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ENDORSEMENT NO. 8 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ECONOMIC SANCTIONS ENDORSEMENT This endorsement modifies insurance provided under the following The Insurer shall not be deemed to provide cover and the Insurer shall not be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover payment of such claim or provision of such benefit would expose the Insurer its parent company or its ultimate controlling entity to any sanction prohibition or restriction under United Nations resolutions or the trade or economic sanctions laws or regulations of the European Union or the United States of America. Brsdetd Gpr Authorized Representative or countersignature where required by law 89644 613 HC0658
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ENDORSEMENT NO. 9 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MINIMUM EARNED PREMIUM ENDORSEMENT This endorsement madifies insurance provided under the following GENERAL POLICY PROVISIONS AND CONDITIONS The last Paragraph of Section IV. CANCELLATION beginning with the words The time of the surrender... and ending with the words... condition of cancellation. is deleted in its entirety and replaced with the following The time of the surrender or the effective date and hour of cancellation stated in the notice shall become the end of the policy period. Delivery of such written notice either by the First Named Insured or by us shall be the equivalent to mailing. If the First Named Insured cancels we shall retain an earned premium which shall be the greater of the customary short rate procedure or the minimum earned premium of 20982. If we cancel unearned premium shall be computed pro rata. Premium adjustment may be made either at the time cancellation is effected or as soon as practicable after cancellation becomes effective but payment or tender of unearned premium is not a condition of cancellation. All other terms conditions and exclusions of the policy remain unchanged. Breded Gppni Authorized Representative or countersignature where required by law 74778 608 HC0088
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ENDORSEMENT NO. 10 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA Employee Benefits Liability Endorsement Claims Made Endorsement NOTICE THIS IS A CLAIMS MADE EMPLOYEE BENEFITS LIABILITY ENDORSEMENT. COVERAGE IS LIMITED GENERALLY TO LIABILITY FOR CLAIMS FIRST MADE AGAINST AN INSURED WHILE THE COVERAGE IS IN FORCE. PLEASE REVIEW THE POLICY AND THE EMPLOYEE BENEFITS LIABILITY ENDORSEMENT CAREFULLY AND DISCUSS THEM WITH YOUR INSURANCE AGENT OR BROKER. Employee Benefits Liability Declarations Each Wrongful Act Limit 1000000 Aggregate Limit 1000000 Per Claim Deductible NIL Retroactive Date 07011976 The insurance afforded is only for the following Endorsement indicated by a specific premium charge on the Employee Benefits Liability Declarations. Our Limit of Insurance for this Endorsement shall be as stated in the above Employee Benefits Liability Declarations subject to all the terms conditions and exclusions of this Endorsement and the Policy to which it is attached. Various provisions in this Endorsement restrict coverage. Read the entire Endorsement carefully to determine rights duties and what is and is not covered. I INSURING AGREEMENT We shall pay those sums that the Insured becomes legally obligated to pay any employee or former employee or his her heirs beneficiaries or legal representatives as damages arising out of a wrongful act. We shall have the right and duty to defend the Insured against any suit seeking those damages. We may at our discretion investigate any wrongful act and settle any claim or suit that may result. However a. The amount we shall pay for damages is limited to the Limits of Insurance and b. Our right and duty to defend end when we have used up the applicable Limit of Insurance in the payment of judgments or settlements. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Common Policy Provisions Section 1V Other Payments Under This Palicy. 68770997 NOTICE Limit le
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ENDORSEMENT NO. 10 This Endorsement applies to a wrongful act only if a. The wrongful act takes place in the coverage territory b. The wrongful act occurs on or after the retroactive date if any shown in the Employee Benefits Liability Declarations and before the end of the policy period and c. A claim for damages because of the wrongful act is first made in writing against any Insured in accordance with the policy and during the policy period or any applicable Extended Reporting Period. 1. EXCLUSIONS In addition to the exclusions found in Coverage Part 1 D. Exclusions and in Section Il of the Common Policy Provisions the following exclusions apply to this Endorsement a. Any personal injury bodily injury or property damage. b. Any failure of performance of contract by any Insurer. c. Any failure of any investments including but not limited to stock to perform as represented by an Insured. d. Any advice given by an Insured to an employee whether or not to participate in any investment plan including but not limited to stock subscription plans. e. Any failure of the Insured ar any insurer fiduciary trustee or fiscal agent to perform any of their duties or obligations whether contractual or provided by law or to fulfill any of their guarantees with respect to 1. The payment of benefits under employee benefit programs or 2. The providing handling or investment of funds. However this exclusion does not apply to administration. f. Any Insured not having adequate insurance or bonds to protect the assets of an employee benefit program. g. Any personal profit or advantage gained by the Insured without the legal right to the gain. 18 LIMITS OF INSURANCE a. The Limits of Insurance shown in the Employee Benefits Liability Declarations and the rules below fix the most we shall pay regardless of the number of 1. Insureds 2. Claims made or suits brought or 68770997
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ENDORSEMENT NO. 10 3. Persons or organizations making claims or bringing suits. b. The each Wrongful Act limit shown in the Employee Benefits Liability Declarations is the most we shall pay for all damages incurred as the result of any one wrongful act. c. The each annual Aggregate limit shown in the Employee Benefits Liability Declarations is the most we shall pay for all damages covered under this Endorsement. V. DEDUCTIBLE Each wrongful act shall be subject to the Deductible amount if any shown in the Employee Benefits Liability Declarations. We shall pay only the difference between the Deductible amount and the amount shown for each wrongful act. b. We may pay any part of your Deductible to settle any claim or suit. In such case we shall notify you and you shall promptly reimburse us for whatever portion of your Deductible we have paid. c. All wrongful acts arising out of the same series of continuous related or repeated wrongful acts shall be subject to one deductible. The limits of this Endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy petiod shown in the Employee Benefits Liability Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period shall be deemed part of the last preceding period for purposes of determining the Limits of Insurance. V. CONDITIONS You must notify us as soon as practicable of an incident or wrongful act which may result in a claim. Your duties and responsibilities in the event of an incident or wrongful act are the same as those duties outlined in the Common Policy Provisions Section V a. Please refer to this section to determine what is required of you in the event of an incident or wrongful act. VI EXTENDED REPORTING PERIOD a. If this Endorsement is canceled or not renewed for any reason other than nonpayment of the premium this section shall provide an extended reporting period. There is no additional premium charge for this extended reporting period. b. When this section applies the following is added to the end of the Insuring Agreement A claim first made within twelve 12 months after the policy period ends shall be deemed to have been made on the last day of the policy period provided the claim is for damages because of a wrongful act that occurred before the end of the policy period and after the applicable retroactive date. 68770897
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ENDORSEMENT NO. 10 This Endorsement is excess over any other vz This policy period ends on the date shown in the Employee Benefits Liability Declarations or on the effective date of any cancellation of this Endorsement whichever is earlier. The Extended Reporting Period shall not reinstate or increase the Limits of Insurance or extend the policy period. and collectible insurance available under policies in force after the extended reporting period starts. Vi DEFINITIONS In addition to the definitions found in the Common Policy Pravisions Section and the definitions found in Coverage Part Section IV the following definitions apply to this Endorsement a. Administration means the following activities if authorized by you 1. Conveying information to employees with respect to employee benefit programs 2. Interpreting employee benefit programs 3. Record keeping in connection with employee benefit programs and 4. Enrolling terminating or canceling employees under employee benefit programs. b. Employee benefit programs means 1. Group life insurance group accident or health insurance profit sharing plans pension plans employee stock subscription plans travel savings or vacation plans and except as respects the insurance benefits provided thereunder to employees shall also include workers compensation insurance unemployment compensation insurance social security and disability benefits insurance and 2. Any other similar employee benefits instituted after the effective date of this Endorsement provided we are notified within thirty 30 days after the institution of such benefits. c. Wrongful act means any negligent act error mistake or omission by an Insured or others for whom the Insured is legally responsible in the admil stration of your employee benefit programs. All other terms conditions and exclusions remain unchanged. Bronde Qs Authorized Representative 68770997
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ENDORSEMENT NO. 11 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA SPECIFIC ADDITIONAL INSURED The policy is hereby amended as follows The following is added as an Insured but solely as respects to claims arising from the interest described below Insured Any lessors of premises and any lessors of leased equipment Interest of Named Insured Named Insureds lease premise or equipment All other terms conditions and exclusions of the policy remain unchanged. Brosded Qs Authorized Representative 68765997
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ENDORSEMENT NO. 12 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA SPECIFIC ADDITIONAL INSURED The policy is hereby amended as follows The following is added as an Insured but solely as respects to claims arising from the interest described below Insured 1. Quorum Health Resources LLC fna Quorum Health Resources Inc. and its parent corporation Community Health Systems Inc. CHS Community Health Systems Inc. and all subsidiaries with insured interests fka Quorum Health Group Inc. John Rossfield CEO QHR Employee Lyon County Commission and Bank IV Kansas N.A. Kansas Board of Regents Emparia State University National Supplier Clearinghouse Interest of Named Insured 1 2 Management services provided to Named Insured 3. Owner of Newman Regional Health 4. As respects to Newman s Nursing Program 5. As respects to Newman s DME Department All other terms conditions and exclusions of the policy remain unchanged. Brooderd Qs Authorized Representative 68765997
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FORMS SCHEDULE NEWMAN MEMORIAL COUNTY HOSPITAL 6796532 January 21 2014 Named Insured Policy No Effective Date Form Number Edition Date 68765 0997 Endt. No. Form Name 13 SPECIFIC ADDITIONAL INSURED CIFMSC Cl0226
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ENDORSEMENT NO. 13 This endorsement effective 1201 AM January 21 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA SPECIFIC ADDITIONAL INSURED The policy is hereby amended as follows The following is added as an Insured but solely as respects to claims arising from the interest described below Insured Deleted 1. Quorum Health Resources LLC fna Quorum Health Resources Inc. and its parent corporation Community Health Systems Inc. CHS Community Health Systems Inc. and all subsidiaries with insured interests fka Quorum Health Group Inc. 2. John Rossfield CEO QHR Employee Interest of Named Insured 1 2 Management services provided to Named Insured All other terms conditions and exclusions of the policy remain unchanged. Bredet Gpprns AUTHORIZED REPRESENTATIVE 68765997
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AES 3061 Ed. 12 05 PL 1944652 00 NEW Policy No. PL 1944652 00 Renewal Of NEW BUSINESSPRO POLICY COMMON DECLARATIONS NAMED INSURED PLATIPUS ANCHORS INC. AND ADDRESS 1902 GARNER STATION BLVD RALEIGH NC 27603 3646 IN RETURN FOR PAYMENT OF THE PREMIUM AND SUBJECT TO ALL TERMS OF THIS POLICY WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. AGENT S NAME AND ADDRESS PARTNERS SPECIALTY GROUP LLC 4520 MAIN STREET SUITE 500 KANSAS CITY MO 64111 1876 Insurance is afforded by the Company named below a Capital Stock Corporation GREAT AMERICAN E S INSURANCE COMPANY POLICY PERIOD From 02282014 To 02282015 1201 AM. Standard Time at the address of the Named Insured This policy consists of the following Coverage Parts for which a premium is indicated. This premium may be subject to adjustment. Premium Commercial Property Commercial General Liability Commercial Crime Commercial Inland Marine Commercial Boiler and Machinery Commercial Auto Commercial Umbrella 30000 NC SL Tax 1500 Filing Fee 110 30000 FORMS AND ENDORSEMENTS applicable to all POLICY ALTERNATE MAILING ADDRESS Coverage Parts and made part of this Policy at time of issue are listed on the attached Forms and Endorsements Schedule IL 88 01 1185. NOTICE See enclosed endorsement for Surplus I.illeslN tification he msurance company with which tha coverage has been litl 15 not licensed by the State of North Carolina and is not subject to its supervision. In the event of the insolvency of the insurance company losses under this policy will not be paid by any State msurance guaranty or solvency fund. AES 3061 Ed. 1205 PRO Daniel P. McDonnell Page 1 of 1 Commercial Property Commercial General Liability Commercial Crime Commercial Inland Marine Commercial Boiler and Machinery Commercial Auto Commercial Umbrella NC SL Tax 1500 Filing Fee 110 DDODDDD DD DD Premium 3000 Commercial Property Commercial General Liability Commercial Crime Commercial Inland Marine Commercial Boiler and Machinery Commercial Auto Commercial Umbrella NC SL Tax 1500 Filing Fee 110 DDDDDDDD DB
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Administrative Offices Stroot I Ohio 45202 4201 GREATAMERICAN. 72553 369 5000 BUSINESSPRO FORMS AND ENDORSEMENTS SCHEDULE IL 88 01 Ed. 11 85 It is hereby understood and agreed the following forms and endorsements are attached to and are a part of this policy Form and Edition 1. AES3012 2. 1L7268DL 3. 1L0017 4. AES3005 5. CG7400 6. CG0001 7. CG7518 8. CG7519 9. AES3011 10. AES3013 11. AES3206 12. CG2165 13. AES3258 14. 1L0021 15. AES3228 16. CG8361 17. CG2147 18. AES3077 19. ESG1001 20. AES3018 21. CG7794 22. AES3103 0811 0809 1198 0501 1185 1207 0390 1207 0501 o411 0510 1204 0711 0908 1110 0205 1207 0707 09813 0411 0798 o411 If not at inception ST Date Deleted NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC Date Added Form Description General Service of Suit Endorsement In Witness Signature Form Common Policy Conditions Common Policy Condition Amendment Businesspro Gen Lia Cov Part Dec CGL Coverage Form Businesspro Employee Benefits Lia Cov Employee Benefits Cov Excl Fid Liab Hired and Non Owned Liability Deductible Liability Insurance Specialty Plus Endorsement Total Pollution Exclusion Endorsement Exclusion of Claims and Suits Allegi Nuclear Energy Liability Exclusion Organic Pathogen Exclusion Silica or Related Dust Exclusion Emp loyment Related Practices Exclusion Professional Liability Testing Consu Exclusion Pre Existing Damage Absolute Asbestos Exclusion Excl. Liability Arising out of Lead Metal Gas Exclusion BUSINESSPRO Reg. U.S. Pat. Off. IL 88 01 Ed. 1185 PRO Page 1 of 2
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Administrative Offices Stroot I Ohio 45202 4201 GREATAMERICAN. 72553 369 5000 BUSINESSPRO FORMS AND ENDORSEMENTS SCHEDULE IL 88 01 Ed. 11 85 It is hereby understood and agreed the following forms and endorsements are attached to and are a part of this policy Form and Edition 1. AES3045 2. AES3229 3. CG2134 4. CG7872 5. 1L7324 6. AES3004 7. NCSN 8. L7210 9. CG2175 10. CG2176 11. CG8366 0807 1110 0187 0399 0812 0501 0304 0108 0608 0108 0605 If not at inception Date Added or ST Date Deleted NC NC NC NC NC NC NC NC NC NC NC Form Description Aircraft Products and Grounding Liabil Employers Liability Exclusion Designated Work Exclusion Earth Movement Exclusion Economic and Trade Sanction Clause Premium Audit Condition Amendment Surplus Lines NC Disclosure Pursuant to Terrorism Risk Exclusion of Certified Acts of Terrori Exclusion of Punitive Damages Related Nuclear Biological or Chemical Exclu BUSINESSPRO Reg. U.S. Pat. Off. IL 88 01 Ed. 1185 PRO Page 2 of 2
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AES 3012 Ed. 08 11 GENERAL SERVICE OF SUIT ENDORSEMENT Not applicable in Delaware or Pennsylvania Pursuant to any statute of any state or district of the United States of America that makes provision therefor the Insurer hereby designates the commissioner superintendent or director of insurance or other officer specified for that purpose in the statute and his or her successors in office and duly authorized deputies as the Insurer s true and lawful attorney for service of legal process in any action suit or proceeding brought in the state where this Policy is issued by or on behalf of an insured or beneficiary against the Insurer arising out of the insurance issued under this Policy. Any legal process received by such attorney for service of legal process shall be forwarded except as provided below to the attention of Eve Cutler Rosen General Counsel Great American Insurance Company 301 E 4th Street Cincinnati Ohio 45202 4201. In California any legal process received by the Ihsurer s statutory attorney for service of process shall be forwarded to the attention of Nancy Flores The CT Corporation System 818 West Seventh Street Los Angeles California 90017 In the District of Columbia any legal process received by the Insurer s statutory attorney for service of process shall be forwarded to CT Corporation System 1015 15 Street NW Suite 1000 Washington DC 20005 In lllinois the Director at his or her option may forward a copy of the process to the Surplus Line Association of lllinois for delivery to the unauthorized insurer or may deliver the process to unauthorized insurer by another means which the Director considers to be reasonably prompt and certain. To be valid the process must state the names of the Insured and the unauthorized insurer and identify the contract of insurance. In Maine the Insurer hereby designates CT Corporation System as its attorney for service of legal process in any action relating to this Policy and directs that all legal process be mailed to. CT Corporation System One Portland Square Portland Maine 04101 In Oregon the Insurer and the Insured policyholder hereby agree to waive the provisions of Oregon Insurance Code section 735.490 requiring that service of legal process in any action relating to this Policy shall be served on the insurance agent who registered or delivered this Policy and instead agree that such service of legal process be mailed directly to Eve Cutler Rosen General Counsel Great American Insurance Company 301 E 4th Street Cincinnati Ohio 45202 4201. In Rhode Island the Insurer hereby designates CT Corporation System as its attorney for service of legal process in any action relating to this Policy and directs that all legal process be mailed to CT Corporation System 10 Weybosset Street Providence Rhode Island 02903. The foregoing designations of attorney for service of legal process upon the Insurer shall not constitute a waiver of the Insurer s rights to remove remand dismiss or transfer any suit or proceeding from any court or to commence any suit or other proceeding in any court of competent jurisdiction. Dated 08012011 AES 3012 Ed. 0811
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301 E 4th Street Cincinnati Ohio 45202 4201 GREATAMERICAN Tol 1 513 366 5000 r IL 72 68 Ed. 09 09 In Witness Clause In Witness Whereof we have caused this Policy to be executed and attested and if required by state law this Policy shall not be valid unless countersigned by our authorized representative. e Cotttor. Fsen. Secretary Qoo President Copyright Great American Insurance Co. 2009 IL72680L 0909 IL 72 68 Ed. 0909 XS
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IL 00 17 Ed. 11 98 COMMON POLICY CONDITIONS All Coverage Parts included in this Policy are subject to the following conditions. IL 00 17 Ed. 1198 XS A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this Policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this Policy by mailing or delivering to the first Named Insured writ ten notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpay ment of premium or b. 30 days before the effective date of cancellation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. 4. Notice of cancellation will state the effec tive date of cancellation. The policy period will end on that date. 5. If this Policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice.. Changes This Policy contains all the agreements be tween 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. Inspections and Surveys 1. We have the right to a. make inspections and surveys at any time b. give you reports on the conditions we find and. recommend changes. 2. We are not obligated to make any inspec tions surveys reports or recommenda tions and any such actions we do under take relate only to insurability and the pre miums 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 ap ply not only to us but also to any rating advisory rate service or similar organiza tion which makes insurance inspections surveys reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections surveys reports or recommendations we may make relative to certification under state or municipal statutes ordinances or regulations of boilers pressure vessels or elevators. Copyright 1SO Properties Inc 1998 Page 1 of 2
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E. Premiums The first Named Insured shown in the Dec larations 1. is responsible for the payment of all pre miums and 2. will be the payee for any return premiums we pay. F. Transfer of Your Rights and Duties Under this Policy Your rights and duties under this Policy may not be transferred without our written con sent except in the case of death of an in dividual hamed 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 re presentative is appointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. Copyright 1SO Properties Inc 1998 Page 2 of 2 IL 00 17 Ed. 1198 XS
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301 E 4th Street Cincinnati Ohio 45202 4201 GREATAMERICAN Tol 1 513 366 5000 r AES 3005 Ed. 05 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMON POLICY CONDITIONS AMENDMENT The following Conditions are added to the COM MON POLICY CONDITIONS of this policy. G. Fraud and Misrepresentation a. This policy was issued based on the in formation supplied on an application and other correspondence including your claim or loss history. This information is consid ered to be part of this policy. b. You should review this information care fully as the truth of this information was of paramount importance in influencing our decision to issue this policy.. You for all the Insureds under this policy do warrant the truth of such information to the best of your knowledge at the in ception date of this policy. d. If such information is false or misleading it may cause denial of coverage or voiding of the policy. H. Premium Financing Cancellation of Fi nanced Policy a. When we receive notification that the premium for this policy has been advanced by a premium financed company we will acknowledge receipt of the premium fi hance agreement to the finance company on our form when requested but we will not amend or extend this policy. b. When we otherwise become aware that you financed all or part of this policy s premium regardless of whether or not we receive a notice of premium financing we will not be bound as respects coverage we provide by the terms of your finance agreement. This policy alone governs cov erage.. When you sign a premium finance agree ment by the terms of the agreement you may be giving the premium finance com pany the right under certain conditions to cancel this policy on your behalf. When we receive hotice of cancellation from the finance company we will recognize their request for termination of this insurance and we will pay any return premium due as directed by the premium finance company. The return premium will be calculated on a prorata basis. d. The premium finance company will usually require that payment of any return pre mium be made directly to them and we will honor that request. If the requested ter mination date set by the premium finance company conflicts with other policy pro visions or the operation of law we will comply with the policy provision andor applicable law. You must resolve any re sulting premium differences directly with the finance company. e. The twenty five percent 25 minimum retained premium described in A. Can cellation may not be financed as it is not refundable. AES 3005 Ed. 0501 XS
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SOTE st Shraer o CG 74 00 Ed. 11 85 N Cis i Ohio 45202 4201 GREATAMERICAN. Tor T515 58655000 Policy No. PL 1944652 00 BUSINESSPRO GENERAL LIABILITY COYERAGE PART DECLARATIONS PAGE NAMED INSURED PLATIPUS ANCHORS INC. POLICY PERIOD 022814 to 022815 LIMITS OF INSURANCE General Aggregate Limit Other Than Products Completed Operations 2000000 Products Completed Operations Aggregate Limit 2000000 Personal and Advertising Injury Limit 1000000 Each Occurrence Limit 1000000 Fire Damage Limit PLUS ENDT Any One Fire Medical Expense Limit PLUS ENDT Any One Person RETROACTIVE DATE CG 00 02 ONLY Coverage A of this Insurance does not apply to bodily injury or property damage which occurs before the Retroactive Date if any shown here NONE enter date or none if does not apply DESCRIPTION OF BUSINESS Form of Business Individual Joint Venture Partnership X Organization Other than Partnership or Joint Venture Business Description MFG ANCHORING SYSTEMS Location of All Premises You Own Rent or Occupy PREMIUM Code Premium Classification No. Basis All Other MACH INERY 15062 D2000000 a Admissions b Area c Each d Gross Sales e Payroll f Total Cost g Units h Other Total Advance Premium 30000 Premium shown is payable 30000 at inception FORMS AND ENDORSEMENTS Applying to this Coverage Part and Made Part of this Policy at Time of Issue 330000 BUSINESSPRO Reg. U.S. Pat. Off. CG 74 00 Ed. 1185 PRO Page 1 of 1
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CG 00 01 Ed. 12 07 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 hot covered. Throughout this Policy the words you and your refer to the Named Insured shown in the Declara tions and any other person or organization quali fying 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 or ganization qualifying as such under SECTION Il WHO IS AN INSURED. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION V DEFINITIONS. SECTION COVERAGES Coverage A Bodily Injury and Property Damage Liability 1. Insuring Agreement a. We will pay those sums that the Insured becomes legally obligated to pay as dam ages because of bodily injury or prop erty damage to which this insurance ap plies. We will have the right and duty to defend the Insured against any suit seek ing 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 insur ance does hot apply. We may at our dis cretion investigate any occurrence and settle any claim or suit that may result. But 1 the amount we will pay for damages is limited as described in SECTION Il LIMITS OF INSURANCE and 2 our right and duty to defend ends when we have used up the applicable Limit of Insurance in the payment of judgments or settlements under Cov erages 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 Sup plementary Payments Coverages A and B.. This insurance applies to bodily injury and property damage only if 1 the bodily injury or property dam age is caused by an occurrence that takes place in the coverage territory 2 the bodily injury or property dam age occurs during the policy period and 3 prior to the policy period ho 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 in sured 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.. 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 nhotice of an oc currence or claim includes any continu ation change or resumption of that bodily injury or property damage after the end of the policy period.. 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 SEC Copyright 1SO Properties Inc 2006 00 01 Ed. 1207 XS Page 1 of 20 CG 00 01 Ed. 1207 XS
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0 01 Ed. 1207 XS TION 1l WHO IS AN INSURED or any employee authorized by you to give or receive notice of an occurrence or claim 0 reports all or any part of the bodily injury or property damage to us or any other insurer 2 receives a written or verbal demand or clam for damages because of the bodily injury or property damage or 3 becomes aware by any other means that bodily injury or property dam age has occurred or has begun to oceur.. Damages because of bodily injury include damages claimed by any person or or ganization for care loss of services or death resulting at any time from the bodi ly injury. 2. Exclusions This insurance does hot apply to a. Expected or Intended Injury Bodily injury or property damage ex pected 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.. Contractual Liability Bodily injury or property damage for which the Insured is obligated to pay dam ages by reason of the assumption of li ability in a contract or agreement. This ex clusion does not apply to liability for dam ages 1 that the Insured would have in the ab sence of the contract or agreement or 2 assumed in a contract or agresment that is an insured contract provided the bodily injury or property dam age occurs subsequent to the execu tion of the contract or agreement Solely for the purposes of liability as sumed in an insured contract rea c. d. sonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and b such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this in surance applies are alleged. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 causing or contributing to the intoxi cation 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. This exclusion applies only if you are in the business of manufacturing distributing 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 Copyright 1SO Properties Inc 2006 Page 2 of 20 CG 00 01 Ed. 1207 XS
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1 Ed. 1207 XS 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 con sequence 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 someonhe else who must pay damages because of the injury. This exclusion does hot apply to liability assumed by the Insured under an insured contract f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seep age 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 hot apply to i bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or origi nating from equipment that is used to heat cool or de humidify 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 addi tional insured with respect to your onhgoihg operations b C performed for that Addi tional Insured at that prem ises site or location and such premises site or loca tion is not and hever was owned or occupied by or rented or loaned to any in sured other than that Addi tional Insured or iii bodily injury or property damage arising out of heat smoke or fumes from a hostile fire at or from any premises site or location which is or was at any time used by or for any insured or others for the handling stor age disposal processing or treatment of waste which are or were at any time transported handled stored treated disposed of or pro cessed as waste by or for i any insured or ii any person or organization for whom you may be legally responsible or at or from any premises site or location on which any insured or any contractors or subcontrac tors working directly or indirectly on any insured s behalf are per forming operations if the pollu tants are brought on or to the premises site or location in con nection with such operations by such insured contractor or sub contractor. However this sub paragraph 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 per form the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equip ment or its parts if such Copyright I1SO Properties Inc 2006 Page 3 of 20 CG 00 01 Ed. 1207 XS
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fuels Iubricants or other operating fluids escape from a vehicle part desighed to hold store or receive them. This exception does hot ap ply 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 dis persed or released as part of the operations being per formed by such insured contractor or subcontractor ii bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contrac tor or subcontractor or i 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 oh which any insured or any contractors or subcontrac tors working directly or indirectly on any insured s behalf are per forming operations if the oper ations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a request demand order or statu tory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neu tralize or in any way respond to or assess the effects of pollu tants 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 re sponding to or assessing the ef fects of pollutants. However this paragraph does not ap ply 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 gov ernmental authority. g. Aircraft Auto or Watercraft Bodily injury or property damage aris ing out of the ownership maintenance use or entrustment to others of any air craft auto or watercraft owned or op erated by or rented or loaned to any in sured. 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 hir ing employment training or monitoring of others by that Insured if the occurrence which caused the bodily injury or prop erty 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 hot own that is a less than 26 feet long and b not being used to carry persons or property for a charge Copyright I1SO Properties Inc 2006 Ed. 1207 XS Page 4 of 20 CG 00 01 Ed. 1207 XS
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3 parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the Insured 4 lisbility assumed under any insured contract for the ownership mainten ance or use of aircraft or watercraft or bodily injury or property damage arising out of a the operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or finan cial responsibility law or other motor vehicle insurance law in the state where it is licensed or prin cipally garaged or b the operation of any of the ma chinery or equipment listed in paragraph f.2 or f.3 of the definition of mobile equipment. h. Mobile Equipment Bodily injury or property damage aris ing out of 1 the transportation of mobile equip ment 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 in directly out of 1 war including undeclared or civil war 2 warlike action by a military force in cluding action in hindering or defend ing against an actual or expected at tack by any government sovereign or other authority using military personnel or other agents or 3 insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. j. Damage to Property Property damage to 1 property you own rent or occupy including any costs or expenses in curred by you or any other person organization or entity for repair re placement enhancement restoration or maintenance of such property for ahy reason including prevention of in jury to a person or damage to an other s property 2 premises you sell give away or aban don if the property damage arises out of any part of those premises 3 property loaned to you 4 personal property in the care custody or control of the Insured 5 that particular part of real property on which you or any contractors or sub contractors working directly or indi rectly on your behalf are performing operations if the property damage arises out of those operations or 6 that particular part of any property that must be restored repaired or re placed because your work was in correctly performed on it Paragraphs 1 3 and 4 of this exclusion do hot apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of 7 or fewer consecu tive days. A separate Limit of Insurance applies to Damage to Premises Rented to You as described in SECTION lll LIMITS OF INSURANCE. 1 Ed. 1207 XS Copyright I1SO Properties Inc 2006 Page 5 of 20 CG 00 01 Ed. 1207 XS
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01 Ed. 1207 XS Paragraph 2 of this exclusion does not apply if the premises are your work and were hever occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this ex clusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does hot apply to property damage included in the products completed operations hazard.. Damage to Your Product Property damage to your product aris ing 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 haz ard 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 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. n. 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 con dition 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 in ability to access or inability to manipulate electronic data. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer soft ware including systems and applications software hard or floppy disks CD ROMS tapes drives cells data processing devices or any other media which are used with electronically controlled equipment.. Distribution of Material in Violation of Statutes Bodily injury or property damage aris ing directly or indirectly out of any action or omission that violates or is alleged to violate 1 the Telephone Consumer Protection Act TCPA including any amendment of or addition to such law or Copyright 1SO Properties Inc 2006 Page 6 of 20 CG 00 01 Ed. 1207 XS
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2 the CAN SPAM Act of 2003 including any amendment of or addition to such law or 3 any statute ordinance or regulation other than the TCPA or CAN SPAM Act of 2003 that prohibits or limits the sending transmitting communicat ing or distribution of material or in formation. Exclusions. through n. do not apply to dam age by fire to premises while rented to you or temporarily occupied by you with permis sion of the owner. A separate Limit of Insur ance applies to this coverage as described in SECTION Ill LIMITS OF INSURANCE. Coverage B Personal and Advertising Injury Liability 1. Insuring Agreement a. We will pay those sums that the Insured becomes legally obligated to pay as dam ages 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 ad vertising injury to which this insurance does not apply. We may at our discretion investigate any offense and settle any claim or suit that may result But 1 the amount we will pay for damages is limited as described in SECTION Il LIMITS OF INSURANCE and 2 our right and duty to defend end when we have used up the applicable Limit of Insurance in the payment of judg ments 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 Sup plementary Payments Coverages A and B. of 2003 including b. or addition to such nce or regulation A or CAN SPAM 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. prohibits or limits 2. Exclusions tting communicat of material or in This insurance does not apply to a. Knowing Violation of Rights of Another not apply to dam hile rented to you you with permis ate Limit of Insur ge as described in NSURANCE. vertising Injury 1s that the Insured ed to pay as dam hal and advertising c. urance applies. We duty to defend the uit seeking those will have ho duty against any suit personal and ad ich this insurance at our discretion d. e and settle any result But pay for damages is in SECTION Il NCE and e defend end when he applicable Limit payment of judg s under Coverages l expenses under iability to pay sums rvices is covered 2d for under Sup Coverages A and 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 per sonal and advertising injury.. Material Published with Knowledge of Falsity Personal and advertising injury arising out of oral or written publication of material if done by or at the direction of the In sured with knowledge of its falsity. Material Published Prior to Policy Pe riod Personal and advertising injury arising out of oral or written publication of material whose first publication took place before the beginning of the policy period. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the Insured. Contractual Liability Personal and advertising injury for which the Insured has assumed liability in a con tract 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 Copyright 1SO Properties Inc 2006 Page 7 of 20 CG 00 01 Ed. 1207 XS
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1 Ed. 1207 XS g. Quality or Performance of Goods Failure to Conform to Statements Personal and advertising injury arising out of the failure of goods products or ser vices to conform with any statement of quality or performance made in your ad vertisement h. Wrong Description of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement.. 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 intellec tual property rights. Under this exclusion such other intellectual property rights do hot include the use of another s advertis ing idea in your advertisement However this exclusion does hot apply to infringement in your advertisement of copyright trade dress or slogan.. Insureds in Media and Intemet Type Businesses Personal and advertising injury commit ted 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. of personal and advertising injury under the Defini tions Section. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting.. Electronic Chat Rooms or Bulletin Boards Personal and advertising injury arising out of an electronic chat room or bulletin board the Insured hosts owns or over which the Insured exercises control.. Unauthorized Use of Another s Name or Product Personal and advertising injury arising out of the unauthorized use of another s hame or product in your e mail address domain hame or metatag or any other similar tac tics to mislead another s potential custom ers.. Pollution Personal and advertising injury arising out of the actual alleged or threatened dis charge dispersal seepage migration re lease or escape of pollutants at any time.. Pollution Related Any loss cost or expense arising out of any 1 request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or heutralize or in any way respond to or assess the effects of pollutants or 2 clam or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants.. War Personal and advertising injury however caused arising directly or indirectly out of 1 war including undeclared or civil war 2 warlike action by a military force in cluding action in hindering or defend ing against an actual or expected at Copyright I1SO Properties Inc 2006 Page 8 of 20 CG 00 01 Ed. 1207 XS
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tack by any government sovereign or other authority using military personnel or other agents or 3 insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. p. Distribution of Material in Violation of Statutes Personal and advertising injury arising di rectly or indirectly out of any action or omission that violates or is alleged to vio late 1 the Telephone Consumer Protection Act TCPA including any amendment of or addition to such law or 2 the CAN SPAM Act of 2003 including any amendment of or addition to such law or 3 any statute ordinance or regulation other than the TCPA or CAN SPAM Act of 2003 that prohibits or limits the sending transmitting communicat ing or distribution of material or in formation. Coverage C Medical Payments 1. Insuring Agreement a. We will pay medical expenhses as de scribed 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 cov erage territory and during the policy period b the expenses are incurred and report ed to us within one year of the date of the accident and ment sovereigh or military personnel llion revolution action taken by b. ity in hindering or y of these. al in Violation of g injury arising di of any action or r is alleged to vio sumer Protection g any amendment h law or c the injured person submits to exami nation at our expense by physicians of our choice as often as we reason ably require. We will make these payments regardless of fault These payments will not exceed the applicable Limit of Insurance. We will pay reasonable expenses for 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 pro fessional nursing and funeral services. 2. Exclusions of 20083 including or addition to such nce or regulation A or CAN SPAM prohibits or limits tting communicat of material or in b. s c. expenses as de dily injury caused M or rent aMises you own or d erations place in the cov during the policy e. curred and report year of the date of We will hot pay expenses for bodily injury a. Any Insured To any insured except volunteer work ers. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured.. Injury on Normally Occupied Premises To a person injured on that part of prem ises you own or rent that the person nor mally occupies.. Workers Compensation and Similar Laws To a person whether or not an employ ee 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.. Athletics Activities To a person injured while practicing in structing or participating in any physical exercises or games sports or contests. Copyright 1SO Properties Inc 2006 Page 9 of 20 CG 00 01 Ed. 1207 XS
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f. a. Products Completed Operations Hazard Included within the products completed operations hazard. Coverage A Exclusions Excluded under Coverage A. Supplementary Payments Coverages A and B 1. We will pay with respect to any clam we investigate or settle or any suit against an insured we defend b. All expenses we incur. Up to 250 for cost of bail bonds re quired 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 hot have to fur nish these bonds.. The cost of bonds to release attachments but only for bond amounts within the ap plicable Limit of Insurance. We do hot have to furnish these bonds.. All reasonable expenses incurred by the Insured at our request to assist us in the investigation or defense of the clam or suit including actual loss of earnings up to 250 a day because of time off from work.. All court costs taxed against the Insured in the suit However these payments do not include attorneys fees or attorneys expenses taxed against the Insured.. Prejudgment interest awarded against the Insured on that part of the judgment we pay. If we make an offer to pay the ap plicable Limit of Insurance we will not pay any prejudgment interest based on that period of time after the offer.. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid of fered to pay or deposited in court the part of the judgment that is within the applicable Limit of Insurance. These payments will not reduce the Limits of Insurance. perations Hazard oducts completed 3 e A overages A and B L to any claim we y suit against an of bail bonds re ents or traffic law f the use of any dily Injury Liability o hot have to fur clease attachments ints within the ap ance. We do not onds. s incurred by the to assist us in the e of the clam or ss of earnings up of time off from jainst the Insured in ese payments do fees or attorneys the Insured. varded against the the judgment we fer to pay the ap ce we will not pay st based on that offer. Il amount of any after entry of the ve have paid of sited in court the that is within the ance. duce the Limits of 2. 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 indem nitee if all of the following conditions are met a. the suit against the indemnitee seeks damages for which the Insured has as sumed the liability of the indemnitee in a contract or agreement that is an insured contract. this insurance applies to such liability as sumed by the Insured. the obligation to defend or the cost of the defense of that indemnitee has also been assumed by the Insured in the same insured contract. the allegations in the suit and the in formation we know about the occur rence are such that ho conflict appears to exist between the interests of the Insured and the interests of the indemnitee. 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. the indemnitee 1 agrees in writing to a cooperate with us in the inves tigation settlement or defense of the suit b immediately send us copies of any demands notices summonses or legal papers received in con nection with the suit notify any other insurer whose coverage is available to the in demnitee and d cooperate with us with respect to coordinating other applicable in surance available to the indem hitee and Copyright 1SO Properties Inc 2006 Page 10 of 20 CG 00 01 Ed. 1207 XS
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2 provides us with written authorization to a obtain records and other infor mation 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 at torneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation ex penses incurred by the indemnitee at our re quest will be paid as Supplementary Payments. Notwithstanding the provisions of paragraph 2.b.2 of Section Coverage A Bodily Injury and Property Damage Liability such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the Limits of Insurance. QOur obligation to defend an insureds indem hitee and to pay for attorneys fees and nec essary 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 agree ment described in paragraph f. above are no longer met. SECTION II WHO IS AN INSURED 1. If you are desighated 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 busi ness.. A limited liability company you are an in sured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insur eds but only with respect to their duties as your managers. ritten authorization d. and other infor o the suit and ontrol the defense ee in such suit An organization other than a partnership joint venture or limited liability company you are an insured. Your executive of ficers and directors are insureds but only with respect to their duties as your of ficers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. ions are met at e. A ftrust you are an insured. Your trustees. n the defense of are also insureds but only with respect to their duties as trustees. litigation expenses sary litigation ex o emnitee at our re 2. Each of the following is also an insured smentary Payments. ions of paragraph a. rerage A Bodily ge Liability such led to be damages perty damage and f Insurance. n insured s indem eys fees and nec as Supplementary have used up the 2 in the payment of or the conditions ms of the agree h f. above are no JRED Declarations as your spouse are h respect to the of which you are enture you are an your partners and insureds but only duct of your busi ny you are an in are also insureds to the conduct of anagers are insur ect to their duties Your volunteer workers ohly while per forming 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 part nership 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 ad vertising injury a to you to your partners or mem bers if you are a partnership or joint venture to your members if you are a limited liability com pany to a coemployee while in the course of his or her em ployment or performing duties related to the conduct of your business or to your other volun teer workers while performing duties related to the conduct of your business b to the spouse child parent brother or sister of that coem ployee or volunteer worker as a consequence of paragraph Ia above c for which there is any obligation to share damages with or repay someohe else who must pay Copyright 1SO Properties Inc 2006 Page 11 of 20 CG 00 01 Ed. 1207 XS
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0 01 Ed. 1207 XS damages because of the injury described in paragraphs INa or b above or d 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 volun teer workers any parther or member if you are a partnership or joint ven ture 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.. 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 prop erty and 2 until your legal representative has been appointed. d. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part.. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a hamed 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 in jury or property damage that occurred before you acquired or formed the or ganization and c. Coverage B does hot 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 re spect to the conduct of any current or past part nership joint venture or limited liability company that is not shown as a hamed insured in the Dec larations. SECTION IIl LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declara tions and the rules below fix the most we will pay regardless of the humber of a. insureds b. claims made or suits brought or. 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 dam ages because of bodily injury or prop erty damage included in the products completed operations hazard and c. damages under Coverage B. 3. The Products Completed Operations Aggre gate Limit is the most we will pay under Cov erage A for damages because of bodily in jury 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 adver tising injury sustained by any one person or organization. Copyright 1SO Properties Inc 2006 Page 12 of 20 CG 00 01 Ed. 1207 XS
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5. Subject to paragraph 2. or 3. above which ever 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 be cause of property damage to any one prem ises while rented to you or in the case of damage by fire while rented to you or tem porarily 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 ohe person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual pe riod and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the poli cy period is extended after issuance for an addi tional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determin ing the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptey 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 occur rence or offense took place 2 the names and addresses of any in jured 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 re ceived 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 de mands 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 en forcement of any right against any person or organization which may be lible 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 as sume any obligation or incur any expense other than for first aid without our con sent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part a. to join us as a party or otherwise bring us into a suit asking for damages from an insured or Copyright 1SO Properties Inc 2006 00 01 Ed. 1207 XS Page 13 of 20 CG 00 01 Ed. 1207 XS
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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 re cover 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 Insur ance. An agreed settlement means a settle ment and release of liability signed by us the Insured and the claimant or the claimant s legal representative.. Other Insurance If other valid and collectible insurance is avail able 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 insur ance 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 de scribed in paragraph c. below. b. Excess Insurance 1 This insurance is excess over a Any of the other insurance whether primary excess contin gent or oh any other basis i that is Fire Extended Cov erage Builder s Risk Installa tion 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 own er iii that is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occu pied by you with permission of the owner or iv if the loss arises out of the maintenance or use of air craft autos or watercraft to the extent not subject to exclusion g. of Section I Coverage A Bodily Injury and Property Damage Li ability. b Any other primary insurance available to you covering liability for damages arising out of the premises or operations or the products and completed oper ations for which you have been added as an additional insured by attachment of an endorsement. 2 When this insurance is excess we will have no duty under Coverages A or B to defend the Insured against any suit if any other insurer has a duty to de fend the Insured against that suit If ho other insurer defends we will un dertake to do so but we will be en titled 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 oth er insurance would pay for the loss in the absence of this insur ance 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 Insur ance Provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Dec larations of this Coverage Part.. Method of Sharing If all of the other insurance permits con tribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it 0 01 Ed. 1207 XS Copyright 1SO Properties Inc 2006 Page 14 of 20 CG 00 01 Ed. 1207 XS
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0 01 Ed. 1207 XS 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 meth od 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 ret rospective 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 ac curate and complete b. those statements are based upoh repre sentations you made to us and. we have issued this Policy in reliance upon your representations.. Separation of Insureds Except with respect to the Limits of Insur ance and any rights or duties specifically as signed in this Coverage Part to the first Named Insured this insurance applies a. as if each named insured were the only hamed 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 hot to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written no tice of the nonrenewal hot 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 nhotice 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 onh the Internet or on similar elec tronic means of communication and b. regarding web sites only that part of a web site that is about your goods pro ducts 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 in cluding any attached machinery or equip ment or Copyright 1SO Properties Inc 2006 Page 15 of 20 CG 00 01 Ed. 1207 XS
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0 01 Ed. 1207 XS b. any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. However auto does not include mobile equipment.. 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. 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 para graph a. above 2 the activities of a person whose home is in the territory described in para graph a. above but is away for a short time on your business or 3 personal and advertising injury of fenses that take place through the In ternet or similar electronic means of communication provided the Insured s responsibility to pay damages is determined in a suit on the mer its in the territory described in paragraph a. above or in a settlement we agree to.. Employee includes a leased worker. Em ployee does nhot include a temporary work er. Executive officer means a person holding any of the officer positions created by your charter constitution by laws or any other similar governing document. 7. Hostile fire means one which becomes un controllable or breaks out from where it was intended to be.. Impaired property means tangible prop erty 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 de fective deficient inadequate or danger ous 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 remov al of your product or your work or your fulfilling the terms of the contract or agree ment.. Insured contract means a. a contract for a lease of premises. How ever 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 tem porarily occupied by you with permission of the owner is not an insured contract b. a sidetrack agreement. any easement or license agreement ex cept in conhection with construction or demolition operations on or within 50 feet of arailroad d. an obligation as required by ordinance to indemnify a municipality except in con nection with work for a municipality e. an elevator maintenance agreement f. that part of any other contract or agree ment 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 persoh or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Copyright 1SO Properties Inc 2006 Page 16 of 20 CG 00 01 Ed. 1207 XS
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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 op erations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks roadbeds tunnel underpass or crossing 2 that indemnifies an architect engineer or surveyor for injury or damage aris ing out of a preparing approving or failing to prepare or approve maps shop drawings opinions reports sur veys 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 archi tect engineer or surveyor assumes li ability for an injury or damage arising out of the Insured s rendering or fail ure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. 10. Leased worker means a person leased to n 00 01 Ed. 1207 XS you by a labor leasing firm under an agree ment between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not in clude a temporary worker. Loading or unloading means the handling of property a. after it is moved from the place where it is accepted for movement into or onto an aircraft watercraft or auto b. while it is in or on an aircraft watercraft or auto or. while it is being moved from an aircraft watercraft or auto to the place where it is finally delivered 12. but loading or unloading does hot include the movement of property by means of a me chanical device other than a hand truck that is not attached to the aircraft watercraft or auto. Mobile equipment means any of the fol lowing 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 hext to premises you own or rent. vehicles that travel on crawler treads d. vehicles whether self propelled or not maintained primarily to provide mohbility to permanently mounted 1 power cranes shovels loaders dig gers or drills or 2 road construction or resurfacing equipment such as graders scrapers or rollers e. vehicles not described in paragraph a. b.. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equip ment of the following types 1 air compressors pumps and gener ators including spraying welding building cleaning geophysical explora tion lighting and well servicing equip ment 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. However self propelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos Copyright 1SO Properties Inc 2006 Page 17 of 20 CG 00 01 Ed. 1207 XS
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1 equipment designed primarily for a snow removal b road maintenance but not con struction or resurfacing or c street cleaning 2 cherry pickers and similar devices mounted onh automobile or truck chas 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 upoh another s copyright trade dress or slogan in your advertisement. sis and used to raise or lower work 15. Pollutants mean any solid liquid gaseous ers and or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis 3 air compressors pumps and gener chemicals and waste. Waste includes materials ators including spraying welding to be recycled reconditioned or reclaimed. building cleaning geophysical explora tion lighting and well servicing equip 16. Products completed operations hazard ment. However mobile equipment does not include any land vehicles that are subject to a com pulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. Land ve hicles subject to a compulsory or financial responsibility law or other motor vehicle in surance law are considered autos. 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 13. Occurrence means an accident including or abandoned. However your work continuous or repeated exposure to substan will be deemed completed at the earli tially the same general harmful conditions. est of the following times 14. Personal and advertising injury means in a When all of the work called for in jury including consequential bodily injury arising out of one or more of the following offenses a. false arrest detention or imprisonment b. malicious prosecution. the wrongful eviction from wrongful en try into or invasion of the right of private occupancy of a room dwelling or prem ises 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 ser vices your contract has been complet ed b When all of the work to be done at the job site has been com pleted 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 main tenance correction repair or replace ment but which is otherwise com plete will be treated as completed. Copyright 1SO Properties Inc 2006 00 01 Ed. 1207 XS Page 18 of 20 essors pumps and gener cluding spraying welding sanine Aacorhveicral evslora CG 00 01 Ed. 1207 XS
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17. 18. b. Does not include bodily injury or prop erty 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 un loading of that vehicle by any insured 2 the existence of tools uninstalled equipment or abandonhed 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. Property damage means a. physical injury to tangible property in cluding all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the phys ical injury that caused it or b. loss of use of tangible property that is hot physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance electronic data is not tangible property. As used in this definition electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including sys tems and applications software hard or flop py disks CD ROMS tapes drives cells data processing devices or any other media which are used with electronically controlled equip ment. 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 ih which such damages are claimed and to which the In sured must submit or does submit with our consent or 19. 20. 21 b. any other alternative dispute resolution proceeding in which such damages are claimed and to which the Insured submits with our consent. Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. Volunteer worker means a person who is hot 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 com pensation by you or anyone else for their work performed for you. Your product a. Means 1 any goods or products other than real property manufactured sold handled distributed or disposed of by a you b others trading under your name or c a person or organization whose business or assets you have ac quired and 2 containers other than vehicles ma terials parts or equipment furnished in connection with such goods or pro ducts. 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 warhings or instructions.. Does not include vending machines or other property rented to or located for the use of others but not sold. perations for which the isted in the Declarations y schedule states that pleted operations are Copyright 1SO Properties Inc 2006 Page 19 of 20 CG 00 01 Ed. 1207 XS
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22. Your work a. Means 0 work or operations performed by you or on your behalf and 2 materials parts or equipment furnished in connection with such work or op erations. b. Includes 1 warranties or representations made at any time with respect to the fithess quality durability performance or use of your work and 2 the providing of or failure to provide warhings or instructions. Copyright 1SO Properties Inc 2006 Page 20 of 20 CG 00 01 Ed. 1207 XS
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Administrative Offices 301 E 4th Stroot Cincinnati Ohio 45202 4201 GREAIAMERICAN Tel 1 513 369 5000 CG 75 18 Ed. 03 90 Policy No. PL 1944652 nan nan nan nan 0.0 BUSINESSPRO EMPLOYEE BENEFITS LIABILITY COVERAGE PART DECLARATIONS PAGE NAMED INSURED POLICY PERIOD PLAT IPUS ANCHORS INC. 022814 to 022815 LIMITS OF INSURANCE Aggregate Limit 2000000 Each Claim Limit 1.000000 Deductible 1000 DESCRIPTION OF BUSINESS Form of Business Individual Joint Venture Partnership X Organization Other than Partnership or Joint Venture Total Advance Premium INCLUDED Premium shown is payable INCLUDED at inception FORMS AND ENDORSEMENTS applicable to this Coverage Part and a made part of this Policy at the time of issue are listed on the attached Forms and Endorsements Schedule CG 88 01 1185. BUSINESSPRO Reg. U.S. Pat. Off. CG 75 18 Ed. 0390 PRO Page 1 of 1
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Administrative Offices 301 E 4th Street Cincinnati Ohio 45202 4201 GREATAMERICAN Tel 1 513 368 5000 CG 75 19 Ed. 12 07 EMPLOYEE BENEFITS LIABILITY COVERAGE FORM EXCLUDING FIDUCIARY LIABILITY Various provisions of this Policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is hot covered. Throughout this Policy the words you and your refer to the Named Insured shown in the Declarations. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under SECTION Il WHO IS AN INSURED. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION VI DEFINITIONS. 2 our right and duty to defend end when we have used up the applicable Limit of Insurance in the payment of judg ments or settlements under this Cov erage Part. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Sup plemental Payments. 2. Exclusions This insurance does not apply to Damages actually or allegedly arising out of any intentional dishonest fraudulent criminal or malicious act error or omis sion committed by any insured including but not limited to the willful violation of any statute.. Damages claimed for any bodily injury property damage or personal and ad vertising injury.. Damages actually or allegedly arising out of any breach of or failure to perform any contract by any insured or insurer.. Damages arising out of an insufficiency of funds to meet any obligations under any plan included in an employee benefit pro gram. SECTION EMPLOYEE BENEFITS COVERAGES 1. Insuring Agreement a. We will pay those sums that the Insured becomes legally obligated to pay as dam ages sustained by an employee former employee prospective employee or the beneficiaries or legal representatives thereof and caused by any negligent act error or omission of the Insured or any other person for whose acts you are le gally liable in the administration of your employee benefit program. This insurance applies to any negligent act error or omission which occurs in the coverage territory and during the policy period. We will have the right and duty to defend any suit seeking those damages. How ever we will have no duty to defend the Insured against any suit seeking damages for any negligent act error or omission to which this insurance does not apply. We may at our discretion investigate any hegligent act error or omission and set tle any claim or suit that may result. But 1 the amount we pay for damages is limited as described in SECTION Il LIMITS OF INSURANCE. CG 75 19 Ed 1207 XS Page 1 of 7
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2. 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. 3. All reasonable expenses incurred by the In sured at our request to assist us in the inves tigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from work. 4. All court costs taxed against the Insured in the suit However these payments do nhot in clude attorneys fees or attorneys expenses taxed against the Insured. 5. Prejudgment interest awarded against the In sured 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 we made the offer. 6. 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 de posited ih court the part of the judgment that is within the applicable Limit of Insurance. These payments will not reduce the Limits of Insurance. 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 busi ness. c. A limited liability company you are an in sured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insur eds 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 of e. Damages actually or allegedly arising out of any 1 failure of any investment to perform as predicted expected anticipated advertised or desired 2 advice given to any person with re spect to that person s decisioh to par ticipate or not to participate in any plan included in the employee benefit program 3 error in providing information on past performance of any investment vehi cle or 4 investment or non investment of funds. f. Damages arising out of your failure to comply with the mandatory provisions of any law concerning workers compensa tion employment compensation insurance social security or disability benefits law or any similar law. g. Damages for which the Insured is liable because of liability imposed on a fiduciary by the Employee Retirement Income Se curity Act of 1974 as how or hereafter amended or by any similar federal state or local law. h. Any claim arising from any failure to pay an employee benefit to the extent such employee benefit is payable from applica ble accrued funds or other collectible in surance with the reasonable effort and cooperation of the Insured. i. Any tax fine or penalty including but not limited to those imposed under the Inter nal Revenue Code or any similar state or local law. j. Damages actually or allegedly arising out of wrongful termination of employment any unlawful discrimination or any other employment related practice. Supplementary Payments We will pay with respect to any claim we in vestigate or settle or any suit against an insured we defend 1. All expenses we incur. CG 75 19 Ed 1207 XS Page 2 of 7
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ficers and directors are insureds but only with respect to their duties as your of ficers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders.. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. 2. The following are also insureds Each of your employees who is or was authorized to administer your employee benefit program but only with respect to their administration of your employee benefit program.. Any person organization or employee having proper temporary authorization to administer your employee benefit pro gram if you die but only with respect to their administration of your employee benefit program and only until your legal representative is appointed.. 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 Form.. Any organization you newly acquire or form other than a partnership joint ven ture 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 1 coverage under this provision is af forded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier 2 coverage does not apply to negligent acts errors or omissions that oc curred 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 11l LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declara tions and the rules below fix the most we will pay regardless of the number of a. insureds b. claims made or suits brought. persons or organizations making claims or bringing suits d. negligent acts errors or omissions or e. benefits included in your employee bene fit program 2. The Limits of Liability shown in the Declara tions applicable to Each Claim is subject to the following provision respecting Aggregate the most we will pay for all damages arising out of any covered claim. The Limit of Liability shown in the Declarations as Aggregate is the most we will pay for the sum of all damages on account of all claims. The limits of this Coverage Part apply sepa rately 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 un less the policy period is extended after issu ance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV DEDUCTIBLE 1. Our obligation to pay damages on your behalf applies only to the amount of damages in excess of the deductible amount stated in the Declarations. The Limits of Insurance shall not be reduced by the amount of the deductible. 2. The terms of this insurance including those with respect to a our right and duty to defend any suits seeking those damages and b your duties and the duties of any other involved insured in the event of a neg ligent act error or omission claim or suit CG 75 19 Ed 1207 XS Page 3 of 7
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apply irrespective of the application of the deductible amount. 3. 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 tak en you shall promptly reimburse us for such part of the deductible amount as has been paid by us. SECTION V EMPLOYEE BENEFITS 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 a Claim or Suit a. You and any other involved insured must see to it that we are notified as soon as practicable of any negligent act error or omission which may result in a claim. To the extent possible notice should include 1 how when and where the negligent act error or omission took place 2 the names and addresses of any in jured persons and withesses and 3 the nature of any injury or damage arising out of the negligent act error or omission. b. If a claim is received by an insured or a suit is brought against any insured you must 1 immediately record the specifics of the claim or suit and the date re ceived and 2 notify us as soon as practicable. You and any other involved insured 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 de mands 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 settlement or defense of the claim or suit and 4 assist us upon our request in the en forcement of any right against any person or organization which may be liable to the Insured because of injury or damage to which this insurance may also apply. d. No insured will except at their own cost voluntarily make a payment assume any obligation or incur any expense without our consent. 3. Legal Action Against Us No persoh or organization has a right under this Coverage Part a. to join us as a party or 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 re cover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not due under the terms of this Coverage Part or that are in excess of the Limits of Insurance. An agreed settlement means a settlement and release of lisbility signed by us the Insured and the claimant or the claimant s legal agent. 4. Other Insurance If other valid and collectible insurance is avail able to the Insured for a loss we cover under this Coverage Part our obligations are limited as follows a Primary Insurance This insurance is primary except when paragraph b. below applies. If this insur ance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method de scribed in paragraph. below. CG 75 19 Ed 1207 XS Page 4 of 7
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b Excess Insurance c As respects any additional insured added to this Policy by attachment of an en dorsement this insurance is excess over any other insurance available to that In sured that applies oh a primary basis to any claim suit negligent act error or omission or damages to which this Policy also applies. When this insurance is excess we will have no duty to defend that Insured against any suit if any other insurer has a duty to defend the Insured against that suit If no other insurer defends we will undertake to do so but we will be entitled to the Insured s rights against all those other insurers. When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that ex ceeds the sum of 1 the total amount that all such other insurance would pay for the loss in the absence of this insurance and 2 the total of all deductible and self insured amounts under all that other insurance. We will share the remaining loss if any with any other insurance that is not de scribed in this Excess Insurance provision and was hot bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. Method of Sharing If all of the other insurance permits con tribution 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 In surance 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 meth od 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 endorsement in accordance with our rules and rates. b. Premium shown 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 hotice 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 pre miums paid for the policy term 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 ac curate and complete b. those statements are based upon repre sentations you made to us and. we have issued this Policy in reliance upon your representations. 7. Separation of Insureds Except with respect to the Limits of Insur ance and any rights or duties specifically as signed to the first Named Insured this insur ance applies a. as if each named insured were the only hamed 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 CG 75 19 Ed 1207 XS Page 5 of 7
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. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time.. Cafeteria plans means plans authorized by applicable law to allow employees to elect to pay for certain benefits with their own pretax dollars.. Claim means any demand made or suit brought by an employee or an employee s dependents or beneficiaries for damages as a result of a negligent act error or omission in the administration of your employee benefit program.. Coverage territory means the United States of America including its territories and pos sessions Puerto Rico and Canada.. Employee means a persoh currently or formerly employed on leave of absence dis abled or retired. Employee includes a leased worker. Employee does hot include a tem porary worker.. Employee benefit program means a pro gram providing some or all of the following benefits to employees whether provided through a cafeteria plan or otherwise a. group life insurance group accident or health insurance dental vision and hearing plans and flexible spending accounts provided that i no one other than an employee may subscribe to such bene fits and i such benefits are made gen erally available to those employees who satisfy the plan s eligibility requirements b. profit sharing plans employee savings plans employee stock ownership plans pension plans and stock subscription plans provided that i no one other than an employee may subscribe to such benefits and ii such benefits are made generally available to all employees who are eligble for such benefits under the plan. unemployment insurance social security benefits workers compensation and dis ability benefits d. vacation plans including buy and sell pro grams leave of absence programs in cluding those for military maternity fam 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 no tice 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 VI DEFINITIONS 1. Administration means a. giving counsel or providing information to employees or to their dependents or beneficiaries with respect to the eligibility for or scope of any employee benefit program b. interpreting any employee benefit pro gram. handling records in conhnection with any employee benefit program d. effecting enroliment or continuing termi nating or canceling any employee s par ticipation in any benefit included in an employee benefits program provided all such acts are authorized by you. However administration does hot include handling any payroll deductions. 2. 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 elec tronic means of communication and b. regarding web sites only that part of a web site that is about your goods pro ducts or services for the purpose of at tracting customers or supporters is con sidered an advertisement. CG 75 19 Ed 1207 XS Page 6 of 7
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9. 10. n ily and civil leaves tuition assistance plans transportation and health club subsidies and e. any other similar plan designated in the Declarations or added thereto by en dorsement. Leased Worker means a person leased to you by a labor leasing firm under an agree ment between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does hot in clude a temporary worker. Negligent act error or omission means the failure to execute a required action or the execution of a mistaken action committed in the administration of the Insured s employee benefit program. Personal and advertising injury means in jury 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 en ry into or invasion of the right of private occupancy of a room dwelling or prem ises 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 organizations goods products or ser vices e. oral or written publication in any manher of material that violates a person s right of privacy. 12 13. 14. f. the use of another s advertising idea in your advertisement g. infringing upon another s copyright trade dress or slogan in your advertisement. Property damage means a. physical injury to tangible property in cluding all resulting loss of use of that property or b. loss of use of tangible property that is not physically injured. For the purposes of this insurance elec tronic data is not tangible property. As used in this definition electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer soft ware including systems and applications software or hardware hard or floppy disks CD ROMS tapes drives cells data processing devices or any other media which are used with electronically con trolled equipment. Suit means a civil proceeding in which damages because of a negligent act error or omission to which this insurance applies are claimed. Suit includes a. an arbitration proceeding in which such damages are claimed and to which the In sured must submit or does submit with our consent or b. any other alternative dispute resolution proceeding in which such damages are claimed and to which the Insured submits with our consent. Temporary worker means a person who substitutes for a permanent employee on leave or to meet seasonal or short term workload conditions. CG 75 19 Ed 1207 XS Page 7 of 7
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Administrative Offices 301 E 4th Stroot Cincinnati Ohio 45202 4201 GREAIAMERICAN Tel 1 513 369 5000 AES 301 Ed 05 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO AND NON OWNED AUTO LIABILITY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Insurance is provided only with respect to those coverages for which a specific premium charge is shown Coverage Additional Premium NonOwnership Liability Incl. Hired Auto Liability INCLUDED f no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement HIRED AUTO LIABILITY The insurance provided under Coverage A Section I applies to bodily injury or property damage arising out of the maintenance or use of a hired auto by you or your employees in the course of your business. With respect to the insurance provided by this endorsement 1 The exclusions under Coverage A Section I other than exclusions a b d f and i and the Nuclear Energy Liability Exclusion Broad Form are deleted and replaced by the following a. Bodily injury I to an employee of the Insured arising out of and in the course of employment by the Insured or 2 to the spouse child parent brother or sister of that employee as a consequence of 1 above. This exclusion applies whether the Insured may be liable as an employer or in any other capacity and 2 to any obligation to share damages with or repay someone else who must pay damages because of injury. This exclusion does not apply to m liability assumed by the Insured under an insured contract or AES 3011 Ed. 0501 PRO Page 1 of 2
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2 bodily injury arising out of and in the course of domestic employment by the Insured unless benefits for such injury are in whole or in part either payable or required to be provided under any workers compensation law. b. Property damage to 1 property owned or being transported by or rented or loaned to the Insured or 2 property in the care custody or control of the Insured. 2 Who Is An Insured Section 11 is replaced by the following Each of the following is an Insured under this insurance to the extent set forth below a. you b. any other person using a hired auto with your permission c. with respect to a non owned auto any partner or executive officer of yours but only while such non owned auto is being used in your business. d. Any other person or organization but only with respect to their liability because of acts or omissions of an Insured under a. b. or. above. of the following is an Insured a. any person engaged in the business of his or her employer with respect to bodily injury to any co employee of such person injured in the course of employment b. any partner or executive officer with respect to any auto owned by such partner or officer or a member of his or her household c. any persoh while employed in or otherwise engaged in duties in connection with an auto business other than an auto business you operate d. the owner or lessee of whom you are a sublessee of a hired auto or the owner of a nhon owned auto or any agent or employee of any such owner or lessee e. any person or organization with respect to the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. NON OWNED AUTO LIABILITY The insurance provided under Coverage A Section 1 applies to bodily injury or property damage arising out of the use of any non owned auto in your business by any person other than you. The following additional definitions apply Auto business means the business or occupation of selling repairing servicing storing or parking autos. Hired auto means any auto you lease hire or borrow. This does not include any auto you lease hire or borrow from any of your employees or members of their households or from any partner or executive officer of yours. Nonowned auto means any auto you do not own lease hire or borrow which are used in connection with your business. However if you are a partnership a non owned auto does not include any auto owned by any partner. AES 3011 Ed 0501 PRO Page 2 of 2 Page 2 of 2
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AES 3013 Ed. 04 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM Schedule DEDUCTIBLE AMOUNT AND COVERAGE DEDUCTIBLE BASIS Bodily Injury Liability X per claim Personal and Advertising Injury per occurrence Property Damage Liability Applicable to the sum of damages Supplementary Bodily Injury and Property Damage Liability Payments and defense costs 10000 Bodily Injury Personal and Advertising Injury and Property Damage Liability combined If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement APPLICATION OF ENDORSEMENT Enter below any limitations on the application of this endorsement. If no limitation is entered the deductibles apply to damages for all bodily injury personal and advertising injury and property damage however caused. 1. Qur obligation under Bodily Injury Liability Personal and Advertising Injury and Property Damage Liability Coverages to pay damages on your behalf applies only to the amount of damages in excess of any deductible amounts stated in the Schedule above as applicable to such coverages. 2. The deductible applies for the deductible amount and coverage option and on the deductible basis indicated in the Schedule above. The deductible amount stated in the Schedule above applies as follows a. PER CLAIM BASIS If the deductible amount indicated in the Schedule is on a per claim basis that deductible applies as follows 1 Under the Bodily Injury Liability Personal and Advertising Injury Liability or Property Damage Liability Coverage respectively a to the sum of damages supplementary payments and defense costs because of bodily injury sustained by any ohe personh b to the sum of damages supplementary payments and defense costs because of personal and advertising injury sustained by any one persoh or DEDUCTIBLE BASIS X per claim per occurrence Applicable to the sum of damages Supplementary Payments and defense costs 10000 AES 3013 Ed. 0411 PRO Page 1 of 3
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c to the sum of damages supplementary payments and defense costs because of property damage sustained by any one person 2 under Bodily Injury andor Property Damage Liability Coverage combined to the sum of damages supplementary payments and defense costs because of bodily injury and property damage sustained by any one person or 3 under Bodily Injury Personal and Advertising Injury andor Property Damage Liability Coverage combined to the sum of damages supplementary payments and defense costs because of bodily injury personal and advertising injury and property damage sustained by any ohe personh as a result of any one occurrence or offense. If damages are claimed for care loss of services or death resulting at any time from bodily injury a separate deductible amount will be applied to each person making a claim for such damages. With respect to personal and advertising injury and property damage person includes organization. b. PER OCCURRENCE BASIS If the deductible amount indicated in the Schedule is on a per occurrence basis that deductible applies as follows 1 under the Bodily Injury Liability Personal and Advertising Injury Liability or Property Damage Liability Coverage respectively a to the sum of damages supplementary payments and defense costs because of bodily injury b to the sum of damages supplementary payments and defense costs because of personal and advertising injury or to the sum of damages supplementary payments and defense costs because property damage 2 under Bodily Injury andor Property Damage Liability Coverage combined to the sum of damages supplementary payments and defense costs because of all bodily injury and property damage or 3 under Bodily Injury Personal and Advertising Injury andor Property Damage Liability Coverage combined to the sum of damages supplementary payments and defense costs because of bodily injury personal and advertising injury and property damage as a result of any one occurrence or offense regardless of the number of persons or organizations who sustain damages because of that occurrence or offense. The terms of this insurance including those with respect to a our right and duty to defend any suits seeking those damages and b your duties in the event of an occurrence offense 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 hotification of the action taken you shall promptly reimburse us for such part of the deductible amount that has been paid by us. The deductible applies whether or hot a payment for damages is made. AES 3013 Ed. 0411 PRO Page 2 of 3
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Defense Costs mean all expenses incurred in the investigation defense and settlement of any claim or suit under this policy including attorneys fees court reporter fees charges for independent medical examinations and expert witnesses provided such claim expense is incurred by us or with our prior written permission. Defense Costs will not include salaried employees counsel on retainer and office expense of either you or us. AES 3013 Ed. 0411 PRO Page 3 of 3
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AES 3206 Ed. 05 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPECIALTY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is a summary of the Limits of Insurance and additional coverage provided by this endorsement. For complete details oh specific coverages consult the Policy contract wording. Subjects of Insurance Non Owned Watercraft up to 51 feet Non Owned Aircraft Chartered with Crew Medical Expenses 5000 Limit Medical Expenses Completed Operations Dental Services Who Is an Insured Fellow Employee Coverage Broadened Named Insured Additional Insured Ongoing Operations Subject to Exclusions Additional Insured Vendors Subject to Exclusions Fire Legal Liability 300000 Limit Broad Notice of Occurrence Unintentional Errors or Omissions Waiver of Subrogation Non Employee Discrimination Incidental Malpractice Liability Contractual Liability for Railroad Exposures The following amends the Commercial General Liability Coverage Part NON OWNED WATERCRAFT SECTION COVERAGES Coverage A Bodily Injury and Property Damage Liability 2. Exclusions g. Aircraft Auto or Watercraft 2 is deleted and replaced with the following AES 3206 Ed. 0510 XS Page 1 of 7
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This exclusion does not apply to 2 a watercraft that you do hot own that is a less than 51 feet long and b not being used to carry persons or property for a charge NON OWNED AIRCRAFT The following is added to SECTION COVERAGES Coverage A Bodily Injury and Property Damage Liability 2. Exclusions g. Aircraft Auto or Watercraft This exclusion does not apply to 6 An aircraft in which you have no ownership interest and that you have chartered with crew. MEDICAL PAYMENTS Unless Coverage C Medical Payments or the Products Completed Operations Hazard has been excluded from this Policy the following applies SECTION COVERAGES Coverage C Medical Payments 2.f. is deleted and replaced with the following f. Products Completed Operations Hazard Included within the products completed operations hazard. However this exclusion does hot apply to expenses for dental services. SECTION Il LIMITS OF INSURANCE 7. is deleted entirely and replaced with the following 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 is the greater of a. 5000 any one Person or b. the Medical Expense Limit shown in the Declarations. WHO IS AN INSURED SECTION Il WHO IS AN INSURED is deleted entirely and replaced with the following 1. If you are desighated 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 ohly with respect to the conduct of your business.. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. AES 3206 Ed. 0510 XS Page 2 of 7
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An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. 2. Each of the following is also an insured b. Your volunteer workers only while performing duties related to the conduct of your business and 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 is an insured for 1 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 b to the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of paragraph IMa above c for which there is any obligation to share damages with or repay someonhe else who must pay damages because of the injury described in paragraphs Ia or 1Mb above or 2 Bodily injury or Personal and advertising injury a arising out of incidental medical malpractice due to his or her providing or failing to provide professional health care services. However this exclusion does not apply to nurses emergency medical technicians or paramedics who are employed by you to provide medical or paramedical services. 3 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 parther or member if you are a partnership or joint venture or any member if you are a limited liability company. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. 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 AES 3206 Ed. 0510 XS Page 3 of 7
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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 that you own at the inception of this Policy or any organization you hewly acquire or form other than a partnership joint venture or limited liability company and over which you maintain during the policy period majority ownership or majority interest will qualify as a Named Insured if a. there is no other similar insurance available to that organization and b. the first Named Insured shown in the Declarations has the responsibility of placing insurance for that organization and. that organization is incorporated or organized under the laws of the United States of America. However 1 coverage under this provision 3. is afforded only until the next occurring anhual anniversary of the beginning of the policy period shown in the Declarations or the end of the policy period whichever is earlier and 2 coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and 3 coverage B does nhot apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. ADDITIONAL INSURED ONGOING OPERATIONS The following is added to SECTION Il WHO IS AN INSURED SECTION 2. e. Any person or organization called additional insured that you are required to add as an additional insured on this Policy under 1 a written contract or agreement or 2 an oral contract or agreement where a certificate of insurance showing that person or organization as an additional insured has been issued however the written or oral contract must be a currently in effect or becoming effective during the term of this Policy and b executed prior to the bodily injury property damage personal injury or advertising injury which first manifests on or after the date of the inception of this policy period as shown in the Declarations Page of the Policy but prior to the earlier of the date of expiration or cancellation of this Policy. With respect to the insurance afforded such additional insured the following additional provisions apply 1 that person or organization is only an additional insured with respect to liability arising out of a premises or equipment you own rent lease or occupy or AES 3206 Ed. 0510 XS Page 4 of 7
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b your ongoing operations performed for that additional insured by or for you. The insurance provided to such additional insured does hot apply to bodily injury or property damage included within the products completed operations hazard. 2 The Limits of Insurance applicable to any such additional insured are those specified in the written contract or agreement or in the Declarations for this Policy whichever are less and are subject to the terms and conditions of this Coverage Form. These Limits of Insurance are inclusive of and hot in addition to the Limits of Insurance shown in the Declarations. 3 A person s or organization s status as an additional insured under this endorsement ends 30 days after your operations or agreement for that additional insured are completed or cease or the expiration of this Policy whichever is earlier. The insurance provided to any additional insured does hot apply to bodily injury property damage personal injury or advertising injury arising out of an architect s engineer s or surveyors rendering of or failure to render any professional services including 1 the preparing approving or failing to prepare or approve maps drawings opinions reports surveys change orders designs or specifications and 2 supervisory inspection or engineering services. It is further agreed that this insurance shall be primary and honcontributory but only in the event of the Named Insured s sole negligence. ADDITIONAL INSURED VENDORS The following is added to SECTION Il WHO IS AN INSURED 2 f. Any person or organization referred to below as 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 subject to the following additional exclusions 1 The insurance afforded the vendor does not apply to bodily injury or property damage for which the 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 the vendor would have in the absence of the contract or agreement b any express warranty unauthorized by you any physical or chemical change in the product made intentionally by the vendor d repackaging unless 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 e any failure to make such inspections adjustments tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of busihess in connection with the distribution or sale of the products. f demonstration installation servicing or repair operations except such operations performed by the vendor in full compliance with the manufacturer s written instructions at the vendor s premises in connection with the sale of the product AES 3206 Ed. 0510 XS Page 5 of 7
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g 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 the vendor. th bodily injury or property damage arising out of the sole negligence of the vendors for its own acts or omission of those of its employees or anyone else acting on its behalf. However this exclusion does not apply to 1 the exceptions contained in subparagraphs d or f or 2 such inspections adjustments tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in cohnection 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. 3 Itis further agreed that this insurance shall be primary and noncontributory but only in the event of the Named Insured s sole negligence. FIRE LEGAL LIABILITY SECTION Ill LIMITS OF INSURANCE 6. is deleted and replaced by the following 6. Subject to paragraph 5. above the Damage to Premises Rented to You Limit shown in the Declarations for damages because of property damage to any ohe premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with the permission of the owner is the greater of a. 300000 any One Premises or b. the Damage to Premises Rented to You Limit shown in the Declarations. DUTIES IN THE EVENT RR E. OF LAIM OR The following is added to SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 2. Duties in the Event of Occurrence Offense Claim or Suit e. Knowledge of any occurrence offense claim or suit by any agent servant or employee of the Named Insured does not in itself constitute knowledge by the Insured unless notice of such injury claim or suit shall have been received by an officer manager risk manager authorized employee or partner of a Named Insured. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 6. Representations d. If you unintentionally fail to disclose any hazards existing at the inception date of this Policy we will hot deny coverage under this Coverage Form because of such failure. However this does nhot affect our right to collect additional premium or exercise our right of cancellation or non renewal. AES 3206 Ed. 0510 XS Page 6 of 7
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WAIVER OF SUBROGATION SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 8. is deleted and replaced with the following 8. Transfer or Rights of Recovery Against Others to Us a. 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 hothing after loss to impair those rights. At our request the Insured will bring suit or transfer those rights to us and help us enforce those rights. b. If required by a written insured contract executed prior to the occurrence or offense we waive any right of recovery we have against any person or organization named in such insured contract because of payments we make for injury or damage arising out of your onhgoing operations or your work for that person or organization. NON EMPLOYMENT DISCRIMINATION LIABILITY Unless Coverage B Personal and Advertising Injury Liability is excluded from this Policy the following applies The following is added to SECTION V DEFINITIONS 14. Personal and advertising injury h. discrimination or humiliation that results in injury to the feelings or reputation of a natural person but only if such discrimination or humiliation is not done intentionally by or at the direction of the Insured with the khowledge that the act would violate the rights of another and would inflict personal and advertising injury and not directly or indirectly related to the employment prospective employment or termination of employment of any person or persons by any insured. INCIDENTAL MALPRACTICE LIABILITY The following is added to SECTION V DEFINITIONS 23. Incidental Medical Malpractice means injury arising out of the negligent rendering or failure to render medical or paramedical services to persons by any physician dentist hurse emergency medical technician or paramedic who is employed by you to provide such services provided you are not engaged in the business or occupation of providing any services referred to in this definition. CONTRACTUAL LIABILITY FOR RAILROAD EXPOSURES SECTION V DEFINITIONS 9. Insured Contract f.1 is deleted in its entirety. This endorsement does not change any other provision of the Policy. AES 3206 Ed. 0510 XS Page 7 of 7
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CG 21 65 Ed. 12 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION WITH A BUILDING HEATING COOLING AND DEHUMIDIFYING EQUIPMVENT EXCEPTION AND A HOSTILE FIRE EXCEPTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART i at any premises site or location which is or was at any time used by or for any insured or others for the handling storage dispos al processing or treatment of waste or i at any premises site or location on which any insured or any con tractors or subcontractors work ing directly or indirectly on any insured s behalf are performing operations 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 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. Exclusion f. under paragraph 2. Exclusions of SECTION Coverage A Bodily Injury and Property Damage Liabilityis replaced by the fol lowing This insurance does not apply to f. Pollution 1 Bodily injury or property damage which would hot have occurred in whole or part but for the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants at any time. This exclusion does not apply to bodily injury if sustained within a building which is or was at any time owned or occupied by or rented or loaned to any insured and caused by smoke fumes vapor or soot pro duced by or originating from equip ment that is used to heat cool or de humidify the building or equipment that is used to heat water for personal use by the building s occupants or their guest or bodily injury or property damage arising out of heat smoke or fumes from a hostile fire unless that hostile fire occurred or originated Copyright 1SO Properties Inc 2003 CG 21 65 Ed. 1204 XS
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AES 3258 Ed. 07 11 EXCLUSION OF CLAIMS AND SUITS ALLEGING INFRINGEMENT OF INTELLECTUAL PROPERTY This endorsement applies to insurance under the COMMERCIAL GENERAL LIABILITY COVERAGE FORM I. Coverage B Personal and Advertising Injury Liability 2. Exclusions i. Infringement of Copyright Patent Trademark or Trade Secret is deleted and replaced by the following i. Claim or Suit Alleging Infringement of Intellectual Property 1 Any claim or suit that alleges personal and advertising injury arising out of any actual alleged or threatened misappropriation infringement or violation of any onhe or more of the following rights or laws a U m copyright patent trademark trade name trade secret trade dress service mark slogan service name claim of authorship other right to or law recognizing an interest in any expression idea likeness name style of doing business symbol or title laws or regulations concerning piracy unfair competition unfair trade practices or other similar practices or any other intellectual property right or law. This exclusion applies whether such misappropriation infringement or violation is committed in your advertisement or otherwise. 2 Any other bodily injury property damage personal and advertising injury or medical expenses alleged in a claim or suit that also alleges any misappropriation infringement or violation excluded by paragraph 1 of this exclusion. AES 3258 Ed. 0711 XS Page 1 of 2
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The following exclusion is added to SECTION COVERAGES COVERAGE A Bodily Injury and Property Damage Liability 2. Exclusions Claim or Suit Alleging Infringement of Intellectual Property Any bodily injury or property damage alleged in any claim or suit that also alleges any personal and advertising injury of a kind described in paragraph 1 of Coverage B exclusion i. Claim or Suit Alleging Infringement of Intellectual Property. This endorsement does not change any other provision of the Policy. AES 3258 Ed. 0711 XS Page 2 of 2
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IL 00 21 Ed. 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COVIMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY B. Under any Medical Payments Coverage to expenses incurred with respect to bodily injury resulting from the hazardous properties of huclear material and aris ing out of the operation of a nuclear fa cility by any person or organization. C. Under any Liability Coverage to bodily in jury or property damage resulting from hazardous properties of nuclear mate rial if 1 the nuclear material a is at any nu clear facility owned by or operated by or on behalf of an insured or b has been discharged or dispersed therefrom 2 the nuclear material is contained in spent fuel or waste at any time possessed handled used processed stored transported or disposed of by or on behalf of an insured or 3 the bodily injury or property dam age arises out of the furnishing by an insured of services materials parts or equipment in conhection with the planning construction maintenance operation or use of any nuclear fa cility but if such facility is located within the United States of America its 1. The insurance does hot apply A. Under any Liability Coverage to bodily in jury or property damage 1 with respect to which an insured un der the Policy is also an insured under a nuclear energy liability policy issued by Nuclear Energy Liability Insurance Association Mutual Atomic Energy Li ability Underwriters Nuclear Insurance Association of Canada or any of their successors or would be an insured under any such policy but for its ter mination upon exhaustion of its Limit of Liability or 2 resulting from the hazardous prop erties of nuclear material and with respect to which a any person or organization is required to maintain fi nancial protection pursuant 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 agree ment entered into by the United States of America or any agency thereof with any person or organization. Copyright 1SO Properties Inc 2007 Page 1 of 2 IL 00 21 Ed. 0908 XS
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territories or possessions or Canada this exclusion 3 applies only to property damage to such nuclear facility and any property thereat.. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source material special nuclear material or by product ma terial. Nuclear facility means a b e d any nuclear reactor any equipment or device desighed or used for 1 separating the isotopes of uranium or plutonium 2 processing or utilizing spent fuel or 3 handling processing or packaging waste any equipment or device used for the processing fabricating or alloying of special nuclear material if at any time the total amount of such material in the cus tody of the Insured at the premises where such equipment or device is lo cated 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 any structure basin excavation premises or place prepared or used for the storage or disposal of waste and includes the site on which any of the foregoing is located all operations conducted on such site and all premises used for such operations. Nuclear reactor means any apparatus de signed 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 ra dioactive contamination of property. Source material special nuclear material and by product material have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. Spent fuel means any fuel element or fuel component solid or liquid which has been used or exposed to radiation in a nuclear reactor. Waste means any waste material a con taining by product material other than the tailings or wastes produced by the extraction or concentration of uranium or thorium from any ore processed primarily for its source material content and b resulting from the operation by any person or organization of any nuclear facility included under the first two paragraphs of the definition of nuclear facility. Copyright 1SO Properties Inc 2007 Page 2 of 2 IL 00 21 Ed. 0908 XS
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AES 3228 Ed. 11 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ORGANIC PATHOGEN EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM A. The following exclusion is added to paragraph 2. Exclusions of Section. Coverages Bodily Injury and Property Damage Liability 2. Exclusions This insurance does hot apply to Organic Pathogens a. Any bodily injury which would not have occurred in whole or in part but for the actual alleged threatened or suspected inhalation or ingestion of exposure to discharge dispersal seepage migration growth release or escape or contact with any organhic pathogen. b. Any property damage which would not have occurred in whole or in part but for the actual alleged threatened or suspected contact with exposure to discharge dispersal seepage migration growth release or escape existence of or presence of any organic pathogen. c. Any loss cost or expense arising out of any i 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 any organic pathogen or i 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 any organic pathogen. This exclusion applies regardless of the circumstances of or leading to such actual alleged threatened or suspected inhalation ingestion exposure contact existence or presence. B. The following exclusion is added to paragraph 2. Exclusions of Section I. Coverages Personal and Advertising Injury Liability of the Commercial General Liability Coverage Form 2. Exclusions This insurance does hot apply to AES 3228 Ed. 1110 XS Page 1 of 2
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Organic Pathogens a. Any personal and advertising injury which would not have taken place in whole or in part but for the actual alleged threatened or suspected inhalation or ingestion of contact with exposure to existence of or presence of any organic pathogen. b. Any loss cost or expense arising out of any i 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 any organic pathogen or ii 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 any organic pathogen. This exclusion applies regardless of the circumstances of or leading to such actual alleged threatened or suspected inhalation ingestion exposure contact existence or presence. C. The following definition is added to the Definitions section Organic pathogen means any bacteria including Escherichia coli Salmonella Listerium microbe virus fungi mold mildew mycotoxins spores or their scent or byproducts. This endorsement does not change any other provision of the Policy. AES 3228 Ed. 1110 XS Page 2 of 2
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Administrative Offices 301 E 4th Street Cincinnati Ohio 45202 4201 GREATAMERICAN Tel 1 513 368 5000 CG 83 61 Ed. 02 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SILICA OR RELATED DUST EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM COVERAGE FOR OPERATIONS OF DESIGNATED CONTRACTOR A. The following exclusion is added to paragraph 2. Exclusions of SECTION I. Coverage A. Bodily Injury and Property Damage Li ity of the Commercial General Liability Coverage Form and to paragraph 2. Exclu sions of SECTION I. COVERAGES of the Owners and Contractors Protective Liability Coverage Form Coverage for Operations of Designated Contractor 2. Exclusions This insurance does hot apply to Silica or Related Dust a. Any bodily injury which would hot have occurred in whole or in part but for the actual alleged threatened or suspected inhalation or ingestion of exposure to or contact with silica or dust that includes or contains sili ca b. Any property damage which would hot have occurred in whole or in part but for the actual alleged threatened or suspected contact with exposure to existence of or presence of sili ca or dust that includes or contains silica c. Any loss cost or expense arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing re mediating or disposing of or in any way responding to or assessing the effects of silica or dust that includes or contains silica by any insured or by any other person or entity. This exclusion applies regardless of i the circumstances of or leading to such actual alleged threat ened or suspected inhalation in gestion exposure contact exis tence or presence and ii whether the silica or dust that includes or contains silica is mixed or combined with or also includes or contains any other substance. B. The following exclusion is added to paragraph 2. Exclusions of SECTION I. Coverage B. Personal and Advertising Injury Liability of the Commercial General Liability Coverage Form 2. Exclusions This insurance does not apply to Silica or Related Dust a. Any personal and advertising injury which would not have taken place in whole or in part but for the actual alleged threatened or suspected in halation or ingestion of contact with exposure to existence of or pres ence of silica or dust that includes or contains silica CG 83 61 Ed. 0205 XS Page 1 of 2
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b. Any loss cost or expense arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing re mediating or disposing of or in any way responding to or assessing the effects of silica or dust that includes or contains silica by any insured or by any other persoh or entity. This exclusion applies regardless of i the circumstances of or leading to such actual alleged threat ened or suspected inhalation in gestion exposure contact exis tence or presence and i whether the silica or dust that includes or contains silica is mixed or combined with or also includes or contains any other substance. C. The following definition is added to the Defi nitions Section Silica means silicon dioxide SiO2 in any form from any source. CG 83 61 Ed. 0205 XS Page 2 of 2
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CG 21 47 Ed. 12 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYMENT RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following COMIMERCIAL 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 employ ment or c employment related practices poli cies acts or omissions such as coer cion demotion evaluation reassign ment discipline defamation harass ment humiliation discrimination or malicious prosecution directed at that person or 2 the spouse child parent brother or sister of that person as a consequence of bodily injury to that person at whom any of the employment related practices de scribed in paragraphs a b or above is directed. This exclusion applies 1 whether the injury causing event de scribed in paragraphs a b or c above occurs before employment during employment or after employ ment of that person 2 whether the Insured may be liable as an employer or in any other capacity and 3 to any obligation to share damages with or repay someohe else who must pay damages because of the injury. B. The following exclusion is added to paragraph 2. Exclusions of Section Coverage B Personal and Advertising Injury Liability This insurance does hot 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 employ ment or c employment related practices poli cies acts or omissions such as coer cion demotion evaluation reassign ment discipline defamation harass ment humiliation discrimination or malicious prosecution directed at that person or 2 the spouse child parent brother or sister of that person as a consequence of per sonal 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 de scribed in paragraphs a b or c above occurs before employment during em ployment or after employment of that person 2 whether the Insured may be liable as an employer or in any other capacity and 3 to any obligation to share damages with or repay someone else who must pay dam ages because of the injury. Copyright 1SO Properties Inc 2006 21 47 Ed 1207 XS CG 21 47 Ed. 1207 XS
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AES 3077 Ed. 07 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PROFESSIONAL LIABILITY TESTING AND CONSULTING ERRORS AND OMISSIONS EXCLUSION This insurance does hot apply to 1 Any bodily injury property damage personal and advertising injury arising out of the rendering of or failure to render any professionhal services. Any bodily injury property damage personal and advertising injury arising out of a. an error omission defect or deficiency in 1. any test performed or 2. an evaluation a consultation or advice given by or on behalf or any insured b. the reporting of or reliance upon any such test evaluation consultation or advice or. an error omission defect or deficiency in experimental data or the Insured s interpretation of that data. This endorsement does not change any other provision of the Policy. AES 3077 Ed. 0707 XS
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301 E 4th Street Cincinnati Ohio 45202 4201 GREATAMERICAN Tol 1 513 366 5000 r ESG 1001 Ed. 09 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION PRE EXISTING DAMAGE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM A. The following is added to COMMERCIAL GENERAL LIABILITY COVERAGE FORM SECTION I COVERAGES COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2. Exclusions Pre Existing Damage 1. Bodily injury or property damage arising out of or related in any way in whole or in part either directly or indirectly whether known or unkhown a. which first occurred prior to the inception date of this policy or the retroactive date of this policy if any whichever is earlier or b. which is or is alleged to be in the process of occurring as of the inception date of this policy or the retroactive date of this policy if any whichever is earlier. 2. Bodily injury or property damage arising out of or related in any way in whole or in part either directly or indirectly whether known or unknown which is in the process of settlement adjustment or suit as of the inception date of this policy or the retroactive date of this policy if any whichever is earlier. B. The following is added to PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM SECTION I COVERAGES PRODUCTS COMPLETED OPERATIONS Bodily Injury and Property Damage Liability 2. Exclusions Pre Existing Damage 1. Bodily injury or property damage arising out of or related in any way in whole or in part either directly or indirectly whether known or unkhown a. which first occurred prior to the inception date of this policy or the retroactive date of this policy if any whichever is earlier or b. which is or is alleged to be in the process of occurring as of the inception date of this policy or the retroactive date of this policy if any whichever is earlier. 2. Bodily injury or property damage arising out of or related in any way in whole or in part either directly or indirectly whether known or unknown which is in the process of settlement adjustment or suit as of the inception date of this policy or the retroactive date of this policy if any whichever is earlier. All Other Terms and Conditions Remain Unchanged. ESG 1001 Ed. 0913
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AES 3018 Ed. 04 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ABSOLUTE ASBESTOS EXCLUSION This insurance does not apply to a. Bodily injury property damage or personal and advertising injury arising whether in whole or in part and whether directly or indirectly out of any kind of asbestos including but not limited to any kind of asbestos contained or incorporated in any material or product. Any loss cost or expense arising out of any 1 request demand order writ injunction or judgment that any insured or others test for monitor clean up remove contain treat detoxify neutralize prevent abate or in any way respond to or assess the presence or effect of asbestos or 2 claim or suit for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing preventing abating or in any way responding to or assessing the presence or effect of asbestos. AES 3018 Ed. 0411 XS
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Administrative Offices 01 E 4th Street Cincil i Ohio 45202 4201 GREATAMERICAN ToF 1 515 365 5000 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 77 94 Ed. 07 98 EXCLUSION LIABILITY ARISING OUT OF LEAD This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS COVERAGE PART This insurance does not apply to 1. bodily injury property damage or per sonal and advertising injury arising out of resulting from or in any way caused by or related to the actual alleged or threatened ingestion inhalation absorption or exposure to lead in any form from any source or 2. any loss cost expense liability or other type of obligation arising out of or resulting from or in any way related to any a. claim suit request demand directive or order by or on behalf of any person en tity or governmental authority that any In sured or others test for monitor clean up remove contain treat detoxify neu tralize or in any way respond to or as sess the effects of lead in any form from any source or to any b. claim or suit by or on behalf of any per son entity or governmental authority for damages or any other relief or remedy because of testing for monitoring clean ing up removing containing treating or detoxifying or heutralizing or in any way responding to or assessing the effects of lead in any form. We shall not be obligated to investigate on behalf of an Insured or to defend or indemnify an In sured or any persoh or entity claiming any right under the policy for the matters excluded in this endorsement. Includes copyrighted material of Insurance Services Office Inc. with its permission. Copyright Insurance Services Office Inc 1998 CG 77 94 Ed 0798 XS
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AES 3103 Ed. 04 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. METAL GAS EXCLUSION This insurance does not apply to Bodily Injury Property Damage Personal and Advertising Injury arising out of or allegedly due to the existence inhalation exposure to or contact with Manganese Aluminum Zinc Magnesium Cadmium Nickel Beryllium Chromium Arsenic Iron Iron Oxide Copper Copper Oxide or any other metal gas fume or metal by product of metal heating processing or welding. AES 3103 Ed. 0411 XS
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AES 3045 Ed. 08 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AIRCRAFT PRODUCTS AND GROUNDING LIABILITY EXCLUSION This insurance does hot apply to liability arising out of aircraft products or reliance upon any representation or warranty made with respect thereto or any liability arising out of the grounding of any aircraft including missiles and spacecraft. Aircraft products means aircraft including missiles or spacecraft or any ground support or control equipment used therewith any aircraft part and goods or products installed in or on aircraft or used in cohnection with aircraft manufactured sold handled or distributed or services provided or recommended by any insured or by others trading under any insured s name. Aircraft products includes tooling used in the manufacture of aircraft products and also includes ground handling tools and equipment training aids instructions manuals blueprints engineering and other data engineering and other advice and services and labor relating to aircraft products. Grounding means the withdrawal of one or more aircraft including missiles or spacecraft from flight operations or the imposition of speed passenger or load restrictions on such aircraft by reason of the actual alleged or suspected existence of any defect fault or condition in such aircraft or any part thereof a sold handled or distributed by any insured or b manufactured assembled or processed by any other person or organization according to your specifications plans suggestions orders or drawings of any insured or with tools machinery or other equipment furnished to such persons or organizations by any insured whether such aircraft so withdrawn or restricted is or are owned or operated by the same or other persons or organizations. This endorsement does not change any other provision of the policy. AES 3045 Ed. 0807 XS
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AES 3229 Ed. 11 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYERS LIABILITY EXCLUSION ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM Exclusion e. Employer s Liability under paragraph 2. Exclusions of SECTION COVERAGES Bodily Injury and Property Damage Liability is deleted and replaced by the following e. Employer s Liability Bodily injury to 1 an employee of any insured arising out of and in the course of a employment by any 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 1 whether the Insured may be liable as an employer or in any other capacity 2 to any obligation to share damages with or repay someone else who must pay damages because of the injury and 3 to liability assumed by any insured under an insured contract. This endorsement does not change any other provision of the Policy. AES 3229 Ed. 1110 XS
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CG 21 34 Ed. 01 87 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION DESIGNATED WORK This endorsement modifies insurance provided under the following COVMERC IAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Installation Description of your work 1f no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. The insurance does not apply to bodily injury or property damage included in the products completed operations hazard and arising out of your work shown in the Schedule. Copyright Insurance Services Office Inc. 1986 CG 21 34 Ed. 0187 PRO Page 1 of 1
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Administrative Offices 01 E 4th Street Cincil i Ohio 45202 4201 GREATAMERICAN ToF 1 515 365 5000 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 78 72 Ed. 03 99 EARTH MOVEMENT EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART This insurance does not apply to any bodily injury property damage or personal and advertising injury personal injury or advertising injury directly or indirectly arising out of caused by resulting from contributed to or aggravated by subsidence expanding contracting rising settling sinking slipping falling away caving in shifting eroding mudflow tilting heaving cratering doming or any other movement of land soil or earth including but not limited to earthquake landslide mudslide or mine subsidence whether such movement of land soil or earth occurs alone in combination with before after or concurrently with any other cause contributing condition or aggravating factor either manmade or hatural. This endorsement does not change any other provision of the policy. CG 78 72 Ed. 0399 XS
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301 E 4th Street Cincinnati Ohio 45202 4201 GREATAMERICAN Tol 1 513 366 5000 r IL 73 24 Ed. 08 12 THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY. ECONOMIC AND TRADE SANCTIONS CLAUSE This insurance does hot apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing insurance. IL 73 24 Ed. 0812
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301 E 4th Street Cincinnati Ohio 45202 4201 GREATAMERICAN Tol 1 513 366 5000 r AES 3004 Ed. 05 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PREMIUM AUDIT CONDITION AMENDMENT Condition 5. Premium Audit Section IV is re placed by the following 5. Premium Audit Minimum Premium Mini mum Retained Premium a. We will compute all premiums for this Coverage Form in accordance with the terms and conditions of this policy. b. Premium shown in this policy as Advance Premium is a deposit premium. At the close of each audit period we will com pute the earned premium for that period. Audit premiums are due and payable upon notice to the first Named Insured. If the sum of the Advance and Audit Premiums paid for the policy term is greater than the earned premium we will return the excess to the first Named Insured subject to the minimum and minimum retained premiums described below.. In no event will the final premium retained by us be less than the minimum premium shown in the Declarations of this policy. If nho other premium is desighated specifi cally as a minimum premium. Such mini mum premium the Advance Premium shown in the Declarations is the minimum premium. Such minimum premium is sub ject to the short rate or prorate adjust ment according to policy provisions in case of cancellation of the policy.. This policy is also subject to a minimum retained premium of 25 of the Advance Premium shown in the Declarations of this policy. Such minimum retained premium is hot subject to prorate or short rate ad justment in the event of cancellation by you and we shall retain no less than the minimum retained premium regardless of the policy term. Cancellation of the policy for non payment of premium shall be deemed a request by you for cancellation of this policy thereby invoking the mini mum retained premium unless the short rate calculation earns more than the mini mum retained premium.. 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. AES 3004 Ed. 0501 XS
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GREAT AMERICAN E S INSURANCE COMPANY PLEASE READ THIS CAREFULLY. SURPLUS LINES NOTIFICATION THE INSURANCE COMPANY WITH WHICH THIS COVERAGE HAS BEEN PLACED IS NOT LICENSED BY THE STATE OF NORTH CAROLINA AND IS NOT SUBJECT TO ITS SUPERVISION. IN THE EVENT OF THE INSOLVENCY OF THE INSURANCE COMPANY LOSSES UNDER THIS POLICY WILL NOT BE PAID BY ANY STATE INSURANCE GUARANTY OR INSOLVENCY FUND. NAME AND LICENSE NUMBER OF BROKER OR AUTHORIZED REPRESENTATIVE NCSN Ed. 0304 XS
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301 E 4th Street Cincinnati Ohio 45202 4201 GREATAMERICAN Tol 1 513 366 5000 r IL 72 10 Ed. 01 08 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT Rejection Of Offer You have rejected the offer of terrorism coverage for Acts of Terrorism that are certified under the Terrorism Risk Insurance Act as an Act of Terrorism. An exclusion of terrorism losses has been made a part of this policy. 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 hot make any payment for any portion of the amount of such losses that exceeds 100 billion. You have rejected this offer of coverage. IL 72 10 Ed. 0108 XS
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CG 2175 Ed. 06 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF CERTIFIED ACTS OF TERRORISM AND EXCLUSION OF OTHER ACTS OF TERRORISM COMMITTED OUTSIDE THE UNITED STATES This endorsement modifies insurance under the following COMIMERCIAL 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 2. fifty or more persons sustain death or serious physical injury. For the purposes of this provision serious physical injury means a. physical injury that involves a substan tial risk of death or b. protracted and obvious physical dis figurement or. protracted loss of or impairment of the function of a bodily member or organ or 3. the terrorism involves the use release or escape of nuclear materials or directly or indirectly results in huclear reaction or ra diation or radioactive contamination or 4. the terrorism is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemical ma terials or 5. pathogenic or poisonhous biological or chemical materials are released and it ap pears that one purpose of the terrorism was to release such materials. With respect to this exclusion paragraphs 1. and 2. describe the thresholds used to mea sure the magnitude of an incident of an other act of terrorism and the circumstances in Terrorism Any injury or damage arising directly or in directly out of a certified act of terrorism or out of an other act of terrorism that is committed outside of the United States in cluding its territories and possessions and Puerto Rico but within the coverage terri tory. However with respect to an other act of terrorism this exclusion applies only when one or more of the following are attributed to such act 1. the total of insured damage to all types of property exceeds 25000000 valued in US dollars. In determining whether the 25000000 threshold is exceeded we will include all insured damage sustained by property of all persons and entities affected by the terrorism and business in terruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision insured damage means damage that is covered by any insurance plus damage that would be covered by any insurance but for applica tion of any terrorism exclusions or Copyright I1SO Properties Inc 2008 Page 1 of 2 CG 21 75 Ed. 0608 XS
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which the threshold will apply for the purpose of determining whether this exclusion will ap ply to that incident B. The following definitions are added 1. For the purposes of this endorsement any injury or damage means any injury or damage covered under any coverage part to which this endorsement is applica ble and includes but is not limited to bodily injury property damage per sonal and advertising injury injury or environmental damage as may be defined in any applicable coverage part. 2. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in concurrence with the Sec retary of State and the Attorney General of the United States to be an act of ter rorism pursuant to the federal Terrorism Risk Insurance Act The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following a. the act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insur ance Act b. the act resulted in damage 1 within the United States including its territories and possessions and Puerto Rico or 2 outside of the United States in the case of a an air carrier as defined in Section 40102 of title 49 United States Code or Unit ed 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 regu lation in the United States regardless of where the loss occurs or b the premises of any United States mission and c. 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. 3. Other act of terrorism means a violent act or an act that is dangerous to human life property or infrastructure that is committed by an individual or individuals and that appears to be part of an effort to coerce a civilian population or to influence the Policy or affect the conduct of any government by coercion and the act is not a certified act of terrorism. Multiple incidents of an other act of ter rorism which occur within a seventy two hour period and appear to be carried out in concert or to have a related purpose or common leadership shall be considered to be one incident. C. In the event of any incident of a certified act of terrorism or an other act of terrorism that is not subject to this exclusion coverage does not apply to any loss or damage that is otherwise excluded under this Coverage Part. Copyright 1SO Properties Inc 2008 Page 2 of 2 CG 21 75 Ed. 0608 XS
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CG 21 76 Ed. 01 08 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 Trea sury in concurrence with the Secretary of State and the Attorney General of the United States to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act The criteria contained in the Terrorism Risk Insur ance Act for a certified act of terrorism include the following 1. the act resulted in insured losses in ex cess of 5 million in the aggregate attrib utable to all types of insurance subject to the Terrorism Risk Insurance Act and 2. the act is a violent act or an act that is dangerous to human life property or in frastructure and is committed by an in dividual 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. Copyright 1SO Properties Inc 2007 CG 21 76 Ed 0108 XS
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Administrative Offices 301 E 4th Street Cincinnati Ohio 45202 4201 GREATAMERICAN Tel 1 513 368 5000 CG 83 66 Ed. 06 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR BIOLOGICAL OR CHEMICAL EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM COVERAGE FOR OPERATIONS OF DESIGNATED CONTRACTORS A. The following exclusion is hereby added to paragraph 2. Exclusions of SECTION COVERAGE A. Bodily Injury and Property Damage Liability of the Commercial Gen eral Liability Coverage Form and to para graph 2. Exclusions of SECTION I. COV ERAGES of the Owners and Contractors Protective Liability Coverage Form Cov erage for Operations of Designated Con tractor 2. Exclusions Nuclear Biological or Chemical Notwithstanding any other provision of this policy this insurance does not apply to any bodily injury or property damage caused directly or indirectly in whole or in part by any of the following regardless of any other causes or events that may contribute concurrently or in any other sequence to the bodily injury or prop erty damage Any actual attempted suspected or threatened use of any NBC material as part of any plan effort or design actually or apparently intended to cause any a loss or damage to any tangible or intangible property or b bodily injury or emotional dis tress. 2 Any actual attempted suspected or threatened presence spread dissemi nation release escape or distribution of any NBC material as a direct or indirect result of any actual attempted suspected or threatened plan effort or desigh actually or gpparently in tended to cause any a loss or damage to any tangible or intangible property or b bodily injury or emotional dis tress. NBC Material means any nuclear bio logical or chemical material or substance that causes damage to property or is harmful to human health. NBC material includes but is not limited to 1 any radioactive substance or material and the radiation it releases 2 any pathogen bacterium microbe virus or other organism 3 any substance or material produced by or from any pathogen bacterium mi crobe virus or other organism and 4 any poison toxin or other harmful chemical substance or material. The foregoing list 1 through 4 is only illustrative and should not be construed as a complete exclusive or exhaustive list of all NBC materials. B. The following exclusion is hereby added to paragraph 2. Exclusions of SECTION I COVERAGE B. Personal and Advertising In jury Liability of the Commercial General Li ability Coverage Form CG 83 66 Ed. 0605 XS Page 1 of 2
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2. Exclusions Nuclear Biological or Chemical Notwithstanding any other provision of this policy this insurance does not apply to any personal or advertising injury caused directly or indirectly in whole or in part by any of the following regardless of any other causels or events that may contribute concurrently or in any other sequence to the personal and advertising injury 1 Any actual attempted suspected or threatened use of any NBC material as part of any plan effort or design actually or apparently intended to cause any a loss or damage to any tangible or intangible property or b bodily injury or emotional dis tress. 2 Any actual attempted suspected or threatened presence spread dissemi nation release escape or distribution of any NBC material as a direct or indirect result of any actual attempted suspected or threatened plan effort or desigh actually or apparently in tended to cause any a loss or damage to any tangible or intangible property or b bodily injury or emotional dis tress. NBC Material means any nuclear bio logical or chemical material or substance that causes damage to property or is harmful to human health. NBC material includes but is not limited to 1 any radioactive substance or material and the radiation it releases 2 any pathogen bacterium microbe virus or other organism 3 any substance or material produced by or from any pathogen bacterium mi crobe virus or other organism and 4 any poison toxin or other harmful chemical substance or material. The foregoing list 1 through 4 is only illustrative and should not be construed as a complete exclusive or exhaustive list of all NBC materials. This endorsement does not change any other provision of the policy. CG 83 66 Ed. 0605 XS Page 2 of 2
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A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY PRIOR POLICY 4D9 85 92 GENERAL LIABILITY DECLARATIONS POLICY PERIOD FROM 101714 TO 101715 POLICY NUMBER 4D9 85 9 2 15 NAMED INSURED PRODUCER KAV CONTRACTING LLC LOCKTON COMPANIES LLC 318 N 16TH ST 1015 N 98TH ST STE 101 COUNCIL BLUFFS IA 51501 2532 OMAHA NE 68114 2357 AGENT AB 8210 AGENT PHONE 402 9706100 DIRECT BILL BENJAMIN J. STRUYK INSURED IS LLC BUSINESS DESC INTERIOR REMODELING LIMITS OF INSURANCE EACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT 300000 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 PROVIDED PREMIUM PRODUCTS COMPLETED OPERATIONS 4659.00 OTHER THAN PRODUCTS COMPLETED OPERATIONS 5618.00 SEE ATTACHED SCHEDULE FOR LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED. FORMS APPLICABLE CG00010413 CG21700108 CG71411001 CG71910113 CG21471207 CG21671204 CG7001A1012 CG70031013 CG7193.11013 CG72531296 CG75551013 CGB0810406 CG82540614 CGB2820414 CG21060514 G8283 0414 IL00210908 IL02590907 IL02760908 M CG2176 0108 IL70281005 IL7131A0401 IL73390511 IL8383.50108 IL8384A0108 IL85760909 AUDIT PERIOD ANNUAL DATE OF ISSUE 102714 BPP FORM CG7000A ED. 08 99 BPP 090814 003 LN 7MAISQBEQZ 1501 YAt A PN Al GENERAL LIABILITY DE POLICY PERIOD FROM 101714 TO 101715 318 N 16TH ST 1015 N 98TH ST STE 101 COUNCIL BLUFFS IA 51501 2532 OMAHA NE 68114 2357 AGENT AB 8210 AGENT PHONE 402 9706100 T BT T e T R vrrra ey EACH OCCURRENCE LIMIT DAMAGE TO PREMISES RENTED TO YOU LIMIT MEDICAL EXPENSE LIMIT PERSONAL AND ADVERTISING INJURY LIMIT GENERAL AGGREGATE LIMIT T TN T Ty P RATNT TR ITAT T R T ARTE T AT TIN R YT T TRA 100000 30000 1000 1000001 PRODUCTS COMPLETED OPERATIONS 4659.00 OTHER THAN PRODUCTS COMPLETED OPERATIONS 5618.00 AUDIT PERIOD ANNUAL
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A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D9 85 92 15 KAV CONTRACTING LLC EFF DATE 101714 EXP DATE 101715 POLICY ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM CG0001 04 13 COMMERCIAL GEN LIABILITY COV FORM 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 CG7001A 10 12 GENERAL LIABILITY SCHEDULE CG7003 10 13 GL QUICK REFERENCE OCCURRENCE CG7141 10 01 EXTENDED PROPERTY DAMAGE COVERAGE CG7191 01 13 COMML GENERAL LIABILITY AMENDMENT CG7193.1 10 13 AI OWN LESS CONTR INCL COMP OPS NAME ANY OR ALL PERSONS OR ORG. SUB.TO A WRITTEN CONTRACT REQ. SUCH AN ADDLT. INS. AGREEMENT PROJECT ADDRESS ANY CG7253 12 96 CONTRACTORS EXTENDED PROPERTY DAMAGE CG7555 10 13 BLKT WAIV SUBRO WRITTEN CONT AGREE CGB081 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 IL0021 09 08 NUCLEAR ENERGY LIAB EXCL BROAD FORM IL0259 09 07 NE CHANGES CANCELLATION NONRENEWAL IL0276 09 08 IA CHANGES CANCELLATION NONRENEWAL IL7028 10 05 ASBESTOS EXCLUSION IL7131A 04 01 COMML POLICY ENDORSEMENT SCHEDULE IL7339 05 11 DEFINITION OF YOUR WORK AMEND ENDST IL8383.5 01 08 DISCL PURSUANT TERRSM RISK INS. ACT PREMIUM THROUGH 123114 17 PREMIUM BEYOND 123114 66 IL8384A 01 08 TERRORISM NOTICE IL8576 09 09 MEDICARE IMPT NOTICE TO POLICYHOLDER DATE OF ISSUE 102714 FORM IL7131A ED. 04 01 003 N 4D98592 1501 EDITION AR TN T T T T AT TN T T AT R T T AT k e e I CG7001A CG7003 CG7141 CG7191 CG7193.1 CG7253 CG7555 CGB081 CG8254 CG8282 CG8283 IL0021 1L0259 IL0276 IL7028 IL7131A IL7339 I1.8383.5 IL8384A IL8576 12 96 10 13 04 06 06 14 04 14 04 14 08 08 09 07 09 08 10 05 04 01 05 11 01 08 01 08 09 09 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 COMML GENERAL LIABILITY AMENDMENT AI OWN LESS CONTR INCL COMP OPS NAME ANY OR ALL PERSONS OR ORG. SUB.TO A WRITTEN CONTRACT REQ. SUCH AN ADDLT. INS. AGREEMENT PROJECT ADDRESS ANY CONTRACTORS EXTENDED PROPERTY DAMAGE BLKT WAIV SUBRO WRITTEN CONT AGREE FUNGI BACTERIA NOTICE TO POLICYHOLDR ADVISORY NOTICE TO POLICYHOLDERS ADVISORY NOTICE TO POLICYHOLDERS ADVISORY NOTICE TO POLICYHOLDERS NUCLEAR ENERGY LIAB EXCL BROAD FORM NE CHANGES CANCELLATION NONRENEWAL IA CHANGES CANCELLATION NONRENEWAL ASBESTOS EXCLUSION COMML POLICY ENDORSEMENT SCHEDULE DEFINITION OF YOUR WORK AMEND ENDST DISCL PURSUANT TERRSM RISK INS. ACT PREMIUM THROUGH 123114 PREMIUM BEYOND 123114 TERRORISM NOTICE MEDICARE IMPT NOTICE TO POLICYHOLDER wn 6 wn
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A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D9 85 92 15 KAV CONTRACTING LLC EFF DATE 101714 EXP DATE 101715 TERRORTIGSM NOTICE 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 102714 FORM IL8384A 01 08 003 LN 4D98592 1501 KAV CONTRACTING LLC EFF DATE 101714 EXP DATE 1017 TERRORTIGSM NOTICE 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 TERRORTIGSM NOTICE 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
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A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D9 85 92 15 KAV CONTRACTING LLC EFF DATE 101714 EXP DATE 101715 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. DISCLOSURE PURSUANT T O TERRORISM RISK INSURANCE SCHEDULE Terrorism Premium Certified Acts A. Premium through end of year 123114 17.00 B. Premium beyond the date specified above 66.00 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 102714 continued FORM IL8383.5 01 08 003 N 4D98592 1501 This disclo disclosure This disclo and conditi T E A. DISCLOSU In accor required your prer certifiec to such the polic w DISCLOSUE The Unite a share c federal insured 1 However certifiec in a Proc not make that exce C. CAP ON IN If aggrec under the Program 3 insurer not be 1i losses tk up to tha with proc D. PREMIUM B The premi based in losses as federal r the end o unless ex is extend attributa If the Fe coverage the cover attributa to your policy in response to the he Terrorism Risk Insurance Act. nt any coverage or change the terms je under the policy. R E PURSUANT T O ISK INSURANCE d Acts f year 123114 17.00 ce specified above 66.00 below jeral Terrorism Risk Insurance Act we are ith a notice disclosing the portion of ributable to coverage for terrorism acts The portion of your premium attributable in the schedule of this disclosure or in 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 U IN PAYMENT OF TERRORISM LOSSES attributable to terrorist acts certified surance Act exceed 100 billion in a ough December 31 and we have met our Terrorism Risk Insurance Act we shall it of any portion of the amount of such lion and in such case insured losses t to pro rata allocation in accordance by the Secretary of the Treasury. IFIED IN THE SCHEDULE ABOVE ts of terrorism coverage is calculated. participation in payment of terrorism errorism Risk Insurance Act. The by the Act is scheduled to terminate at d in the Schedule of this endorsement al government. If the federal program wn in B in the Schedule shall be terrorism acts certified under the act. nates your policy will still contain sm unless you have elected to exclude hown in B of the schedule shall be e for terrorism.
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A EMC Insurance Companies Page 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D9 85 9215 KAV CONTRACTING LLC EFF DATE 101714 EXP DATE 101715 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 102714 FORM IL8383.5 01 08 003 LN 4D98592 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 copyvrighted material of ISO Properties Inc. with its permission
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A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D9 85 92 15 KAV CONTRACTING LLC EFF DATE 101714 EXP DATE 101715 GENERAL LIABILITY SCHEDULE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 001 87224 25 CONTRACTORS EXTENDED PROPERTY DAMAGE ENDORSEMENT PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87711 1 DAMAGE TO PREMISES RENTED TO YOU LIMITS 1 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87781 OWNERS LESSEES OR CONTRACTORS INCL COMPL OPS PRIMARY NONCONTRIBUTORY ADDL INSURED G7193.1 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 ADDITIONAL INTEREST 1 334 ANY OR ALL PERSONS OR ORG. 87786 BLANKET WAIVER OF SUBROGATION PREMIUM BASIS FLAT CHARG EXPOSURE 1 i SUBLINE 334 87793 INCREASE MEDICAL PAYMENTS PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 91342 CARPENTRY NOC PREMIUM BASIS 1 THOUSANDS OF PAYROLL EXPOSURE 175000 SUBLINE 336334 DATE OF ISSUE 102714 BPP CONTINUED FORM CG7001A ED.10 12 BPP 090814 003 N 4D98592 1501.TENDED PROPERTY. ey Y ADDL INSURED EREST 1 334 OF SUBROGATION S 1 e ay AL PAYMENTS S..YROLL 75000
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A EMC Insurance Companies PAGE 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D9 85 92 15 KAV CONTRACTING LLC EFF DATE 101714 EXP DATE 101715 LITY SCHEDULE NUED 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 GENERAL L c EXPOSURE IF ANY SUBLINE 334 91585 o3.41118 0 CONTRACTORS SUBCONT WORK IN CONNECT WITH CONST RECONST REPAIR OR EREC TION OF BUILDINGS NOC PREMIUM BASIS THOUSANDS OF TOTAL COST EXPOSURE IF ANY SUBLINE 3236334 LOCATION 002 91342 CARPENTRY NOC PREMIUM BASIS t THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 f 91585 1 0.3491 0 t CONTRACTORS SUBCONT WORK IN CONNECT WITH CONST RECONST REPAIR OR EREC TION OF BUILDINGS NOC PREMIUM BASIS THOUSANDS OF TOTAL COST EXPOSURE IF ANY SUBLINE 336334 PREMIUM FOR CERTIFIED ACTS OF TERRORISM 83.00 TOTAL ESTIMATED POLICY PREMIUM 10277.00 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 DATE OF ISSUE 102714 BPP CONTINUED FORM CG7001A ED.10 12 BPP 090814 003 LN 4D98592 1501 St PAYROLL CLASSIFICATION CODE
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A EMC Insurance Companies PAGE 3 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D9 85 92 15 KAV CONTRACTING LLC EFF DATE 101714 EXP DATE 101715 GENERAL LIABILTI CONTINU LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIE RATED LOCATIONS LOC 001 1511 AVENUE L COUNCIL BLUFFS IA 51501 1182 LOC 002 UNKNOWN OMAHA NE 68101 DATE OF ISSUE 102714 BPP FORM CG7001A ED.10 12 BPP 090814 003 LN 4D98592 1501 RATED LOCATIONS LOC 001 1511 AVENUE L COUNCIL BLUFFS IA 51501 1182 LOC 002 UNKNOWN OMAHA NE 68101 LOC 002 UNKNOWN OMAHA NE 68101
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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 I WHOISANINSURED............ SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS Bankruptey...... 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 WhenWe Do NotRenew................... COMMON POLICY CONDITIONS Cancellation Changes Examination Of Your Books And Records Inspections And Surveys Premiums Insuring Agreement................. Exclusions Insuring Agreement Exclusions Insuring Agreement Exclusions Transfer Of Your Rights And Duties Under This Policy ENDORSEMENTS if Any Beginning on Page CG700310 13 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under Section Il Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section Hl 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 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. I 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. 2 CG 00010413 Insurance Services Office Inc. 2012 Page 1 of 16
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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. 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 b 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. CG 00010413 Insurance Services Office Inc. 2012 Page 2 of 16
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f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a At 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 focation has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not and never was owned or occupied by or rented or loaned to any insured other than that additional insured or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire b At or from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste c Which are or were at any time transported handled stored treated disposed of or processed as waste by or for i Any insured or ii Any person or organization for whom you may be legally responsible or d At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by such insured contractor or subcontractor. However this subparagraph does not apply to i Bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or released as part of the operations being performed by such insured contractor or subcontractor i Bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the operations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. CG 00010413 Insurance Services Office Inc. 2012 Page 3 of 16
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5 Bodily injury or property damage arising out of a The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or The operation of any of the machinery or equipment listed in Paragraph f.2 or f3 of the definition of mobile equipment. h. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any 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 undeciared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or 3 Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. 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 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 poliutants or Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a governmental authority. g. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or b 4 Insurance Services Office Inc. 2012 CG 00010413 Page 4 of 16
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