reports on the conditions we find and c. Recommend changes. Page 2 of 4 Insurance Services Office Inc. 2010 IL 01 46 08 10 o | 2 |
2. We are not obligated to make any inspections surveys reports or recommendations and any such actions we do undertake relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions a. Are safe or healthful or b. Comply with laws regulations codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us but also to any rating advisory rate service or similar organization which makes insurance inspections surveys reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections surveys reports or recommendations we may make relative to certification under state or municipal statutes ordinances or regulations of boilers pressure vessels or elevators.. Premiums The first Named Insured shown in the Declarations 1. Is responsible for the payment of all premiums and 2. Will be the payee for any return premiums we pay.. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual Named Insured. If you die your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. G. Nonrenewal 1. We may elect not to renew this policy by mailing or delivering written notice of nonrenewal stating the reasons for nonrenewal to the first Named Insured and the first Named Insured s agent or broker at their last mailing addresses known to us. We will also mail to any mortgage holder pledgee or other person shown in this policy to have an interest in any loss which may occur under this policy at their last mailing address known to us written notice of nonrenewal. We will mail or deliver these notices at least 45 days before the a. Expiration of the policy or b. Anniversary date of this policy if this policy has been written for a term of more than one year. Otherwise we will renew this policy unless a. The first Named Insured fails to pay the renewal premium after we have expressed our willingness to renew including a statement of the renewal premium to the first Named Insured and the first Named Insured s insurance agent or broker at least 20 days before the expiration date b. Other coverage acceptable to the insured has been procured prior to the expiration date of the policy or c. The policy clearly states that it is not renewable and is for a specific line subclassification or type of coverage that is not offered on a renewable basis. a. You are an individual b. A covered auto you own is of the private passenger type and c. The policy does not cover garage automobile sales agency repair shop service station or public parking place operations hazards IL 01 46 08 10 Insurance Services Office Inc. 2010 Page 30f4 o | 2 |
the following applies to nonrenewal of the Commercial Automobile Coverage Part in place of G.1. a. We may elect not to renew or continue this policy by mailing or delivering to you and your agent or broker written notice at least 20 days before the end of the policy period including the actual reason for nonrenewal. If the policy period is more than one year we will have the right not to renew or continue it only at an anniversary of its original effective date. 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. b. We will not refuse to renew Liability Coverage or Collision Coverage solely because an insured has submitted claims under Comprehensive Coverage or Towing And Labor Coverage.. If we fail to mail or deliver proper notice of nonrenewal and you obtain other insurance this policy will end on the effective date of that insurance. Page 4 of 4 Insurance Services Office Inc. 2010 IL 01 46 08 10 o | 2 |
IL 0198 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 1. 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 PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY The insurance does not apply A. Under any Liability Coverage to bodily injury or property damage 1 With respect to which an insured under the policy is also an insured under a nu clear energy liability policy issued by Nu clear Energy Liability Insurance Association Mutual Atomic Energy Liability Underwrit ers Nuclear Insurance Association of Can ada or any of their successors or would be 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 hazardous properties of nuclear material if 1 The nuclear material a is at any nuclear an insured under any such policy but for its termination upon exhaustion of its limit of li ability or facility owned by or operated by or on be half of an insured or b has been dis charged or dispersed therefrom 2 Resulting from the hazardous properties 2 The nuclear material is contained in spent of nuclear material and with respect to fuel or waste at any time possessed han which a any person or organization is re dled used processed stored transported quired to maintain financial protection pur or disposed of by or on behalf of an in suant to the Atomic Energy Act of 1954 or sured or any law amendatory thereof or b the in 3 The bodily injury or property damage 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. 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 DA e N 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 hazardous properties of nuclear material if 1 The nuclear material a is at any nuclear facility owned by or operated by or on be half of an insured or b has been dis charged or dispersed therefrom 2 The nuclear material is contained in spent fuel or waste at any time possessed han dled used processed stored transported or disposed of by or on behalf of an in sured or 3 The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any 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 prop erty thereat. IL 01 98 09 08 ISO Properties Inc. 2007 Page 10f 2 m | 2 |
2. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties Nuclear material means source material Special nuclear material or by product material Source material special nuclear material and by product material have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof Spent fuel means any fuel element or fuel com ponent solid or liquid which has been used or exposed to radiation in a nuclear reactol Waste means any waste material a containing by product material other than the tailings or wastes produced by the extraction or concentration of ura nium or thorium from any ore processed primarily for its source material content and b resulting from the operation by any person or organization of any nuclear facility included under the first two para graphs of the definition of nuclear facility. Nuclear facility means a Any nuclear reactor b Any equipment or device designed or used for 1 separating the isotopes of uranium or plu tonium 2 processing or utilizing spent fuel or 3 handling processing or packaging waste c Any equipment or device used for the process ing fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 d Any structure basin excavation premises or place prepared or used for the storage or dis posal 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 fission able material Property damage includes all forms of radioactive contamination of property. Page 2 of 2 ISO Properties Inc. 2007 IL 0198 09 08 o | 2 |
Z ZURICH Policyholder Notice General Liability Access Or Disclosure Of Confidential Or Personal Information Exclusions This Notice does not form part of your policy. 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 a conflict between the Policy and this Notice THE PROVISIONS OF THE POLICY SHALL PREVAIL. Carefully read your policy including the endorsements attached to your policy. This Notice provides information concerning the following new endorsements which applies to your renewal policy being issued by us CG 21 06 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information And Data related Liability With Limited Bodily Injury Exception For Use With The Commercial General Liability Coverage Part When this endorsement is attached to your policy Under Coverage A Bodily Injury And Property Damage Liability coverage is excluded for damages arising out of any access to or disclosure of any person s or organization s confidential or personal information. This is a reinforcement of coverage intent. Under Coverage B Personal And Advertising Injury Liability coverage is excluded for personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information. To the extent that any access or disclosure of confidential or personal information results in an oral or written publication that violates a person s right of privacy this may result in a reduction in coverage. CG 21 07 05 14 Exclusion Access or Disclosure of Confidential or Personal Information and Data related Liability Limited Bodily Injury Exception Not Included For Use With The Commercial General Liability Coverage Part When this endorsement is attached to your policy Under Coverage A Bodily Injury And Property Damage Liability coverage is excluded for damages arising out of any access to or disclosure of any person s or organization s confidential or personal information. This is a reinforcement of coverage intent. Coverage is also excluded for damages because of bodily injury arising out of loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. This is a reduction of coverage. Under Coverage B Personal and Advertising Injury Liability coverage is excluded for personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information. To the extent that any access or disclosure of confidential or personal information results in an oral or written publication that violates a person s right of privacy this may result in a reduction of coverage. CG 21 08 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information Coverage B Only For Use With The Commercial General Liability Coverage Part When this endorsement is attached to your policy coverage is excluded for personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information. To the extent that any access or disclosure of confidential or personal information results in an oral or written publication that violates a person s right of privacy this may result in a reduction in coverage. U GL2110 A CW 0115 Page 10f 2 | 2 |
CG 04 37 05 14 Electronic Data Liability For Use With The Commercial General Liability Coverage Part With respect to damages arising out of any access to or disclosure of any person s or organization s confidential or personal information when this endorsement is attached to your policy Under Coverage A Bodily Injury And Property Damage Liability coverage is excluded for damages arising out of any access to or disclosure of any person s or organization s confidential or personal information. This is a reinforcement of coverage intent. Under Coverage B Personal And Advertising injury Liability coverage is excluded for personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information. To the extent that any access or disclosure of confidential or personal information results in an oral or written publication that violates a person s right of privacy this may result in a reduction of coverage. CG 33 53 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information And Data related Liability With Limited Bodily Injury Exception For Use With The Owners and Contractors Protective Liability Coverage Part and Products Completed Operations Coverage Parts When this endorsement is attached to your policy coverage is excluded for damages arising out of any access to or disclosure of any person s or organization s confidential or personal information. This is a reinforcement of coverage intent. CG 33 59 05 14 Exclusion Access Or Disclosure Of Confidential Or Personal Information And Data related Liability Limited Bodily Injury Exception Not Included For Use With The Owners And Contractors Protective Liability and Products Completed Operations Liability Coverage Parts When this endorsement is attached to your policy coverage is excluded for damages arising out of any access to or disclosure of any person s or organization s confidential or personal information. This is a reinforcement of coverage intent. Coverage is also excluded for damages because of bodily injury arising out of loss loss of use of damage to corruption of inability to access or inability to manipulate electronic data. This is a reduction of coverage. U GL2110 A CW 0115 Page 2of 2 | 2 |
COMMERCIAL INSURANCE CANCELLATION BY US This endorsement changes the policy. Please read it carefully. This endorsement modifies insurance provided by the following BOILER AND MACHINERY COVERAGE FORM BUSINESS AUTO COVERAGE FORM COMMERCIAL CRIME COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL INLAND MARINE COVERAGE FORM COMMERCIAL PROPERTY COVERAGE FORM FARM COVERAGE FORM GARAGE COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM MOTOR CARRIER COVERAGE FORM POLLUTION LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM TRUCKERS COVERAGE FORM SCHEDULE Number of Days Notice 90 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. U GU298 B CW 494 Page 1 of | 2 |
Z ZURICH NOTIFICATION OF IMPORTANT CHANGES RELATING TO TERRORISM RISK INSURANCE ACT To Our Valued Customers The Terrorism Risk Insurance Program Reauthorization Act of 2007 TRIPRA 2007 had been scheduled to expire on December 31 2014. Congress enacted a six year extension of TRIA entitled Terrorism Risk Insurance Program Reauthorization Act of 2015TRIPRA 2015 which will expire on December 31 2020. For purposes of simplicity we will simply reference the act as TRIA. There are several important changes to TRIA included within the extension of which you should be aware A. Change in Definition of Act of Terrorism Prior to the enactment of the extension legislation TRIA had required that an act of terrorism meant any act that is certified by the Secretary of the Treasury in concurrence with the Secretary of State. However this has been changed in that certification by the Secretary of the Treasury shall be in consultation with the Secretary of Homeland Security and the United States Attorney General. B. Reduction in the Federal Share of Terrorism Losses by Increasing the Insurer Co Pay from 15 to 20 Over Five Years The United States Government may pay a share of insured losses resulting from an act of terrorism. The federal share will decrease by 5 from 85 to 80 over a five year period while the insurer share increases by the same amount during the same period. The schedule below illustrates the decrease in the federal share January1 2015 December 31 2015 federal share 85 January1 2016 December 31 2016 federal share 84 January1 2017 December 31 2017 federal share 83 January1 2018 December 31 2018 federal share 82 January1 2019 December 31 2019 federal share 81 January1 2020 December 31 2020 federal share 80 C. The Current Program Trigger for Aggregate Industry Insured Losses Will Increase from 100 Million to 200 Million Over Five Years The extension of TRIA increases the Program trigger from 100 million to 200 million over a five year period. This means that the Program trigger will increase by 20 million with respect to any such insured losses occurring in calendar year 2016 and continue to increase by 20 million until calendar year 2020. At the end of this five year period the Program trigger will be 200 million. D. Increases in the Recoupment of the Federal Share of Insured Losses The extension of TRIA increases the amount used to calculate marketplace aggregate retention from 27.5 billion to 37.5 billion in 2 billion increments beginning in the calendar year 2015 and reaching 37.5 billion in calendar year 2019. Beginning in calendar year 2020 the TRIA extension revises the mandatory recoupment amount to be the amount equal to the annual average of the sum of insurer deductibles for all insurers participating in the Program for the prior three calendar years with such amount to be determined annually by the Secretary of the Treasury. Under the TRIA extension the recoupment of mandatory recoupment amounts has increased from 133 to 140. U GU766 8 CW 0115 Page 1 of 1 Copyright 2015 Zurich American Insurance Company Includes copyrighted material of Insurance Services Office Inc. with its permission. | 2 |
Z ZURICH e I ENA N B R CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM Insureds Name Policy Number Effective Date Endorsement Number Groupe SITQ Inc. GLO983573403 11012015 THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies your insurance Commercial General Liability Coverage Part A. Cap on Losses From Certified Terrorism Losses Certified act of terrorism means an act that is certified by the Secretary of the Treasury in accordance with provisions of the federal Terrorism Risk Insurance Act TRIA to be an act of terrorism. The Terrorism Risk Insurance Act provides that the Secretary of Treasury shall certify an act of terrorism 1. To be an act of terrorism 2. Tobe a violent act or an act that is dangerous to human life property or infrastructure 3. To have resulted in damage within the United States or outside of the United States in the case of an air carrier as defined in section 40102 of Title 49 United States Code or a United States flag vessel or a vessel based principally in the United States on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States or the premises of a United States mission and 4. To have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. No act may be certified as an act of terrorism if the act is committed as part of the course of a war declared by Congress except for workers compensation or if losses resulting from the act in the aggregate for insurance subject to TRIA do not exceed 5000000. If aggregate insured losses attributable to one or more certified acts of terrorism exceed 100 billion in a calendar year January 1 through December 31 and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of Treasury. B. Application of Other Exclusions The terms and limitations of a terrorism exclusion or any other exclusion or the inapplicability or omission of a terrorism exclusion or any other exclusion do not serve to create coverage which would otherwise be excluded limited or restricted under this policy. Copyright 2015 Zurich American Insurance Company Includes copyrighted material of Insurance Services Office Inc. with ts permission. U GU767 B CW 0115 Page 1 of 1 | 2 |
Insured Name Groupe SITQ Inc. Policy Number GL0O983573403 Effective Date 11012015 ZURICH THIS DISCLOSURE IS ATTACHED TO AND MADE PART OF YOUR POLICY. DISCLOSURE OF IMPORTANT INFORMATION RELATING TO TERRORISM RISK INSURANCE ACT SCHEDULE Premium attributable to risk of loss from certified acts of terrorism for lines of insurance subject to TRIA 769 Any information required to complete this Schedule if not shown above will be shown in the Declarations. A. Disclosure of Premium In accordance with the federal Terrorism Risk Insurance Act TRIA as amended we are required to provide you with a notice disclosing the portion of your premium if any attributable to the risk of loss from terrorist acts certified under that Act for lines subject to TRIA. That portion of premium attributable is shown in the Schedule above. The premium shown in the Schedule above is subject to adjustment upon premium audit if applicable. B. Disclosure of Federal Participation in Payment of Terrorism Losses The United States Government may pay a share of insured losses resulting from an act of terrorism. The federal share will decrease by 5 from 85 to 80 over a five year period while the insurer share increases by the same amount during the same period. The schedule below illustrates the decrease in the federal share January1 2015 December 31 2015 federal share 85 January1 2016 December 31 2016 federal share 84 January1 2017 December 31 2017 federal share 83 January1 2018 December 31 2018 federal share 82 January1 2019 December 31 2019 federal share 81 January1 2020 December 31 2020 federal share 80 C. Disclosure of 100 Billion Cap on All Insurer and Federal Obligations If aggregate insured losses attributable to terrorist acts certified under TRIA exceed 100 billion in a calendar year January 1 through December 31 and an insurer has met its deductible under the program that insurer shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of Treasury. D. Availability As required by TRIA we have made available to you for lines subject to TRIA coverage for losses resulting from acts of terrorism certified under TRIA with terms amounts and limitations that do not differ materially from those for losses arising from events other than acts of terrorism. E. Definition of Act of Terrorism under TRIA TRIA defines act of terrorism as any act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act TRIA to be an act of terrorism. The Terrorism Risk Insurance Act provides that the Secretary of Treasury shall certify an act of terrorism 1. To be an act of terrorism 2. Tobe a violent act or an act that is dangerous to human life property or infrastructure U GU630 D CW 0115 Copyright 2015 Zurich American Insurance Company Page 1 0of 2 Includes copyrighted material of Insurance Services Office Inc. with its permission. oo VI THoUTalILE sUuljeut v T idm. U GU630 D CW 0115 Page 1 of 2 | 2 |
3. To have resulted in damage within the United States or outside of the United States in the case of an air carrier as defined in section 40102 of Title 49 United States Code or a United States flag vessel or a vessel based principally in the United States on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States or the premises of a United States mission and 4. To have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. No act may be certified as an act of terrorism if the act is committed as part of the course of a war declared by Congress except for workers compensation or if losses resulting from the act in the aggregate for insurance subject to TRIA do not exceed 5000000. U GU630 D CW 0115 Page 20f 2 Copyright 2015 Zurich American Insurance Company Includes copyrighted material of Insurance Services Office Inc. with its permission. | 2 |
Z ZURICH Hlinois Civil Union Act Policyholder Notice On June 1 2011 Public Act 96 1513 the Religious Freedom Protection and Civil Union Act the Act became effective. Under the Act both same sex and opposite sex couples may enter into a civil union. A party to a civil union is entitled to the same legal obligations responsibilities protections and benefits as are afforded or recognized by the law of lllinois a spouse whether they derive from statute administrative rule common law or any other source of civil or criminal law. A marriage between persons of the same sex a civil union or a substantially similar legal relationship other than common law marriage legally entered into in another jurisdiction shall be legally recognized in lllinois as a civil union. CAUTION FEDERAL LAW RIGHTS MAY OR MAY NOT BE AVAILABLE llinois law grants parties to a civil union the same benefits protections and responsibilities that flow from marriage under state law. However some or all of the benefits protections and responsibilities related to health insurance that are available to married persons under federal law may not be available to parties to a civil union. For example the Employee Retirement Income Security Act of 1974 a federal law known as ERISA controls the employer employee relationship with regard to determining eligibility for enrollment in private employer health benefit plans. Because of ERISA Act 91 does not state requirements pertaining to a private employer s enrollment of a party to a civil union in an ERISA employee welfare benefit plan. However governmental employers not federal government are required to provide health benefits to the dependents of a party to a civil union if the public employer provides health benefits to the dependents of married persons. Federal law also controls group health insurance continuation rights under COBRA for employers with 20 or more employees as well as the Internal Revenue Code treatment of health insurance premiums. As a result parties to a civil union and their families may or may not have access to certain benefits under this policy contract certificate rider or endorsement that derive from federal law. You are advised to seek expert advice to determine your rights. U GU1110 B IL 1011 Page 1 of | 2 |
Z ZURICH Pollution Liability Exclusion Disclosure Notice This insurance policy does not apply to or provides very limited coverage as respects pollution liability. You should refer to the specific pollution liability policy exclusions or pollution liability exclusion endorsements of your policy for determination of specific terms and conditions as respects exclusion of any pollution liability exposures that you may have. The policy exclusions of the Commercial General Liability Coverage Part apply to pollution exposures in the coverage territory unless replaced or modified as indicated in the applicable endorsement by one or more of the following pollution exclusion endorsements. The pollution exclusion endorsements that are checked XJ apply to pollu tion exposures in the indicated areas of the coverage territory X Total Pollution Exclusion Endorsement ISO Form All states in the coverage territory except CG2149 HLIL ME MN VT TX XITotal Pollution Exclusion Hostile Fire Exception All states in the coverage territory except 1SO Form CG 21 55 XI Only applicable in the following states IL MN VT. Total Pollution Exclusion with a Building Heating All states in the coverage territory except Equipment Exception and a Hostile Fire Exception SO Form CG 21 65 Only applicable in the following states XITotal Pollution Exclusion Hostile Fire Exception ISO Form CG 21 55 Total Pollution Exclusion with a Building Heating Equipment Exception and a Hostile Fire Exception 1SO Form CG 21 65 Other State Endorsements X Indiana Changes Pollution Exclusion ISO Form Indiana CG 0123 X Missouri Changes Pollution Exclusion ISO Form X Missouri CG 01 34 or Missouri Changes Gasoline Risks Pollution Exclusion Missouri ISO Form CG 01 35 X Vt. Changes Pollution ISO form CG 01 54 Vermont Other Applicable in the following states Assuming risk does not qualify as a large risk according to Texas law Indiana Missouri U GL1203 A CW 404 Page I of 1 | 2 |
2 ZURICH Important Notice to Policyholders The address for the headquarters of Zurich North America will change after August 1 2016 due to a relocation of our office in the same city. The new address is Customer Inquiry Center Zurich North America 1299 Zurich Way Schaumburg IL 60196 1 800 382 2150 For specific questions regarding your policy please contact your agent or broker. For other questions you may contact the Customer Inquiry Center of Zurich North America. Any references to post office boxes previously provided remain unchanged. U GU1194 A CW 0815 Page 1 of 1 | 2 |
Z ZURICH SANCTIONS EXCLUSION ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY The following exclusion is added to the policy to which it is attached and supersedes any existing sanctions language in the policy whether included in an Exclusion Section or otherwise SANCTIONS EXCLUSION Notwithstanding any other terms under this policy we shall not provide coverage nor will we make any payments or provide any service or benefit to any insured beneficiary or third party who may have any rights under this policy to the extent that such cover payment service benefit or any business or activity of the insured would violate any applicable trade or economic sanctions law or regulation. The term policy may be comprised of common policy terms and conditions the declarations notices schedule coverage parts insuring agreement application enrollment form and endorsements or riders if any for each coverage provided. Policy may also be referred to as contract or agreement. We may be referred to as insurer underwriter we us and our or as otherwise defined in the policy and shall mean the company providing the coverage. Insured may be referred to as policyholder named insured covered person additional insured or claimant or as otherwise defined in the policy and shall mean the party person or entity having defined rights under the policy. These definitions may be found in various parts of the policy and any applicable riders or endorsements. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED U GU1191 A CW 0315 Page I of 1 | 2 |
MNEMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY PRIOR POLICY 4D8 63 89 GENERAL LIABILTITY DECLARATIONS POLICY PERIOD FROM 011018 TO 011019 POLICY NUMBER 4D8 63 8 9 19 NAMED INSURED PRODUCER SKILLEDSET FLOORING WALLS LOCKTON COMPANIES LLC LLC 13710 FNB PKWY STE 400 2532 NORTH 18TH AVE OMAHA NE 68154 5298 ELKHORN NE 68022 AGENT AB 8210 AGENT PHONE 402970 6100 DIRECT BILL JACK H. STRUYK CLAIM REPORTING 888362 2255 SERVICING CARRIER 402951 8300 THIS POLICY RENEWAL IS OFFERED CONTINGENT UPON THE RECEIPT OF PAYMENT WHICH IS DUE ON 021018. EACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT 500000 ANY ONE PREMISES MEDICAL EXPENSE LIMIT 10000 ANY ONE PERSON PERSONAL AND ADVERTISING INJURY LIMIT 1000000 ANY ONE PERSON OR ORGANIZATION GENERAL AGGREGATE LIMIT 2000000 PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT 2000000 COVERAGES PROVIDETD PREMIUM SEE ATTACHED SCHEDULE FOR LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED. DATE OF ISSUE 010918 BPP FORM CG7000A ED. 08 99 BPP 102317 017 LN 4D86389 1901 GENERAL LIABILTITY D E POLICY PERIOD FROM 011018 TO 011019 LLC 13710 FNB PKWY STE 400 2532 NORTH 18TH AVE OMAHA NE 68154 5298 ELKHORN NE 68022 AGENT AB 8210 AGENT PHONE 402970 6100 JACK H. STRUYK CLAIM REPORTING 888362 2255 DIRECT BILL DIRECT BILL EACH OCCURRENCE LIMIT DAMAGE TO PREMISES RENTED TO YOU LIMIT MEDICAL EXPENSE LIMIT PERSONAL AND ADVERTISING INJURY LIMIT GENERAL AGGREGATE LIMIT 1000 00 500 00 10 00 1000 00 TOTAL ESTIMATED POLICY PREMIUM 2868.00 | 2 |
MNEMC INSURANCE PAGE 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D8 63 89 SKILLEDSET FLOORING AND WALLS EFF DATE 011018 EXP DATE 011019 FORMS APPLICABLE CG00010413 CG20100413 CG20370413 CG21060514 CG21471207 CG21671204 CG21700115 CG21760115 CG7001A1012 CG70031013 CG71410590 CG7174.31013 CG74291198 CG75780617 CG76440209 CGB0810406 IL00210502 IL02590907 IL70280515 IL7130A0401 IL7131A0401 IL73380515 IL80210488 IL8383.2A0115 IL8384A0108 IL85760909 IL87450317 AUDIT PERIOD ANNUAL DATE OF ISSUE 010918 BPP FORM CG7000A ED. 08 99 BPP 102317 017 LN 4D86389 1901 413 CG20100413 CG20370413 CG21060514 AUDIT PERIOD ANNUAL | 2 |
MNEMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D8 63 89 19 SKILLEDSET FLOORING WALLS EFF DATE 011018 EXP DATE 011019 GENERATL L Cc ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM CG0001 04 13 COMMERCIAL GEN LIABILITY COV FORM CG2010 04 13 AI OWNERS LESSEES OR CONTRACTORS.. NAME ANY OR ALL PERSONS OR ORG. SUBJECT TO A WRITTEN CONTRACT REQ. ADDL INS. STATUS EXCEPT WHERE THE CONTRACT REQ. COVERAGE TO BE PRIMARY NON CONTRIBUTORY. CG2037 04 13 AI OWNERS LESSEES OR CONT COMP OPS NAME ANY OR ALL PERSONS OR ORG. SUBJECT TO A WRITTEN CONTRACT REQ. ADDL INS. STATUS EXCEPT WHERE THE CONTRACT REQ. COVERAGE TO BE PRIMARY NON CONTRIBUTORY. CG2106 05 14 EXCL ACCESS DISCL OF CONFID PERSONAL CG2147 12 07 EXCL EMPLOYMENT RELATED PRACTICES CG2167 12 04 FUNGI OR BACTERIA EXCLUSION CG2170 01 15 CAP LOSSES FROM CERT ACTS TERRORISM CG2176 01 15 EXCL PUNITIVE DMGS ACTS OF TERRORISM CG7001A 10 12 GENERAL LIABILITY SCHEDULE CG7003 10 13 GL QUICK REFERENCE OCCURRENCE CG7141 05 90 EXTENDED PROPERTY DAMAGE COVERAGE CG7174.3 10 13 AUTOMATIC AI CONST CONT INCL COMP OP CG7429 11 98 AMEND AGGREGATE LIMIT PER PROJECT CG7578 06 17 GENERAL LIABILITY ELITE EXTENSION CG7644 02 09 CONTRACTORS OCCURRENCE DEFINITION CG8081 04 06 FUNGI BACTERIA NOTICE TO POLICYHOLDR IL0021 05 02 NUCLEAR ENERGY LIAB EXCL BROAD FORM IL0259 09 07 NE CHANGES CANCELLATION NONRENEWAL IL7028 05 15 ASBESTOS EXCLUSION IL7130A 04 01 NAMED INSURED ENDORSEMENT IL7131A 04 01 COMML POLICY ENDORSEMENT SCHEDULE IL7338 05 15 NOTICE OF CANC PROV BY US DESIGNATED NAME OF ENTITY JE DUNN CONSTRUCTION COMPANY INC. OR ANY OF ITS AFFILIATES SUBSIDIARIES OR RELATED COMPANIES CAPITOL DISTRICT HOTEL LLC. MAILING ADDRESS C0 LOCKTON COMPANIES 444 W 47TH ST STE 900 KANSAS CITY MO 64112 NUMBER OF DAYS NOTICE 30 IL8021 04 88 ASBESTOS NOTICE IL8383.2A 01 15 DISCL PURSUANT TERRSM RISK INS. ACT 23 DATE OF ISSUE 010918 CONTINUED FORM IL7131A ED. 04 01 017 LN 4D86389 1901 EDITION CG2037 CG2106 CG2147 CG2167 CG2170 CG2176 CG7001A CG7003 CG7141 CG7174.3 CG7429 CG7578 CG7644 CG8081 IL0021 IL0259 IL7028 IL7130A IL7131A IL7338 IL8021 IL8383.2A 04 13 05 14 12 07 12 04 01 15 01 15 10 12 10 13 05 90 10 13 11 98 06 17 02 09 04 06 05 02 09 07 05 15 04 01 04 01 05 15 04 88 01 15 AI OWNERS LESSEES OR CONTRACTORS.. NAME ANY OR ALL PERSONS OR ORG. SUBJECT TO A WRITTEN CONTRACT REQ. ADDL INS. STATUS EXCEPT WHERE THE CONTRACT REQ. COVERAGE TO BE PRIMARY NON CONTRIBUTORY. AI OWNERS LESSEES OR CONT COMP OPS NAME ANY OR ALL PERSONS OR ORG. SUBJECT TO A WRITTEN CONTRACT REQ. ADDL INS. STATUS EXCEPT WHERE THE CONTRACT REQ. COVERAGE TO BE PRIMARY NON CONTRIBUTORY. EXCL ACCESS DISCL OF CONFID PERSONAL EXCL EMPLOYMENT RELATED PRACTICES FUNGI OR BACTERIA EXCLUSION CAP LOSSES FROM CERT ACTS TERRORISM EXCL PUNITIVE DMGS ACTS OF TERRORISM GENERAL LIABILITY SCHEDULE GL QUICK REFERENCE OCCURRENCE EXTENDED PROPERTY DAMAGE COVERAGE AUTOMATIC AI CONST CONT INCL COMP OP AMEND AGGREGATE LIMIT PER PROJECT GENERAL LIABILITY ELITE EXTENSION CONTRACTORS OCCURRENCE DEFINITION FUNGI BACTERIA NOTICE TO POLICYHOLDR NUCLEAR ENERGY LIAB EXCL BROAD FORM NE CHANGES CANCELLATION NONRENEWAL ASBESTOS EXCLUSION NAMED INSURED ENDORSEMENT COMML POLICY ENDORSEMENT SCHEDULE NOTICE OF CANC PROV BY US DESIGNATED NAME OF ENTITY JE DUNN CONSTRUCTION COMPANY INC. OR ANY OF ITS AFFILIATES SUBSIDIARIES OR RELATED COMPANIES CAPITOL DISTRICT HOTEL LLC. MAILING ADDRESS C0 LOCKTON COMPANIES 444 W 47TH ST STE 900 KANSAS CITY MO 64112 NUMBER OF DAYS NOTICE 30 ASBESTOS NOTICE DISCL PURSUANT TERRSM RISK INS. ACT | 2 |
MNEMC INSURANCE PAGE NO 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D8 63 89 19 SKILLEDSET FLOORING WALLS EFF DATE 011018 EXP DATE 011019 GENERATL L Cc ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM IL8384A 01 08 TERRORISM NOTICE IL8576 09 09 MEDICARE IMPT NOTICE TO POLICYHOLDER IL8745 03 17 IMPORTANT NOTICE TO POLICYHOLDERS DATE OF ISSUE 010918 FORM IL7131A ED. 04 01 017 LN 4D86389 1901 EDITION MEDICARE IMPT NOTICE TO POLICYHOLDER IMPORTANT NOTICE TO POLICYHOLDERS | 2 |
MNEMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D8 63 89 19 SKILLEDSET FLOORING WALLS EFF DATE 011018 EXP DATE 011019 TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent DATE OF ISSUE 010918 FORM IL8384A 01 08 017 LN 4D86389 1901 SKILLEDSET FLOORING WALLS EFF DATE 011018 EXP DATE 0110 TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent | 2 |
NE INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D8 63 89 19 SKILLEDSET FLOORING WALLS EFF DATE 011018 EXP DATE 011019 THIS DISCLOSURE IS ATTACHED TO YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS DISLOSURE DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. SCHEDUTLE Terrorism Premium Certified Acts 23.00 A. Disclosure Of Premium In accordance with the federal Terrorism Risk Insurance Act we are required to provide you with a notice disclosing the portion of your premium if any attributable to coverage for terrorism acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this disclosure or in the policy Declarations. B. Disclosure Of Federal Participation In Payment Of Terrorism Losses The United States Government Department of the Treasury will pay a share of terrorism losses insured under the federal program. For losses occurring in 2015 the federal share equals 85 of that portion of the amount of such insured losses that exceeds the applicable insurer retention. Beginning on January 1 2016 the federal share will decrease by one percentage point per calendar year until equal to 80 of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. C. Cap On Insurer Participation In Payment Of Terrorism Losses If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. The following statement is required to be part of the disclosure notice in MISSOURI The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your policy carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Includes copyrighted material of ISO Properties Inc. with its permission DATE OF ISSUE 010918 FORM IL8383.2A01 15 017 LN 4D86389 1901 THIS DISCLOSURE IS ATTACHED TO YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS DISLOSURE DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. SCHEDUTLE Terrorism Premium Certified Acts 23.00 A. Disclosure Of Premium In accordance with the federal Terrorism Risk Insurance Act we are required to provide you with a notice disclosing the portion of your premium if any attributable to coverage for terrorism acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this disclosure or in the policy Declarations. B. Disclosure Of Federal Participation In Payment Of Terrorism Losses The United States Government Department of the Treasury will pay a share of terrorism losses insured under the federal program. For losses occurring in 2015 the federal share equals 85 of that portion of the amount of such insured losses that exceeds the applicable insur retention. Beginning on January 1 2016 the federal share will decrease by one percentage point per calendar year until equal to 80 that portion of the amount of such insured losses that exceeds the applicable insurer retention. However if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year the Treasury sha not make any payment for any portion of the amount of such losses that exceeds 100 billion. C. Cap On Insurer Participation In Payment Of Terrorism Losses If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calend year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasur The following statement is required to be part of the disclosure notice in MISSOURI The premium above is for certain losses resulting from certified acts terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your poli carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Includes copyrighted material of ISO Properties Inc. with its permission SCHEDUTLE i m Certified Acts 23.00 th the federal Terrorism Risk Insurance Act we are side you with a notice disclosing the portion of any attributable to coverage for terrorism acts the Terrorism Risk Insurance Act. The portion of ributable to such coverage is shown in the Schedule ire or in the policy Declarations. deral Participation In Payment Of Terrorism Losses s Government Department of the Treasury will pay In Payment Of Terrorism Losses | 2 |
MNEMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY NAMED INSURED ENDORSEMENT POLICY PERIOD FROM 011018 TO 011019 POLICY NUMBER 4D8 63 8 9 19 N NAMED INSURED SKILLEDSET FLOORING WALLS LOCKTON COMPANIES LLC LLC 13710 FNB PKWY STE 400 2532 NORTH 18TH AVE OMAHA NE 68154 5298 ELKHORN NE 68022 AGENT AB 8210 AGENT PHONE 402970 6100 DIRECT BILL JACK H. STRUYK CLAIM REPORTING 888362 2255 SERVICING CARRIER 402951 8300 IT IS HEREBY AGREED AND UNDERSTOOD THAT THE NAMED INSURED IS AMENDED TO READ AS FOLLOWS 1ST NAMED INSURED SKILLEDSET FLOORING WALLS LLC NO. 02 SKILLEDSET FLOORING AND WALLS LLC DBA SKILLEDSET TILE AND STONE PLACE OF ISSUE OMAHA NE DATE OF ISSUE 010918 FORM IL7130A ED. 04 01 017 LN 4D86389 1901 NAMED INSURED ENDO POLICY PERIOD FROM 011018 TO 011019 LLC 13710 FNB PKWY STE 400 2532 NORTH 18TH AVE OMAHA NE 68154 5298 ELKHORN NE 68022 AGENT AB 8210 AGENT PHONE 402970 6100 JACK H. STRUYK CLAIM REPORTING 888362 2255 DIRECT BILL DIRECT BILL IT IS HEREBY AGREED AND UNDERSTOOD THAT THE NAMED INSURED IS AMENDED TO READ AS FOLLOWS 1ST NAMED INSURED SKILLEDSET FLOORING WALLS LLC NO. 02 SKILLEDSET FLOORING AND WALLS LLC DBA AND STONE SKILLEDSET TILE PLACE OF ISSUE OMAHA NE OLICY. | 2 |
MNEMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D8 63 89 SKILLEDSET FLOORING AND WALLS EFF DATE 011018 EXP DATE 011019 GENERAL LIABILITY SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 001 87635 1 19.276 2188 TILE STONE MARBLE MOSAIC OR TERRAZZO WORK INTERIOR 3 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 113500 SUBLINE CTR 87748 125 AMENDMENT AGGREGATE LIMITS OF INSURANCE PER PROJECT PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87780 150 CONSTRUCTION CONTRACTS INCLUDING COMPLETED OPERATIONS BLANKET ADDL INSUREDS PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87830 82 CONTRACTORS OCCURRENCE DEFINITION PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87865 0.743 0 CONTRACTORS SUBCONTRACTED WORK PREMIUM BASIS THOUSANDS OF TOTAL COST EXPOSURE IF ANY SUBLINE CTR DATE OF ISSUE 010918 BPP CONTINUED FORM CG7001A ED.10 12 BPP 102317 017 LN 4D86389 1901 IARBLE MOSAIC OR INTERIOR 3 S PAYROLL GREGATE LIMITS OF. PROJECT S | 2 |
MNEMC INSURANCE PAGE 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D8 63 89 SKILLEDSET FLOORING AND WALLS EFF DATE 011018 EXP DATE 011019 19 SCHEDUTLE POLICY LEVEL COVERAGES PREMIUM FOR CERTIFIED ACTS OF TERRORISM 23.00 TOTAL ESTIMATED POLICY PREMIUM 2868.00 1 OTHER THAN NOT FOR PROFIT 2 NOT FOR PROFIT 3 INCLUDING PRODUCTS AND OR COMPLETED OPERATIONS UNLESS OTHERWISE EXCLUDED 4 PRODUCTS COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT 5 A 250 PD DEDUCTIBLE PER CLAIM APPLIES TO CUSTOMERS AUTOS UNLESS OTHERWISE DESIGNATED BY THIS CLASSIFICATION CODE 6 FOR SPRAY PAINTING OPERATIONS A PD DEDUCTIBLE OF 250 PER CLAIM APPLIES UNLESS A HIGHER DEDUCTIBLE IS OTHERWISE DESIGNATED FOR THIS CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED RATED LOCATIONS LOC 001 1009 JONES ST OMAHA NE 68102 2913 ALL OTHER LOCATIONS 14910 GROVER ST STE 200 OMAHA NE 68144 DATE OF ISSUE 010918 BPP FORM CG7001A ED.10 12 BPP 102317 017 LN 4D86389 1901 CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED RATED LOCATIONS LOC 001 1009 JONES ST OMAHA NE 68102 2913 ALL OTHER LOCATIONS 14910 GROVER ST STE 200 OMAHA NE 68144 ALL OTHER LOCATIONS 14910 GROVER ST STE 200 OMAHA NE 68144 | 2 |
COMMERCIAL GENERAL LIABILITY CG 00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under Section I Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll 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 to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 2 The bodily injury or property damage occurs during the policy period and Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. c. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. d. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim 1 Reports all or any part of the bodily injury or property damage to us or any other insurer Receives a written or verbal demand or claim for damages because of the bodily injury or property damage or 3 Becomes aware by any other means that bodily injury or property damage has occurred or has begun to occur. e. Damages because of bodily injury include damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. 3 2 CG 00010413 Insurance Services Office Inc. 2012 Page 1 0f 16 | 0 |
2. Exclusions This insurance does not apply to a. Expected Or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Contractual Liability Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the absence of the contract or agreement or 2 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorneys fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and Such attorneys fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. b This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in a The supervision hiring employment training or monitoring of others by that insured or b Providing or 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 furnishing alcoholic beverages. For the purposes of this exclusion permitting a person to bring alcoholic beverages on your premises for consumption on your premises whether or not a fee is charged or a license is required for such activity is not by itself considered the business of selling serving or furnishing alcoholic beverages.. Workers Compensation And Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law.. Employer s Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a Employment by the insured or b Performing duties related to the conduct of the insured s business or 2 The spouse child parent brother or sister of that employee as a consequence of Paragraph 1 above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. Page 2 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a At or from any premises site or location which is or was at any time owned or occupied by or rented or loaned to any insured. However this subparagraph does not apply to i Bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or originating from equipment that is used to heat cool or dehumidify the building or equipment that is used to heat water for personal use by the building s occupants or their guests ii Bodily injury or property damage for which you may be held liable if you are a contractor and the owner or lessee of such premises site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not and never was owned or occupied by or rented or loaned to any insured other than that additional insured or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire b At or from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste c Which are or were at any time transported handled stored treated disposed of or processed as waste by orfor i Any insured or ii Any person or organization for whom you may be legally responsible or d At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by such insured contractor or subcontractor. However this subparagraph does not apply to i Bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or released as part of the operations being performed by such insured contractor or subcontractor ii Bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor or Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the operations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. iii CG 00010413 Insurance Services Office Inc. 2012 Page 3 of 16 | 1 |
2 Any loss cost or expense arising out of any a Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or b Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a governmental authority. g. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed wunder any insured contract for the ownership maintenance or use of aircraft or watercraft or 4 5 Bodily injury or property damage arising out of a The operaton of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law 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 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 expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. j. Damage To Property Property 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 | 1 |
4 Personal property in the care custody or control of the insured 5 That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the property damage arises out of those operations or That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section Il Limits Of Insurance. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard. 6. Damage To Your Product Property damage to your product arising out of it or any part of it.. Damage To Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor.. Damage To Impaired Property Or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 A defect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use.. Recall Of Products Work Or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it.. Personal And Advertising Injury Bodily injury arising out of personal and advertising injury.. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. However this exclusion does not apply to liability for damages because of bodily injury. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment.. Recording And Distribution Of Material Or Information In Violation Of Law Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or CG 00010413 Insurance Services Office Inc. 2012 Page 5 of 16 | 1 |
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 2 Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to personal and advertising injury caused by an offense arising out of your business but only if the offense was committed in the coverage territory during the policy period. 2. Exclusions This insurance does not apply to Knowing Violation Of Rights Of Another Personal and advertising injury caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising injury.. Material Published With Knowledge Of Falsity Personal and advertising injury arising out of oral or written publication in any manner of material if done by or at the direction of the insured with knowledge of its falsity.. Material Published Prior To Policy Period Personal and advertising injury arising out of oral or written publication in any manner of material whose first publication took place before the beginning of the policy period.. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured.. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement.. Breach Of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s advertising idea in your advertisement.. Quality Or Performance Of Goods Failure To Conform To Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your advertisement.. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Page 6 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
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. j 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. I. 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 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or 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 CG 00010413 Insurance Services Office Inc. 2012 Page 7 of 16 | 1 |
COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that a The accident takes place in the coverage territory and during the policy period b The expenses are incurred and reported to us within one year of the date of the accident and 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 | 1 |
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 o. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the insured and the indemnitee and f. The indemnitee 1 Agrees in writing to a Cooperate with us in the investigation settlement or defense of the suit Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit b c Notify any other insurer whose coverage is available to the indemnitee and d Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee and 2 Provides us with written authorization to a Obtain records and other information related to the suit and b Conduct and control the defense of the indemnitee in such suit. So long as the above conditions are met attorneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.2 of Section Coverage A Bodily Injury And Property Damage Liability such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the limits of insurance. Our obligation to defend an insured s indemnitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above or the terms of the agreement described in Paragraph f. above are no longer met. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. c. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. CG 00010413 Insurance Services Office Inc. 2012 Page 9 of 16 | 1 |
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 For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph 1a or b above or Arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b Rented to in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees volunteer workers any partner or member if you are a partnership or joint venture or any member if you are a limited liability company. b. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. b c d c. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that property and 2 Until your legal representative has been appointed. d. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION Il LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. Page 10 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
3. The Products Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. 4. Subject to Paragraph 2. above the Personal And Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all personal and advertising injury sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above whichever applies the Each Occurrence Limit is the most we will pay for the sum of a. Damages under Coverage A and b. Medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to Paragraph 5. above the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of property damage to any one premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence Offense Claim Or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or an offense which may result in a claim. To the extent possible notice should include 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured persons and witnesses and 3 The nature and location of any injury or damage arising out of the occurrence or offense. b. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent.. 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. CG 00010413 Insurance Services Office Inc. 2012 Page 11 of 16 | 1 |
4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance 1 This insurance is excess over a Any of the other insurance whether primary excess contingent or on any other basis i That is Fire Extended Coverage Builder s Risk Installation Risk or similar coverage for your work ii That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner iii That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner or iv If the loss arises out of the maintenance or use of aircraft autos or watercraft to the extent not subject to Exclusion g. of Section I Coverage A Bodily Injury And Property Damage Liability. b Any other primary insurance available to you covering liability for damages arising out of the premises or operations or the products and completed operations for which you have been added as an additional insured. 2 When this insurance is excess we will have no duty under Coverages A or B to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be entitted to the insured s rights against all those other insurers. 3 When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of a The total amount that all such other insurance would pay for the loss in the absence of this insurance and b The total of all deductible and self insured amounts under all that other insurance. 4 We will share the remaining loss if any with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. 6. Representations By accepting this policy you agree a. The statements in the Declarations are accurate and complete Page 12 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
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.. Hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be.. lmpaired 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. 2 3 CG 00010413 Insurance Services Office Inc. 2012 Page 13 of 16 | 1 |
9. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract b. A sidetrack agreement c. Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality e. An elevator maintenance agreement f. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 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. 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. 11.Loading or unloading means the handling of property a. After it is moved from the place where it is accepted for movement into or onto an aircraft watercraft or auto b. While it is in or on an aircraft watercraft or auto or c. While it is being moved from an aircraft watercraft or auto to the place where it is finally delivered but loading or unloading does not include the movement of property by means of a mechanical device other than a hand truck that is not attached to the aircraft watercraft or auto. 12.Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment a. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads b. Vehicles maintained for use solely on or next to premises you own or rent c. Vehicles that travel on crawler treads d. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers e. Vehicles not described in Paragraph a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types 1 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers f. Vehicles not described in 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 | 1 |
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. 13.Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. 14.Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution c. The wrongful eviction from 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. 15.Pollutants mean any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals and waste. Waste includes materials to be recycled reconditioned or reclaimed. 16.Products completed operations hazard a. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 Products that are still in your physical possession or 2 Work that has not yet been completed or abandoned. However your work will be deemed completed at the earliest of the following times a When all of the work called for in your contract has been completed. b When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. c When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. b. Does not include bodily injury or property damage arising out of 1 The transportation of property unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you and that condition was created by the loading or unloading of that vehicle by any insured 2 The existence of tools uninstalled equipment or abandoned or unused materials or 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 | 1 |
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. 18.Suit means a civil proceeding in which damages because of bodily injury property damage or personal and advertising injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 19.Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. 20.Volunteer worker means a person who is not your employee and who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other compensation by you or anyone else for their work performed for you. 21.Your product a. Means 1 Any goods or products other than real property manufactured sold handled distributed or disposed of by a You b Others trading under your name or c A person or organizaton 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 | 1 |
POLICY NUMBER POLICY NUMBER 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 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 | 2 |
C. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 Insurance Services Office Inc. 2012 CG201004 13 | 2 |
POLICY NUMBER POLICY NUMBER 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 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 | 2 |
COMMERCIAL GENERAL LIABILITY CG 2106 0514 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA RELATED LIABILITY WITH LIMITED BODILY INJURY EXCEPTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.p. of Section Coverage A As used in this exclusion electronic data Bodily Injury And Property Damage Liability is replaced by the following 2. Exclusions This insurance does not apply to p. Access Or Disclosure Of Confidential Or Personal Information And Data related Liability Damages arising out of 1 Any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information or The loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of that which is described in Paragraph 1 or 2 above. However unless Paragraph 1 above applies this exclusion does not apply to damages because of bodily injury. means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. B. The following is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or organization s confidential or personal information As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. B. The following is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or organization s confidential or personal information. CG 21060514 Insurance Services Office Inc. 2013 Page 1 of 1 | 2 |
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 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. 2 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 Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. 2 CG 21471207 ISO Properties Inc. 2006 Page 1 of 1 a | 2 |
COMMERCIAL GENERAL LIABILITY CG 21671204 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. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Bodily injury or property damage which would not have occurred in whole or in part but for the actual alleged or 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 or damage. b. Any loss cost or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxify ing neutralizing remediating or disposing of or in any way responding to or assess ing the effects of fungi or bacteria by any insured or by any other person or entity. This exclusion does not apply to any fungi or bacteria that are are on or are contained in a good or product intended for bodily consump tion. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Per sonal And Advertising Injury Liability 2. Exclusions This insurance does not apply to 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 in sured or by any other person or entity. C. The following definition is added to the Definitions Section Fungi means any type or form of fungus includ ing mold or mildew and any mycotoxins spores scents or byproducts produced or released by fungi. CG 21671204 ISO Properties Inc. 2003 Page 1 of 1 a | 2 |
COMMERCIAL GENERAL LIABILITY CG 21700115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following 1. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. B. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. B. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. CG 21700115 Insurance Services Office Inc. 2015 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG 21760115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF PUNITIVE DAMAGES RELATED TO A CERTIFIED ACT OF TERRORISM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. The following exclusion is added This insurance does not apply to TERRORISM PUNITIVE DAMAGES Damages arising directly or indirectly out of a certified act of terrorism that are awarded as punitive damages. B. The following definition is added Certified act of terrorism means an act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following 1. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion.. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. C. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. CG 21760115 Insurance Services Office Inc. 2015 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY QUICK REFERENCE COMMERCIAL GENERAL LIABILITY COVERAGE FORM OCCURRENCE COVERAGE READ YOUR POLICY CAREFULLY DECLARATIONS PAGES Named Insured And Mailing Address Policy Period Description Of Business And Location Coverages And Limits Of Insurance SECTION COVERAGES Coverage A Bodily Injury And Property Damage Liability Coverage B Personal And Advertising Injury Liability Coverage C Medical Payments Supplementary Payments..................... SECTION Il WHO ISAN INSURED............ SECTION Il LIMITS OF INSURANCE................ it Insuring Agreement. Exclusions Insuring Agreement.............. Exclusions Insuring Agreement. Exclusions SECTION IV COMMERCIAL GENERAL LIABILITYCONDITIONS........................... Bankruptcy Duties In The Event Of Occurrence Offense Claim Or Suit Legal Action Against Us Other Insurance.. Premium Audit. Representations Separation Of Insureds..................... Transfer Of Rights Of Recovery Against Others To Us When We Do Not Renew... SECTIONV DEFINITIONS.................. COMMON POLICY CONDITIONS Cancellation Changes Examination Of Your Books And Records Inspections And Surveys Premiums Transfer Of Your Rights And Duties Under This Policy ENDORSEMENTS If Any Beginning on Page CG700310 13 Page 10f 1 | 2 |
Commercial General Liability THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXTENDED PROPERTY DAMAGE COVERAGE Schedule Limits of Insurance Deductible 5000 Each Occurrence 250 Per Claim 25000 Annual Aggregate Insuring Agreement We will pay for loss to personal property of others including the loss of use of such property while in your care custody or control or personal property over which you for any purpose are exercising physical control when 1. loss arises out of operations away from your premises 2. loss is incidental to your normal business operations and 3. you have property damage liability coverage for that business under the coverage form to which this endorse ment is attached. Loss means unintentional damage or destruction but does not include disappearance or obstruction. Exclusions The coverage under this endorsement does not apply to loss to 1. property held by you for servicing repair storage or sale on premises you own rent occupy or otherwise con trol 2. property while being transported by or caused by the ownership maintenance operation use loading or un loading of any automobile watercraft or aircraft 3. property you own rent or occupy 4. real property. Limit of Insurance The limit of insurance stated in the Schedule of Limits as each occurrence is the most we will pay for all damages on account of each claim or suit covered under this endorsement. The limit of insurance stated in the Schedule of Limits as Annual Aggregate is subject to the above provision respecting each claim the total limit of our liability for all damages under this endorsement in any one policy period. Deductible We will not be liable on account of any loss except to the extent such loss is in excess of the deductible amount stated in the Schedule of Limits with the insurance then applying to such excess only subject otherwise to the appli cable limits of insurance. The terms of the policy with respect to your duties in the event of occurrence claim or suit and our right to investi gate negotiate and settle any claim or suit apply irrespective of the application of the deductible amount. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification of the action taken you will promptly reimburse us for any part of the deductible amount as has been paid by us. Settlement In the event of loss covered by this endorsement you will if requested by us replace the property or furnish the labor and materials necessary for repairs at actual cost to you excluding prospective profit or overhead charges of any nature. Any property so paid for or replaced at our option becomes our property. Payment will not constitute an admission of any liability on your part. Other Insurance If any other insurance carried by you applies to a loss covered by this endorsement this endorsement will not ap ply. Nothing herein contained will be held to alter vary or waive any of the agreements conditions or declarations of this policy except as herein stated. Form CG7141 Ed. 5 90 | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION CONTRACT OR AGREEMENT INCLUDING COMPLETED OPERATIONS PRIMARY AND NONCONTRIBUTORY COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section Il Who Is An Insured is amended to include as an additional insured 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. Such persons or organizations is an additional insured only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by a. Your acts or omissions or b. The acts or omissions of those acting on your behalf in the performance of a. your ongoing operations for the additional insured or b. Your work for the additional insured and included in the products completed operations hazard. However the insurance afforded to such additional insured described above a. Only applies to the extent permitted by law and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured.. With respect to the insurance afforded to these additional insureds the exclusion applies This insurance does not apply to bodily injury property damage and personal and advertising injury arising out of the rendering of or the failure to render any professional architectural engineering or surveying services including a. The preparing approving or failing to prepare or approve maps shop drawings opinions reports following additional E. This endorsement modifies the insurance provided under the following surveys field orders change orders or drawings and specifications or b. Supervisory inspection engineering activities. 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 the 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 the failure to render any professional architectural engineering or surveying services. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance The most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or described in Paragraph A.1. 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. The following is added to the Other Insurance Condition and supersedes any provision to the contrary Primary and Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that 1 The additional insured is a Named Insured under such other insurance and 2 You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of this policy remain unchanged. architectural or agreement CG7174.310 13 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT AGGREGATE LIMITS OF INSURANCE PER PROJECT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The General Aggregate Limit under LIMITS OF INSURANCE Section Ill applies separately to each of your projects away from premises owned by or rented to you. Includes copyrighted material of Insurance Services Office Inc. with its permission. Form CG7429 Ed. 11 98 Copyright Insurance Services Office Inc. 1984 | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY ELITE EXTENSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM The COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to include the following clarifications and extensions of coverage. The provisions of the Coverage Form apply unless modified by endorsement. A. EXPECTED OR INTENDED INJURY Section Coverage A Exclusion a. is amended as follows a. Bodily injury or property damage expected or intended from the standpoint of an insured. This exclusion does not apply to bodily injury or property damage resulting from the use of reasonable force to protect persons or property. NON OWNED WATERCRAFT Section Coverage A Exclusion g.2 is amended as follows 2 A watercraft you do not own that is a Less than 60 feet long and b Not being used to carry persons or property for a charge EXTENDED PROPERTY DAMAGE COVERAGE Section Coverage A Exclusions j.3 and 4 is amended to add the following Paragraphs 3 and 4 of this exclusion do not apply to tools or equipment loaned to you provided they are not being used to perform operations at the time of loss. SCHEDULE Limits Of Insurance Deductible 5000 Each Occurrence 250 Per Claim 10000 Annual Aggregate a. The each occurrence limit listed above is the most we will pay for all damages because of property damage to property in the care custody and control of or property loaned to an insured as the result of any one occurrence regardless of the number of 1 insureds 2 claims made or suits brought 3 persons or organizations making claims or bringing suits. The aggregate limit listed above is the most we will pay for all damages because of property damage to property in the care custody and control of or property loaned to an insured during the policy period. Any payment we make for damages because of property damage to property in the care custody and control of or property loaned to an insured will apply against the General Aggregate Limit shown in the declarations. b. Our obligation to pay damages on your behalf applies only to the amount of damages in excess of the deductible amount listed above. We may pay any part or all of the deductible amount listed above. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification by us you will promptly reimburse us for that part of the deductible we paid. c. If two or more coverages apply under one occurrence only the highest per claim deductible applicable to these coverages will apply. d. Insurance provided by this provision is excess over any other insurance whether primary excess contingent or any other basis. Since insurance provided by this endorsement is excess we will have no duty to defend any claim or suit to which insurance provided by this endorsement applies if any other insurer has a duty to defend such a claim or 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. PROPERTY DAMAGE ELEVATORS Section Coverage A.2. Exclusions paragraphs j3 j4 j.6 and k. do not apply to use of elevators. This insurance afforded by this provision is excess over any valid and collectible property insurance including any deductible available to the insured and Section IV Commercial General Liability Conditions Paragraph 4. Other Insurance is changed accordingly. CGT5786 17 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f6 | 2 |
FIRE LIGHTNING OR EXPLOSION DAMAGE Except where it is used in the term hostile fire the word fire includes fire lightning or explosion wherever it appears in the Coverage Form. Under Section Coverage A the last paragraph after the exclusions is replaced with the following Exclusions c. through n. do not apply to damage by fire smoke or leakage from automatic fire protection systems 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 Ill Limits of Insurance. MEDICAL PAYMENTS If Section Coverage C. Medical Payments Coverage is not otherwise excluded from this Coverage Form The requirement in the Insuring Agreement of Coverage C. that expenses must be incurred and reported to us within one year of the accident date is changed to three years.. SUPPLEMENTARY PAYMENTS Supplementary Payments Coverages A and B Paragraphs 1.b. and 1.d. are replaced by the following 1.b. Up to 5000 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. 1.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 500 a day because of time off from work. SUBSIDIARIES AS INSUREDS Section Il Who Is An Insured is amended to add the following 1.f. Any legally incorporated subsidiary in which you own more than 50 of the voting stock on the effective date of this policy. However insured does not include any subsidiary that is an insured under any other general liability policy or would have been an insured under such a policy but for termination of that policy or the exhaustion of that policy s limits of liability. BLANKET ADDITIONAL INSUREDS AS REQUIRED BY CONTRACT 1. Section Il Who Is An Insured is amended to include as an additional insured any persons or organizations subject to provisions in Paragraph 2. below hereinafter referred to as additional insured when you and such persons or organizations have agreed in a written contract or written agreement that such persons or organizations be added as an additional insured on your policy provided that the written contract or agreement is a. Currently in effect or becomes effective during the policy period and b. Executed prior to an occurrence or offense to which this insurance would apply. However the insurance afforded to such additional insured a. Only applies to the extent permitted by law and b. Wil not be broader than that which you are required by the contract or agreement to provide for such additional insured and c. Applies only if the person or organization is not specifically named as an additional insured under any other provision of or endorsement added to Section Il Who Is An Insured of this policy. As provided herein the insurance coverage provided to such additional insureds is limited to a. Any Controlling Interest but only with respect to their liability arising out of their financial control of you or premises they own maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations new construction and demolition operations performed by or for that person or organization. b. Any architect engineer or surveyor engaged by you but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by your acts or omissions or the acts or omissions of those acting on your behalf 1 In connection with your premises or 2 In the performance of your ongoing operations. With respect to the insurance afforded to these additional insureds the following additional exclusion applies This insurance does not apply to bodily j property damage or personal and advertising injury arising out of the rendering of or the failure to render any professional services by or for you including 1 The preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or 2 Supervisory inspection architectural or engineering activities. CG75786 17 Includes copyrighted material of ISO Properties Inc. with its permission. Page 2 of 6 | 2 |
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 the failure to render any professional services by or for you. Any manager or lessor of a premises leased to you but only with respect to liability arising out of the ownership maintenance or use of that part of a premises leased to you subject to the following additional exclusions This insurance does not apply to 1 Any occurrence which takes place after you cease to be a tenant in that premises. 2 Structural alterations new construction or demolition operations performed by or on behalf of such additional insured. Any state or governmental agency or subdivision or political subdivision subject to the following 1 This insurance applies only with respect to the following hazards for which any state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own rent or control and to which this insurance applies a The existence maintenance repair construction erection or removal of advertising signs awnings canopies cellar entrances coal holes driveways manholes marquees hoist away openings sidewalk vaults street banners or decorations and similar exposures or b The construction erection or removal of elevators or c The ownership maintenance or use of any elevators covered by this insurance. 2 This insurance applies only with respect to operations performed by you or on your behalf for which any state or governmental agency or subdivision or political subdivision has issued a permit or authorization. This insurance does not apply to a Bodily injury property damage or personal and advertising injury arising out of operations performed for the federal government state or municipality or Bodily injury or property damage included within the products completed operations hazard. Any vendor but only with respect to bodily injury or property damage arising out of your products which are distributed or sold in the regular course of the vendor s business. With respect to the insurance afforded to these vendors the following additional exclusions apply 1 The insurance afforded any vendor does not apply to a Bodily injury or property damage for which any vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that any vendor would have in the absence of the contract or agreement Any express warranty unauthorized by you Any physical or chemical change in the product made intentionally by any vendor Repackaging except when unpacked solely for the purpose of inspection demonstration testing or the substitution of parts under instructions from the manufacturer and then repackaged in the original container Any failure to make such inspections adjustments tests or servicing as any vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the distribution or sale of the products f Demonstration installation servicing or repair operations except such operations performed at any vendor s premises in connection with the sale of the product Products which after distribution or sale by you have been labeled or relabeled or used as a container part or ingredient of any other thing or substance by or for any vendor or b b c d e g CGT5786 17 Includes copyrighted material of ISO Properties Inc. with its permission. Page 30f 6 | 2 |
h Bodily injury or property damage arising out of the sole negligence of any vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However this exclusion does not apply to The exceptions contained in Subparagraphs d or f or ii Such inspections adjustments tests or servicing as any vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the distribution or sale of the products. 2 This insurance does not apply to any insured person or organization from whom you have acquired such products or any ingredient part or container entering into accompanying or containing such products. Any Mortgagee Assignee Or Receiver but only with respect to their liability as mortgagee assignee or receiver and arising out of the ownership maintenance or use of the premises by you. This insurance does not apply to structural alterations new construction and demolition operations performed by or for that person or organization. Any Owners Or Other Interests From Whom Land Has Been Leased but only with respect to liability arising out of the ownership maintenance or use of that part of the land leased to you. With respect to the insurance afforded to these additional insureds the following additional exclusions apply 1 This insurance does not apply to Any occurrence which takes Any hich tak place after you cease to lease that land or b Structural alterations new construction or demolition operations performed by or on behalf of such additional insured. Any person or organization from whom you lease equipment but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by your maintenance operation or use of equipment leased to you by such persons or organizations. A person s or organization s status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded to these additional insureds this insurance does not apply to any occurrence which takes place after the equipment lease expires. Any Owners Lessees or Contractors for whom you are performing operations 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 insured. A person s or organization s status as an additional insured under this endorsement ends when your operations for that additional insured are completed. With respect to the insurance afforded to these additional insureds the following additional exclusions apply This insurance does not apply to 1 Bodily injury property damage or personal and advertising injury arising out of the rendering of or the failure to render any professional architectural engineering or surveying services including a The preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Supervisory inspection architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision 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 the failure to render any professional architectural engineering or surveying services. 2 Bodily injury or property damage occurring after CG75786 17 Includes copyrighted material of ISO Properties Inc. with its permission. Page 4 of 6 | 2 |
a All work including materials parts or equipment furnished in connection with such work on the project other than service maintenance or repairs to be performed by or on behalf of the additional insureds at the location of the covered operations has been completed or 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. j Any Grantor of Licenses to you but only with respect to their liability as grantor of licenses to you. Their status as additional insured under this endorsement ends when 1. The license granted to you by such persons or organizations expires or 2. Your license is terminated or revoked by such persons or organizations prior to expiration of the license as stipulated by the contract or agreement. k. Any Grantor of Franchise but only with respect to their liability as grantor of a franchise to you. I. Any Co owner of Insured Premises but only with respect to their liability as co owner of any insured premises. m. Any Concessionaires Trading Under Your Name but only with respect to their liability as a concessionaire trading under your name. Any insurance provided to any additional insured does not apply to bodily injury property damage or personal and advertising injury arising out of the sole negligence or willful misconduct of the additional insured or its agents employees or any other representative of the additional insured. With respect to the insurance afforded to these additional insureds the following is added to Section Il Limits of Insurance If coverage provided to any 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 a. Required by the contract or agreement or b. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. b This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. COVERAGE FOR INJURY TO CO EMPLOYEES AND OR YOUR OTHER VOLUNTEER WORKERS Section Il Who is an Insured Paragraph 2.a. 1 is amended to add the following e. Paragraphs a b and c do not apply to your employees or volunteer workers with respect to bodily injury to a coemployee or other volunteer worker. Damages owed to an injured coemployee or volunteer worker will be reduced by any amount paid or available to the injured co employee or volunteer worker under any other valid and collectible insurance. HEALTH CARE SERVICE PROFESSIONALS AS INSUREDS INCIDENTAL MALPRACTICE Section Il Who is an Insured Paragraph 2.a. 1 d is amended as follows This provision does not apply to Nurses Emergency Medical Technicians or Paramedics who provide professional health care services on your behalf. However this exception does not apply if you are in the business or occupation of providing any such professional services. NEWLY FORMED OR ACQUIRED ORGANIZATIONS Section Il Who Is An Insured Paragraph 3.a. is replaced by the following 3.a. Coverage under this provision is afforded until the end of the policy period. This provision does not apply if newly formed or acquired organizations coverage is excluded either by the provisions of the Coverage Form or by endorsements.. DAMAGE TO PREMISES RENTED TO YOU Section lll Limits of Insurance Paragraph 6. is replaced by the following Subject to 5.a. above the Damage To Premises Rented To You Limit or 500000 whichever is higher 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 smoke or leakage from automatic protection systems while rented to you or temporarily occupied by you with permission of the owner. MEDICAL PAYMENTS INCREASED LIMITS Section lll Limits of Insurance Paragraph 7. is replaced by the following 7. Subject to Paragraph 5. above 10000 is the Medical Expense Limit we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person unless the amount shown on the Declarations of this Coverage Part for Medical Expense Limit states CGT5786 17 Includes copyrighted material of ISO Properties Inc. with its permission. Page 50f 6 | 2 |
a No Coverage or b 1000 or c 5000 or d A limit higher than 10000. O. DUTIES IN THE EVENT OF OCCURRENCE OFFENSE CLAIM OR SUIT Section IV Commercial General Liability Conditions Paragraph 2. is amended to add the following e. The requirement in Condition 2.a. that 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 applies only when the occurrence or offense is known to 1 You if you are an individual or a limited liability company 2 A partner if you are a partnership 3 A member or manager if you are a limited liability company 4 An executive officer or insurance manager if you are a corporation or 5 Atrustee if you are a trust. f. The requirement in Condition 2.b. that you must see to it that we receive notice of a claim or suit as soon as practicable will not be considered breached unless the breach occurs after such claim or suit is known to 1 You if you are an individual or a limited liability company 2 A partner if you are a partnership 3 A member or manager if you are a limited liability company 4 An executive officer or insurance manager if you are a corporation or 5 Atrustee if you are a trust. P. PRIMARY AND NONCONTRIBUTORY ADDITIONAL INSURED EXTENSION Section IV Commercial General Liability Conditions Paragraph 4. Other Insurance is amended to add the following This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that 1 The additional insured is a Named Insured under such other insurance and 2 You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. However if the additional insured has been added as an additional insured on other policies whether primary excess contingent or on any other basis this insurance is excess over any other insurance regardless of the written agreement between you and an additional insured. Q. UNINTENTIONAL FAILURE TO DISCLOSE EXPOSURES Section IV Commercial General Liability Conditions Paragraph 6. Representations is amended to add the following If you unintentionally fail to disclose any exposures existing at the inception date of your policy we will not deny coverage under the Coverage Form solely because of such failure to disclose. However this provision does not affect our right to collect additional premium or exercise our right of cancellation or non renewal. This provision does not apply to any known injury or damage which is excluded under any other provision of this policy. R. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Section IV Commercial General Liability Condition Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us is amended to add the following We waive any right of recovery we may have against any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement 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. S. MENTAL ANGUISH Section V Definition 3. is replaced by the following Bodily injury means bodily injury sickness or disease sustained by a person including mental anguish or death resulting from bodily injury sickness or disease. T. LIBERALIZATION If we revise this endorsement to provide greater coverage without additional premium charge we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. CG75786 17 Includes copyrighted material of ISO Properties Inc. with its permission. Page 6 of 6 | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS OCCURRENCE DEFINITION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART For the purposes of the coverage provided by this endorsement Section V DEFINITIONS Paragraph 13. is amended to read Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions and also means accidental property damage but does not include faulty workmanship which is the defective condition of an insured s or subcontractor s work without a change or alteration in your work. CGT6442 09 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10of 1 | 2 |
COMMERCIAL GENERAL LIABILITY FUNGI OR BACTERIA EXCLUSION NOTICE TO POLICYHOLDERS RESTRICTIONS AND CLARIFICATIONS OF COVERAGE NO COVERAGE IS PROVIDED BY THIS POLICYHOLDER NOTICE NOR CAN IT BE CONSTRUED TO REPLACE ANY PROVISIONS OF YOUR POLICY. YOU SHOULD READ YOUR POLICY ALL ATTACHED ENDORSEMENTS AND THE DECLARATIONS PAGE FOR COMPLETE INFORMATION ON THE COVERAGE YOU ARE PROVIDED. IF THERE IS ANY CONFLICT BETWEEN THE POLICY AND THIS NOTICE THE PROVISIONS OF THE POLICY SHALL PREVAIL. THIS NOTICE HAS BEEN PREPARED IN CONJUNCTION WITH THE IMPLEMENTATION OF CHANGES TO YOUR POLICY. THIS NOTICE PROVIDES INFORMATION CONCERNING FUNGI OR BACTERIA EXCLUSIONS AND YOUR POLICY. PLEASE READ THIS NOTICE CAREFULLY. Please contact your agent to discuss any questions. Your right to cancel remains unchanged. CG2167 Fungi or Bacteria Exclusion Commercial General Liability Coverage Part When this endorsement is attached to your policy coverage is restricted to exclude bodily injury or property damage arising directly or indirectly out of any fungi including but not limited to mold or bacteria on or in a building or structure. coverage is clarified to exclude personal and advertising injury or personal injury or advertising injury if defined as such in your policy arising directly or indirectly out of any fungi including but not limited to mold or bacteria on or in a building or structure. This exclusion applies whether or not any other cause event material or product contributed in any sequence to the injury. coverage is restricted to exclude clean up costs associated with fungi or bacteria. The exclusion does not apply to fungi or bacteria intended for bodily consumption such as mushrooms. CG3131 Fungi or Bacteria Exclusion Owners and Contractors Protective Liability Coverage Part and Products Completed Operations Coverage Part When this endorsement is attached to your policy coverage is restricted to exclude bodily injury or property damage arising directly or indirectly out of any fungi including but not limited to mold or bacteria on or in a building or structure. This exclusion applies whether or not any other cause event material or product contributed in any sequence to the injury or damage. coverage is restricted to exclude clean up costs associated with fungi or bacteria. The exclusion does not apply to fungi or bacteria intended for bodily consumption such as mushrooms. G081 4 06 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1 | 2 |
IL 00 21 05 02 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 PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE 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 Under writers Nuclear Insurance Association of Canada or any of their successors or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability or Resulting from the hazardous properties of nuclear material and with respect to which a any person or organization is re quired to maintain financial protection pur suant to the Atomic Energy Act of 1954 or any law amendatory thereof or b the in sured is or had this policy not been issued would be entitled to indemnity from the United States of America or any agency thereof under any agreement entered into by the United States of America or any agency thereof with any person or organi zation. B. Under any Medical Payments coverage to expenses incurred with respect to bodily in jury resulting from the hazardous properties of nuclear material and arising out of the op eration of a nuclear facility by any person or organization. C. Under any Liability Coverage to bodily injury or property damage resulting from hazard ous properties of nuclear material if 1 The nuclear material a is at any nuclear facility owned by or operated by or on be half of an insured or b has been dis charged or dispersed therefrom 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 prop erty thereat. 2 3. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source material Spe cial nuclear material or by product material. C. Under any Liability Coverage to bodily injury or property damage resulting from hazard ous properties of nuclear material if 1 The nuclear material a is at any nuclear facility owned by or operated by or on be half of an insured or b has been dis charged or dispersed therefrom 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 prop erty 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 05 02 ISO Properties Inc. 2001 Page 1 of 2 a | 2 |
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 exposed to radiation in a nuclear reactor. Waste means any waste material a containing by product material other than the tailings or wastes produced by the extraction or 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 plu tonium 2 processing or utilizing spent fuel or 3 handling processing or packaging waste c Any equipment or device used for the process ing fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 d Any structure basin excavation premises or place prepared or used for the storage or dis posal of waste and includes the site on which any of the forego ing is located all operations conducted on such site and all premises used for such operations. Nuclear reactor means any apparatus designed or used to sustain nuclear fission in a self supporting chain reaction or to contain a critical mass of fissionable material. Property damage includes all forms of radioac tive contamination of property. Page 2 of 2 ISO Properties Inc. 2001 IL 00 21 05 02 m | 2 |
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. 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 | 2 |
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 | 2 |
INTERLINE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ASBESTOS EXCLUSION This endorsement modifies insurance provided under the following BUSINESSOWNERS COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM POLLUTION LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM The policy does not apply to bodily injury personal injury or personal and advertising injury if defined as such in your policy or property damage including any associated clean up obligations arising out of the installation existence removal or disposal of asbestos or any substance containing asbestos fibers. 1L70285 15 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1 | 2 |
COMMERCIAL INTERLINE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION PROVIDED BY US DESIGNATED ENTITY SCHEDULE 1. Name of Entity 2. Mailing Address 3. Number of Days Notice Information required to complete this Schedule if not shown above will be shown in the Declarations. If we cancel this policy by notice to the first Named Insured for any statutorily permitted reason other than nonpayment of premium notice of such cancellation will be provided to the entity in the Schedule at least the number of days in advance of the cancellation effective date also as shown in the Schedule. If notice is mailed proof of mailing to the mailing address shown in the Schedule will be sufficient proof of notice. Failure to provide such notice to the designated entity will not amend or extend the date the cancellation becomes effective nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon us our agents or our representatives. 1L73385 15 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1 | 2 |
ASBESTOS NOTICE The Asbestos Exclusion attached to this policy clarifies our intent not to provide this coverage. It should be noted that by virtue of the Pollution Exclusion little if any coverage is thought to have existed previously. Involvement with asbestos exposures should be directed to highly skilled asbestos contractors andor consultants that have specialized insurance programs. EMC Insurance Companies Form IL8021 Ed. 4 88 | 2 |
COMMERCIAL INTERLINE IMPORTANT NOTICE TO POLICYHOLDERS Re New Federal Claim Information Reporting Requirements New federal reporting requirements for claims involving parties potentially eligible for Medicare are now in place. With your continued cooperation EMC Insurance Companies will be able to meet these new reporting responsibilities. To help us comply with the new requirements you simply need to make sure you report all claims to your agent or EMC Insurance Companies. If you choose to pay a claim or attempt to settle a claim on your own you may become responsible for these new reporting requirements. For specific information on Section 111 of the Medicare Medicaid and SCHIP Extension Act of 2007 MMSEA P.L. 110 173 go to www.cms.hhs.govMandatorylnsRep or consult with your attorney. 1L85769 09 Page 1 0f 1 | 2 |
COMMERCIAL INTERLINE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. IMPORTANT NOTICE TO POLICYHOLDERS This Notice does not form part of your policy. No coverage is provided by the Notice nor can it be construed to replace any provision of your policy. You should read your policy including all endorsements and review you Declarations page for complete information on the coverage you are provided. If there is any conflict between the policy and this notice THE PROVISIONS OF THE POLICY SHALL PREVAIL. Carefully read your policy including the endorsements attached to your policy. Please contact your agent to discuss any questions. Your right to cancel remains unchanged. This Notice provides information concerning the following new endorsements which may apply to your General Liability Businessowners andor Umbrella renewal policies issued by us BP0412 Limitation Of Coverage To Designated Premises Project Or Operation CG2144 Limitation Of Coverage To Designated Premises Project Or Operation When these endorsements are attached to your General Liability or Businessowners policies coverage is limited to specific premises andor projects or operations designated in the Schedule of the endorsement. These endorsements have been revised to explicitly address in the context of a scheduled premises the location wherein e Under Paragraph A. bodily injury or property damage must occur e Under Paragraph B. the following location based offenses must be committed 1. False arrest detention or imprisonment or 2. 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 and e Under Paragraph C. bodily injury must occur. If the previous edition of these endorsements were attached to your policy the attachment of these endorsements may result in a reduction of coverage in the context of a scheduled premises to the extent coverage might have been previously available or provided for bodily injury or property damage that occurs or a location based offense that is committed away from a scheduled premises. CU2111 Limitation Of Coverage To Designated Premises Project Or Operation CU2199 Arkansas Limitation Of Coverage To Designated Premises Project Or Operation CU3401 Colorado Limitation Of Coverage To Designated Premises Project Or Operation CU3402 lllinois Limitation Of Coverage To Designated Premises Project Or Operation CU2198 Connecticut Limitation Of Coverage To Designated Premises Project Or Operation CU2197 North Carolina Limitation Of Coverage To Designated Premises Project Or Operation When this endorsement is attached to your Umbrella policy coverage is limited to specific premises andor projects or operations designated in the Schedule of the endorsement. This endorsement has been revised to explicitly address in the context of a scheduled premises the location wherein e Under Coverage A. bodily injury or property damage must occur and e Under Coverage B. the following location based offenses must be committed 1. False arrest detention or imprisonment or 2. 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. If the previous edition of this endorsement was attached to your policy the attachment of this endorsement may result in a reduction of coverage in the context of a scheduled premises to the extent coverage might have been previously available or provided for bodily injury or property damage that occurs or a location based offense that is committed away from a scheduled premises. 1L87453 17 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1 | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY INSTALLMENT PREMIUM PAYMENT SCHEDULE H POLICY NUMBER POLICY PERIOD 10012014 TO 10012015 4D6 19 18 15 Mmoo T TT NAMED INSURED PRODUCER STAROSTKA GROUP. LOCKTON COMPANIES LLC UNLIMITED INC... 1015 N 98TH ST STE 101 429 INDUSTRIAL LN.. OMAHA NE. GRAND ISLAND NE.. 68114 2357 68803 5239. AGENT NO. AB8210 THE ADVANCE ESTIMATED PREMIUM WILL BE DUE AS FOLLOWS 1 SCHEDULE INSTALLMENT DUE DATE AMOUNT 100114 6405.00 i 110114 2132 OOE P i 120114 2132 OOE P E 010115 2132 OO Voz011s 1 2132.00 P i 030115 2132 OOE P i 040115 2132 OOE P i 050115 2132 OOE P i 060115 2132 OOE P i 070115 2132 OOE P TOTAL 25593 OO THIS INSTALLMENT SCHEDULE WILL NOT BE REVISED BY ANY FUTURE ENDORSEMENT RESULTING IN PREMIUM CHANGES UNLESS APPROVED BY THE COMPANY. PLACE OF ISSUE OMAHA NE DATE OF ISSUE 09162014 FORM IL7007A ED.03 86 11062014 007 B8 4D61918 15001 INSTALLMENT PREMIUM PAYMENT SCHEDULE A POLICY NUMBER POLICY PERIOD 10012014 TO 10012015 4D6 19 18 15 NAMED INSURED STAROSTKA GROUP. LOCKTON COMPANIES LLC UNLIMITED INC... 1015 N 98TH ST STE 101 429 INDUSTRIAL LN.. OMAHA NE. GRAND ISLAND NE.. 68114 2357 68803 5239. AGENT NO. AB8210 SCHEDULE DUE DATE INSTALLMENT AMOUNT THIS INSTALLMENT SCHEDULE WILL NOT BE REVISED BY ANY FUTURE ENDORSEMENT RESULTING IN PREMIUM CHANGES UNLESS APPROVED BY THE COMPANY. PLACE OF ISSUE OMAHA NE ST STE 101 THE ADVANCE ESTIMATED PREMIUM WILL BE DUE AS FOLLOWS SCHEDULE DUE DATE | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY PRIOR POLICY 4D6 19 18 GENERAL LIABILTITY DECLARATIONS POLICY PERIOD FROM 100114 TO 100115 POLICY NUMBER 4D6 19 1 8 15 STAROSTKA GROUP LOCKTON COMPANIES LLC UNLIMITED INC. 1015 N 98TH ST STE 101 429 INDUSTRIAL LN OMAHA NE 68114 2357 GRAND ISLAND NE 68803 5239 AGENT AB 8210 AGENT PHONE 402 970 6100 AGENCY BILL JACK H. STRUYK JR INSURED IS CORPORATION BUSINESS DESC CONTRACTOR LIMITS OF INSURANCE EACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT 100000 ANY ONE PREMISES MEDICAL EXPENSE LIMIT 5000 ANY ONE PERSON PERSONAL AND ADVERTISING INJURY LIMIT 1000000 ANY ONE PERSON OR ORGANIZATION GENERAL AGGREGATE LIMIT 2000000 PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT 2000000 COVERAGES PROVIDETD PREMIUM PRODUCTS COMPLETED OPERATIONS 10434.00 OTHER THAN PRODUCTS COMPLETED OPERATIONS 15159.00 TOTAL ESTIMATED POLICY PREMIUM 25593.00 SEE ATTACHED SCHEDULE FOR LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED. DATE OF ISSUE 103014 BPP FORM CG7000A ED. 08 99 BPP 082814 007 Jo 4D61918 1501 GENERAL LIABILTITY D E POLICY PERIOD FROM 100114 TO 100115 UNLIMITED INC. 1015 N 98TH ST STE 101 429 INDUSTRIAL LN OMAHA NE 68114 2357 GRAND ISLAND NE 68803 5239 AGENT AB 8210 AGENT PHONE 402 970 6100 EACH OCCURRENCE LIMIT DAMAGE TO PREMISES RENTED TO YOU LIMIT MEDICAL EXPENSE LIMIT PERSONAL AND ADVERTISING INJURY LIMIT GENERAL AGGREGATE LIMIT 1000 00 100 00 500 1000 00 PRODUCTS COMPLETED OPERATIONS 10434.00 OTHER THAN PRODUCTS COMPLETED OPERATIONS 15159.00 TOTAL ESTIMATED POLICY PREMIUM | 2 |
A EMC Insurance Companies PAGE 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 FORMS APPLICABLE CG00010413 G20320413 G21700108 G23010413 CG71050714 CG71400714 CG71910113 CG7193.11013 CG04351207 CG74281198 CG74291198 CG21060514 CG21760108 CG24121185 CG76270309 CG76440209 CG82820414 CGB82830414 IL02580112 IL02590907 IL70281005 IL7130A0401 IL73390511 IL8383.50108 Footnotes CG04370413 CG21471207 CG22741001 CG7001A1012 CG70031013 CG71410590 CG72531296 CG72761008 CG7523.30307 CG75551013 CG80810406 FL04111006 IL02760908 IL7131A0401 IL73130711 IL8384A0108 IL85760909 G20110413 CG21671204 G22800413 CG7174.31013 G8254 0614 IL00210502 IL12010199 CG2010 07 04 AI OWNERS LESSEES OR CONTRACTORS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEP WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. CG2037 07 04 AI OWNERS LESSESS OR CONT COMP OPS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEPT WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. AUDIT PERIOD ANNUAL DATE OF ISSUE 103014 BPP FORM CG7000A ED. 08 99 BPP 082814 007 Jo 4D61918 1501 0413 CG04351207 CG04370413 CG20110413 0413 CG21060514 CG21471207 CG21671204 IA1 0QY RO 17C 01 N R99TALI1INA0TY 2980 AA 7172 CG2 Footnotes CG2010 07 04 AI OWNERS LESSEES OR CONTRACTORS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEP WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. CG2037 07 04 AI OWNERS LESSESS OR CONT COMP OPS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEPT WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. AUDIT PERIOD ANNUAL | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERATL L Cc ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM CG0001 04 13 COMMERCIAL GEN LIABILITY COV FORM CG0435 12 07 EMPLOYEE BENEFITS LIABILITY COVERAGE EACH EMPLOYEE 1000000 AGGREGATE 2000000 DEDUCTIBLE EACH EMPLOYEE 1000 RETROACTIVE DATE 10011998 CG0437 04 13 ELECTRONIC DATA LIAB ENDORSEMENT LOSS OF ELECTRONIC DATA LIMIT 50000 CG2011 04 13 AI MANAGERS OR LESSORS OF PREMISES NAME L W HOLDINGS INC. CG2032 04 13 AI ENGRS ARCHTCT SURVYRS NOT ENGAGED NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. BLANKET WHERE REQUIRED BY WRITTEN CONTRACT CG2106 05 14 EXCL ACCESS DISCL OF CONFID PERSONAL CG2147 12 07 EXCL EMPLOYMENT RELATED PRACTICES CG2167 12 04 FUNGI OR BACTERIA EXCLUSION CG2170 01 08 CAP LOSSES FROM CERT ACTS TERRORISM CG2176 01 08 EXCL PUNITIVE DMGS ACTS OF TERRORISM CG2274 10 01 LTD CONTRACTUAL LIAB COV PERS ADV DESIGNATED CONTRACT OR AGREEMENT ANY CONTRACT CG2280 04 13 LIMITED EXCL CONTRACTOR PROF LIAB CG2301 04 13 EXCL REAL ESTATE AGENT OR BROKE EO CG2412 11 85 BOATS DESCRIPTION OF WATERCRAFT ADDITIONAL PREMIUM 1998 20 FT. CRESTLINE 2000 RAMPAGE 2008 SKI DOO 2006 TYEE LUND 20FT BOAT 1997 TIGER SHARK JET SKI 2006 YAMAHA VX1100E JET SKI 2006 LUND BOAT CG7001A 10 12 GENERAL LIABILITY SCHEDULE CG7003 10 13 GL QUICK REFERENCE OCCURRENCE CG7105 07 14 EXT OF THE DEFINITION OF INSURED CG7140 07 14 INJ TO CO EMPL OR O VOLUNTEER WKRS NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. ALL MANAGERIAL OR SUPERVISORY EMPLOYEES AND OR EXECUTIVE OFFICERS CG7141 05 90 EXTENDED PROPERTY DAMAGE COVERAGE DATE OF ISSUE 103014 CONTINUED FORM IL7131A ED. 04 01 007 Jo 4D61918 1501 EDITION CG0437 CG2011 CG2032 CG2106 CG2147 CG2167 CG2170 CG2176 CG2274 CG2280 CG2301 CG2412 CG7001A CG7003 CG7105 CG7140 CG7141 12 07 04 13 04 13 04 13 05 14 12 07 12 04 01 08 01 08 10 01 04 13 04 13 11 85 10 12 10 13 07 14 07 14 05 90 EMPLOYEE BENEFITS LIABILITY COVERAGE EACH EMPLOYEE 1000000 AGGREGATE 2000000 DEDUCTIBLE EACH EMPLOYEE 1000 RETROACTIVE DATE 10011998 ELECTRONIC DATA LIAB ENDORSEMENT LOSS OF ELECTRONIC DATA LIMIT 50000 AI MANAGERS OR LESSORS OF PREMISES NAME L W HOLDINGS INC. AI ENGRS ARCHTCT SURVYRS NOT ENGAGED NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. BLANKET WHERE REQUIRED BY WRITTEN CONTRACT EXCL ACCESS DISCL OF CONFID PERSONAL EXCL EMPLOYMENT RELATED PRACTICES FUNGI OR BACTERIA EXCLUSION CAP LOSSES FROM CERT ACTS TERRORISM EXCL PUNITIVE DMGS ACTS OF TERRORISM LTD CONTRACTUAL LIAB COV PERS ADV DESIGNATED CONTRACT OR AGREEMENT ANY CONTRACT LIMITED EXCL CONTRACTOR PROF LIAB EXCL REAL ESTATE AGENT OR BROKE EO BOATS DESCRIPTION OF WATERCRAFT ADDITIONAL PREMIUM 1998 20 FT. CRESTLINE 2000 RAMPAGE 2008 SKI DOO 2006 TYEE LUND 20FT BOAT 1997 TIGER SHARK JET SKI 2006 YAMAHA VX1100E JET SKI 2006 LUND BOAT GENERAL LIABILITY SCHEDULE GL QUICK REFERENCE OCCURRENCE EXT OF THE DEFINITION OF INSURED INJ TO CO EMPL OR O VOLUNTEER WKRS NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. ALL MANAGERIAL OR SUPERVISORY EMPLOYEES AND OR EXECUTIVE OFFICERS EXTENDED PROPERTY DAMAGE COVERAGE | 2 |
A EMC Insurance Companies PAGE NO 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERATL L Cc ENDORSEMENT SCHEDULE EDITION DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM CG7174.3 10 13 AUTOMATIC AI CONST CONT INCL COMP OP CG7191 01 13 COMML GENERAL LIABILITY AMENDMENT CG7193.1 10 13 AI OWN LESS CONTR INCL COMP OPS NAME ALTRA NEBRASKA LLP NAME DELTA T CORP CG7253 12 96 CONTRACTORS EXTENDED PROPERTY DAMAGE CG7276 10 08 LIMITED POLLUTION COV WORK SITES 225 CG7428 11 98 AMEND AGGREGATE LIMIT PER LOCATION CG7429 11 98 AMEND AGGREGATE LIMIT PER PROJECT CG7523.3 03 07 EXCL EXT INSULATION FINISH SYSTEMS CG7555 10 13 BLKT WAIV SUBRO WRITTEN CONT AGREE CG7627 03 09 AMENDMENT OF EMPL BENEFITS PROGRAM DESCRIPTION OF OTHER SIMILAR BENEFITS NONE CG7644 02 09 CONTRACTORS OCCURRENCE DEFINITION CG8081 04 06 FUNGI BACTERIA NOTICE TO POLICYHOLDR CG8254 06 14 ADVISORY NOTICE TO POLICYHOLDERS CG8282 04 14 ADVISORY NOTICE TO POLICYHOLDERS CG8283 04 14 ADVISORY NOTICE TO POLICYHOLDERS FL0411 10 06 BASIC FARM PREMISES LIABILITY IL0021 05 02 NUCLEAR ENERGY LIAB EXCL BROAD FORM IL0258 01 12 AZ CHANGES CANCELLATION NONRENEWAL IL0259 09 07 NE CHANGES CANCELLATION NONRENEWAL IL0276 09 08 IA CHANGES CANCELLATION NONRENEWAL IL1201 01 99 CHANGE ENDORSEMENT IL7028 10 05 ASBESTOS EXCLUSION IL7130A 04 01 NAMED INSURED ENDORSEMENT IL7131A 04 01 COMML POLICY ENDORSEMENT SCHEDULE IL7313 07 11 RESIDENT AGT COUNTERSIGNATURE ENDST IL7339 05 11 DEFINITION OF YOUR WORK AMEND ENDST IL8383.5 01 08 DISCL PURSUANT TERRSM RISK INS. ACT PREMIUM THROUGH 123114 s 51 PREMIUM BEYOND 123114 154 IL8384A 01 08 TERRORISM NOTICE IL8576 09 09 MEDICARE IMPT NOTICE TO POLICYHOLDER FOOTNOTES CG2010 07 04 AI OWNERS LESSEES OR CONTRACTORS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEP WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. DATE OF ISSUE 103014 CONTINUED FORM IL7131A ED. 04 01 007 Jo 4D61918 1501 EDITION CG7253 CG7276 CG7428 CG7429 CG7523.3 CG7555 CG7627 CG7644 CG8081 CG8254 CG8282 CG8283 FLO411 IL0021 IL0258 IL0259 IL0276 IL1201 IL7028 IL7130A IL7131A IL7313 IL7339 IL8383.5 IL8384A IL8576 01 13 10 13 12 96 10 08 11 98 11 98 03 07 10 13 03 09 02 09 04 06 06 14 04 14 04 14 10 06 05 02 01 12 09 07 09 08 01 99 10 05 04 01 04 01 07 11 05 11 01 08 01 08 09 09 CG7191 01 13 COMML GENERAL LIABILITY AMENDMENT CG7193.1 10 13 AI OWN LESS CONTR INCL COMP OPS NAME ALTRA NEBRASKA LLP NAME DELTA T CORP CG7253 12 96 CONTRACTORS EXTENDED PROPERTY DAMAGE CG7276 10 08 LIMITED POLLUTION COV WORK SITES 22 CG7428 11 98 AMEND AGGREGATE LIMIT PER LOCATION CG7429 11 98 AMEND AGGREGATE LIMIT PER PROJECT CG7523.3 03 07 EXCL EXT INSULATION FINISH SYSTEMS CG7555 10 13 BLKT WAIV SUBRO WRITTEN CONT AGREE CG7627 03 09 AMENDMENT OF EMPL BENEFITS PROGRAM DESCRIPTION OF OTHER SIMILAR BENEFITS NONE CG7644 02 09 CONTRACTORS OCCURRENCE DEFINITION CG8081 04 06 FUNGI BACTERIA NOTICE TO POLICYHOLDR CG8254 06 14 ADVISORY NOTICE TO POLICYHOLDERS CG8282 04 14 ADVISORY NOTICE TO POLICYHOLDERS CG8283 04 14 ADVISORY NOTICE TO POLICYHOLDERS FL0411 10 06 BASIC FARM PREMISES LIABILITY IL0021 05 02 NUCLEAR ENERGY LIAB EXCL BROAD FORM IL0258 01 12 AZ CHANGES CANCELLATION NONRENEWAL IL0259 09 07 NE CHANGES CANCELLATION NONRENEWAL IL0276 09 08 IA CHANGES CANCELLATION NONRENEWAL IL1201 01 99 CHANGE ENDORSEMENT IL7028 10 05 ASBESTOS EXCLUSION IL7130A 04 01 NAMED INSURED ENDORSEMENT IL7131A 04 01 COMML POLICY ENDORSEMENT SCHEDULE IL7313 07 11 RESIDENT AGT COUNTERSIGNATURE ENDST IL7339 05 11 DEFINITION OF YOUR WORK AMEND ENDST IL8383.5 01 08 DISCL PURSUANT TERRSM RISK INS. ACT PREMIUM THROUGH 123114 s 5 PREMIUM BEYOND 123114 15 IL8384A 01 08 TERRORISM NOTICE IL8576 09 09 MEDICARE IMPT NOTICE TO POLICYHOLDER FOOTNOTES CG2010 07 04 AI OWNERS LESSEES OR CONTRACTORS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEP WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. w o | 2 |
A EMC Insurance Companies PAGE NO 3 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERATL ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM CG2037 07 04 AI OWNERS LESSESS OR CONT COMP OPS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEPT WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. DATE OF ISSUE 103014 FORM IL7131A ED. 04 01 007 Jo 4D61918 1501 EDITION NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEPT WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent DATE OF ISSUE 103014 FORM IL8384A 01 08 007 Jo 4D61918 1501 STAROSTKA GROUP EFF DATE 100114 EXP DATE 1001 TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 This disclosure is attached to your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This disclosure does not grant any coverage or change the terms and conditions of any coverage under the policy. SCHEDUTLE Terrorism Premium Certified Acts A. Premium through end of year 123114 51.00 B. Premium beyond the date specified above 154.00 Refer to paragraph D. below A. DISCLOSURE OF PREMIUM In accordance with the Federal Terrorism Risk Insurance Act we are required to provide you with a notice disclosing the portion of your premium if any attributable to coverage for terrorism acts certified under that act. The portion of your premium attributable to such coverage is shown in the schedule of this disclosure or in the policy Declarations. B. DISCLOSURE OF FEDERAL PARTICIPATION IN PAYMENT OF TERRORISM LOSSES The United States Government Department of the Treasury will pay a share of terrorism losses insured under the federal program. The federal share equals 85 of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a Program Year January 1 through December 31 the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. C. CAP ON INSURER PARTICIPATION IN PAYMENT OF TERRORISM LOSSES If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a Program Year January 1 through December 31 and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. D. PREMIUM BEYOND THE YEAR SPECIFIED IN THE SCHEDULE ABOVE The premium for certified acts of terrorism coverage is calculated based in part on the federal participation in payment of terrorism losses as set forth in the Terrorism Risk Insurance Act. The federal program established by the Act is scheduled to terminate at the end of the year specified in the Schedule of this endorsement unless extended by the federal government. If the federal program is extended the premium shown in B in the Schedule shall be attributable to coverage for terrorism acts certified under the act. If the Federal program terminates your policy will still contain coverage for acts of terrorism unless you have elected to exclude the coverage. The premium shown in B of the schedule shall be attributable to that coverage for terrorism. Includes copyrighted material of ISO Properties Inc. with its permission DATE OF ISSUE 103014 continued FORM IL8383.5 01 08 007 Jo 4D61918 1501 This disclo disclosure This disclo and conditi T E Terrorism A. Prem B. Prem Ref A. DISCLOSUI In accor required your pre certifie to such the poli B. DISCLOSU The Unit a share federal insured However certifie in a Pro not make that exc C. CAP ON II If aggre under th Program insurer not be 1 losses tl up to th with pro D. PREMIUM I The prem based in losses a federal the end unless e is exten attribut. If the Fo coverage the cove attribut. o your policy in response to the le Terrorism Risk Insurance Act. 1 t any coverage or change the terms je under the policy. d Acts year 123114 51.00 specified above 154.00 below jeral Terrorism Risk Insurance Act we are th a notice disclosing the portion of ibutable to coverage for terrorism acts The portion of your premium attributable in the schedule of this disclosure or in ICIPATION IN PAYMENT OF TERRORISM LOSSES nt Department of the Treasury will pay s insured under the federal program. The f that portion of the amount of such is the applicable insurer retention. ired losses attributable to terrorist acts IN PAYMENT OF TERRORISM LOSSES attributable to terrorist acts certified surance Act exceed 100 billion in a ugh December 31 and we have met our. Terrorism Risk Insurance Act we shall 1 t of any portion of the amount of such lion and in such case insured losses t to pro rata allocation in accordance by the Secretary of the Treasury. IFIED IN THE SCHEDULE ABOVE ts of terrorism coverage is calculated participation in payment of terrorism ferrorism Risk Insurance Act. The by the Act is scheduled to terminate at d in the Schedule of this endorsement al government. If the federal program wn in B in the Schedule shall be terrorism acts certified under the act. nates your policy will still contain sm unless you have elected to exclude shown in B of the schedule shall be je for terrorism. | 2 |
A EMC Insurance Companies Page 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 This disclosure is attached to your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This disclosure does not grant any coverage or change the terms and conditions of any coverage under the policy. THE FOLLOWING STATEMENT IS REQUIRED TO BE PART OF THE DISCLOSURE NOTICE IN MISSOURI The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your policy carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Includes copyrighted material of ISO Properties Inc. with its permission DATE OF ISSUE 103014 FORM IL8383.5 01 08 007 Jo 4D61918 1501 This disclosure is attached to your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This disclosure does not grant any coverage or change the terms and conditions of any coverage under the policy. THE FOLLOWING STATEMENT IS REQUIRED TO BE PART OF THE DISCLOSURE NOTICE IN MISSOURI The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your policy carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Includes copyrighted material of ISO Properties Inc. with its permission | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY NAMED INSURED ENDORSEMENT POLICY PERIOD FROM 100114 TO 100115 POLICY NUMBER 4D6 19 1 8 15 NAMED INSURETD PRODUCER STAROSTKA GROUP LOCKTON COMPANIES LLC UNLIMITED INC. 1015 N 98TH ST STE 101 429 INDUSTRIAL LN OMAHA NE 68114 2357 GRAND ISLAND NE 68803 5239 AGENT AB 8210 AGENT PHONE 402 970 6100 AGENCY BILL JACK H. STRUYK JR IT IS HEREBY AGREED AND UNDERSTOOD THAT THE NAMED INSURED IS AMENDED TO READ AS FOLLOWS 1ST NAMED INSURED STAROSTKA GROUP UNLIMITED INC. NO. 02 STAROSTKA HOMES INC. NO. 03 STAROSTKA CONSTRUCTION INC. NO. 04 HASTINGS VENTURE LLC NO. 05 D D INVESTMENTS A PARTNERSHIP NO. 06 GRAND ISLAND COMMERCIAL VENTURES NO. 08 LEWIS STAROSTKA INC. NO. 09 LP INVESTMENTS PLACE OF ISSUE OMAHA NE DATE OF ISSUE 103014 CONTINUED FORM IL7130A ED. 04 01 007 Jo 4D61918 1501 NAMED INSURED ENDO POLICY PERIOD FROM 100114 TO 100115 UNLIMITED INC. 1015 N 98TH ST STE 101 429 INDUSTRIAL LN OMAHA NE 68114 2357 GRAND ISLAND NE 68803 5239 AGENT AB 8210 AGENT PHONE 402 970 6100 IT IS HEREBY AGREED AND UNDERSTOOD THAT THE NAMED INSURED IS AMENDED TO READ AS FOLLOWS 1ST NAMED INSURED STAROSTKA GROUP UNLIMITED INC. NO. 02 STAROSTKA HOMES INC. NO. 03 STAROSTKA CONSTRUCTION INC. NO. 04 HASTINGS VENTURE LLC NO. 05 D D INVESTMENTS A PARTNERSHIP NO. 06 GRAND ISLAND COMMERCIAL VENTURES NO. 08 LEWIS STAROSTKA INC. NO. 09 LP INVESTMENTS PLACE OF ISSUE OMAHA NE OLICY. | 2 |
A EMC Insurance Companies PAGE 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 NAMED INSURED ENDORSEMENT CONTTINUED NO. 11 STAROSTKA LEWIS LLC NO. 12 BONE CREEK PARTNERSHIP PLACE OF ISSUE OMAHA NE DATE OF ISSUE 103014 FORM IL7130A ED. 04 01 007 Jo 4D61918 1501 NO. 11 STAROSTKA LEWIS LLC NO. 12 BONE CREEK PARTNERSHIP PLACE OF ISSUE OMAHA NE | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 001 40115 BOATS 2 NOT FOR RENT AND JETSKIS 2 NOT FOR RENT 3 PREMIUM BASIS PER BOAT EXPOSURE 6 SUBLINE 334 47050 REAL ESTATE AGENTS 4 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 334 87224 CONTRACTORS EXTENDED PROPERTY DAMAGE ENDORSEMENT PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87654 ADDITIONAL INSURED CO EMPLOYEE BODILY INJURY OR PERSONAL AND ADVERTISING INJURY FORM CG7140 PREMIUM BASIS FLAT CHARG EXPOSURE 50 SUBLINE 334 87741 LIMITED POLLUTION COVERAGE WORKSITES SEE FORM CG7276 PREMIUM BASIS FLAT CHARG EXPOSURE IF ANY SUBLINE 334 87747 AMENDMENT AGGREGATE LIMITS OF INSURANCE PER LOCATION SEE FORM CG7428 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 NOT FOR RENT AND NOT FOR RENT 3 5IS nan nan nan nan 1.0 TENDED PROPERTY MENT JURY FORM CG7140 S 50 COVERAGE DRM CG7276 ANY GREGATE LIMITS OF. LOCATION 8 | 2 |
A EMC Insurance Companies PAGE 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 15 SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 87748 AMENDMENT AGGREGATE LIMITS OF INSURANCE PER PROJECT SEE FORM CG7429 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87780 CONSTRUCTION CONTRACTS INCLUDING COMPLETED OPERATIONS BLANKET ADDL INSUREDS FORM CG7174.3 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87781 OWNERS LESSEES OR CONTRACTORS INCL COMPL OPS PRIMARY NONCONTRIBUTORY ADDL INSURED CG7193.1 CG7193.1 PREMIUM BASIS EACH EXPOSURE 2 SUBLINE 334 ADDITIONAL INTEREST 1 334 ALTRA NEBRASKA LLP ADDITIONAL INTEREST 2 334 DELTA T CORP 87786 BLANKET WAIVER OF SUBROGATION CG7555 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87808 ELECTRONIC DATA LIABILITY CG0437 LIMIT 5000050000 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 GREGATE LIMITS OF. PROJECT 9 FORM CG7174.3 334 NTEREST 1 334 SKA LLP NTEREST 2 334. OF SUBROGATION | 2 |
A EMC Insurance Companies PAGE 3 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 87825 1132.000 132 EMPLOYEE BENEFITS LIABILITY COVERAGE PREMIUM BASIS PER EMP EXPOSURE 50 SUBLINE EBL 1000 DEDUCTIBLE APPLIES EACH EMPLOYEE 87830 639 CONTRACTORS OCCURRENCE DEFINITION PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 91340 17.883 1611 7.7921 702 CARPENTRY CONSTRUCTION OF RESIDENTIAL PROPERTY NOT EXCEEDING THREE STORIES IN HEIGHT PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 90100 SUBLINE 336334 91342 10.628 0 8.343 0 CARPENTRY NOC PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 91560 11.5178 73621 7.297 4664 CONCRETE CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 639233 SUBLINE 336334 91580 9.6341 3008 CONTRACTORS EXECUTIVE SUPERVISORS OR EXECUTIVE SUPERINTENDENTS 4 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 312192 SUBLINE 334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 sFITS LIABILITY 5IS 50 EBL TIBLE APPLIES YROLL F ANY | 2 |
A EMC Insurance Companies PAGE 4 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 15 SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 91583 0.173 519 0.170 s 510 CONTRACTORS SUBCONT WORK IN CONNECT WITH BUILD CONST RECON REPAIR OR ERECT ONE OR TWO FAMILY DWELL PREMIUM BASIS THOUSANDS OF TOTAL COST EXPOSURE 3000000 SUBLINE 336334 ADDITIONAL INTEREST 1 334 BLANKET WHERE REQUIRED BY ENGRS ARCHTCT SURVYRS NOT ENGAGED CG2032 98677 ROOFING RESIDENTIAL OVER THREE STORIES AND OR COMMERCIAL PREMIUM BASIS 150 THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 98820 SEWER MAINS OR CONNECTIONS CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 126077 SUBLINE 336334 99793 TRUCKERS 4 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 334 99946 WATER MAIN OR CONNECTIONS CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 1 334 INECTIONS NECTIONS | 2 |
A EMC Insurance Companies PAGE 5 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 002 49451 0.573 5 VACANT LAND 1 4 PREMIUM BASIS PER ACRE EXPOSURE 9 SUBLINE 334 LOCATION 003 49451 0.573 5 VACANT LAND 1 4 PREMIUM BASIS PER ACRE EXPOSURE 9 SUBLINE 334 LOCATION 004 49451 0.573 5 VACANT LAND 1 4 PREMIUM BASIS PER ACRE EXPOSURE 9 SUBLINE 334 LOCATION 005 63010 21.663 108 SPEC HOMES DWELLINGS ONE FAMILY LESSOR S RISK ONLY 4 PREMIUM BASIS EACH DWELL EXPOSURE 5 SUBLINE 334 LOCATION 006 91342 9.1441 0 10.078 0 CARPENTRY NOC PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 91560 8.373 0 10.836 0 CONCRETE CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 NE FAMILY X ONLY 4 S PAYROLL IF ANY | 2 |
A EMC Insurance Companies PAGE 6 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 15 SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 91580 CONTRACTORS EXECUTIVE SUPERVISORS OR EXECUTIVE SUPERINTENDENTS 4 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 334 91583 1.9228 0 CONTRACTORS SUBCONT WORK IN CONNECT WITH BUILD CONST RECON REPAIR OR ERECT ONE OR TWO FAMILY DWELL PREMIUM BASIS THOUSANDS OF TOTAL COST EXPOSURE IF ANY SUBLINE 336334 98677 ROOFING RESIDENTIAL OVER THREE STORIES AND OR COMMERCIAL PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 98820 SEWER MAINS OR CONNECTIONS CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 99946 WATER MAIN OR CONNECTIONS CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 LOCATION 007 47051 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 50 SUBLINE 334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 INECTIONS NECTIONS IS 50 | 2 |
A EMC Insurance Companies PAGE 7 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 15 SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 008 47051 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 50 SUBLINE 334 LOCATION 009 49451 VACANT LAND 1 4 PREMIUM BASIS PER ACRE EXPOSURE 1 SUBLINE 334 LOCATION 010 49451 VACANT LAND 1 4 PREMIUM BASIS PER ACRE EXPOSURE 1 SUBLINE 334 LOCATION 011 49451 VACANT LAND 1 4 PREMIUM BASIS PER ACRE EXPOSURE 1 SUBLINE 334 LOCATION 012 49451 VACANT LAND 1 4 PREMIUM BASIS ACRE EXPOSURE 1 SUBLINE 334 LOCATION 013 06519 FARMS NOT MORE THAN 160 ACRES TYPE IV PREMIUM BASIS FARM EXPOSURE 1 SUBLINE 338 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 IS 50 RE THAN 160 ACRES | 2 |
A EMC Insurance Companies PAGE 8 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 014 49451 0.573 7 VACANT LAND 1 4 PREMIUM BASIS EACH ACRE EXPOSURE 12 SUBLINE 334 LOCATION 015 47051 13.42218 16 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EA ACRE EXPOSURE 4.56 SUBLINE 334 LOCATION 016 49451 0.578 19 VACANT LAND 1 4 PREMIUM BASIS EACH ACRE EXPOSURE 33 SUBLINE 334 LOCATION 017 06719 60.649 61 FARMS MORE THAN 500 BUT NOT MORE THAN 2000 ACRES TYPE IV PREMIUM BASIS FARM EXPOSURE 1 SUBLINE 338 LOCATION 018 47051 13.42218 34 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EA ACRE EXPOSURE 10 SUBLINE 334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 nan nan nan nan 12.0 nan nan nan nan 33.0 nan nan nan nan 10.0 | 2 |
A EMC Insurance Companies PAGE 9 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 019 63010 45.756 46 DWELLINGS ONE FAMILY LESSOR S RISK ONLY 4 PREMIUM BASIS EACH DWELL EXPOSURE 1 SUBLINE 334 LOCATION 020 47051 1o3.4221 99 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 29 SUBLINE 334 LOCATION 021 47051 3.39218 17 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 5 SUBLINE 334 LOCATION 022 47051 1o3.4221 3 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 1 SUBLINE 334 LOCATION 023 47051 3.39218 75 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS PER ACRE EXPOSURE 22 SUBLINE 334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 E FAMILY. ONLY 4 1 IS 29 IS IS nan nan nan nan 22.0 | 2 |
A EMC Insurance Companies PAGE 10 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 15 SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 024 47051 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 6 SUBLINE 334 63010 DWELLINGS ONE FAMILY LESSOR S RISK ONLY 4 PREMIUM BASIS EACH DWELL EXPOSURE 1 SUBLINE 334 LOCATION 025 06619 FARMS MORE THAN 160 BUT NOT MORE THAN 500 ACRES TYPE IV PREMIUM BASIS FARM EXPOSURE 1 SUBLINE 338 ADDITIONAL INTEREST 1 338 L W HOLDINGS INC. MANAGERS OR LESSORS OF PREMISES CG2011 40.664E 41 25 LOCATION 026 63010 DWELLINGS ONE FAMILY LESSOR S RISK ONLY 4 PREMIUM BASIS EACH DWELL EXPOSURE 1 SUBLINE 334 LOCATION 027 63010 DWELLINGS ONE FAMILY LESSOR S RISK ONLY 4 PREMIUM BASIS EACH DWELL EXPOSURE 1 SUBLINE 334 21.663 22 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 IS E FAMILY ONLY 4 S 1 338 ITEREST 1 338 E FAMILY. ONLY 4 1 E FAMILY. ONLY 4 1 | 2 |
A EMC Insurance Companies PAGE 11 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 028 47051 3.422 s 34 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS PER ACRE EXPOSURE 10 SUBLINE 334 PREMIUM FOR CERTIFIED ACTS OF TERRORISM 205.00 TOTAL ESTIMATED POLICY PREMIUM 25593.00 1 OTHER THAN NOT FOR PROFIT 2 NOT FOR PROFIT 3 INCLUDING PRODUCTS AND OR COMPLETED OPERATIONS UNLESS OTHERWISE EXCLUDED 4 PRODUCTS COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT 5 A 250 PD DEDUCTIBLE PER CLAIM APPLIES TO CUSTOMERS AUTOS UNLESS OTHERWISE DESIGNATED BY THIS CLASSIFICATION CODE 6 FOR SPRAY PAINTING OPERATIONS A PD DEDUCTIBLE OF 250 PER CLAIM APPLIES UNLESS A HIGHER DEDUCTIBLE IS OTHERWISE DESIGNATED FOR THIS CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED RATED LOCATIONS LOC 001 429 INDUSTRIAL LN GRAND ISLAND NE 68803 5239 LOC 002 417 CONGDON AVE GRAND ISLAND NE 68801 2939 LOC 003 LAMBERT S SUB PT LT 14 GRAND ISLAND NE 68803 LOC 004 LAMBERT S SUB W 12 LT 11 GRAND ISLAND NE 68803 LOC 005 SPEC HOMES COMPLETED BUT NOT YET SOLD GRAND ISLAND NE 68802 LOC 006 UNKNOWN RAKE IA 50465 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 nan nan nan nan 10.0 CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RATED LOCATIONS LOC 001 429 INDUSTRIAL LN RENTED OR OCCUPIED GRAND ISLAND NE 68803 5239 LOC 002 417 CONGDON AVE GRAND ISLAND NE 68801 2939 LOC 003 LAMBERT S SUB PT LT 14 GRAND ISLAND NE 68803 LOC 004 LAMBERT S SUB W 12 LT 11 GRAND ISLAND NE 68803 LOC 005 SPEC HOMES COMPLETED BUT NOT YET SOLD GRAND ISLAND NE 68802 LOC 006 UNKNOWN RAKE IA 50465 LOC 002 417 CONGDON AVE GRAND ISLAND NE 68801 2939 LOC 003 LAMBERT S SUB PT LT 14 GRAND ISLAND NE 68803 LOC 004 LAMBERT S SUB W 12 LT 11 GRAND ISLAND NE 68803 LOC 005 SPEC HOMES COMPLETED BUT NOT YET SOLD GRAND ISLAND NE 68802 LOC 006 UNKNOWN RAKE IA 50465 | 2 |
A EMC Insurance Companies PAGE 12 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE CONTINUED LOC 007 ABOOD ADDN TRACT 5 KEARNEY NE 68847 LOC 008 LOTS 5 8 KEARNEY NE 68847 LOC 009 UNKNOWN KEARNEY NE 68847 LOC 010 UNKNOWN KEARNEY NE 68847 LOC 011 UNKNOWN KEARNEY NE 68847 LOC 012 BLK 1 LOTS 1 5 CASTLE RIDGE BLK 2 LOTS 1 10 CASTLE RIDG KEARNEY NE 68847 LOC 013 NW12 E12 EXCEPT 38.99 ACRESIN NE14 SEC 35 TWP 31N RG 10 ONEILL NE 68763 LOC 014 BOULDER RUN ADDITION LINCOLN NE 68501 LOC 015 LOTS 1 4 BLOCK 1 LOTS 1 4 KEARNEY NE 68848 LOC 016 WINDMILL RIDGE ESTATES LINCOLN NE 68516 LOoC 017 UNKNOWN BUTTE NE 68722 LOC 018 BLK 1 LOTS 1 5 CASTLE RIDGE KEARNEY NE 68847 LOC 019 5333 W HARTFORD AVE GLENDALE AZ 85308 3935 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 Loc Loc Loc Loc Loc Loc Loc Loc Loc Loc Loc Loc Loc 007 008 009 010 011 012 013 014 015 016 017 018 019 ABOOD ADDN KEARNEY NE LOTS 5 8 KEARNEY NE UNKNOWN KEARNEY NE UNKNOWN KEARNEY NE UNKNOWN KEARNEY NE BLK 1 LOTS KEARNEY NE NW1l2 E12 ONEILL NE BOULDER RUN LINCOLN NE LOTS 1 4 BLO KEARNEY NE WINDMILL RID LINCOLN NE UNKNOWN BUTTE NE 6 BLK 1 LOTS KEARNEY NE 5333 W HARTF GLENDALE AZ TRACT 5 68847 68847 68847 68847 68847 1 5 CASTLE RIDGE BLK 2 LOTS 1 10 CASTLE RIDG 68847 EXCEPT 38.99 ACRESIN NE14 SEC 35 TWP 31N RG 10 68763 ADDITION 68501 CK 1 LOTS 1 4 68848 GE ESTATES 68516 8722 1 5 CASTLE RIDGE 68847 ORD AVE 85308 3935 LOC 008 LOTS 5 8 KEARNEY NE 68847 LOC 009 UNKNOWN KEARNEY NE 68847 LOC 010 UNKNOWN KEARNEY NE 68847 LOC 011 UNKNOWN KEARNEY NE 68847 LOC 012 BLK 1 LOTS 1 5 CASTLE RIDGE BLK 2 LOTS 1 10 CASTLE RIDG KEARNEY NE 68847 LOC 013 NW12 E12 EXCEPT 38.99 ACRESIN NE14 SEC 35 TWP 31N RG 10 ONEILL NE 68763 LOC 014 BOULDER RUN ADDITION LINCOLN NE 68501 LOC 015 LOTS 1 4 BLOCK 1 LOTS 1 4 KEARNEY NE 68848 LOC 016 WINDMILL RIDGE ESTATES LINCOLN NE 68516 LOoC 017 UNKNOWN BUTTE NE 68722 LOC 018 BLK 1 LOTS 1 5 CASTLE RIDGE KEARNEY NE 68847 LOC 019 5333 W HARTFORD AVE GLENDALE AZ 85308 3935 | 2 |
A EMC Insurance Companies PAGE 13 EMPLOYERS MUTUAL CASUALTY COMPANY POLIC STAROSTKA GROUP EFF DATE 100114 S CHE Y NO 4D6 19 18 15 EXP DATE 100115 DULE LOC 020 120TH STREET AND MILITARY RD OMAHA NE 68142 LOC 021 CHARLESTON HEIGHTS SUBDIVISION LINCOLN NE 68501 LOC 022 6604 AVENUE M PLACE KEARNEY NE 68845 LOC 023 NE 14 OF SEC 27 TWP 9 N RGE 16 KEARNEY NE 68847 LOC 024 6509 AVENUE 0 KEARNEY NE 68847 W OF 6TH PM LOC 025 NW14PART OF NE14PART OF THE SW14 PART AINSWORTH NE 69210 LOC 026 712 RICHMOND AVE HASTINGS NE 68901 3322 LOC 027 3504 WENDELL DRIVE HASTINGS NE 68901 2641 LOC 028 PT SE 14 NW 14 OF 34 9 16 KEARNEY NE 68847 ALL OTHER LOCATIONS 1060 E ARCHWAY RD KEARNEY NE. 68847 DATE OF ISSUE 103014 BPP OF THE SE14 FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 Loc Loc Loc Loc Loc Loc Loc Loc Loc 020 021 022 023 024 025 026 027 028 120TH STREET AND MILITARY RD OMAHA NE 68142 CHARLESTON HEIGHTS SUBDIVISION LINCOLN NE 68501 6604 AVENUE M PLACE KEARNEY NE 68845 NE 14 OF SEC 27 TWP 9 N RGE 16 KEARNEY NE 68847 6509 AVENUE 0 KEARNEY NE 68847 NW14PART OF NE14PART OF AINSWORTH NE 69210 712 RICHMOND AVE HASTINGS NE 68901 3322 3504 WENDELL DRIVE HASTINGS NE 68901 2641 PT SE 14 NW 14 OF 34 9 16 KEARNEY NE 68847 ALL OTHER LOCATIONS 1060 E ARCHWAY RD KEARNEY NE. 68847 THE SW14 W OF 6TH PM PART OF THE SE14 LOC 021 CHARLESTON HEIGHTS SUBDIVISION LINCOLN NE 68501 LOC 022 6604 AVENUE M PLACE KEARNEY NE 68845 LOC 023 NE 14 OF SEC 27 TWP 9 N RGE 16 W OF 6TH PM KEARNEY NE 68847 LOC 024 6509 AVENUE 0 KEARNEY NE 68847 LOC 025 NW14PART OF NE14PART OF THE SW14 PART OF THE SE14 AINSWORTH NE 69210 LOC 026 712 RICHMOND AVE HASTINGS NE 68901 3322 LOC 027 3504 WENDELL DRIVE HASTINGS NE 68901 2641 LOC 028 PT SE 14 NW 14 OF 34 9 16 KEARNEY NE 68847 ALL OTHER LOCATIONS 1060 E ARCHWAY RD KEARNEY NE. 68847 | 2 |
COMMERCIAL GENERAL LIABILITY CG 00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under Section I Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll 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 to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 2 The bodily injury or property damage occurs during the policy period and Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. c. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. d. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim 1 Reports all or any part of the bodily injury or property damage to us or any other insurer Receives a written or verbal demand or claim for damages because of the bodily injury or property damage or 3 Becomes aware by any other means that bodily injury or property damage has occurred or has begun to occur. e. Damages because of bodily injury include damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. 3 2 CG 00010413 Insurance Services Office Inc. 2012 Page 1 0f 16 | 0 |
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