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Policy Number TBC Z91 469603 010 Issued by Employers Insurance Co. Wausau THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Land or Earth Movement Exclusion This endorsement modifies the insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY NEW YORK insurance does not apply to bodily injury property damage or personal or advertising injury directly or indirectly d by arising out of relating to resulting from attributable to contributing to or aggravated by any actual or alleged land or earth movement. P Land or earth movement means movement in any direction including but not limited to instability rising upheaval expansion settling sinking shrinkage slipping falling away tilting caving in eroding shifting in a horizontal or sideways direction mud flow mudslide volcanic eruption or earthquake or any other movement of land or earth regardless of the cause whether manmade or natural. LC 21 64 08 07 Page 1 of 1 | 2 |
Policy Number TBC Z91 469603 010 Issued by Employers Insurance Co. Wausau THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RESIDENTIAL CONSTRUCTION OPERATIONS EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART This insurance does not apply to bodily injury property damage or personal and advertising injury resulting from residential construction operations whether ongoing or completed. If a residential construction project includes a component that is intended for commercial non residential use this exclusion shall not apply to that portion of the structure or project. Residential construction includes but is not limited to construction reconstruction demolition remodeling or repair of any phase of construction or site preparation for the following types of residential structures single or multi family dwellings tract homes apartments townhomes condominiums or any mixed use structures with a residential component but does not include hotels motels nursing homes college campus dormitories or government housing on military bases. 2011 Liberty Mutual Group of Companies. All rights reserved. Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 1 LC 21681011 | 2 |
Policy Number TBC Z91 469603 010 Issued by Employers Insurance Co. Wausau THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Damage First Occurring Prior to Policy Period Exclusion This endorsement modifies the insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART This insurance does not apply to bodily injury or property damage within the products completed operations hazard if the injury or damage first occurred prior to the effective date of this policy. Page 1 of 1 LG 3205 06 05 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMUNICABLE DISEASE EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Communicable Disease Bodily injury or property damage arising out of the actual or alleged transmission of a com municable disease. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the a. Supervising hiring employing training or monitoring of others that may be infected with and spread a communicable disease b. Testing for a communicable disease c. Failure to prevent the spread of the dis ease or d. Failure to report the disease to authorities. Exclusions of Section Coverage B Person al And Advertising Injury Liability 2. Exclusions This insurance does not apply to Communicable Disease Personal and advertising injury arising out of the actual or alleged transmission of a com municable disease. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the a. Supervising hiring employing training or monitoring of others that may be infected with and spread a communicable disease b. Testing for a communicable disease c. Failure to prevent the spread of the dis ease or d. Failure to report the disease to authorities. CG 21 3205 09 Insurance Services Office Inc. 2008 Page 1 of 1 | 2 |
POLICY NUMBER TBC Z291 469603 010 t 1 DL TR0V IV IL 01210908 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ALASKA CHANGES ATTORNEY S FEES This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART COMMERCIAL PROPERTY LEGAL LIABILITY COVERAGE FORM COMMERCIAL PROPERTY MORTGAGEHOLDER S ERRORS AND OMISSIONS COVERAGE FORM FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART SCHEDULE Attorney s Fees For A Judgment Of Additional Premium Not to exceed policy limits. Included. In any suit we defend in Alaska our obligation under Supplementary Payments to pay all costs taxed against the insured is amended by the following A. We will pay that portion of the attorney s fees awarded as costs which does not exceed the amount allowed for a contested case in the sched ule of attorney s fees contained in Alaska Civil Rule 82 for a judgment equal to the applicable Limit of Insurance. B. Information required to complete this Schedule if not shown above will be shown in the Declarations. However if a premium and a judgment amount are shown in the Schedule we will pay instead of the attorney s fees provided in Paragraph A. above that portion of the attorney s fees awarded as costs which do not exceed the amount allowed for a contested case in Civil Rule 82 for the judg ment amount shown in the Schedule. Insurance Services Office Inc. 2008 Page 1 of 1 IL 01210908 | 2 |
IL 0128 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RHODE ISLAND CHANGES PREJUDGMENT INTEREST This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART COMMERCIAL PROPERTY LEGAL LIABILITY COVERAGE FORM COMMERCIAL PROPERTY MORTGAGEHOLDER S ERRORS AND OMISSIONS COVERAGE FORM EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK COVERAGE PART The paragraph in the Supplementary Payments Section relating to prejudgment interest is replaced by the following 1. Prejudgment interest awarded against you on the entire judgment if we reject a written settlement of fer by the plaintiff that is equal to or less than the applicable limit of insurance in this policy or 2. If Paragraph 1. above does not apply prejudg ment interest awarded against you on that part of the judgment we pay. For the Commercial General Liability Coverage Part Commercial Liability Umbrella Coverage Part Employment related Practices Liability Cov erage Part Farm Coverage Part Farm Umbrella Liability Policy Liquor Liabilty Coverage Part Owners And Contractors Protective Liability Cov erage Part Pollution Liability Coverage Part Prod ucts Completed Operations Liability Coverage Part Medical Professional Liability Coverage Part Railroad Protective Liability Coverage Part and the Underground Storage Tank Policy the word you is replaced by the term the insured. ISO Properties Inc. 2007 Page 1 of 1 IL 012809 08 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONNECTICUT CHANGES CIVIL UNION IL 01 40 09 08 This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART A. The term spouse is replaced by the following Spouse or party to a civil union recognized under Connecticut law. B. Under the Commercial Auto Coverage Part the term family member is replaced by the following Family member means a person related to the 1. Individual Named Insured by blood adoption marriage or civil union recognized under Con necticut law who is a resident of such Named Insured s household including a ward or foster child or 2. Individual named in the Schedule by blood adoption marriage or civil union recognized under Connecticut law who is a resident of the individual s household including a ward or fos ter child if the Drive Other Car Coverage Broadened Coverage For Named Individual Endorsement is attached. C. With respect to coverage for the ownership main tenance or use of covered autos provided under the Commercial Liability Umbrella Coverage Part or Farm Umbrella Liability Policy the term family member is replaced by the following Family member means a person related to you by blood adoption marriage or civil union recog nized under Connecticut law who is a resident of your household including a ward or foster child. C. With respect to coverage for the ownership main tenance or use of covered autos provided under the Commercial Liability Umbrella Coverage Part or Farm Umbrella Liability Policy the term family member is replaced by the following Family member means a person related to you by blood adoption marriage or civil union recog nized under Connecticut law who is a resident of your household including a ward or foster child. ISO Properties Inc. 2007 Page 1 of 1 IL 01 40 09 08 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. IL 0199 09 08 ARKANSAS CHANGES TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART FARM LIABILITY COVERAGE FORM FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY 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 COVERAGE PART The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition We will be entitled to recovery only after the insured insured has been fully compensated for the loss or damage sustained including expenses incurred in obtaining full compensation for the loss or damage. ISO Properties Inc. 2007 Page 1 of 1 IL 0199 09 08 | 2 |
IMPORTANT NOTICE TO POLICYHOLDERS PREMIUM DETERMINATION SUBCONTRACTORS Do you employ independent contractors or subcontractors If so you may be subject to added insurance costs. You can minimize these added insurance costs by obtaining valid certificates of insurance from all of your independent contractors and subcontractors indicating the presence of liability insurance. These certificates should be maintained for review by our auditor. Such certificates must 1. Specify an Each Occurrence Limit at least equal to 1000000 2. Specify the insurance is written on an occurrence basis 3. Specify insurance that is effective during the entirety of the course of their work for you. Failure to provide adequate certificates of insurance for any contractor or subcontractor will result in the inclusion of those exposures in the calculation of your primary insurance premium. Recent court decisions have held general or principle contractors liable for the acts of uninsured subcontractors. If you are able to produce valid certificates at the time of audit an appropriate subcontracted work class such as the following will be added to your exposures such as Contractors Subcontracted Work in connection with building construction reconstruction repair or erection apartment or office buildings over four stories. This is a secondary or contingent insurance charge based on the availability of other insurance which may apply to aloss involving you and your independent contractors or subcontractors. 2013 Liberty Mutual Insurance. All rights reserved. Page 1 of 1 CNL 90011013 | 2 |
Kentucky Notice to Policyholders This policy includes a surcharge that has been added to your insurance premium as required by Kentucky Revised Statutes 136.392. Currently Section 136.3921a of KRS imposes a surcharge of 1.50 per 100 of premium for insurance coverage provided to policyholders with exposures in Kentucky. Effective April 1 2010 this surcharge amount is increased from 1.50 to 1.80 per 100 of premium. The funds collected from the surcharge will provide sufficient funds for the uses and purposes of the Firefighters Foundation Program fund and the Law Enforcement Foundation Program fund. Insurance companies have been directed to collect this surcharge from their policyholders. We will collect the surcharge at the same time that we bill and collect your premium. The amount will be identified on your policy as Kentucky Surcharge. 2010 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 EN 9009 0110 | 2 |
Policy Number TBC Z91 469603 010 Issued by Employers Insurance Co. Wausau West Virginia Property and Casualty Policy Surcharge Your policy is subject to a West Virginia Surcharge. The amount will be identified on your policy as West Virginia Surcharge. Companies writing insurance in West Virginia are required by law to surcharge all West Virginia exposures a specified amount and remit it to the state. West Virginia distributes the monies collected to provide additional revenue to volunteer fire departments and part volunteer fire departments. 2008 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 EN 90 14 07 09 | 2 |
Policy Number TBC Z91 469603 010 Issued by Employers Insurance Co. Wausau NOTICE TO OUR MISSOURI POLICYHOLDERS Commercial General Liability In accordance with Missouri Insurance Department regulation 20 CSR 500 4.100 7A we are required to notify you the premium for this policy includes Schedule Rating Modifications for the conditions shown below that are not otherwise reflected in the rating of this policy Credit Debit Applied Explanation Comments a. 25 Location Exposure inside Debit premises b. Location Exposure outside premises Premises Condition Care Comments Debit Equipment Type Condition Care Classification Peculiarities Employees Selection Training Supervision Experience Cooperation Medical Facilities Cooperation Safety Program Total 25 These factors have been applied to the annual rates for your exposures in the state of Missouri. 2015 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1of 1 EN90310315 | 2 |
Policy Number TBC Z91 469603 010 Issued by Employers Insurance Co. Wausau NOTICE TO OUR NEW MEXICO POLICYHOLDERS Commercial General Liability In accordance with New Mexico Administrative Code Title 13 Chapter 8 Part 5 13 NMAC 8.5 we are required to notify you the premium for this policy includes Schedule Rating Modifications for the conditions shown below that are not otherwise reflected in the rating of this policy Credit Debit Applied Explanation Possible Range Comments a. 5 Location Exposure inside Debit premises 10 to 10 Comments Debit Location Exposure outside premises 10 to 10 Premises Condition Care 20 to 20 Equipment Type Condition Care 20 to 20 Classification Peculiarities 20 to 20 20 Debit Employees Selection Training Supervision Experience 12 to 12 Cooperation Medical Facilities 4 to 4 Cooperation Safety Program 4 to 4 Total 25 These factors have been applied to the annual rates for your exposures in the state of New Mexico. The following experience modification has also been applied to your rates N A. 2015 Liberty Mutual Insurance Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1of 1 EN 9056 0315 | 2 |
LIBERTY MUTUAL GROUP CALIFORNIA PRIVACY NOTICE Commercial Lines excluding Workers Compensation Effective January 1 2020 Liberty Mutual Group and its affiliates subsidiaries and partners collectively Liberty Mutual or we us and our provide insurance to companies and other insurers. This Privacy Notice explains how we gather use and share your data. This Privacy Notice applies to you if you are a Liberty Mutual commercial line insured or are a commercial line claimant residing in California. It does not apply to covered employees or claimants under Workers Compensation policies. If this notice does not apply to you go to libertymutual.comprivacy to review the applicable Liberty Mutual privacy notice. What Data Does Liberty Mutual Gather We may collect the following categories of data o Identifiers including a real name alias postal address unique personal identifier online identifier Internet Protocol address email address account name Social Security Number driver s license number or other similar identifiers e Personal information described in California Civil Code 1798.80e such as your name signature Social Security Number physical characteristics or description address telephone number driver s license or state identification card number insurance policy number education employment employment history bank account number financial information medical information or health insurance information o Protected classification characteristics including age race color national origin citizenship religion or creed marital status medical condition physical or mental disability sex including gender gender identity gender expression pregnancy or childbirth and related medical conditions sexual orientation or veteran or military status o Commercial information including records of personal property products or services purchased obtained or considered or other purchasing or consuming histories and tendencies o Internet or other similar network activity including browsing history search history information on a consumer s interaction with a website application or advertisement e Professional or employment related information including current or past job history or performance evaluations o Inferences drawn from other personal information such as a profile reflecting a person s preferences characteristics psychological trends predispositions behavior attitudes intelligence abilities and aptitudes e Risk data including data about your driving andor accident history this may include data from consumer reporting agencies such as your motor vehicle records and loss history information health data or criminal convictions and o Claims data including data about your previous and current claims which may include data regarding your health criminal convictions third party reports or other personal data. For information about the types of personal data we have collected about California consumers in the past twelve 12 months please go to libertymutual.comprivacy and click on the link for the California Supplemental Privacy Policy. How We Get the Personal Data We gather your personal data directly We also gather your personal data from other people. For from you. For example you provide us example with data when you o ask about buy insurance or file a claim o your insurance agent or broker o pay your policy e your employer association or business if you are insured through them o Visit our websites call us or visit our e our affiliates or other insurance companies about your office transactions with them Insurance Services Office Inc. 2019 Page 1 of 6 SNI 04 010120 | 2 |
consumer reporting agencies Motor Vehicle Departments and inspection services to gather your credit history driving record claims history or value and condition of your property other public directories and sources third parties including other insurers brokers and insurance support organizations who you have communicated with about your policy or claim anti fraud databases sanctions lists court judgments and other databases government agencies open electoral register or in the event of a claim third parties including other parties to the claim witnesses expert loss adjustors and claim handlers other third parties who take out a policy with us and are required to provide your data such as when you are named as a beneficiary or where a family member has taken out a policy which requires your personal data For information about how we have collected personal data in the past twelve 12 months please go to libertymutual.comprivacy and click on the link for the California Supplemental Privacy Policy. How Does Liberty Mutual Use My Data Liberty Mutual uses your data to provide you with our products and services and as otherwise provided in this Privacy Notice. Your data may be used to Business Purpose Data Categories Identifiers Market sell and provide insurance. This includes o for example o Personal Information o calculating your premium o Protected Classification Characteristics o determining your eligibility for a quote o Commercial Information o confirming your identity and service your policy o Internet or other similar network activity o Professional or employment related information o Inferences drawn from other personal information o Risk data o Claims data Manage your claim. This includes for example o Identifiers e managing your claim if any Personal Information o conducting claims investigations o Protected Classification Characteristics e conducting medical examinations o Commercial Information o conducting inspections appraisals o Internet or other similar network activity o providing roadside assistance o Professional or employment related information o providing rental car replacement or repairs o Inferences drawn from other personal information o Risk data o Claims data Day to Day Business and Insurance Operations. Identifiers This includes for example o Personal Information o creating maintaining customizing and securing e Protected Classification Characteristics accounts o Commercial Information o supporting day to day business and insurance Internet or other similar network activity related functions o Professional or employment related information e doing internal research for technology e Inferences drawn from other personal information development o Risk data e marketing and creating products and services o Claims data o conducting audits related to a current contact with a consumer and other transactions nation sification Characteristics formation r similar network activity r employment related information wn from other personal information. determinidyouf eligibility for a quote o confirming your identity and service your policy managmg your clalm if an conducting claims investigations conducting medical examinations conducting inspections appraisals providing roadside assistance providing rental car replacement or repairs nation sification Characteristics formation r similar network activity r employment related information wn from other personal information Personal Information Protected Classification Characteristics Commercial Information Internet or other similar network activity Professional or employment related information Inferences drawn from other personal information Risk data Claims data Insurance Services Office Inc. 2019 Page 2 of 6 SNI 04010120 | 2 |
o as described at or before the point of gathering personal data or with your authorization Security and Fraud Detection. This includes for o Identifiers example o Personal Information o detecting security issues o Protected Classification Characteristics o protecting against fraud or illegal activity and to Commercial Information comply with regulatory and law enforcement e Internet or other similar network activity authorities o Professional or employment related information e managing risk and securing our systems e Inferences drawn from other personal information assets infrastructure and premises roadside Risk data assistance rental car replacement or repairs o Claims data o help to ensure the safety and security of Liberty staff assets and resources which may include physical and virtual access controls and access rights management e supervisory controls and other monitoring and reviews as permitted by law and emergency and business continuity management Regulatory and Legal Requirements. This includes Identifiers for example o Personal Information o controls and access rights management o Protected Classification Characteristics e to evaluate or conduct a merger divestiture Commercial Information restructuring reorganization dissolution or e Internet or other similar network activity other sale or transfer of some or all of Liberty s o Professional or employment related information assets whether as a going concern or as part of e Inferences drawn from other personal information bankruptcy liquidation or similar proceeding in o Risk data which personal data held by Liberty is among Claims data the assets transferred e exercising and defending our legal rights and positions o to meet Liberty contract obligations o to respond to law enforcement requests and as required by applicable law court order or governmental regulations o as otherwise permitted by law. Improve Your Customer Experience and Our e Identifiers Products. This includes for example o Personal Information e improve your customer experience our Commercial Information products and service o Internet or other similar network activity o to provide support personalize and develop our e Professional or employment related information website products and services o Inferences drawn from other personal information o create and offer new products and services o Risk data o Claims data Analytics to identify understand and manage our o Identifiers risks and products. This includes for example o Personal Information e conducting analytics to better identify e Protected Classification Characteristics understand and manage risk and our products o Commercial Information o Internet or other similar network activity o Professional or employment related information o Inferences drawn from other personal information o Risk data o Claims data Customer service and technical support. This e Identifiers includes for example o Personal Information e answer questions and provide notifications o Commercial Information o provide customer and technical support o Internet or other similar network activity o Professional or employment related information Personal Information Protected Classification Characteristics Commercial Information Internet or other similar network activity Professional or employment related information Inferences drawn from other personal information Risk data Claims data Personal Information Protected Classification Characteristics Commercial Information Internet or other similar network activity Professional or employment related information Inferences drawn from other personal information Risk data Claims data nation formation r similar network activity r employment related information wn from other personal information nation sification Characteristics formation r similar network activity r employment related information wn from other personal information understand and manage risk and our products network activity Insurance Services Office Inc. 2019 Page 3 of 6 SNI 04 010120 | 2 |
o Inferences drawn from other personal information o Risk data o Claims data How Does Liberty Mutual Share My Data Liberty Mutual does not sell your personal data as defined by the California Consumer Privacy Act. Liberty Mutual shares personal data of California consumers with the following categories of third parties o Liberty Mutual affiliates o Service Providers o Public entities and institutions e.g. regulatory quasi regulatory tax or other authorities law enforcement agencies courts arbitrational bodies and fraud prevention agencies e Professional advisors including law firms accountants auditors and tax advisors o Insurers re insurers policy holders and claimants and e As permitted by law. Liberty Mutual shares the following categories of personal data regarding California consumers to service providers for business purposes Identifiers Personal Data Protected Classification Characteristics Commercial Information Internet or other similar network activity Claims Data Inferences drawn from other personal information Risk Data Professional employment and education information For information about how we have shared personal information in the past twelve 12 months please go to libertymutual.comprivacy and click on the link for the California Supplemental Privacy Policy. What Privacy Rights Do Have The California Consumer Privacy Act provides California residents with specific rights regarding personal information. These rights are subject to certain exceptions. Our response may be limited as permitted under law. Access or Deletion You may have the right to request that Liberty Mutual disclose certain information to you about our collection and use of your personal data in the twelve 12 months preceding such request including a copy of the personal data we have collected. You also may have the right to request that Liberty Mutual delete personal data that Liberty Mutual collected from you subject to certain exceptions. Specifically you have the right to request that we disclose the following to you in each case for the twelve 12 month period preceding your request the categories of personal data we have collected about you the categories of sources from which the personal data wasf is collected our business or commercial purpose for collecting personal data the categories of third parties with whom we share personal data the specific pieces of data we have collected about you the categories of personal data about you if any that we have disclosed for monetary or other valuable consideration including the categories of third parties to which we have disclosed the data by category or categories of personal data for each third party to which we disclosed the personal data and o the categories of personal data about you that we disclosed for a business purpose. Personal Data Commercial Information Claims Data Risk Data Insurance Services Office Inc. 2019 Page 4 of 6 SNI 04010120 | 2 |
You can make a request by either Calling 800 344 0197 Online libertymutualgroup.comprivacypolicydatarequest Mail Attn Privacy Office Liberty Mutual Insurance Company 175 Berkeley St. 6th Floor Boston MA 02116 You may also make a verifiable consumer request on behalf of your minor child. You or your authorized agent may only make a verifiable consumer request for access or data deletion twice within a twelve 12 month period. The verifiable consumer request must provide sufficient information that allows Liberty Mutual to reasonably verify that you are the person about whom Liberty Mutual collected personal data or an authorized representative of such person and describe your request with sufficient detail that allows Liberty Mutual to properly understand evaluate and respond to it. For more information about how Liberty Mutual will verify your identity and how an authorized agent may make a request on your behalf go to libertymutual.comprivacy and click on the California Supplemental Privacy Policy. Response Timing Liberty Mutual will respond to a verifiable consumer request within forty five 45 days of its receipt. If more time is needed Liberty Mutual will inform you of the reason and extension period in writing. Any disclosures that will be provided will only cover the twelve 12 month period preceding our receipt of the verifiable consumer request. If Liberty Mutual is unable to fulfill your request you will be provided with the reason that the request can not be completed. For more information about how we will respond to requests go to libertymutual.comprivacy and click on the California Supplemental Privacy Policy. Rights to opt in and out of data selling California consumers have the right to direct businesses not to sell your personal data opt out rights and personal data of minors under 16 years of age will not be sold as is their right without theirs or their parents opt in consent. Liberty Mutual does not sell the personal data of consumers. For more information go to libertymutual.comprivacy and click on the California Supplemental Privacy Policy. No account needed You do not need to create an account with Liberty Mutual to exercise your rights. Liberty Mutual will only use personal data provided in a request to review and comply with the request. No discrimination You have the right not to be discriminated against for exercising any of your CCPA rights. Unless permitted by the CCPA exercising your rights will not cause Liberty Mutual to o Deny you goods or services e Charge you different prices or rates for goods or services including through granting discounts or other benefits or imposing penalties o Provide you a different level or quality of goods or services or e Suggest that you may receive a different price or rate for goods or services or a different level or quality of goods or services. Insurance Services Office Inc. 2019 Page 5 of 6 SNI 04 010120 | 2 |
Will Liberty Mutual Update This Privacy Notice We reserve the right to makes changes to this notice at any time and for any reason. The updated version of this policy will be effective once it is accessible. You are responsible for reviewing this policy to stay informed of any changes or updates. Who Do Contact Regarding Privacy If you have any questions or comments about this Notice or the Supplemental CCPA Notice your rights or are requesting the Notice in an alternative format please do not hesitate to contact Liberty Mutual at Phone 800 344 0197 Email privacylibertymutual.com Postal Address Attn Privacy Office Liberty Mutual Insurance Company 175 Berkeley St. 6th Floor Boston MA 02116 Insurance Services Office Inc. 2019 Page 6 of 6 SNI 04010120 | 2 |
Risk Control Services Important Information for Florida Policyholders Through its Risk Control Services department Liberty Mutual Insurance has safety consultation services that are available to policyholders. We have found that some of these services are consistent with your workplace hazards. These services may be available to you as our policyholder at no additional cost. To obtain further information about our safety consultation services please contact our Risk Control Consulting Center at 1 866 757 7324 or email RCConsultingCenter LibertyMutual.com. 2016 Liberty Mutual Insurance. Page 1 of 1 SNI 09 02 06 16 | 2 |
TEXAS NOTICE NOTIFICATION OF THE AVAILABILITY OF LOSS CONTROL INFORMATION SERVICES We are committed to providing loss control information services at no charge to Texas commercial automobile liability general liability and professional liability policyholders in an effort to prevent and reduce potential claims and losses. To obtain further information about these services please contact our Risk Control Consulting Center at 1 866 757 7324 or email RCConsultingCenterLibertyMutual.com. 2015 Liberty Mutual Insurance Page 1 of 1 SNI 420204 15 | 2 |
UTAH INFORMATION TO POLICYHOLDERS Pursuant to the laws of Utah section 31A21 201 you are hereby informed that Employers Insurance Company of Wausau is the exact name of your insurer which is domiciled in the state of Wisconsin. 2013 Liberty Mutual Insurance. All rights reserved. Page 1 of 1 SNI 43 06 05 13 | 2 |
POLICYHOLDER NOTICE COMPANY CONTACT INFORMATION In the event you need to contact someone about this policy for any reason please contact your Sales Representative or Producer of Record as shown on the policy Declarations or Information Page. If you have additional questions you may contact the company at the following address Liberty Mutual Insurance 175 Berkeley Street Boston MA 02116 1800 344 0197 Insurance Services Office Inc. 2018 Page 1 of 1 SNI 90011218 | 2 |
POLICYHOLDER DISCLOSURE TERRORISM RISK INSURANCE ACT THIS NOTICE CONTAINS IMPORTANT INFORMATION PURSUANT TO THE TERRORISM RISK INSURANCE ACT. PLEASE READ ITCAREFULLY. In accordance with the Terrorism Risk Insurance Act including all amendments TRIA or the Act we are required to provide you with a notice of the portion of your premium attributable to coverage for certified acts of terrorism the federal share of payment of losses from such acts and the limitation or cap on our liability under the Act. Disclosure of Premium The Company has made available coverage for certified acts of terrorism as defined in the Act. If purchased the portion of your premium attributable to coverage for certified acts of terrorism is shown in the Declarations Declarations Extension Schedule or elsewhere by endorsement in your policy. Federal Participation In Payment Of Terrorism Losses If an individual insurer s losses from certified acts of terrorism exceed a specified deductible amount the government will generally reimburse the insurer for a percentage of losses the Federal Share paid in excess of the deductible but only if aggregate industry losses from certified acts of terrorism exceed the Program Trigger. Beginning in calendar year 2020 the Federal Share is 80 and Program Trigger is 200000000. Cap On Insurer Participation In Payment Of Terrorism Losses If aggregate insured losses attributable to certified acts of terrorism exceed 100 billion in a calendar year and we have met our deductible under the Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion. Nor shall Treasury make any payment for any portion of the amount of such losses that exceeds 100 billion. 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. 2020 Liberty Mutual Insurance Page 1 of 1 SNI 90 02 01 20 | 2 |
New Jersey Property Liability Insurance Guaranty Association Surcharge This is an explanation of the NJ Surcharge which may appear on the enclosed policy. Companies writing property and casualty insurance in New Jersey are required to participate in the New Jersey Property Liability Insurance Guaranty Association PLIGA. The purpose of this association is to pay covered claims for insolvent insurers. The PLIGA assesses each member insurer for its fair share of the association expens New Jersey law allows companies to surcharge policies to recover these assessments. If your policy is subject to this surcharge NJ Surcharge with an amount will appear on your premium notice. ST9010 02 92 Page 1 of 1 | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY INSTALLMENT PREMIUM PAYMENT SCHEDULE H POLICY NUMBER POLICY PERIOD 10012014 TO 10012015 4D6 19 18 15 Mmoo T TT NAMED INSURED PRODUCER STAROSTKA GROUP. LOCKTON COMPANIES LLC UNLIMITED INC... 1015 N 98TH ST STE 101 429 INDUSTRIAL LN.. OMAHA NE. GRAND ISLAND NE.. 68114 2357 68803 5239. AGENT NO. AB8210 THE ADVANCE ESTIMATED PREMIUM WILL BE DUE AS FOLLOWS 1 SCHEDULE INSTALLMENT DUE DATE AMOUNT 100114 6405.00 i 110114 2132 OOE P i 120114 2132 OOE P E 010115 2132 OO Voz011s 1 2132.00 P i 030115 2132 OOE P i 040115 2132 OOE P i 050115 2132 OOE P i 060115 2132 OOE P i 070115 2132 OOE P TOTAL 25593 OO THIS INSTALLMENT SCHEDULE WILL NOT BE REVISED BY ANY FUTURE ENDORSEMENT RESULTING IN PREMIUM CHANGES UNLESS APPROVED BY THE COMPANY. PLACE OF ISSUE OMAHA NE DATE OF ISSUE 09162014 FORM IL7007A ED.03 86 11062014 007 B8 4D61918 15001 INSTALLMENT PREMIUM PAYMENT SCHEDULE A POLICY NUMBER POLICY PERIOD 10012014 TO 10012015 4D6 19 18 15 NAMED INSURED STAROSTKA GROUP. LOCKTON COMPANIES LLC UNLIMITED INC... 1015 N 98TH ST STE 101 429 INDUSTRIAL LN.. OMAHA NE. GRAND ISLAND NE.. 68114 2357 68803 5239. AGENT NO. AB8210 SCHEDULE DUE DATE INSTALLMENT AMOUNT THIS INSTALLMENT SCHEDULE WILL NOT BE REVISED BY ANY FUTURE ENDORSEMENT RESULTING IN PREMIUM CHANGES UNLESS APPROVED BY THE COMPANY. PLACE OF ISSUE OMAHA NE ST STE 101 THE ADVANCE ESTIMATED PREMIUM WILL BE DUE AS FOLLOWS SCHEDULE DUE DATE | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY PRIOR POLICY 4D6 19 18 GENERAL LIABILTITY DECLARATIONS POLICY PERIOD FROM 100114 TO 100115 POLICY NUMBER 4D6 19 1 8 15 STAROSTKA GROUP LOCKTON COMPANIES LLC UNLIMITED INC. 1015 N 98TH ST STE 101 429 INDUSTRIAL LN OMAHA NE 68114 2357 GRAND ISLAND NE 68803 5239 AGENT AB 8210 AGENT PHONE 402 970 6100 AGENCY BILL JACK H. STRUYK JR INSURED IS CORPORATION BUSINESS DESC CONTRACTOR LIMITS OF INSURANCE EACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT 100000 ANY ONE PREMISES MEDICAL EXPENSE LIMIT 5000 ANY ONE PERSON PERSONAL AND ADVERTISING INJURY LIMIT 1000000 ANY ONE PERSON OR ORGANIZATION GENERAL AGGREGATE LIMIT 2000000 PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT 2000000 COVERAGES PROVIDETD PREMIUM PRODUCTS COMPLETED OPERATIONS 10434.00 OTHER THAN PRODUCTS COMPLETED OPERATIONS 15159.00 TOTAL ESTIMATED POLICY PREMIUM 25593.00 SEE ATTACHED SCHEDULE FOR LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED. DATE OF ISSUE 103014 BPP FORM CG7000A ED. 08 99 BPP 082814 007 Jo 4D61918 1501 GENERAL LIABILTITY D E POLICY PERIOD FROM 100114 TO 100115 UNLIMITED INC. 1015 N 98TH ST STE 101 429 INDUSTRIAL LN OMAHA NE 68114 2357 GRAND ISLAND NE 68803 5239 AGENT AB 8210 AGENT PHONE 402 970 6100 EACH OCCURRENCE LIMIT DAMAGE TO PREMISES RENTED TO YOU LIMIT MEDICAL EXPENSE LIMIT PERSONAL AND ADVERTISING INJURY LIMIT GENERAL AGGREGATE LIMIT 1000 00 100 00 500 1000 00 PRODUCTS COMPLETED OPERATIONS 10434.00 OTHER THAN PRODUCTS COMPLETED OPERATIONS 15159.00 TOTAL ESTIMATED POLICY PREMIUM | 2 |
A EMC Insurance Companies PAGE 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 FORMS APPLICABLE CG00010413 G20320413 G21700108 G23010413 CG71050714 CG71400714 CG71910113 CG7193.11013 CG04351207 CG74281198 CG74291198 CG21060514 CG21760108 CG24121185 CG76270309 CG76440209 CG82820414 CGB82830414 IL02580112 IL02590907 IL70281005 IL7130A0401 IL73390511 IL8383.50108 Footnotes CG04370413 CG21471207 CG22741001 CG7001A1012 CG70031013 CG71410590 CG72531296 CG72761008 CG7523.30307 CG75551013 CG80810406 FL04111006 IL02760908 IL7131A0401 IL73130711 IL8384A0108 IL85760909 G20110413 CG21671204 G22800413 CG7174.31013 G8254 0614 IL00210502 IL12010199 CG2010 07 04 AI OWNERS LESSEES OR CONTRACTORS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEP WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. CG2037 07 04 AI OWNERS LESSESS OR CONT COMP OPS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEPT WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. AUDIT PERIOD ANNUAL DATE OF ISSUE 103014 BPP FORM CG7000A ED. 08 99 BPP 082814 007 Jo 4D61918 1501 0413 CG04351207 CG04370413 CG20110413 0413 CG21060514 CG21471207 CG21671204 IA1 0QY RO 17C 01 N R99TALI1INA0TY 2980 AA 7172 CG2 Footnotes CG2010 07 04 AI OWNERS LESSEES OR CONTRACTORS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEP WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. CG2037 07 04 AI OWNERS LESSESS OR CONT COMP OPS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEPT WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. AUDIT PERIOD ANNUAL | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERATL L Cc ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM CG0001 04 13 COMMERCIAL GEN LIABILITY COV FORM CG0435 12 07 EMPLOYEE BENEFITS LIABILITY COVERAGE EACH EMPLOYEE 1000000 AGGREGATE 2000000 DEDUCTIBLE EACH EMPLOYEE 1000 RETROACTIVE DATE 10011998 CG0437 04 13 ELECTRONIC DATA LIAB ENDORSEMENT LOSS OF ELECTRONIC DATA LIMIT 50000 CG2011 04 13 AI MANAGERS OR LESSORS OF PREMISES NAME L W HOLDINGS INC. CG2032 04 13 AI ENGRS ARCHTCT SURVYRS NOT ENGAGED NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. BLANKET WHERE REQUIRED BY WRITTEN CONTRACT CG2106 05 14 EXCL ACCESS DISCL OF CONFID PERSONAL CG2147 12 07 EXCL EMPLOYMENT RELATED PRACTICES CG2167 12 04 FUNGI OR BACTERIA EXCLUSION CG2170 01 08 CAP LOSSES FROM CERT ACTS TERRORISM CG2176 01 08 EXCL PUNITIVE DMGS ACTS OF TERRORISM CG2274 10 01 LTD CONTRACTUAL LIAB COV PERS ADV DESIGNATED CONTRACT OR AGREEMENT ANY CONTRACT CG2280 04 13 LIMITED EXCL CONTRACTOR PROF LIAB CG2301 04 13 EXCL REAL ESTATE AGENT OR BROKE EO CG2412 11 85 BOATS DESCRIPTION OF WATERCRAFT ADDITIONAL PREMIUM 1998 20 FT. CRESTLINE 2000 RAMPAGE 2008 SKI DOO 2006 TYEE LUND 20FT BOAT 1997 TIGER SHARK JET SKI 2006 YAMAHA VX1100E JET SKI 2006 LUND BOAT CG7001A 10 12 GENERAL LIABILITY SCHEDULE CG7003 10 13 GL QUICK REFERENCE OCCURRENCE CG7105 07 14 EXT OF THE DEFINITION OF INSURED CG7140 07 14 INJ TO CO EMPL OR O VOLUNTEER WKRS NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. ALL MANAGERIAL OR SUPERVISORY EMPLOYEES AND OR EXECUTIVE OFFICERS CG7141 05 90 EXTENDED PROPERTY DAMAGE COVERAGE DATE OF ISSUE 103014 CONTINUED FORM IL7131A ED. 04 01 007 Jo 4D61918 1501 EDITION CG0437 CG2011 CG2032 CG2106 CG2147 CG2167 CG2170 CG2176 CG2274 CG2280 CG2301 CG2412 CG7001A CG7003 CG7105 CG7140 CG7141 12 07 04 13 04 13 04 13 05 14 12 07 12 04 01 08 01 08 10 01 04 13 04 13 11 85 10 12 10 13 07 14 07 14 05 90 EMPLOYEE BENEFITS LIABILITY COVERAGE EACH EMPLOYEE 1000000 AGGREGATE 2000000 DEDUCTIBLE EACH EMPLOYEE 1000 RETROACTIVE DATE 10011998 ELECTRONIC DATA LIAB ENDORSEMENT LOSS OF ELECTRONIC DATA LIMIT 50000 AI MANAGERS OR LESSORS OF PREMISES NAME L W HOLDINGS INC. AI ENGRS ARCHTCT SURVYRS NOT ENGAGED NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. BLANKET WHERE REQUIRED BY WRITTEN CONTRACT EXCL ACCESS DISCL OF CONFID PERSONAL EXCL EMPLOYMENT RELATED PRACTICES FUNGI OR BACTERIA EXCLUSION CAP LOSSES FROM CERT ACTS TERRORISM EXCL PUNITIVE DMGS ACTS OF TERRORISM LTD CONTRACTUAL LIAB COV PERS ADV DESIGNATED CONTRACT OR AGREEMENT ANY CONTRACT LIMITED EXCL CONTRACTOR PROF LIAB EXCL REAL ESTATE AGENT OR BROKE EO BOATS DESCRIPTION OF WATERCRAFT ADDITIONAL PREMIUM 1998 20 FT. CRESTLINE 2000 RAMPAGE 2008 SKI DOO 2006 TYEE LUND 20FT BOAT 1997 TIGER SHARK JET SKI 2006 YAMAHA VX1100E JET SKI 2006 LUND BOAT GENERAL LIABILITY SCHEDULE GL QUICK REFERENCE OCCURRENCE EXT OF THE DEFINITION OF INSURED INJ TO CO EMPL OR O VOLUNTEER WKRS NAME CONCESSIONAIRES JOB TITLES POLITICAL ENTITY ASSOC. OR ORG.ETC. ALL MANAGERIAL OR SUPERVISORY EMPLOYEES AND OR EXECUTIVE OFFICERS EXTENDED PROPERTY DAMAGE COVERAGE | 2 |
A EMC Insurance Companies PAGE NO 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERATL L Cc ENDORSEMENT SCHEDULE EDITION DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM CG7174.3 10 13 AUTOMATIC AI CONST CONT INCL COMP OP CG7191 01 13 COMML GENERAL LIABILITY AMENDMENT CG7193.1 10 13 AI OWN LESS CONTR INCL COMP OPS NAME ALTRA NEBRASKA LLP NAME DELTA T CORP CG7253 12 96 CONTRACTORS EXTENDED PROPERTY DAMAGE CG7276 10 08 LIMITED POLLUTION COV WORK SITES 225 CG7428 11 98 AMEND AGGREGATE LIMIT PER LOCATION CG7429 11 98 AMEND AGGREGATE LIMIT PER PROJECT CG7523.3 03 07 EXCL EXT INSULATION FINISH SYSTEMS CG7555 10 13 BLKT WAIV SUBRO WRITTEN CONT AGREE CG7627 03 09 AMENDMENT OF EMPL BENEFITS PROGRAM DESCRIPTION OF OTHER SIMILAR BENEFITS NONE CG7644 02 09 CONTRACTORS OCCURRENCE DEFINITION CG8081 04 06 FUNGI BACTERIA NOTICE TO POLICYHOLDR CG8254 06 14 ADVISORY NOTICE TO POLICYHOLDERS CG8282 04 14 ADVISORY NOTICE TO POLICYHOLDERS CG8283 04 14 ADVISORY NOTICE TO POLICYHOLDERS FL0411 10 06 BASIC FARM PREMISES LIABILITY IL0021 05 02 NUCLEAR ENERGY LIAB EXCL BROAD FORM IL0258 01 12 AZ CHANGES CANCELLATION NONRENEWAL IL0259 09 07 NE CHANGES CANCELLATION NONRENEWAL IL0276 09 08 IA CHANGES CANCELLATION NONRENEWAL IL1201 01 99 CHANGE ENDORSEMENT IL7028 10 05 ASBESTOS EXCLUSION IL7130A 04 01 NAMED INSURED ENDORSEMENT IL7131A 04 01 COMML POLICY ENDORSEMENT SCHEDULE IL7313 07 11 RESIDENT AGT COUNTERSIGNATURE ENDST IL7339 05 11 DEFINITION OF YOUR WORK AMEND ENDST IL8383.5 01 08 DISCL PURSUANT TERRSM RISK INS. ACT PREMIUM THROUGH 123114 s 51 PREMIUM BEYOND 123114 154 IL8384A 01 08 TERRORISM NOTICE IL8576 09 09 MEDICARE IMPT NOTICE TO POLICYHOLDER FOOTNOTES CG2010 07 04 AI OWNERS LESSEES OR CONTRACTORS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEP WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. DATE OF ISSUE 103014 CONTINUED FORM IL7131A ED. 04 01 007 Jo 4D61918 1501 EDITION CG7253 CG7276 CG7428 CG7429 CG7523.3 CG7555 CG7627 CG7644 CG8081 CG8254 CG8282 CG8283 FLO411 IL0021 IL0258 IL0259 IL0276 IL1201 IL7028 IL7130A IL7131A IL7313 IL7339 IL8383.5 IL8384A IL8576 01 13 10 13 12 96 10 08 11 98 11 98 03 07 10 13 03 09 02 09 04 06 06 14 04 14 04 14 10 06 05 02 01 12 09 07 09 08 01 99 10 05 04 01 04 01 07 11 05 11 01 08 01 08 09 09 CG7191 01 13 COMML GENERAL LIABILITY AMENDMENT CG7193.1 10 13 AI OWN LESS CONTR INCL COMP OPS NAME ALTRA NEBRASKA LLP NAME DELTA T CORP CG7253 12 96 CONTRACTORS EXTENDED PROPERTY DAMAGE CG7276 10 08 LIMITED POLLUTION COV WORK SITES 22 CG7428 11 98 AMEND AGGREGATE LIMIT PER LOCATION CG7429 11 98 AMEND AGGREGATE LIMIT PER PROJECT CG7523.3 03 07 EXCL EXT INSULATION FINISH SYSTEMS CG7555 10 13 BLKT WAIV SUBRO WRITTEN CONT AGREE CG7627 03 09 AMENDMENT OF EMPL BENEFITS PROGRAM DESCRIPTION OF OTHER SIMILAR BENEFITS NONE CG7644 02 09 CONTRACTORS OCCURRENCE DEFINITION CG8081 04 06 FUNGI BACTERIA NOTICE TO POLICYHOLDR CG8254 06 14 ADVISORY NOTICE TO POLICYHOLDERS CG8282 04 14 ADVISORY NOTICE TO POLICYHOLDERS CG8283 04 14 ADVISORY NOTICE TO POLICYHOLDERS FL0411 10 06 BASIC FARM PREMISES LIABILITY IL0021 05 02 NUCLEAR ENERGY LIAB EXCL BROAD FORM IL0258 01 12 AZ CHANGES CANCELLATION NONRENEWAL IL0259 09 07 NE CHANGES CANCELLATION NONRENEWAL IL0276 09 08 IA CHANGES CANCELLATION NONRENEWAL IL1201 01 99 CHANGE ENDORSEMENT IL7028 10 05 ASBESTOS EXCLUSION IL7130A 04 01 NAMED INSURED ENDORSEMENT IL7131A 04 01 COMML POLICY ENDORSEMENT SCHEDULE IL7313 07 11 RESIDENT AGT COUNTERSIGNATURE ENDST IL7339 05 11 DEFINITION OF YOUR WORK AMEND ENDST IL8383.5 01 08 DISCL PURSUANT TERRSM RISK INS. ACT PREMIUM THROUGH 123114 s 5 PREMIUM BEYOND 123114 15 IL8384A 01 08 TERRORISM NOTICE IL8576 09 09 MEDICARE IMPT NOTICE TO POLICYHOLDER FOOTNOTES CG2010 07 04 AI OWNERS LESSEES OR CONTRACTORS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEP WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. w o | 2 |
A EMC Insurance Companies PAGE NO 3 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERATL ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM CG2037 07 04 AI OWNERS LESSESS OR CONT COMP OPS NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEPT WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. DATE OF ISSUE 103014 FORM IL7131A ED. 04 01 007 Jo 4D61918 1501 EDITION NAME OF ADDL INSURED PERSON SORGANIZATIONS ORGANIZATIONS SUBJECT TO A WRITTEN CONTRACT REQUIRING ADDITIONAL INSURED STATUS EXCEPT WHERE THE CONTRACT REQUIRES COVERAGE TO BE PRIMARY NON CONTRIBUTORY. | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent DATE OF ISSUE 103014 FORM IL8384A 01 08 007 Jo 4D61918 1501 STAROSTKA GROUP EFF DATE 100114 EXP DATE 1001 TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 This disclosure is attached to your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This disclosure does not grant any coverage or change the terms and conditions of any coverage under the policy. SCHEDUTLE Terrorism Premium Certified Acts A. Premium through end of year 123114 51.00 B. Premium beyond the date specified above 154.00 Refer to paragraph D. below A. DISCLOSURE OF PREMIUM In accordance with the Federal Terrorism Risk Insurance Act we are required to provide you with a notice disclosing the portion of your premium if any attributable to coverage for terrorism acts certified under that act. The portion of your premium attributable to such coverage is shown in the schedule of this disclosure or in the policy Declarations. B. DISCLOSURE OF FEDERAL PARTICIPATION IN PAYMENT OF TERRORISM LOSSES The United States Government Department of the Treasury will pay a share of terrorism losses insured under the federal program. The federal share equals 85 of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a Program Year January 1 through December 31 the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. C. CAP ON INSURER PARTICIPATION IN PAYMENT OF TERRORISM LOSSES If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a Program Year January 1 through December 31 and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. D. PREMIUM BEYOND THE YEAR SPECIFIED IN THE SCHEDULE ABOVE The premium for certified acts of terrorism coverage is calculated based in part on the federal participation in payment of terrorism losses as set forth in the Terrorism Risk Insurance Act. The federal program established by the Act is scheduled to terminate at the end of the year specified in the Schedule of this endorsement unless extended by the federal government. If the federal program is extended the premium shown in B in the Schedule shall be attributable to coverage for terrorism acts certified under the act. If the Federal program terminates your policy will still contain coverage for acts of terrorism unless you have elected to exclude the coverage. The premium shown in B of the schedule shall be attributable to that coverage for terrorism. Includes copyrighted material of ISO Properties Inc. with its permission DATE OF ISSUE 103014 continued FORM IL8383.5 01 08 007 Jo 4D61918 1501 This disclo disclosure This disclo and conditi T E Terrorism A. Prem B. Prem Ref A. DISCLOSUI In accor required your pre certifie to such the poli B. DISCLOSU The Unit a share federal insured However certifie in a Pro not make that exc C. CAP ON II If aggre under th Program insurer not be 1 losses tl up to th with pro D. PREMIUM I The prem based in losses a federal the end unless e is exten attribut. If the Fo coverage the cove attribut. o your policy in response to the le Terrorism Risk Insurance Act. 1 t any coverage or change the terms je under the policy. d Acts year 123114 51.00 specified above 154.00 below jeral Terrorism Risk Insurance Act we are th a notice disclosing the portion of ibutable to coverage for terrorism acts The portion of your premium attributable in the schedule of this disclosure or in ICIPATION IN PAYMENT OF TERRORISM LOSSES nt Department of the Treasury will pay s insured under the federal program. The f that portion of the amount of such is the applicable insurer retention. ired losses attributable to terrorist acts IN PAYMENT OF TERRORISM LOSSES attributable to terrorist acts certified surance Act exceed 100 billion in a ugh December 31 and we have met our. Terrorism Risk Insurance Act we shall 1 t of any portion of the amount of such lion and in such case insured losses t to pro rata allocation in accordance by the Secretary of the Treasury. IFIED IN THE SCHEDULE ABOVE ts of terrorism coverage is calculated participation in payment of terrorism ferrorism Risk Insurance Act. The by the Act is scheduled to terminate at d in the Schedule of this endorsement al government. If the federal program wn in B in the Schedule shall be terrorism acts certified under the act. nates your policy will still contain sm unless you have elected to exclude shown in B of the schedule shall be je for terrorism. | 2 |
A EMC Insurance Companies Page 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NUMBER 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 This disclosure is attached to your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This disclosure does not grant any coverage or change the terms and conditions of any coverage under the policy. THE FOLLOWING STATEMENT IS REQUIRED TO BE PART OF THE DISCLOSURE NOTICE IN MISSOURI The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your policy carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Includes copyrighted material of ISO Properties Inc. with its permission DATE OF ISSUE 103014 FORM IL8383.5 01 08 007 Jo 4D61918 1501 This disclosure is attached to your policy in response to the disclosure requirements of the Terrorism Risk Insurance Act. This disclosure does not grant any coverage or change the terms and conditions of any coverage under the policy. THE FOLLOWING STATEMENT IS REQUIRED TO BE PART OF THE DISCLOSURE NOTICE IN MISSOURI The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your policy carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Includes copyrighted material of ISO Properties Inc. with its permission | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY NAMED INSURED ENDORSEMENT POLICY PERIOD FROM 100114 TO 100115 POLICY NUMBER 4D6 19 1 8 15 NAMED INSURETD PRODUCER STAROSTKA GROUP LOCKTON COMPANIES LLC UNLIMITED INC. 1015 N 98TH ST STE 101 429 INDUSTRIAL LN OMAHA NE 68114 2357 GRAND ISLAND NE 68803 5239 AGENT AB 8210 AGENT PHONE 402 970 6100 AGENCY BILL JACK H. STRUYK JR IT IS HEREBY AGREED AND UNDERSTOOD THAT THE NAMED INSURED IS AMENDED TO READ AS FOLLOWS 1ST NAMED INSURED STAROSTKA GROUP UNLIMITED INC. NO. 02 STAROSTKA HOMES INC. NO. 03 STAROSTKA CONSTRUCTION INC. NO. 04 HASTINGS VENTURE LLC NO. 05 D D INVESTMENTS A PARTNERSHIP NO. 06 GRAND ISLAND COMMERCIAL VENTURES NO. 08 LEWIS STAROSTKA INC. NO. 09 LP INVESTMENTS PLACE OF ISSUE OMAHA NE DATE OF ISSUE 103014 CONTINUED FORM IL7130A ED. 04 01 007 Jo 4D61918 1501 NAMED INSURED ENDO POLICY PERIOD FROM 100114 TO 100115 UNLIMITED INC. 1015 N 98TH ST STE 101 429 INDUSTRIAL LN OMAHA NE 68114 2357 GRAND ISLAND NE 68803 5239 AGENT AB 8210 AGENT PHONE 402 970 6100 IT IS HEREBY AGREED AND UNDERSTOOD THAT THE NAMED INSURED IS AMENDED TO READ AS FOLLOWS 1ST NAMED INSURED STAROSTKA GROUP UNLIMITED INC. NO. 02 STAROSTKA HOMES INC. NO. 03 STAROSTKA CONSTRUCTION INC. NO. 04 HASTINGS VENTURE LLC NO. 05 D D INVESTMENTS A PARTNERSHIP NO. 06 GRAND ISLAND COMMERCIAL VENTURES NO. 08 LEWIS STAROSTKA INC. NO. 09 LP INVESTMENTS PLACE OF ISSUE OMAHA NE OLICY. | 2 |
A EMC Insurance Companies PAGE 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 NAMED INSURED ENDORSEMENT CONTTINUED NO. 11 STAROSTKA LEWIS LLC NO. 12 BONE CREEK PARTNERSHIP PLACE OF ISSUE OMAHA NE DATE OF ISSUE 103014 FORM IL7130A ED. 04 01 007 Jo 4D61918 1501 NO. 11 STAROSTKA LEWIS LLC NO. 12 BONE CREEK PARTNERSHIP PLACE OF ISSUE OMAHA NE | 2 |
A EMC Insurance Companies EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 001 40115 BOATS 2 NOT FOR RENT AND JETSKIS 2 NOT FOR RENT 3 PREMIUM BASIS PER BOAT EXPOSURE 6 SUBLINE 334 47050 REAL ESTATE AGENTS 4 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 334 87224 CONTRACTORS EXTENDED PROPERTY DAMAGE ENDORSEMENT PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87654 ADDITIONAL INSURED CO EMPLOYEE BODILY INJURY OR PERSONAL AND ADVERTISING INJURY FORM CG7140 PREMIUM BASIS FLAT CHARG EXPOSURE 50 SUBLINE 334 87741 LIMITED POLLUTION COVERAGE WORKSITES SEE FORM CG7276 PREMIUM BASIS FLAT CHARG EXPOSURE IF ANY SUBLINE 334 87747 AMENDMENT AGGREGATE LIMITS OF INSURANCE PER LOCATION SEE FORM CG7428 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 NOT FOR RENT AND NOT FOR RENT 3 5IS nan nan nan nan 1.0 TENDED PROPERTY MENT JURY FORM CG7140 S 50 COVERAGE DRM CG7276 ANY GREGATE LIMITS OF. LOCATION 8 | 2 |
A EMC Insurance Companies PAGE 2 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 15 SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 87748 AMENDMENT AGGREGATE LIMITS OF INSURANCE PER PROJECT SEE FORM CG7429 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87780 CONSTRUCTION CONTRACTS INCLUDING COMPLETED OPERATIONS BLANKET ADDL INSUREDS FORM CG7174.3 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87781 OWNERS LESSEES OR CONTRACTORS INCL COMPL OPS PRIMARY NONCONTRIBUTORY ADDL INSURED CG7193.1 CG7193.1 PREMIUM BASIS EACH EXPOSURE 2 SUBLINE 334 ADDITIONAL INTEREST 1 334 ALTRA NEBRASKA LLP ADDITIONAL INTEREST 2 334 DELTA T CORP 87786 BLANKET WAIVER OF SUBROGATION CG7555 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87808 ELECTRONIC DATA LIABILITY CG0437 LIMIT 5000050000 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 GREGATE LIMITS OF. PROJECT 9 FORM CG7174.3 334 NTEREST 1 334 SKA LLP NTEREST 2 334. OF SUBROGATION | 2 |
A EMC Insurance Companies PAGE 3 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 87825 1132.000 132 EMPLOYEE BENEFITS LIABILITY COVERAGE PREMIUM BASIS PER EMP EXPOSURE 50 SUBLINE EBL 1000 DEDUCTIBLE APPLIES EACH EMPLOYEE 87830 639 CONTRACTORS OCCURRENCE DEFINITION PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 91340 17.883 1611 7.7921 702 CARPENTRY CONSTRUCTION OF RESIDENTIAL PROPERTY NOT EXCEEDING THREE STORIES IN HEIGHT PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 90100 SUBLINE 336334 91342 10.628 0 8.343 0 CARPENTRY NOC PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 91560 11.5178 73621 7.297 4664 CONCRETE CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 639233 SUBLINE 336334 91580 9.6341 3008 CONTRACTORS EXECUTIVE SUPERVISORS OR EXECUTIVE SUPERINTENDENTS 4 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 312192 SUBLINE 334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 sFITS LIABILITY 5IS 50 EBL TIBLE APPLIES YROLL F ANY | 2 |
A EMC Insurance Companies PAGE 4 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 15 SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 91583 0.173 519 0.170 s 510 CONTRACTORS SUBCONT WORK IN CONNECT WITH BUILD CONST RECON REPAIR OR ERECT ONE OR TWO FAMILY DWELL PREMIUM BASIS THOUSANDS OF TOTAL COST EXPOSURE 3000000 SUBLINE 336334 ADDITIONAL INTEREST 1 334 BLANKET WHERE REQUIRED BY ENGRS ARCHTCT SURVYRS NOT ENGAGED CG2032 98677 ROOFING RESIDENTIAL OVER THREE STORIES AND OR COMMERCIAL PREMIUM BASIS 150 THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 98820 SEWER MAINS OR CONNECTIONS CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE 126077 SUBLINE 336334 99793 TRUCKERS 4 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 334 99946 WATER MAIN OR CONNECTIONS CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 1 334 INECTIONS NECTIONS | 2 |
A EMC Insurance Companies PAGE 5 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 002 49451 0.573 5 VACANT LAND 1 4 PREMIUM BASIS PER ACRE EXPOSURE 9 SUBLINE 334 LOCATION 003 49451 0.573 5 VACANT LAND 1 4 PREMIUM BASIS PER ACRE EXPOSURE 9 SUBLINE 334 LOCATION 004 49451 0.573 5 VACANT LAND 1 4 PREMIUM BASIS PER ACRE EXPOSURE 9 SUBLINE 334 LOCATION 005 63010 21.663 108 SPEC HOMES DWELLINGS ONE FAMILY LESSOR S RISK ONLY 4 PREMIUM BASIS EACH DWELL EXPOSURE 5 SUBLINE 334 LOCATION 006 91342 9.1441 0 10.078 0 CARPENTRY NOC PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 91560 8.373 0 10.836 0 CONCRETE CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 NE FAMILY X ONLY 4 S PAYROLL IF ANY | 2 |
A EMC Insurance Companies PAGE 6 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 15 SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM 91580 CONTRACTORS EXECUTIVE SUPERVISORS OR EXECUTIVE SUPERINTENDENTS 4 PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 334 91583 1.9228 0 CONTRACTORS SUBCONT WORK IN CONNECT WITH BUILD CONST RECON REPAIR OR ERECT ONE OR TWO FAMILY DWELL PREMIUM BASIS THOUSANDS OF TOTAL COST EXPOSURE IF ANY SUBLINE 336334 98677 ROOFING RESIDENTIAL OVER THREE STORIES AND OR COMMERCIAL PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 98820 SEWER MAINS OR CONNECTIONS CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 99946 WATER MAIN OR CONNECTIONS CONSTRUCTION PREMIUM BASIS THOUSANDS OF PAYROLL EXPOSURE IF ANY SUBLINE 336334 LOCATION 007 47051 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 50 SUBLINE 334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 INECTIONS NECTIONS IS 50 | 2 |
A EMC Insurance Companies PAGE 7 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 15 SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 008 47051 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 50 SUBLINE 334 LOCATION 009 49451 VACANT LAND 1 4 PREMIUM BASIS PER ACRE EXPOSURE 1 SUBLINE 334 LOCATION 010 49451 VACANT LAND 1 4 PREMIUM BASIS PER ACRE EXPOSURE 1 SUBLINE 334 LOCATION 011 49451 VACANT LAND 1 4 PREMIUM BASIS PER ACRE EXPOSURE 1 SUBLINE 334 LOCATION 012 49451 VACANT LAND 1 4 PREMIUM BASIS ACRE EXPOSURE 1 SUBLINE 334 LOCATION 013 06519 FARMS NOT MORE THAN 160 ACRES TYPE IV PREMIUM BASIS FARM EXPOSURE 1 SUBLINE 338 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 IS 50 RE THAN 160 ACRES | 2 |
A EMC Insurance Companies PAGE 8 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 014 49451 0.573 7 VACANT LAND 1 4 PREMIUM BASIS EACH ACRE EXPOSURE 12 SUBLINE 334 LOCATION 015 47051 13.42218 16 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EA ACRE EXPOSURE 4.56 SUBLINE 334 LOCATION 016 49451 0.578 19 VACANT LAND 1 4 PREMIUM BASIS EACH ACRE EXPOSURE 33 SUBLINE 334 LOCATION 017 06719 60.649 61 FARMS MORE THAN 500 BUT NOT MORE THAN 2000 ACRES TYPE IV PREMIUM BASIS FARM EXPOSURE 1 SUBLINE 338 LOCATION 018 47051 13.42218 34 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EA ACRE EXPOSURE 10 SUBLINE 334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 nan nan nan nan 12.0 nan nan nan nan 33.0 nan nan nan nan 10.0 | 2 |
A EMC Insurance Companies PAGE 9 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 019 63010 45.756 46 DWELLINGS ONE FAMILY LESSOR S RISK ONLY 4 PREMIUM BASIS EACH DWELL EXPOSURE 1 SUBLINE 334 LOCATION 020 47051 1o3.4221 99 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 29 SUBLINE 334 LOCATION 021 47051 3.39218 17 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 5 SUBLINE 334 LOCATION 022 47051 1o3.4221 3 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 1 SUBLINE 334 LOCATION 023 47051 3.39218 75 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS PER ACRE EXPOSURE 22 SUBLINE 334 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 E FAMILY. ONLY 4 1 IS 29 IS IS nan nan nan nan 22.0 | 2 |
A EMC Insurance Companies PAGE 10 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 15 SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 024 47051 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 6 SUBLINE 334 63010 DWELLINGS ONE FAMILY LESSOR S RISK ONLY 4 PREMIUM BASIS EACH DWELL EXPOSURE 1 SUBLINE 334 LOCATION 025 06619 FARMS MORE THAN 160 BUT NOT MORE THAN 500 ACRES TYPE IV PREMIUM BASIS FARM EXPOSURE 1 SUBLINE 338 ADDITIONAL INTEREST 1 338 L W HOLDINGS INC. MANAGERS OR LESSORS OF PREMISES CG2011 40.664E 41 25 LOCATION 026 63010 DWELLINGS ONE FAMILY LESSOR S RISK ONLY 4 PREMIUM BASIS EACH DWELL EXPOSURE 1 SUBLINE 334 LOCATION 027 63010 DWELLINGS ONE FAMILY LESSOR S RISK ONLY 4 PREMIUM BASIS EACH DWELL EXPOSURE 1 SUBLINE 334 21.663 22 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 IS E FAMILY ONLY 4 S 1 338 ITEREST 1 338 E FAMILY. ONLY 4 1 E FAMILY. ONLY 4 1 | 2 |
A EMC Insurance Companies PAGE 11 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE CONTINUED PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 028 47051 3.422 s 34 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS PER ACRE EXPOSURE 10 SUBLINE 334 PREMIUM FOR CERTIFIED ACTS OF TERRORISM 205.00 TOTAL ESTIMATED POLICY PREMIUM 25593.00 1 OTHER THAN NOT FOR PROFIT 2 NOT FOR PROFIT 3 INCLUDING PRODUCTS AND OR COMPLETED OPERATIONS UNLESS OTHERWISE EXCLUDED 4 PRODUCTS COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT 5 A 250 PD DEDUCTIBLE PER CLAIM APPLIES TO CUSTOMERS AUTOS UNLESS OTHERWISE DESIGNATED BY THIS CLASSIFICATION CODE 6 FOR SPRAY PAINTING OPERATIONS A PD DEDUCTIBLE OF 250 PER CLAIM APPLIES UNLESS A HIGHER DEDUCTIBLE IS OTHERWISE DESIGNATED FOR THIS CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED RATED LOCATIONS LOC 001 429 INDUSTRIAL LN GRAND ISLAND NE 68803 5239 LOC 002 417 CONGDON AVE GRAND ISLAND NE 68801 2939 LOC 003 LAMBERT S SUB PT LT 14 GRAND ISLAND NE 68803 LOC 004 LAMBERT S SUB W 12 LT 11 GRAND ISLAND NE 68803 LOC 005 SPEC HOMES COMPLETED BUT NOT YET SOLD GRAND ISLAND NE 68802 LOC 006 UNKNOWN RAKE IA 50465 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 nan nan nan nan 10.0 CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RATED LOCATIONS LOC 001 429 INDUSTRIAL LN RENTED OR OCCUPIED GRAND ISLAND NE 68803 5239 LOC 002 417 CONGDON AVE GRAND ISLAND NE 68801 2939 LOC 003 LAMBERT S SUB PT LT 14 GRAND ISLAND NE 68803 LOC 004 LAMBERT S SUB W 12 LT 11 GRAND ISLAND NE 68803 LOC 005 SPEC HOMES COMPLETED BUT NOT YET SOLD GRAND ISLAND NE 68802 LOC 006 UNKNOWN RAKE IA 50465 LOC 002 417 CONGDON AVE GRAND ISLAND NE 68801 2939 LOC 003 LAMBERT S SUB PT LT 14 GRAND ISLAND NE 68803 LOC 004 LAMBERT S SUB W 12 LT 11 GRAND ISLAND NE 68803 LOC 005 SPEC HOMES COMPLETED BUT NOT YET SOLD GRAND ISLAND NE 68802 LOC 006 UNKNOWN RAKE IA 50465 | 2 |
A EMC Insurance Companies PAGE 12 EMPLOYERS MUTUAL CASUALTY COMPANY POLICY NO 4D6 19 18 15 STAROSTKA GROUP EFF DATE 100114 EXP DATE 100115 GENERAL LIABILITY SCHEDUTLE CONTINUED LOC 007 ABOOD ADDN TRACT 5 KEARNEY NE 68847 LOC 008 LOTS 5 8 KEARNEY NE 68847 LOC 009 UNKNOWN KEARNEY NE 68847 LOC 010 UNKNOWN KEARNEY NE 68847 LOC 011 UNKNOWN KEARNEY NE 68847 LOC 012 BLK 1 LOTS 1 5 CASTLE RIDGE BLK 2 LOTS 1 10 CASTLE RIDG KEARNEY NE 68847 LOC 013 NW12 E12 EXCEPT 38.99 ACRESIN NE14 SEC 35 TWP 31N RG 10 ONEILL NE 68763 LOC 014 BOULDER RUN ADDITION LINCOLN NE 68501 LOC 015 LOTS 1 4 BLOCK 1 LOTS 1 4 KEARNEY NE 68848 LOC 016 WINDMILL RIDGE ESTATES LINCOLN NE 68516 LOoC 017 UNKNOWN BUTTE NE 68722 LOC 018 BLK 1 LOTS 1 5 CASTLE RIDGE KEARNEY NE 68847 LOC 019 5333 W HARTFORD AVE GLENDALE AZ 85308 3935 DATE OF ISSUE 103014 BPP CONTINUED FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 Loc Loc Loc Loc Loc Loc Loc Loc Loc Loc Loc Loc Loc 007 008 009 010 011 012 013 014 015 016 017 018 019 ABOOD ADDN KEARNEY NE LOTS 5 8 KEARNEY NE UNKNOWN KEARNEY NE UNKNOWN KEARNEY NE UNKNOWN KEARNEY NE BLK 1 LOTS KEARNEY NE NW1l2 E12 ONEILL NE BOULDER RUN LINCOLN NE LOTS 1 4 BLO KEARNEY NE WINDMILL RID LINCOLN NE UNKNOWN BUTTE NE 6 BLK 1 LOTS KEARNEY NE 5333 W HARTF GLENDALE AZ TRACT 5 68847 68847 68847 68847 68847 1 5 CASTLE RIDGE BLK 2 LOTS 1 10 CASTLE RIDG 68847 EXCEPT 38.99 ACRESIN NE14 SEC 35 TWP 31N RG 10 68763 ADDITION 68501 CK 1 LOTS 1 4 68848 GE ESTATES 68516 8722 1 5 CASTLE RIDGE 68847 ORD AVE 85308 3935 LOC 008 LOTS 5 8 KEARNEY NE 68847 LOC 009 UNKNOWN KEARNEY NE 68847 LOC 010 UNKNOWN KEARNEY NE 68847 LOC 011 UNKNOWN KEARNEY NE 68847 LOC 012 BLK 1 LOTS 1 5 CASTLE RIDGE BLK 2 LOTS 1 10 CASTLE RIDG KEARNEY NE 68847 LOC 013 NW12 E12 EXCEPT 38.99 ACRESIN NE14 SEC 35 TWP 31N RG 10 ONEILL NE 68763 LOC 014 BOULDER RUN ADDITION LINCOLN NE 68501 LOC 015 LOTS 1 4 BLOCK 1 LOTS 1 4 KEARNEY NE 68848 LOC 016 WINDMILL RIDGE ESTATES LINCOLN NE 68516 LOoC 017 UNKNOWN BUTTE NE 68722 LOC 018 BLK 1 LOTS 1 5 CASTLE RIDGE KEARNEY NE 68847 LOC 019 5333 W HARTFORD AVE GLENDALE AZ 85308 3935 | 2 |
A EMC Insurance Companies PAGE 13 EMPLOYERS MUTUAL CASUALTY COMPANY POLIC STAROSTKA GROUP EFF DATE 100114 S CHE Y NO 4D6 19 18 15 EXP DATE 100115 DULE LOC 020 120TH STREET AND MILITARY RD OMAHA NE 68142 LOC 021 CHARLESTON HEIGHTS SUBDIVISION LINCOLN NE 68501 LOC 022 6604 AVENUE M PLACE KEARNEY NE 68845 LOC 023 NE 14 OF SEC 27 TWP 9 N RGE 16 KEARNEY NE 68847 LOC 024 6509 AVENUE 0 KEARNEY NE 68847 W OF 6TH PM LOC 025 NW14PART OF NE14PART OF THE SW14 PART AINSWORTH NE 69210 LOC 026 712 RICHMOND AVE HASTINGS NE 68901 3322 LOC 027 3504 WENDELL DRIVE HASTINGS NE 68901 2641 LOC 028 PT SE 14 NW 14 OF 34 9 16 KEARNEY NE 68847 ALL OTHER LOCATIONS 1060 E ARCHWAY RD KEARNEY NE. 68847 DATE OF ISSUE 103014 BPP OF THE SE14 FORM CG7001A ED.10 12 BPP 082814 007 Jo 4D61918 1501 Loc Loc Loc Loc Loc Loc Loc Loc Loc 020 021 022 023 024 025 026 027 028 120TH STREET AND MILITARY RD OMAHA NE 68142 CHARLESTON HEIGHTS SUBDIVISION LINCOLN NE 68501 6604 AVENUE M PLACE KEARNEY NE 68845 NE 14 OF SEC 27 TWP 9 N RGE 16 KEARNEY NE 68847 6509 AVENUE 0 KEARNEY NE 68847 NW14PART OF NE14PART OF AINSWORTH NE 69210 712 RICHMOND AVE HASTINGS NE 68901 3322 3504 WENDELL DRIVE HASTINGS NE 68901 2641 PT SE 14 NW 14 OF 34 9 16 KEARNEY NE 68847 ALL OTHER LOCATIONS 1060 E ARCHWAY RD KEARNEY NE. 68847 THE SW14 W OF 6TH PM PART OF THE SE14 LOC 021 CHARLESTON HEIGHTS SUBDIVISION LINCOLN NE 68501 LOC 022 6604 AVENUE M PLACE KEARNEY NE 68845 LOC 023 NE 14 OF SEC 27 TWP 9 N RGE 16 W OF 6TH PM KEARNEY NE 68847 LOC 024 6509 AVENUE 0 KEARNEY NE 68847 LOC 025 NW14PART OF NE14PART OF THE SW14 PART OF THE SE14 AINSWORTH NE 69210 LOC 026 712 RICHMOND AVE HASTINGS NE 68901 3322 LOC 027 3504 WENDELL DRIVE HASTINGS NE 68901 2641 LOC 028 PT SE 14 NW 14 OF 34 9 16 KEARNEY NE 68847 ALL OTHER LOCATIONS 1060 E ARCHWAY RD KEARNEY NE. 68847 | 2 |
COMMERCIAL GENERAL LIABILITY CG 00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under Section I Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 2 The bodily injury or property damage occurs during the policy period and Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. c. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. d. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim 1 Reports all or any part of the bodily injury or property damage to us or any other insurer Receives a written or verbal demand or claim for damages because of the bodily injury or property damage or 3 Becomes aware by any other means that bodily injury or property damage has occurred or has begun to occur. e. Damages because of bodily injury include damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. 3 2 CG 00010413 Insurance Services Office Inc. 2012 Page 1 0f 16 | 0 |
2. Exclusions This insurance does not apply to a. Expected Or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Contractual Liability Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the absence of the contract or agreement or 2 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorneys fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and Such attorneys fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. b This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in a The supervision hiring employment training or monitoring of others by that insured or b Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol if the occurrence which caused the bodily injury or property damage involved that which is described in Paragraph 1 2 or 3 above. However this exclusion applies only if you are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages. For the purposes of this exclusion permitting a person to bring alcoholic beverages on your premises for consumption on your premises whether or not a fee is charged or a license is required for such activity is not by itself considered the business of selling serving or furnishing alcoholic beverages.. Workers Compensation And Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law.. Employer s Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a Employment by the insured or b Performing duties related to the conduct of the insured s business or 2 The spouse child parent brother or sister of that employee as a consequence of Paragraph 1 above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. Page 2 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a At or from any premises site or location which is or was at any time owned or occupied by or rented or loaned to any insured. However this subparagraph does not apply to i Bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or originating from equipment that is used to heat cool or dehumidify the building or equipment that is used to heat water for personal use by the building s occupants or their guests ii Bodily injury or property damage for which you may be held liable if you are a contractor and the owner or lessee of such premises site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not and never was owned or occupied by or rented or loaned to any insured other than that additional insured or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire b At or from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste c Which are or were at any time transported handled stored treated disposed of or processed as waste by orfor i Any insured or ii Any person or organization for whom you may be legally responsible or d At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by such insured contractor or subcontractor. However this subparagraph does not apply to i Bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or released as part of the operations being performed by such insured contractor or subcontractor ii Bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor or Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the operations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. iii CG 00010413 Insurance Services Office Inc. 2012 Page 3 of 16 | 1 |
2 Any loss cost or expense arising out of any a Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or b Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a governmental authority. g. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed wunder any insured contract for the ownership maintenance or use of aircraft or watercraft or 4 5 Bodily injury or property damage arising out of a The operaton of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definiton of mobile equipment. h. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. i. War Bodily injury or property damage however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. j. Damage To Property Property damage to 1 Property you own rent or occupy including any costs or expenses incurred by you or any other person organization or entity for repair replacement enhancement restoration or maintenance of such property for any reason including prevention of injury to a person or damage to another s property Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you b 3 2 Page 4 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
4 Personal property in the care custody or control of the insured 5 That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the property damage arises out of those operations or That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section Il Limits Of Insurance. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard. 6. Damage To Your Product Property damage to your product arising out of it or any part of it.. Damage To Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor.. Damage To Impaired Property Or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 A defect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use.. Recall Of Products Work Or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it.. Personal And Advertising Injury Bodily injury arising out of personal and advertising injury.. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. However this exclusion does not apply to liability for damages because of bodily injury. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment.. Recording And Distribution Of Material Or Information In Violation Of Law Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or CG 00010413 Insurance Services Office Inc. 2012 Page 5 of 16 | 1 |
4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section Il Limits Of Insurance. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of personal and advertising injury to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for personal and advertising injury to which this insurance does not apply. We may at our discretion investigate any offense and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and 2 Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to personal and advertising injury caused by an offense arising out of your business but only if the offense was committed in the coverage territory during the policy period. 2. Exclusions This insurance does not apply to Knowing Violation Of Rights Of Another Personal and advertising injury caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising injury.. Material Published With Knowledge Of Falsity Personal and advertising injury arising out of oral or written publication in any manner of material if done by or at the direction of the insured with knowledge of its falsity.. Material Published Prior To Policy Period Personal and advertising injury arising out of oral or written publication in any manner of material whose first publication took place before the beginning of the policy period.. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured.. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement.. Breach Of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s advertising idea in your advertisement.. Quality Or Performance Of Goods Failure To Conform To Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your advertisement.. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Page 6 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
i. Infringement Of Copyright Patent Trademark Or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trademark trade secret or other intellectual property rights. Under this exclusion such other intellectual property rights do not include the use of another s advertising idea in your advertisement. However this exclusion does not apply to infringement in your advertisement of copyright trade dress or slogan. j Insureds In Media And Internet Type Businesses Personal and advertising injury committed by an insured whose business is 1 Advertising broadcasting publishing or telecasting 2 Designing or determining content of web sites for others or 3 An Internet search access content or service provider. However this exclusion does not apply to Paragraphs 14.a. b. and c. of personal and advertising injury under the Definitions section. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the insured hosts owns or over which the insured exercises control. I. Unauthorized Use Of Another s Name Or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain name or metatag or any other similar tactics to mislead another s potential customers. m. Pollution Personal and advertising injury arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants at any time. n. Pollution related Any loss cost or expense arising out of any 1 Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. o. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. p. Recording And Distribution Of Material Or Information In Violation Of Law Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or 4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. 3 CG 00010413 Insurance Services Office Inc. 2012 Page 7 of 16 | 1 |
COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that a The accident takes place in the coverage territory and during the policy period b The expenses are incurred and reported to us within one year of the date of the accident and c The injured person submits to examination at our expense by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for 1 First aid administered at the time of an accident 2 Necessary medical surgical X ray and dental services including prosthetic devices and 3 Necessary ambulance hospital professional nursing and funeral services. 2. Exclusions We will not pay expenses for bodily injury a. Any Insured To any insured except volunteer workers. b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d. Workers Compensation And Similar Laws To a person whether or not an employee of any insured if benefits for the bodily injury are payable or must be provided under a workers compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing instructing or participating in any physical exercises or games sports or athletic contests. f. Products Completed Operations Hazard Included within the products completed operations hazard. g. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS COVERAGES A AND B 1. We will pay with respect to any claim we investigate or settle or any suit against an insured we defend a. All expenses we incur. b. Up to 250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. c. The cost of bonds to release attachments but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from work. e. All court costs taxed against the insured in the suit. However these payments do not include attorneys fees or attorneys expenses taxed against the insured. f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment interest based on that period of time after the offer. Page 8 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance.. If we defend an insured against a suit and an indemnitee of the insured is also named as a party to the suit we will defend that indemnitee if all of the following conditions are met a. The suit against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an insured contract b. This insurance applies to such liability assumed by the insured. The obligation to defend or the cost of the defense of that indemnitee has also been assumed by the insured in the same insured contract o. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the insured and the indemnitee and f. The indemnitee 1 Agrees in writing to a Cooperate with us in the investigation settlement or defense of the suit Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit b c Notify any other insurer whose coverage is available to the indemnitee and d Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee and 2 Provides us with written authorization to a Obtain records and other information related to the suit and b Conduct and control the defense of the indemnitee in such suit. So long as the above conditions are met attorneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.2 of Section Coverage A Bodily Injury And Property Damage Liability such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the limits of insurance. Our obligation to defend an insured s indemnitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above or the terms of the agreement described in Paragraph f. above are no longer met. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. c. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. CG 00010413 Insurance Services Office Inc. 2012 Page 9 of 16 | 1 |
2. Each of the following is also an insured a. Your volunteer workers only while performing duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a partnership joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees or volunteer workers are insureds for 1 Bodily injury or personal and advertising injury a To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company to a coemployee while in the course of his or her employment or performing duties related to the conduct of your business or to your other volunteer workers while performing duties related to the conduct of your business To the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of Paragraph 1a above For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph 1a or b above or Arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b Rented to in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees volunteer workers any partner or member if you are a partnership or joint venture or any member if you are a limited liability company. b. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. b c d c. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that property and 2 Until your legal representative has been appointed. d. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION Il LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. Page 10 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
3. The Products Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. 4. Subject to Paragraph 2. above the Personal And Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all personal and advertising injury sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above whichever applies the Each Occurrence Limit is the most we will pay for the sum of a. Damages under Coverage A and b. Medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to Paragraph 5. above the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of property damage to any one premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence Offense Claim Or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or an offense which may result in a claim. To the extent possible notice should include 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured persons and witnesses and 3 The nature and location of any injury or damage arising out of the occurrence or offense. b. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent.. Legal Action Against Us No person or organization has a right under this Coverage Part a. To join us as a party or otherwise bring us into a suit asking for damages from an insured or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us the insured and the claimant or the claimant s legal representative. CG 00010413 Insurance Services Office Inc. 2012 Page 11 of 16 | 1 |
4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance 1 This insurance is excess over a Any of the other insurance whether primary excess contingent or on any other basis i That is Fire Extended Coverage Builder s Risk Installation Risk or similar coverage for your work ii That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner iii That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner or iv If the loss arises out of the maintenance or use of aircraft autos or watercraft to the extent not subject to Exclusion g. of Section I Coverage A Bodily Injury And Property Damage Liability. b Any other primary insurance available to you covering liability for damages arising out of the premises or operations or the products and completed operations for which you have been added as an additional insured. 2 When this insurance is excess we will have no duty under Coverages A or B to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be entitted to the insured s rights against all those other insurers. 3 When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of a The total amount that all such other insurance would pay for the loss in the absence of this insurance and b The total of all deductible and self insured amounts under all that other insurance. 4 We will share the remaining loss if any with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. 6. Representations By accepting this policy you agree a. The statements in the Declarations are accurate and complete Page 12 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
b. Those statements are based upon representations you made to us and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this Coverage Part to the first Named Insured this insurance applies a. As if each Named Insured were the only Named Insured and b. Separately to each insured against whom claim is made or suit is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part those rights are transferred to us. The insured must do nothing after loss to impair them. At our request the insured will bring suit or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. SECTION V DEFINITIONS 1. Advertisement means a notice that is broadcast or published to the general public or specific market segments about your goods products or services for the purpose of attracting customers or supporters. For the purposes of this definition a. Notices that are published include material placed on the Internet or on similar electronic means of communication and b. Regarding web sites only that part of a web site that is about your goods products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. Auto means a. A land motor vehicle trailer or semitrailer designed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However auto does not include mobile equipment.. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time.. Coverage territory means a. The United States of America including its territories and possessions Puerto Rico and Canada b. International waters or airspace but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above or c. All other parts of the world if the injury or damage arises out of 1 Goods or products made or sold by you in the territory described in Paragraph a. above The activities of a person whose home is in the territory described in Paragraph a. above but is away for a short time on your business or Personal and advertising injury offenses that take place through the Internet or similar electronic means of communication provided the insured s responsibility to pay damages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to.. Employee includes a leased worker. Employee does not include a temporary worker.. Executive officer means a person holding any of the officer positions created by your charter constitution bylaws or any other similar governing document.. Hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be.. lmpaired property means tangible property other than your product or your work that can not be used or is less useful because a. It incorporates your product or your work that is known or thought to be defective deficient inadequate or dangerous or b. You have failed to fulfill the terms of a contract or agreement if such property can be restored to use by the repair replacement adjustment or removal of your product or your work or your fulfilling the terms of the contract or agreement. 2 3 CG 00010413 Insurance Services Office Inc. 2012 Page 13 of 16 | 1 |
9. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract b. A sidetrack agreement c. Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality e. An elevator maintenance agreement f. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or 3 Under which the insured if an architect engineer or surveyor assumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. 2 10.Leased worker means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker. 11.Loading or unloading means the handling of property a. After it is moved from the place where it is accepted for movement into or onto an aircraft watercraft or auto b. While it is in or on an aircraft watercraft or auto or c. While it is being moved from an aircraft watercraft or auto to the place where it is finally delivered but loading or unloading does not include the movement of property by means of a mechanical device other than a hand truck that is not attached to the aircraft watercraft or auto. 12.Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment a. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads b. Vehicles maintained for use solely on or next to premises you own or rent c. Vehicles that travel on crawler treads d. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers e. Vehicles not described in Paragraph a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types 1 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers f. Vehicles not described in Paragraph a. b. c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. Page 14 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
However self propelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos 1 Equipment designed primarily for a Snow removal b Road maintenance but not construction or resurfacing or c Street cleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and 3 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered autos. 13.Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. 14.Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution c. The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies committed by or on behalf of its owner landlord or lessor d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services e. Oral or written publication in any manner of material that violates a person s right of privacy f. The use of another s advertising idea in your advertisement or g. Infringing upon another s copyright trade dress or slogan in your advertisement. 15.Pollutants mean any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals and waste. Waste includes materials to be recycled reconditioned or reclaimed. 16.Products completed operations hazard a. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 Products that are still in your physical possession or 2 Work that has not yet been completed or abandoned. However your work will be deemed completed at the earliest of the following times a When all of the work called for in your contract has been completed. b When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. c When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. b. Does not include bodily injury or property damage arising out of 1 The transportation of property unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you and that condition was created by the loading or unloading of that vehicle by any insured 2 The existence of tools uninstalled equipment or abandoned or unused materials or 3 Products or operations for which the classification listed in the Declarations or in a policy Schedule states that products completed operations are subject to the General Aggregate Limit. 17.Property damage means a. Physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance electronic data is not tangible property. CG 00010413 Insurance Services Office Inc. 2012 Page 15 of 16 | 1 |
As used in this definition electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMSs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. 18.Suit means a civil proceeding in which damages because of bodily injury property damage or personal and advertising injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 19.Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. 20.Volunteer worker means a person who is not your employee and who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other compensation by you or anyone else for their work performed for you. 21.Your product a. Means 1 Any goods or products other than real property manufactured sold handled distributed or disposed of by a You b Others trading under your name or c A person or organizaton whose business or assets you have acquired and 2 Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 22.Your work a. Means 1 Work or operations performed by you or on your behalf and 2 Materials parts or equipment furnished in connection with such work or operations. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your work and 2 The providing of or failure to provide warnings or instructions. Page 16 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 04351207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYEE BENEFITS LIABILITY COVERAGE THIS ENDORSEMENT PROVIDES CLAIMS MADE COVERAGE. PLEASE READ THE ENTIRE ENDORSEMENT CAREFULLY. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Each Employee Coverage Limit Of Insurance Deductible Premium Employee Benefits each employee Programs aggregate Retroactive Date Information required to complete this Schedule if not shown above will be shown in the Declarations. A. The following is added to Section Coverages No other obligation or liability to pay sums COVERAGE EMPLOYEE BENEFITS or perform acts or services is covered LIABILITY unless explicitly provided for under Sup plementary Payments. b. This insurance applies to damages only if 1 The act error or omission is negligently ages because of any act error or omission Izlromnlmted Ethefadministrtion of your of the insured or of any other person for employee benefit program whose acts the insured is legally liable to 2 The act error or omission did not take 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as dam which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking dam ages to which this insurance does not ap ply. We may at our discretion investigate any report of an act error or omission and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Paragraph D. Section lll 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. place before the Retroactive Date if any shown in the Schedule nor after the end of the policy period and A claim for damages because of an act error or omission is first made against any insured in accordance with Paragraph c. below during the policy period or an Extended Reporting Period we provide under Paragraph F. of this endorsement.. A claim seeking damages will be deemed to have been made at the earlier of the fol lowing times 1 When notice of such claim is received and recorded by any insured or by us whichever comes first or 3 CG 04351207 ISO Properties Inc. 2006 Page 1 0of 6 a | 2 |
2 When we make settlement in accor dance with Paragraph a. above. A claim received and recorded by the in sured within 60 days after the end of the policy period will be considered to have been received within the policy period if no subsequent policy is available to cover the claim. All claims for damages made by an em ployee because of any act error or omis sion or a series of related acts errors or omissions including damages claimed by such employee s dependents and benefi ciaries will be deemed to have been made at the time the first of those claims is made against any insured.. Exclusions This insurance does not apply to Dishonest Fraudulent Criminal Or Malicious Act Damages arising out of any intentional dis honest fraudulent criminal or malicious act error or omission committed by any in sured including the willful or reckless viola tion of any statute.. Bodily Injury Property Damage Or Personal And Advertising Injury Bodily injury property damage or per sonal and advertising injury.. Failure To Perform A Contract Damages arising out of failure of perform ance of contract by any insurer.. Insufficiency Of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the employee benefit pro gram.. Inadequacy Of Performance Of Investment Advice Given With Respect To Participation Any claim based upon 1 Failure of any investment to perform 2 Errors in providing information on past performance of investment vehicles or 3 Advice given to any person with respect to that person s decision to participate or not to participate in any plan included in the employee benefit program. f. Workers Compensation And Similar Laws Any claim arising out of your failure to comply with the mandatory provisions of any workers compensation unemployment compensation insurance social security or disability benefits law or any similar law. g. ERISA Damages for which any insured is liable because of liability imposed on a fiduciary by the Employee Retirement Income Secu rity Act of 1974 as now or hereafter amended or by any similar federal state or local laws. h. Available Benefits Any claim for benefits to the extent that such benefits are available with reasonable effort and cooperation of the insured from the applicable funds accrued or other col lectible insurance. i. Taxes Fines Or Penalties Taxes fines or penalties including those imposed under the Internal Revenue Code or any similar state or local law. j Employment Related Practices Damages arising out of wrongful termina tion of employment discrimination or other employment related practices. B. For the purposes of the coverage provided by this endorsement 1. All references to Supplementary Payments Coverages A and B are replaced by Supple mentary Payments Coverages A B and Em ployee Benefits Liability. 2. Paragraphs 1.b. and 2. of the Supplementary Payments provision do not apply. C. For the purposes of the coverage provided by this endorsement Paragraphs 2. and 3. of Section Il Who Is An Insured are replaced by the following 2. Each of the following is also an insured a. Each of your employees who is or was authorized to administer your employee benefit program. b. Any persons organizations or employees having proper temporary authorization to administer your employee benefit program if you die but only until your legal represen tative is appointed. Page 2 of 6 ISO Properties Inc. 2006 CG 04351207 o | 2 |
c. Your legal representative if you die but only with respect to duties as such. That repre sentative will have all your rights and duties under this Endorsement. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if no other similar insurance applies to that organization. However a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the pol icy period whichever is earlier. b. Coverage under this provision does not apply to any act error or omission that was committed before you acquired or formed the organization. D. For the purposes of the coverage provided by this endorsement Section Ill Limits Of Insurance is replaced by the following 1. Limits Of Insurance a. The Limits of Insurance shown in the Schedule and the rules below fix the most we will pay regardless of the number of 1 Insureds 2 Claims made or suits brought 3 Persons or organizations making claims or bringing suits 4 Acts errors or omissions or 5 Benefits included in your employee benefit program. b. The Aggregate Limit is the most we will pay for all damages because of acts errors or omissions negligently committed in the administration of your employee benefit program. c. Subject to the Aggregate Limit the Each Employee Limit is the most we will pay for all damages sustained by any one em ployee including damages sustained by such employee s dependents and benefi ciaries as a result of 1 An act error or omission or 2 A series of related acts errors or omis sions negligently committed in the administra tion of your employee benefit program. However the amount paid under this en dorsement shall not exceed and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the employee benefit program. The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations of the policy to which this endorsement is attached unless the policy period is extended after issu ance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits Of Insur ance. 2. Deductible a. Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of the deductible amount stated in the Schedule as applica ble to Each Employee. The limits of insur ance shall not be reduced by the amount of this deductible. b. The deductible amount stated in the Sched ule applies to all damages sustained by any one employee including such em ployee s dependents and beneficiaries because of all acts errors or omissions to which this insurance applies. c. The terms of this insurance including those with respect to 1 Our right and duty to defend any suits seeking those damages and 2 Your duties and the duties of any other involved insured in the event of an act error or omission or claim apply irrespective of the application of the deductible amount. d. We may pay any part or all of the deducti ble amount to effect settiement of any claim or suit and upon notification of the action taken you shall promptly reimburse us for such part of the deductible amount as we have paid. E. For the purposes of the coverage provided by this endorsement Conditions 2. and 4. of Section IV Commercial General Liability Conditions are replaced by the following 2. Duties In The Event Of An Act Error Or Omission Or Claim Or Suit a. You must see to it that we are notified as soon as practicable of an act error or omis sion which may result in a claim. To the extent possible notice should include 1 What the act error or omission was and when it occurred and CG 04351207 ISO Properties Inc. 2006 Page 3 of 6 a | 2 |
2 The names and addresses of anyone who may suffer damages as a result of the act error or omission. b. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 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 per son or organization which may be liable to the insured because of an act error or omission to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense without our consent.. Other Insurance If other valid and collectible insurance is avail able to the insured for a loss we cover under this endorsement our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insur ance is primary our obligations are not af fected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method de scribed in Paragraph c. below. b. Excess Insurance 1 This insurance is excess over any of the other insurance whether primary ex cess contingent or on any other basis that is effective prior to the beginning of the policy period shown in the Schedule of this insurance and that applies to an act error or omission on other than a claims made basis if a No Retroactive Date is shown in the Schedule of this insurance or b The other insurance has a policy period which continues after the Ret roactive Date shown in the Schedule of this insurance. 2 When this insurance is excess we will have no duty to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be entitled to the insured s rights against all those other insurers. 3 When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of the total amount that all such other insurance would pay for the loss in absence of this insurance and the total of all deductible and self insured amounts under all that other insurance. 4 We will share the remaining loss if any with any other insurance that is not de scribed in this Excess Insurance provi sion and was not bought specifically to apply in excess of the Limits of Insur ance shown in the Schedule of this en dorsement. c. Method Of Sharing If all of the other insurance permits contri bution by equal shares we will follow this method also. Under this approach each in surer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not per mit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limits of insurance to the total applicable limits of insurance of all insurers. Page 4 of 6 ISO Properties Inc. 2006 CG 04351207 o | 2 |
F. For the purposes of the coverage provided by this endorsement the following Extended Reporting Period provisions are added or if this endorse ment is attached to a claims made Coverage Part replaces any similar Section in that Coverage Part EXTENDED REPORTING PERIOD 1. You will have the right to purchase an Ex tended Reporting Period as described below if a. This endorsement is canceled or not re newed or b. We renew or replace this endorsement with insurance that 1 Has a Retroactive Date later than the date shown in the Schedule of this en dorsement or 2 Does not apply to an act error or omis sion on a claims made basis. 2. The Extended Reporting Period does not ex tend the policy period or change the scope of coverage provided. It applies only to claims for acts errors or omissions that were first committed before the end of the policy period but not before the Retroactive Date if any shown in the Schedule. Once in effect the Ex tended Reporting Period may not be canceled. 3. An Extended Reporting Period of five years is available but only by an endorsement and for an extra charge. You must give us a written request for the en dorsement within 60 days after the end of the policy period. The Extended Reporting Period will not go into effect unless you pay the addi tional premium promptly when due. We will determine the additional premium in accordance with our rules and rates. In doing s0 we may take into account the following a. The employee benefit programs insured b. Previous types and amounts of insurance c. Limits of insurance available under this endorsement for future payment of dam ages and d. Other related factors. The additional premium will not exceed 100 of the annual premium for this endorsement. The Extended Reporting Period endorsement applicable to this coverage shall set forth the terms not inconsistent with this Section appli cable to the Extended Reporting Period includ ing a provision to the effect that the insurance afforded for claims first received during such period is excess over any other valid and col lectible insurance available under policies in force after the Extended Reporting Period starts. 4. If the Extended Reporting Period is in effect we will provide an extended reporting period aggregate limit of insurance described below but only for claims first received and recorded during the Extended Reporting Period. The extended reporting period aggregate limit of insurance will be equal to the dollar amount shown in the Schedule of this endorsement under Limits of Insurance. Paragraph D.1.b. of this endorsement will be amended accordingly. The Each Employee Limit shown in the Schedule will then continue to apply as set forth in Paragraph D.1.c. G. For the purposes of the coverage provided by this endorsement the following definitions are added to the D ions Section 1. Administration means a. Providing information to employees in cluding their dependents and beneficiaries with respect to eligibility for or scope of employee benefit programs b. Handling records in connection with the employee benefit program or c. Effecting continuing or terminating any employee s participation in any benefit in cluded in the employee benefit program. However administration does not include handling payroll deductions. 2. Cafeteria plans means plans authorized by applicable law to allow employees to elect to pay for certain benefits with pre tax dollars. 3. Claim means any demand or suit made by an employee or an employee s dependents and beneficiaries for damages as the result of an act error or omission. CG 04351207 ISO Properties Inc. 2006 Page 5 of 6 a | 2 |
4. Employee benefit program means a program providing some or all of the following benefits to employees whether provided through a cafeteria plan or otherwise a. Group life insurance group accident or health insurance dental vision and hearing plans and flexible spending accounts pro vided that no one other than an employee may subscribe to such benefits and such benefits are made generally available to those employees who satisfy the plan s eligibility requirements b. Profit sharing plans employee savings plans employee stock ownership plans pension plans and stock subscription plans provided that no one other than an em ployee may subscribe to such benefits and such benefits are made generally available to all employees who are eligible under the plan for such benefits c. Unemployment insurance social security benefits workers compensation and dis ability benefits d. Vacation plans including buy and sell pro grams leave of absence programs includ ing military maternity family and civil leave tuition assistance plans transporta tion and health club subsidies and e. Any other similar benefits designated in the Schedule or added thereto by endorse ment. H. For the purposes of the coverage provided by this endorsement Definitions 5. and 18. in the Def tions Section are replaced by the following 5. 18. Employee means a person actively em ployed formerly employed on leave of ab sence or disabled or retired. Employee in cludes a leased worker. Employee does not include a temporary worker. Suit means a civil proceeding in which dam ages because of an act error or omission to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the in sured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. Page 6 of 6 ISO Properties Inc. 2006 CG 04351207 o | 2 |
POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 04370413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ELECTRONIC DATA LIABILITY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Loss Of Electronic Data Limit Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Exclusion 2.p. of Coverage A Bodily Injury And Property Damage Liability in Section Coverages is replaced by the following 2. Exclusions This insurance does not apply to p Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data that does not result from physical injury to tangible property. However this exclusion does not apply to liability for damages because of bodily injury. B. The following paragraph is added to Section Ill Limits Of Insurance Subject to 5. above the Loss of Electronic Data Limit shown in the Schedule above is the most we will pay under Coverage A for property damage because of all loss of electronic data arising out of any one occurrence. C. The following definition is added to the Defi section Electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. ons D. For the purposes of the coverage provided by this endorsement the definition of property damage in the Definitions section is replaced by the following 17. Property damage means a. Physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it or c. Loss of loss of use of damage to corruption of inability to access or inability to properly manipulate electronic data resulting from physical injury to tangible property. All such loss of electronic data shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance electronic data is not tangible property. CG 04370413 Insurance Services Office Inc. 2012 Page 1 0of 1 | 2 |
POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 20110413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises Part Leased To You Name Of Persons Or Organizations Additional Insured Additional Premium Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability arising out of the ownership maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions This insurance does not apply to 1. Any occurrence which takes place after you cease to be a tenant in that premises. 2. Structural alterations new construction or demolition operations performed by or on behalf of the persons or organizations shown in the Schedule. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20110413 Insurance Services Office Inc. 2012 Page 1 0of 1 | 2 |
POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 20320413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENGINEERS ARCHITECTS OR SURVEYORS NOT ENGAGED BY THE NAMED INSURED This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Engineers Architects Or Surveyors Not Engaged By The Named Insured Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the architects engineers or surveyors shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by 1. Your acts or omissions or 2. The acts or omissions of those acting on your behalf in the performance of your ongoing operations performed by you or on your behalf. Such architects engineers or surveyors while not engaged by you are contractually required to be added as an additional insured to your policy. However the insurance afforded to such additional insured 1. Only applies to the extent permitted by law and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following additional exclusion applies This insurance does not apply to bodily injury property damage or personal and advertising injury arising out of the rendering of or the failure to render any professional services including 1. The preparing approving or failing to prepare or approve maps drawings opinions reports surveys change orders designs or specifications or 2. Supervisory inspection or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage or the offense which caused the personal and advertising injury involved the rendering of or the failure to render any professional services. CG 20320413 Insurance Services Office Inc. 2012 Page 1 of 2 | 2 |
C. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance The most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 Insurance Services Office Inc. 2012 CG 20320413 | 2 |
COMMERCIAL GENERAL LIABILITY CG 2106 0514 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA RELATED LIABILITY WITH LIMITED BODILY INJURY EXCEPTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.p. of Section Coverage A As used in this exclusion electronic data Bodily Injury And Property Damage Liability is replaced by the following 2. Exclusions This insurance does not apply to p. Access Or Disclosure Of Confidential Or Personal Information And Data related Liability Damages arising out of 1 Any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information or The loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of that which is described in Paragraph 1 or 2 above. However unless Paragraph 1 above applies this exclusion does not apply to damages because of bodily injury. means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. B. The following is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or organization s confidential or personal information As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. B. The following is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or organization s confidential or personal information. CG 21060514 Insurance Services Office Inc. 2013 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG 21471207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYMENT RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability This insurance does not apply to Bodily injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demo tion evaluation reassignment discipline defamation harassment humiliation dis crimination or malicious prosecution di rected at that person or 2 The spouse child parent brother or sister of that person as a consequence of bodily injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after em ployment of that person Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. 2 B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Per sonal And Advertising Injury Liability This insurance does not apply to Personal and advertising injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demo tion evaluation reassignment discipline defamation harassment humiliation dis crimination or malicious prosecution di rected at that person or 2 The spouse child parent brother or sister of that person as a consequence of personal and advertising injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after em ployment of that person Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. 2 CG 21471207 ISO Properties Inc. 2006 Page 1 of 1 a | 2 |
COMMERCIAL GENERAL LIABILITY CG 21671204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FUNGI OR BACTERIA EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Bodily injury or property damage which would not have occurred in whole or in part but for the actual alleged or threat ened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed con currently or in any sequence to such injury or damage. b. Any loss cost or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxify ing neutralizing remediating or disposing of or in any way responding to or assess ing the effects of fungi or bacteria by any insured or by any other person or entity. This exclusion does not apply to any fungi or bacteria that are are on or are contained in a good or product intended for bodily consump tion. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Per sonal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Personal and advertising injury which would not have taken place in whole or in part but for the actual alleged or threat ened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed con currently or in any sequence to such injury. b. Any loss cost or expense arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any in sured or by any other person or entity. C. The following definition is added to the Definitions Section Fungi means any type or form of fungus includ ing mold or mildew and any mycotoxins spores scents or byproducts produced or released by fungi. CG 21671204 ISO Properties Inc. 2003 Page 1 of 1 a | 2 |
COMMERCIAL GENERAL LIABILITY CG 21700108 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk Insur ance Act exceed 100 billion in a Program Year January 1 through December 31 and we have met our insurer deductible under the Terrorism Risk Insur ance 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 ac cordance with procedures established by the Secre tary of the Treasury. Certified act of terrorism means an act that is certi fied by the Secretary of the Treasury in concurrence with the Secretary of State and the Attorney General of the United States to be an act of terrorism pursu ant 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 1. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. CG 21700108 ISO Properties Inc. 2007 Page 1 of 1 a | 2 |
COMMERCIAL GENERAL LIABILITY CG 21760108 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 2. The act is a violent act or an act that is dan i. gerous to human life property or infrastructure This insurance does not apply to and is committed by an individual or individuals TERRORISM PUNITIVE DAMAGES as part of an effort to coerce the civilian popu Damages arising directly or indirectly out of a lation of the United States or to influence the certified act of terrorism that are awarded as pu policy or affect the conduct of the United States nitive damages. Government by coercion. B. The following definition is added Certified act of terrorism means an act that is certified by the Secretary of the Treasury in con currence with the Secretary of State and the Attor ney General of the United States to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria contained in the Terror ism Risk Insurance Act for a certified act of terror ism include the following 1. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and 2. The act is a violent act or an act that is dan gerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian popu lation of the United States or to influence the policy or affect the conduct of the United States Government by coercion. CG 2176 0108 ISO Properties Inc. 2007 Page 10of 1 m | 2 |
POLICY NUMBER POLICY NUMBER COMMERCIAL GENERAL LIABILITY CG 22741001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED CONTRACTUAL LIABILITY COVERAGE FOR PERSONAL AND ADVERTISING INJURY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Contract Or Agreement If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. A. With respect to the contract or agreement desig nated in the Schedule above Subparagraph e. of Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability is replaced by the following 2. Exclusions This insurance does not apply to e. 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 1 Liability for damages that the insured would have in the absence of the contract or agreement or 2 Liability for personal and advertising injury if a The liability pertains to your busi ness and is assumed in the des ignated contract or agreement shown in the Schedule in which you assume the tort liability of an other. Tort liability means a liabil ity that would be imposed by law in the absence of any contract or agreement b The personal and advertising injury occurs subsequent to the execution of the designated con tract or agreement shown in the Schedule and c The personal and advertising 2 Liability for personal and advertising injury if a The liability pertains to your busi ness and is assumed in the des ignated contract or agreement shown in the Schedule in which you assume the tort liability of an other. Tort liability means a liabil ity that would be imposed by law in the absence of any contract or agreement b The personal and advertising injury occurs subsequent to the execution of the designated con tract or agreement shown in the Schedule and c The personal and advertising injury arises out of the offenses of false arrest detention or im prisonment. CG 22741001 ISO Properties Inc. 2001 Page 1 of 2 o | 2 |
Solely for the purposes of liability so as sumed in such designated contract or agreement reasonable attorney fees and necessary litigation expenses in curred by or for a party other than an in sured are deemed to be damages be cause of personal injury described in Paragraph A.2.e.2c above provided i Liability to such party for or for the cost of that party s defense has also been assumed in the same designated contract or agreement and ii 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. B. With respect to the contract or agreement desig nated in the Schedule above the following is added to Section Supplementary Payments Coverages A And B If we defend an insured against a suit and an in demnitee of the insured is also named as a party to the suit we will defend that indemnitee if all of the following conditions are met 1. The suit against the indemnitee seeks dam ages for which the insured has assumed tort li ability of the indemnitee in a designated con tract or agreement shown in the Schedule if such liability pertains to your business. Tort li ability means a liability that would be imposed by law in the absence of any contract or agreement 2. This insurance applies to such liability assumed by the insured 3. The obligation to defend or the cost of the defense of that indemnitee has also been as sumed by the insured in the same designated contract or agreement 4. The allegations in the suit and the information we know about the offense are such that no conflict appears to exist between the interests of the insured and the interests of the indem nitee 5. The indemnitee and the insured ask us to con duct and control the defense of that indemnitee against such suit and agree that we can as sign the same counsel to defend the insured and the indemnitee and 6. The indemnitee a. Agrees in writing to 1 Cooperate with us in the investigation settlement or defense of the suit Immediately send us copies of any de mands notices summonses or legal papers received in connection with the suit Notify any other insurer whose coverage is available to the indemnitee and 4 Cooperate with us with respect to coor dinating other applicable insurance available to the indemnitee and b. Provides us with written authorization to 1 Obtain records and other information related to the suit and 2 Conduct and control the defense of the indemnitee in such suit. So long as the above conditions are met attorneys fees incurred by us in the defense of that indem nitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supple mentary Payments. Notwithstanding the provisions of Paragraph A.2.e.2 of this endorsement such payments will not be deemed to be damages for personal and advertising injury as described in Paragraph A.2.e.2c above and will not reduce the limits of insurance. Our obligation to defend an insured s indemnitee and to pay for attorneys fees and necessary litiga tion expenses as Supplementary Payments ends when 1. We have used up the applicable limit of insur ance in the payment of judgments or settle ments or 2. The conditions set forth above or the terms of the agreement described in Paragraph 6. above are no longer met. 2 3 Page 2 of 2 ISO Properties Inc. 2001 CG 22741001 o | 2 |
COMMERCIAL GENERAL LIABILITY CG 22800413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED EXCLUSION CONTRACTORS PROFESSIONAL LIABILITY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability This insurance does not apply to bodily injury property damage or personal and advertising injury arising out of the rendering of or failure to render any professional services by you but only with respect to your providing engineering architectural or surveying services in your capacity as an engineer architect or surveyor. Professional services include 1. Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications and 2. Supervisory or inspection activities performed as part of any related architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage or the offense which caused the personal and advertising injury involved the rendering of or failure to render any professional services by you with respect to your providing engineering architectural or surveying services in your capacity as an engineer architect or surveyor. This exclusion does not apply to your operations in connection with construction work performed by you or on your behalf. CG 22800413 Insurance Services Office Inc. 2012 Page 1 0of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG 23010413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION REAL ESTATE AGENTS OR BROKERS ERRORS OR OMISSIONS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability This insurance does not apply to bodily injury property damage or personal and advertising injury arising out of any misrepresentation error or omission by you or any real estate agent or broker who is either employed by you or performing work on your behalf in such capacity. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage or the offense which caused the personal and advertising injury involved any misrepresentation error or omission by you or any real estate agent or broker who is either employed by you or performing work on your behalf in such capacity. CG 23010413 Insurance Services Office Inc. 2012 Page 1 0of 1 | 2 |
POLICY NUMBER COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BOATS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description of Watercraft Additional Premium If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. 1. Exclusion g. of COVERAGE A Section I does not apply to any watercraft owned or used by or rented to the insured shown in the Schedule. 2. WHO IS AN INSURED Section 1 is amended to include as an insured any person or organization legally responsible for the use of any such watercraft you own provided the actual use is with your permission. CG24121185 Copyright Insurance Services Office Inc. 1984 1992 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY QUICK REFERENCE COMMERCIAL GENERAL LIABILITY COVERAGE FORM OCCURRENCE COVERAGE READ YOUR POLICY CAREFULLY DECLARATIONS PAGES Named Insured And Mailing Address Policy Period Description Of Business And Location Coverages And Limits Of Insurance SECTION COVERAGES Coverage A Bodily Injury And Property Damage Liability Coverage B Personal And Advertising Injury Liability Coverage C Medical Payments Supplementary Payments..................... SECTION Il WHO ISAN INSURED............ SECTION Il LIMITS OF INSURANCE................ it Insuring Agreement. Exclusions Insuring Agreement.............. Exclusions Insuring Agreement. Exclusions SECTION IV COMMERCIAL GENERAL LIABILITYCONDITIONS........................... Bankruptcy Duties In The Event Of Occurrence Offense Claim Or Suit Legal Action Against Us Other Insurance.. Premium Audit. Representations Separation Of Insureds..................... Transfer Of Rights Of Recovery Against Others To Us When We Do Not Renew... SECTIONV DEFINITIONS.................. COMMON POLICY CONDITIONS Cancellation Changes Examination Of Your Books And Records Inspections And Surveys Premiums Transfer Of Your Rights And Duties Under This Policy ENDORSEMENTS If Any Beginning on Page CG700310 13 Page 10f 1 | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXTENSION OF WHO IS AN INSURED This Endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section Il Who Is An Insured Paragraphs 2.a. 2 P rty d 4 rty 2.a.1 and 2.a.2 are deleted and replaced by the 2 Property amage. 0 property following a Owned occupied or used by 2. Each of the following is also an insured b Rented to in the care custody or control of or over which physical control is being exercised for any purpose by a. Your volunteer workers only while performing duties related to the conduct of your business or your employees other than either your B N executive officers if you are an organization any of your volunteer workers. 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 volunteer workers is an insured for 1 Bodily injury or personal and advertising injury 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 any of your volunteer workers. CGT1057 14 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1 | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COVERAGE FOR INJURY TO CO EMPLOYEES AND OR YOUR OTHER VOLUNTEER WORKERS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Designated Specific Employees Volunteer Workers Or Specific Job Titles Information required to complete this Schedule if not shown above will be shown in the Declarations. A The following is added to Paragraph 2.a.1 of Section Il Who Is An Insured Paragraphs a b and c above do not apply to the specific employees or volunteer workers or any employees or volunteer workers holding the specific job titles designated in the Schedule of this endorsement with respect to bodily injury to a coemployee or other volunteer worker. B. The following is added to Paragraph 4. Other Insurance Condition under Section IV Commercial General Liability Conditions The coverage provided by this endorsement is excess over any other valid and collectible insurance that covers the liability of the designated employees or volunteer workers or an employee or volunteer worker holding a job title designated in the Schedule of this endorsement. CGT1407 14 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1 | 2 |
Commercial General Liability THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXTENDED PROPERTY DAMAGE COVERAGE Schedule Limits of Insurance Deductible 5000 Each Occurrence 250 Per Claim 25000 Annual Aggregate Insuring Agreement We will pay for loss to personal property of others including the loss of use of such property while in your care custody or control or personal property over which you for any purpose are exercising physical control when 1. loss arises out of operations away from your premises 2. loss is incidental to your normal business operations and 3. you have property damage liability coverage for that business under the coverage form to which this endorse ment is attached. Loss means unintentional damage or destruction but does not include disappearance or obstruction. Exclusions The coverage under this endorsement does not apply to loss to 1. property held by you for servicing repair storage or sale on premises you own rent occupy or otherwise con trol 2. property while being transported by or caused by the ownership maintenance operation use loading or un loading of any automobile watercraft or aircraft 3. property you own rent or occupy 4. real property. Limit of Insurance The limit of insurance stated in the Schedule of Limits as each occurrence is the most we will pay for all damages on account of each claim or suit covered under this endorsement. The limit of insurance stated in the Schedule of Limits as Annual Aggregate is subject to the above provision respecting each claim the total limit of our liability for all damages under this endorsement in any one policy period. Deductible We will not be liable on account of any loss except to the extent such loss is in excess of the deductible amount stated in the Schedule of Limits with the insurance then applying to such excess only subject otherwise to the appli cable limits of insurance. The terms of the policy with respect to your duties in the event of occurrence claim or suit and our right to investi gate negotiate and settle any claim or suit apply irrespective of the application of the deductible amount. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification of the action taken you will promptly reimburse us for any part of the deductible amount as has been paid by us. Settlement In the event of loss covered by this endorsement you will if requested by us replace the property or furnish the labor and materials necessary for repairs at actual cost to you excluding prospective profit or overhead charges of any nature. Any property so paid for or replaced at our option becomes our property. Payment will not constitute an admission of any liability on your part. Other Insurance If any other insurance carried by you applies to a loss covered by this endorsement this endorsement will not ap ply. Nothing herein contained will be held to alter vary or waive any of the agreements conditions or declarations of this policy except as herein stated. Form CG7141 Ed. 5 90 | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION CONTRACT OR AGREEMENT INCLUDING COMPLETED OPERATIONS PRIMARY AND NONCONTRIBUTORY COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section Il Who Is An Insured is amended to include as an additional insured 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. Such persons or organizations is an additional insured only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by a. Your acts or omissions or b. The acts or omissions of those acting on your behalf in the performance of a. your ongoing operations for the additional insured or b. Your work for the additional insured and included in the products completed operations hazard. However the insurance afforded to such additional insured described above a. Only applies to the extent permitted by law and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured.. With respect to the insurance afforded to these additional insureds the exclusion applies This insurance does not apply to bodily injury property damage and personal and advertising injury arising out of the rendering of or the failure to render any professional architectural engineering or surveying services including a. The preparing approving or failing to prepare or approve maps shop drawings opinions reports following additional E. This endorsement modifies the insurance provided under the following surveys field orders change orders or drawings and specifications or b. Supervisory inspection engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by the insured if the occurrence which caused the bodily injury or property damage or the offense which caused the personal and advertising injury involved the rendering of or the failure to render any professional architectural engineering or surveying services. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance The most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or described in Paragraph A.1. or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. The following is added to the Other Insurance Condition and supersedes any provision to the contrary Primary and Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that 1 The additional insured is a Named Insured under such other insurance and 2 You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of this policy remain unchanged. architectural or agreement CG7174.310 13 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1 | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY AMENDMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM The COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to include the following clarifications and extensions of coverage. The provisions of the coverage part apply unless modified by endorsement. A. NEWLY FORMED OR ACQUIRED E. FIRE LIGHTNING OR EXPLOSION DAMAGE ORGANIZATIONS 1. In paragraph 3.a. of Section Il Who is an Insured 90th Day is changed to 180th day. 2. This provision does not apply if newly formed or acquired organizations coverage is excluded either by the provisions of the Coverage Form or by endorsements. B. SUBSIDIARIES AS INSUREDS Section Il Who Is An Insured is amended by adding the following 1.f. Any legally incorporated subsidiary in which you own more than 50 of the voting stock on the effective date of this policy. However insured does not include any subsidiary that is an insured under any other general liability policy or would have been an insured under such a policy but for termination of that policy or the exhaustion of that policy s limits of liability.. SUPPLEMENTARY PAYMENTS Supplementary Payments Coverages A and B Paragraphs 1.b. and 1.d. are replaced by the following 1.b. Up to 3000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 1.d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit including actual loss of earnings up to 350 a day because of time off from work.. MEDICAL PAYMENTS If Section Coverage C Medical Payments Coverage is not otherwise excluded from this Coverage Form The requirement in the Insuring Agreement of Coverage C. that expenses must be incurred and reported to us within one year of the accident date is changed to three years. The word fire is changed to fire lightning or explosion wherever it appears in the Coverage Form. This amended wording does not apply to hostile fire. Under Section I Coverage A the last paragraph after the exclusions is replaced by the following Exclusions c. through n. do not apply to damage by fire lightning explosion smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section lll Limits of Insurance. NON OWNED WATERCRAFT Paragraph g.2 of Section Coverage A Exclusions is changed to read 2 A watercraft you do not own that is a Less than 51 feet long and b Not being used to carry persons or property for a charge. PROPERTY DAMAGE ELEVATORS With respect to Section Coverage A Exclusions paragraphs j.3 j.4 j.6 and k. do not apply to the use of elevators. The insurance afforded by this provision is excess over any valid and collectible property insurance including any deductible available to the insured and the Other Insurance Condition is changed accordingly.. MENTAL ANGUISH Section V Definition 3. is replaced by the following Bodily injury means bodily injury sickness or disease sustained by a person including mental anguish or death resulting from bodily injury sickness or disease. CGT1911 13 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f2 | 2 |
DUTIES IN THE EVENT OF OCCURRENCE OFFENSE CLAIM OR SUIT Section IV Commercial General Liability Condition paragraph 2. is amended by the following provision 1. The requirement in Condition 2.a. that you must see to it that we are notified as soon as practicable of an occurrence or an offense which may result in a claim applies only when the occurrence or offense is known to a. You if you are an individual or a limited liability company b. A partner if you are a partnership c. A manager if you are a limited liability company d. An executive officer or insurance manag er if you are a corporation or e. Atrustee if you are a trust. 2. The requirement in Condition 2.b. that you must see to it that we receive notice of a claim or suit as soon as practicable will not be considered breached unless the breach occurs after such claim or suit is known to a. You if you are an individual or a limited liability company b. A partner if you are a partnership c. A manager if you are a limited liability company d. An executive officer or insurance manag er if you are a corporation or e. Atrustee if you are a trust. UNINTENTIONAL FAILURE TO DISCLOSE EXPOSURES Section IV Commercial General Liability Condition paragraph 6. is amended to add the following provision If you unintentionally fail to disclose any exposures existing at the inception date of your policy we will not deny coverage under this Coverage Part solely because of such failure to disclose. However this provision does not affect our right to collect additional premium or exercise our right of cancellation or non renewal. This provision does not apply to any known injury or damage which is excluded under any other provision of this policy. LIBERALIZATION If we revise this endorsement to provide greater coverage without additional premium charge we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. CG71911 13 Includes copyrighted material of ISO Properties Inc. with its permission. Page 20f 2 | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS INCLUDING COMPLETED OPERATIONS PRIMARY AND NONCONTRIBUTORY This endorsement modifies the insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name Of Additional Insured Persons Or Organizations Project Location Of Project Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability arising out of your work performed for that additional insured by or for you at the location designated and described in the Schedule of this endorsement. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.. The following is added to the Other Insurance Condition and supersedes any provision to the contrary Primary and Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that 1 The additional insured is a Named Insured under such other insurance and 2 You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. f Project CG7193.110 13 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS EXTENDED PROPERTY DAMAGE COVERAGE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The COMMERCIAL GENERAL LIABILITY COVERAGE PART is amended to include the following extension of cov erage. The provisions of the Coverage Part apply unless modified by this endorsement. SCHEDULE LIMITS OF INSURANCE DEDUCTIBLE 5000 EACH OCCURRENCE 250 EACH CLAIM 25000 ANNUAL AGGREGATE INSURING AGREEMENT We will pay those sums that an insured becomes legally obligated to pay as damages because of property dam age to real or personal property of others while the property is in the insured s care custody or control or over which the insured is for any reason exercising physical control. EXCLUSIONS a. Coverage A Section I Exclusions j3 and j5 are deleted in their entireties. b. Coverage A Section Exclusion j4 is deleted and replaced with the following 1 Personal property in the care custody and control of an insured which is held for servicing repair stor age or sale at premises owned rented operated or used by the insured. LIMITS OF INSURANCE a. The each occurrence limit listed above is the most we will pay for all damages because of property damage to real and personal property in the care custody and control of an insured as the result of any one occur rence regardless of the number of 1 insureds 2 claims made or suits brought 3 persons or organizations making claims or bringing suits. b. The aggregate limit listed above is the most we will pay for all damages because of property damage to real or personal property in your care custody and control during the policy period. c. Any payments we make for damages because of property damage to real or personal property in your care custody or control will apply against the General Aggregate Limit shown in the declarations. DEDUCTIBLE Our obligation to pay damages on your behalf applies only to the amount of damages in excess of the deductible amount listed above. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification by us you will promptly reimburse us for that part of the deductible we paid. OTHER INSURANCE Insurance provided by this endorsement is excess over any other insurance whether primary excess contingent or any other basis. Since insurance provided by this endorsement applies if any other insurer has a duty to defend such a claim or suit. If no other insurer defends we will undertake to do so but we will be entitled to the in sured s rights against all those other insurers. DEDUCTIBLE 250 EACH CLAIM Form CG7253 Ed. 12 96 | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED POLLUTION COVERAGE WORK SITES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM With respect to SCHEDULE Each Pollution Incident Limit Pollution Liability Aggregate Limit Property Damage Deductible 100000 100000 1000 Each pollution incident coverage provided by this endorsement the provisions of the Coverage Form apply unless modified by this endorsement. A. Section COVERAGES is amended to include the following LIMITED POLLUTION COVERAGE SITES WORK 1. Insuring Agreement CG727610 08 We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage or clean up costs because of environmental 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 those damages for bodily injury property damage or clean up costs because of environmental damage to which this insurance does not apply. We may at our discretion investigate any pollution incident and settle any claim or suit that may result. But 1 The amount we will pay for damages and clean up costs is limited as described in SECTION C LIMITS OF INSURANCE of this endorsement and Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under SECTION B SUPPLEMENTARY PAYMENTS of this endorsement. This insurance applies to bodily injury property damage or clean up costs because of environmental damage but only if the bodily injury property damage or environmental damage is caused by a pollution incident 2 Includes copyrighted material of ISO Properties Inc. with its permission. 1 at or from a work site within the coverage territory 2 which first commences during the policy period 3 which ceases within 72 hours after it commences and 4 is reported to us within 30 days of its commencement. This reporting provision is in addition to the notification requirements set out in Section IV CONDITIONS. Damages because of bodily injury include damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. 2. Exclusions The insurance provided by this endorsement does not apply to Bodily injury property damage or environmental damage expected or intended from the standpoint of the insured. Bodily injury property damage or environmental 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 that the insured would have in the absence of the contract or agreement. Property damage or damage at or from 1 awaste facility 2 property or premises you own rent or environmental occupy 3 premises you sell give away or abandon if the property damage arises out of any part of those premises 4 property loaned to you or 5 personal property in your care custody or control. Page 10f3 Page 10f3 | 2 |
1 the transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or the use of mobile equipment in or while in practice or preparation for a prearranged racing speed or demolition contest or in any stunt activity or 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. I. Any loss cost or expense arising out of any request demand or order by a governmental authority 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 at any site which is included or proposed for inclusion on a governmental authority s clean up priority list. m. Any injury or damage included in the insurance provided by Section 1 Coverage A of this policy. B. For the purposes of the coverage provided by this endorsement 1. All references to Supplementary Payments Coverages A and B are replaced by Supplementary Payments Coverages A B and Limited Pollution Coverage Work Sites. 2. Paragraphs 1.b. and 2. of the Supplementary Payments provision do not apply. C. Section Il LIMITS OF INSURANCE is deleted in its entirety and replaced with the following For the purposes of the coverage provided by this endorsement. 1. Regardless of the number of insureds claims made or suits brought or persons or organizations making claims or bringing suits our liability under this endorsement is limited as follows a. The Each Pollution Incident Limit shown in the Schedule of Limits of Insurance of this endorsement is the most we will pay for all damages and clean up costs arising out of any one discharge dispersal seepage migration release or escape of pollutants under this endorsement. b. The Pollution Liability Aggregate Limit shown in the Schedule of Limits of Insurance of this endorsement is the most we will pay for the aggregate of all damages covered under this endorsement. 2 3 Clean up costs or any other expense incurred by you or others to test for monitor clean up remove contain treat detoxify or neutralize pollutants at or from 1 awaste facility or 2 premises you own rent or occupy or to any recovery claimed for such cost or expense. Bodily injury property damage or environmental damage included within the products completed operations hazard. Bodily injury property damage or environmental damage arising out of the ownership or operation of any offshore facility as defined in the Outer Continental Shelf Lands Act Amendment of 1978 to the Clean Water Act of 1977 or any deepwater port as defined in the Deepwater Port Act of 1974 as amended or as either Act may be amended. Bodily injury property damage or environmental damage arising out of a pollution incident from a work site or any part of a work site that is or was at any time used by you for the storage disposal processing or treatment of waste materials. Bodily injury property damage or environmental damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto rolling stock or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. Bodily injury property damage or environmental damage arising out of the emission discharge release or escape of drilling fluid oil gas or other fluids from any oil gas mineral water or geothermal well. Bodily injury property damage or environmental damage arising out of a pollution incident which results from or is directly attributable to failure to comply with any applicable statute regulation ordinance directive or order relating to the protection of the environment and promulgated by any governmental body provided that failure to comply is a willful or deliberate act or omission of 1 the insured or 2 you or any of your members partners or executive officers. Bodily injury property damage or environmental damage arising out of CG727610 08 Page 20f3 Includes copyrighted material of ISO Properties Inc. with its permission. | 2 |
2. The Limits of Insurance for coverages available within the Commercial General Liability Coverage Form that is part of this policy will be reduced by any damages paid on your behalf under this endorsement. 3. Property Damage Deductible a. Our obligation under this endorsement to pay damages for property damage or clean up costs because of environmental damage on your behalf applies only to the amount of damages or clean up costs in excess of any deductible amount stated in this endorsement as applicable to the Each Pollution Incident Limit. Neither the Each Pollution Incident Limit nor the Pollution Liability Aggregate Limit will be reduced by the application of such deductible amount. b. The terms of this insurance including those with respect to 1 our right and duty to defend any suits seeking those damages and 2 your duties in the event of a pollution incident claim or suit apply irrespective of the application of the deductible amount. c. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification or the action taken you shall promptly reimburse us of such part of the deductible amount as has been paid by us.. For the purposes of the coverage provided by this endorsement Condition 4. of Section IV Commercial Liability Conditions is amended as follows All references to Coverages A or B are amended to read Coverages A B or Limited Pollution Coverage Work Sites.. For the purposes of the coverage provided by this endorsement the following definitions are added to Section V DEFINITIONS. Clean up costs means expenses for and includes any costs for testing performed in connection with the removal remediation neutralization or disposal of pollutants. Environmental damage means the injurious presence in or upon land the atmosphere or any water course or body of water of pollutants which results directly from any physical injury to tangible property. Pollution incident means the actual emission discharge release or escape of pollutants from a work site provided that such emission discharge release or escape results in bodily injury property damage or environmental damage. The entirety of any such emission discharge release or escape will be deemed to be one pollution incident. Waste facility means any site to which waste from the operations or a work site is consigned for delivery or delivered for storage disposal processing or treatment. Work site means any premises site or location on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by you any contractor or subcontractor. Work site does not include any premises site or location which currently is or was at any time owned or occupied by or rented or loaned to you. CGT27610 08 Page 30f3 Includes copyrighted material of ISO Properties Inc. with its permission. | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT AGGREGATE LIMITS OF INSURANCE PER LOCATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The General Aggregate Limit under LIMITS OF INSURANCE Section Ill applies separately to each of your locations owned by or rented to you. Location means premises involving the same or connecting lots or premises whose connection is interrupted only by a street roadway waterway or right of way of a railroad. Includes copyrighted material of Insurance Services Office Inc. with its permission. Form CG7428 Ed. 11 98 Copyright Insurance Services Office Inc. 1984 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT AGGREGATE LIMITS OF INSURANCE PER PROJECT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The General Aggregate Limit under LIMITS OF INSURANCE Section Ill applies separately to each of your projects away from premises owned by or rented to you. Includes copyrighted material of Insurance Services Office Inc. with its permission. Form CG7429 Ed. 11 98 Copyright Insurance Services Office Inc. 1984 | 2 |
COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION EXTERIOR INSULATION AND FINISH SYSTEMS COMMERCIAL GENERAL LIABILITY COVERAGE FORM This endorsement modifies insurance provided under the following PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM. This insurance does not apply to bodily injury or property damage included within the products completed operations hazard or personal and advertising injury arising out of caused by or attributable to whether in whole or in part the design manufacture construction fabrication preparation distribution and sale installation application alteration maintenance or repair including remodeling service correction or replacement of any exterior insulation and finish system or any part thereof or any substantially similar system or any part thereof including the application or use of conditioners primers accessories flashings coatings caulking or sealants in connection with such a system. B. The following definition is added to the Definitions Section Exterior insulation and finish system means a non load bearing exterior cladding or finish system and all component parts therein used on any part of any structure and consisting of 1. A rigid or semi rigid insulation board made of expanded polystyrene and other materials 2. The adhesive andor mechanical fasteners used to attach the insulation board to the substrate 3. Areinforced or unreinforced base coat 4. A finish coat providing surface texture to which color may be added and 5. Any flashing caulking or sealant used with the system for any purpose. CG7523.33 07 Includes copyrighted material of ISO Properties Inc. with its permission. Page 10f 1 | 2 |
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