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ILLINOIS CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 39 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation Condition is replaced by the following CANCELLATION A. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 1. 2. We may cancel this policy by mailing to you written notice stating the reason for cancellation. If we cancel for nonpayment of premium we will mail the notice at least 10 days prior to the effective date of cancellation. If we cancel for a reason other than nonpayment of premium we will mail the notice at least a. 30 days prior to the effective date of cancellation if the policy has been in effect for 60 days or less. b. 60 days prior to the effective date of cancellation if the policy has been in effect for more than 60 days. B. If this policy has been in effect for more than 60 days we may cancel only for one or more of the following reasons 1. 2 3. 4. 5. Nonpayment of premium The policy was obtained through a material misrepresentation Any insured has violated any of the terms and conditions of the policy The risk originally accepted has measurably increased Certification to the Director of Insurance of the loss of reinsurance by the insurer that provided coverage to us for all or a substantial part of the underlying risk insured or A determination by the Director of Insurance that the continuation of the policy could place us in violation of the insurance laws of this State. C. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. D. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund will be less than pro rata. The cancellation will be effective even if we have not offered a refund. LD2861a 0201 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 10f2 | 2 |
The following is added and supersedes any provision to the contrary NONRENEWAL A If we decide not to renew this policy we will mail written notice stating the reason for nonrenewal no less than 60 days before the expiration date to 1. Youand 2. The broker if known to us or the agent of record. Even if we do not comply with these terms this policy will terminate 1. On the expiration date if a. You fail to perform any of your obligations in connection with the payment of the premium for the policy or any installment payment whether payable directly to us or our agents or indirectly under any premium finance plan or extension of credit or b. We have indicated our willingness to renew this policy to you or your representative or c. You have notified us or our agent that you do not want to renew this policy. Mailing of Notices We will mail cancellation and nonrenewal notices to you and the agent or broker at the last addresses known to us. Proof of mailing will be sufficient proof of notice. Authorized Agent LD2861a 0201 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 0f 2 | 2 |
INDIANA CHANGES CANCELLATION AND NONRENEWAL Named Insured Forward Air Corporation Endorsement Number 40 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Tssued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation condition is replaced by the following A. Cancellation 1. 2. 6. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. a. Cancellation of Policies in Effect for 90 Days or Less If this policy has been in effect for 90 days or less we may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least 1 10 days before the effective date of cancellation if we cancel for nonpayment of premium. 2 20 days before the effective date of cancellation if you have perpetrated a fraud or material misrepresentation on us 3 30 days before the effective date of cancellation if we cancel for any other reason. b. Cancellation of Policies in Effect for More Than 90 Days If this policy has been in effect for more than 90 days or is a renewal of a policy we issued we may cancel this policy only for one or more of the reasons listed below by mailing or delivering to the first Named Insured written notice of cancellation at least 1 10 days before the effective date of cancellation if we cancel for nonpayment of premium 2 20 days before the effective date of cancellation if you have perpetrated a fraud or material misrepresentation on us 3 45 days before the effective date of cancellation if a There has been a substantial change the scale of risk covered by this policy or b Reinsurance of the risk associated with this policy has been cancelled. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be loss than pro rata. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficient proof of notice. LD2S862a 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 10f 2 | 2 |
II. The following Condition supersedes any other provisions to the contrary. NONRENEWAL A If we elect not to renew this policy we will mail or deliver to the first Named Insured written notice of nonrenewal at least 45 days before 1. The expiration date of this policy if the policy is written for a term of one year or less or 2. The anniversary date of this policy if the policy is written for a term of more than one year. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. If notice is mailed proof of mailing will be sufficient proof of notice. Authorized Agent LD2S862a 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 of 2 | 2 |
IOWA CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 41 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation condition is replaced by the following A C. D. Cancellation The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 1. We may cancel this policy by mailing or delivering to the first Named Insured and any loss payee written notice of cancellation at least a. 30 days before the effective date of cancellation if we cancel due to loss of reinsurance coverage b. 10 days before the effective date of cancellation if we cancel for any other reason. 2. Ifthis policy is a new policy and has been in effect for less than 60 days we may cancel for a. loss of reinsurance subject to 4. below or b. any other reason. 3. If this policy has been in effect for 60 days or more or is a renewal of a policy we issued we may cancel only for one or more of the following reasons a. Nonpayment of premium b. Misrepresentation or fraud made by or with your knowledge in obtaining the policy when renewing the policy or in presenting a claim under the policy c. Acts or omissions by you that substantially change or increase the risk insured d. Determination by the commissioner that the continuation of the policy would jeopardize our solvency or would place us in violation of the insurance laws of this or any other state e. You have acted in a manner which you knew or should have known was in violation or breach of a policy term or condition or f. Loss of reinsurance subject to 4. below. 4. We may cancel due to loss of reinsurance which provides coverage to us for a significant portion of the underlying risk insured but only if the commissioner determines that such cancellation is justified. We will mail or deliver our notice to the first Named Insured s and any loss payee s last mailing address known to us. Notice of cancellation will state 1. The reason for cancellation and 2. The effective date of cancellation. The policy period will end on that date. LD2563 0392 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 10f2 | 2 |
E. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. F. If notice is mailed a post office department certificate of mailing is proof of receipt of notice. However if cancellation is for non payment of premium a certificate of mailing is not required. II. The following supersedes any other provision to the contrary NONRENEWAL A. If we decide not to renew this policy we will mail or deliver written notice of nonrenewal to the first Named Insured and any loss payee at least 45 days before the expiration date of this policy except if a. We have offered to issue a renewal policy or b. You have failed to pay a premium due or any advance premium required by us for renewal. B. If notice is mailed a post office department certificate of mailing is proof of receipt of notice. Authorized Agent LD2563 0392 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 0f 2 | 2 |
KANSAS CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 42 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. a. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation stating the reasons for cancellation at least 1 10 days before the effective date of cancellation if we cancel for nonpayment of premium 2 30 days before the effective date of cancellation if we cancel for any other reason. b. If this policy has been in effect for 90 days or more or if it is a renewal of a policy we issued we man cancel this policy only for one or more of the following reasons 1 Nonpayment of premium 2 3 4 This policy was issued because of material misrepresentation You or any other insured violated any of the material terms and conditions of this policy Unfavorable underwriting factors specific to you exist that were not present at the inception of this policy 5 A determination by the insurance commissioner that continuation of coverage could place us in a hazardous financial condition or in violation of the laws of Kansas or G A determination by the insurance commissioner that we no longer have adequate reinsurance to meet our needs. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficient proof of notice. LD2S64a 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 10f 2 | 2 |
II. The following Condition supersedes any other provisions to the contrary. NONRENEWAL A If we decide not to renew this policy we will mail or deliver written notice of nonrenewal stating the reasons for nonrenewal to the first Named Insured at least 60 days prior to the expiration of the policy. Any notice of nonrenewal will be mailed or delivered to the first Named Insured s last mailing address known to us. If notice is mailed proof of mailing will be sufficient proof of notice. Authorized Agent LD2S64a 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 of 2 | 2 |
KENTUCKY CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 43 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation Condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. Cancellation of Policies in Effect For 60 Days Or Less If this policy has been in effect for 60 days or less we may cancel this policy for any reason by mailing or delivering to the first Named Insured written notice of cancellation stating the reason for cancellation at least 14 days before the effective date of cancellation. 3. Cancellation of Policies In Effect For More Than 60 Days A. If this policy has been in effect for more than 60 days or is a renewal of a policy we issued we may cancel this policy only for one or more of the following reasons 1 Nonpayment of premium 2 Discovery of fraud or material misrepresentation made by you or with your knowledge in obtaining the policy continuing the policy or in presenting a claim under the policy 3 Discovery of willful or reckless acts or omissions on your part which increase any hazard insured against 4 The occurrence of a change in the risk which substantially increases any hazard insured against after insurance coverage has been issued or renewed s A violation of any local fire health safety building or construction regulation or ordinance with respect to any insured property or the occupancy thereof which substantially increases any hazard insured against 6 We are unable to reinsure the risk covered by the policy or 7 A determination by the commissioner that the continuation of the policy would place us in violation of the Kentucky insurance code or regulations of the commissioner. B. If we cancel this policy based on paragraph G.1. Above we will mail or deliver to the first Named Insured a written notice of cancellation stating the reason for cancellation at least 75 days before the effective date of the cancellation at least 1 14 days before the effective date of the cancellation if cancellation is for non payment of premium or 2 75 days before the effective date of the cancellation if cancellation is for any reason stated in G.1.b. through G.1.g. above. LD2865a 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 10f2 | 2 |
4. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 6. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 7. If notice is mailed proof of mailing will be sufficient proof of notice. II. The following Condition supersedes any other provisions to the contrary. XIV. NONRENEWAL A. For the purpose of this Condition 1. Any policy period or term of less than 6 months shall be considered to be a policy period or term of six months and 2. Any policy period or term of more than 1 year or any policy with no fixed expiration date shall be considered a policy period or term of 1 year. B. If we elect not to renew this policy we will mail or deliver written notice of nonrenewal stating the reason for nonrenewal to the first Named Insured shown in the Declarations at the last mailing address known to us at least 75 days before the expiration date of the policy period. C. If notice of nonrenewable is not provided pursuant to this Condition coverage under the same terms and conditions shall be deemed to be renewed for the ensuing policy period upon payment of the appropriate premium until you have accepted replacement coverage with another insurer or until you have agreed to the nonrenewal. D. If we mail or deliver a renewal notice to the first Named Insured at least 30 days before the end of the policy period stating the renewal premium and its due date the policy will terminate without further notice unless the renewal premium is received by us or our authorized agent by the due date. E. If this policy terminates because the renewal premium has not been received by the due date we will within 15 days mail or deliver to the first Named Insured at his last known address a notice that the policy was not renewed and the date it was terminated. F. If notice is mailed proof of mailing is sufficient proof of notice. Authorized Agent LD2865a 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 0f 2 | 2 |
LOUISIANA CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 44 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information s to be completed only when this endorsement is fssued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation Condition is replaced by the following A. Cancellation 1. 2. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. CANCELLATION OF POLICIES IN EFFECT FOR FEWER THAN 60 DAYS AND NOT RENEWALS. If this policy has been in effect for fewer than 60 days and is not a renewal of a policy we issued we may cancel this policy for any reason subject to the following 1 Cancellation for nonpayment of premium We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least 30 days before the effective date of cancellation. 2 Cancellation for any other reason We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. CANCELLATION OF RENEWAL POLICIES AND NEW POLICIES IN EFFECT FOR 60 DAYS OR MORE If this policy has been in effect for 60 days or more or is a renewal of a policy we issued we may cancel only for one or more of the following reasons 1 Nonpayment of premium 2 Fraud or material misrepresentation made by you or with your knowledge in obtaining the policy continuing the policy or in presenting a claim under the policy 3 4 Change in the risk which increases the risk of loss after we issued or renewed this policy including an increase in exposure due to regulation legislation or court decision Activities or omissions by you which change or increase any hazard insured against 5 Determination by the Commissioner of Insurance that the continuation of this policy would jeopardize our solvency or would place us in violation of the insurance laws of this or any other state 6 7 Any other reason that are approved by the Commissioner of Insurance. The insured s violation or breach of any policy terms or conditions or LD2S66 082001 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 1 of 2 | 2 |
We will mail or deliver written notice of cancellation under this item 2. to the first Named Insured at least a 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b 30 days before the effective date of cancellation if we cancel for a reason described in 2.a. through g. above. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due subject to paragraphs e.1. and e.2. The cancellation will be effective even if we have not made or offered a refund. a. If we cancel the refund will be pro rata. b. If the first Named Insured cancels the refund may be less than pro rata and will be sent to the first Named Insured within 30 days after the effective date of cancellation. 6. If notice is mailed proof of mailing will be sufficient proof of notice. The following Condition supersedes any other provisions to the contrary. NONRENEWAL A If we decide not to renew this policy we will mail or deliver written notice of nonrenewal to the first Named Insured at the last address shown on the policy at least 60 days before its expiration date or its anniversary date if it is a policy written for a term of more than one year or with no fixed expiration date.. We need not mail or deliver this notice if 1. We or another company within our insurance group have offered to issue a renewal policy or 2. You have obtained replacement coverage or have agreed in writing to obtain replacement coverage. Any notice of nonrenewal will be mailed or delivered to the First Named Insured at the last mailing address known to us. If notice is mailed proof of mailing will be sufficient proof of notice. Our notice of nonrenewal shall include the Named Insured s loss run information for the period the policy has been in force with us but will not exceed the last three years of coverage. If the nonrenewal notice is mailed less than sixty days before expiration coverage will remain in effect under the same terms and conditions until sixty days after notice is mailed or delivered. Earned premium for any period of coverage that extends beyond the expiration date shall be considered pro rata based upon the previous year s rate. The transfer of a policyholder between companies within the same insurance group shall not be a refusal to renew. In addition changes in the deductible changes in rate changes in the amount of insurance or reductions in policy limits or coverage shall not be refusals to renew. Authorized Agent LD2S66 082001 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 0f 2 | 2 |
MARYLAND CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 45 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. A. The Cancellation Condition is replaced by the following 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. When this policy has been in effect for 45 days or less and is not a renewal policy we may cancel this Coverage Part by mailing to the first Named Insured at the last mailing address known to us written notice of cancellation stating the reason for cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium b. 15 days before the effective date of cancellation if we cancel because the risk does not meet our underwriting standards. 3. When this policy has been in effect for more than 45 days or is a renewal policy we may cancel this Policy by mailing to the first Named Insured at the last mailing address known to us written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium. b. 45 days before the effective date of cancellation if we cancel for a permissible reason other than nonpayment of premium stating the reason for cancellation. Under this Paragraph b. we may cancel only for one or more of the following reasons 1 When there exists material misrepresentation or fraud in connection with the application policy or presentation of a claim. 2 A change in the condition of the risk that results in an increase in the hazard insured against. 3 A matter or issue related to the risk that constitutes a threat to public safety. If we cancel pursuant to Paragraph 3.b. you may request additional information on the reason for cancellation within 30 days from the date of our notice. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund will be calculated as follows a. Policies Written For One Year Or Less We will refund 90 of the pro rata unearned premium. b. Policies Written For More Than One Year 1 If the policy is cancelled in the first year we will refund 90 of the pro rata unearned premium for the first year plus the full annual premium for subsequent years. 2 Ifthe policy is cancelled after the first year we will refund the pro rata unearned premium. Includes copyrighted material of Insurance Services Office Inc. with its permission. LD2S68c 0516 Page 1 of 2 | 2 |
c. Continuous And Annual Premium Payment Policies We will refund 90 of the pro rata unearned premium for the year in which the policy is cancelled. We will retain the minimum premium except if the Policy is cancelled as of the inception date. However if this policy is financed by a premium finance company and we or the premium finance company or the first Named Insured cancels the policy the refund will consist of the gross unearned premium computed pro rata excluding any expense constant administrative fee or nonrefundable charge filed with and approved by the insurance commissioner. The cancellation will be effective even if we have not made or offered a refund. We will send notice of cancellation to the first Named Insured by a first class mail tracking method if a. We cancel for nonpayment of premium or b. This Policy is not a renewal of a policy we issued and has been in effect for 45 days or less. We will send notice to the first Named Insured by a first class mail tracking method or by commercial mail delivery service if we cancel for a reason other than nonpayment of premium and this Policy a. Is a renewal of a policy we issued or b. Has been in effect for more than 45 days. We will maintain proof of mailing in a form authorized or accepted by the United States Postal Service or by other commercial mail delivery service when such service is used. Proof of mailing will be sufficient proof of notice.. The following condition is added and supersedes any provisions to the contrary When We Do Not Renew 1. We may elect not to renew this policy by mailing notice of nonrenewal to the first Named Insured at the last mailing address known to us at least 45 days before the expiration date of this policy. We will send notice of nonrenewal to the first Named Insured by a first class mail tracking method or by commercial mail delivery service. We will maintain proof of mailing in a form authorized or accepted by the United States Postal Service or by other commercial mail delivery service when such service is used. Proof of mailing will be sufficient proof of notice. When we elect not to renew a policy that has been in effect for more than 45 days for a reason other than nonpayment of premium we will provide a written statement of the actual reason for the refusal to renew. You may request additional information within 30 days from the date of our notice. If we offer to renew at least 45 days before the renewal date and you fail to make the required premium payment by the renewal date the policy will terminate on the renewal date for nonpayment of premium.. The following definition is added First class mail tracking method means a method that provides evidence of the date that a piece of first class mail was accepted for mailing by the United States Postal Service including a certificate of mail and an electronic mail tracking system used by the United States Postal Service. First class mail tracking method does not include a certificate of bulk mailing. Authorized Representative Includes copyrighted material of Insurance Services Office Inc. with its permission. LD2S68c 0516 Page 2 of 2 | 2 |
MICHIGAN CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 46 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation Condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this Policy by giving us or our authorized agent notice of cancellation. We may cancel this Policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 30 days before the effective date of cancellation if we cancel for any other reason. We will mail or deliver our notice to the first Named Insured s last mailing address known to us or our authorized agent. The time of surrender or the effective date and hour of cancellation stated in the notice shall become the end of the policy period. If this policy is cancelled we will send the first Named Insured any pro rata premium refund due. The minimum earned premium shall not be less than the pro rata premium for the expired time or 25.00 whichever is greater. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficient proof of notice. II. The following condition supersedes any other provisions to the contrary Nonrenewal If we decide not to renew this Policy we will mail or deliver to the first Named Insured s last mailing address known to us or our authorized agent 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. Authorized Representative Includes copyrighted material of Insurance Services Office Inc. with its permission. Page1of1 LD2S69e 0417 | 2 |
MINNESOTA CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 47 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The CANCELLATION Condition is replaced by the following A. CANCELLATION 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy subject to the provisions of A.3. below by first class mailing or by delivery of a written notice of cancellation to the first Named Insured and any agent to their last mailing addresses known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 3. Policies In Effect a. Less than 90 days If this policy is a new policy and has been in effect for fewer than 90 days we may cancel for any reason by giving notice at least 1. 2. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or 30 days before the effective date of cancellation if we cancel for any other reason. b. 90 Days Or More If this policy has been in effect for 90 days or more or if it is a renewal of policy we issued we may cancel only for one or more of the following reasons 1. 2. Nonpayment of premium Misrepresentation or fraud made by you or with your knowledge in obtaining the policy or in pursuing a claim under the policy An act or omission by you that substantially increases or changes the risk insured Refusal by you to eliminate known conditions that increase the potential for loss after notification by us that the condition must be removed Substantial change in the risk assumed except to the extent that we should reasonably have foreseen the change or contemplated the risk in writing the contract Loss of reinsurance by us which provided coverage to us for a significant amount of the underlying risk insured. Any notice of cancellation pursuant to this item shall advise the policyholder that he or she has 10 days from the date of receipt of the notice to appeal the cancellation to the commissioner of commerce and that the commissioner will render a decision as to whether the cancellation is justified because of the loss of reinsurance within 30 business days after receipt of the appeal LD2S70a 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. Page 10f 2 with its permission Page 10f 2 | 2 |
7. A determination by the commissioner that the continuation of the policy could place us in violation of the Minnesota insurance laws or 8. Nonpayment of dues to an association or organization other than an insurance association or organization where payment of dues is a prerequisite to obtaining or continuing such insurance. This provision for cancellation for failure to pay dues shall not be applicable to persons who are retired at 62 years of age or older or who are disabled according to social security standards. Under this item A.3.b. will give notice at least 1 10 days before the effective date of cancellation if we cancel for nonpayment of premium. The cancellation notice shall contain the information regarding the amount of premium due and the due date and shall state the effect of nonpayment by the due date. Cancellation shall not be effective if payment of the amount due is made prior to the effective date of cancellation or 2 60 days before the effective date if we cancel for a reason described in A.3.b.2 through 8 above. The notice of cancellation will state the reason for cancellation. 4. If this policy is canceled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 5. Proof of mailing of any notice shall be sufficient proof of notice. B. The following supersedes any provisions to the contrary NONRENEWAL If we decide not to renew this policy we may do so by giving the first Named Insured and any agent written notice of our intent not to renew at least 60 days before the expiration date of this policy. Such notice will be delivered or mailed by first class mail to their last mailing addresses known to us. Proof of mailing of any notice shall be sufficient proof of notice. We need not mail or deliver this notice if you have 1. Insured elsewhere 2. Accepted replacement coverage or 3. Agreed not to renew this policy. Authorized Agent LD2870a 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 of 2 | 2 |
MINNESOTA CHANGES ENDORSEMENT Named Insured Forward Air Corporation Endorsement Number 48 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Tssued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies all insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY Item 1. Bankruptcy of Section IV Conditions is replaced by the following Bankruptcy or insolvency or dissolution of the insured or of the insured s estate will not relieve us of our obligations under this policy. Authorized Agent X8 22360 0607 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 1 of 1 | 2 |
MISSISSIPPI CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 49 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. The following Condition supersedes any other provisions to the contrary. NONRENEWAL A. If we decide not to renew this policy we will mail or deliver written notice of nonrenewal to the first Named Insured at least 1. 10 days before the effective date of nonrenewal if the nonrenewal is due to nonpayment of premium or 2. 30 days before an anniversary date or the expiration date of the policy if the nonrenewal is for any other reason. B. The notice of nonrenewal will be mailed or delivered to the first Named Insured s last mailing address known to us. If notice is mailed proof of mailing will be sufficient proof of notice. Authorized Agent LD2S71a 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 1 of 1 | 2 |
MISSOURI CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 50 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Tssued By Name of Insurance Company ACE Ameri ican Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. T If the policy more favoral HIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions ble to the Named Insured than this endorsement then those provisions apply. I. The Cancellation Condition is replaced by the following A. Cancellation 1. 6. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation stating the actual reason for cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium b. 30 days before the effective date of cancellation if cancellation is for one or more of the following reasons 1 Fraud or material misrepresentation affecting this policy or a claim filed under this policy or a violation of any of the terms or conditions of this policy 2 Changes in conditions after the effective date of this policy which have materially increased the risk assumed 3 We become insolvent or 4 We involuntarily lose reinsurance for this policy. c. 60 days before the effective date of cancellation if we cancel for any other reason. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficient proof of notice. II. The following Condition supersedes any other provisions to the contrary NONRE A. We maill NEWAL may elect not to renew this policy by mailing or delivering to the first Named Insured at the last ing address known to us written notice of nonrenewal stating the actual reason for nonrenewal at least sixty days prior to the effective date of the nonrenewal. B. If notice is mailed proof of mailing will be sufficient proof of notice. LD2872c 0805 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 10f 2 | 2 |
The following is added Missouri Property and Casualty Insurance Guaranty Association Coverage Limitations A. Subject to the provisions of the Missouri Property and Casualty Insurance Guaranty Association Act to be referred to as the Act if we are a member of the Missouri Property and Casualty Insurance Guaranty Association to be referred to as the Association the Association will pay claims covered under the Act if we become insolvent.. The Act contains various exclusions conditions and limitations that govern a claimant s eligibility to collect payment from the Association and affect the amount of any payment. The following limitations apply subject to all other provisions of the Act 1. Claims covered by the Association do not include a claim by or against an insured of an insolvent insurer if the insured has a net worth of more than 25 million on the later of the end of the insured s most recent fiscal year or the December thirty first of the year next preceding the date the insurer becomes insolvent provided that an insured s net worth on such date shall be deemed to include the aggregate net worth of the insured and all of its affiliates as calculated on a consolidated basis. 2. Payments made by the Association for covered claims will include only that amount of each claim which is less than 300000. However the Association will not 1 Pay an amount in excess of the applicable limit of insurance of the policy from which a claim arises or 2 Return to an insured any unearned premium in excess of 25000. These limitations have no effect on the coverage we will provide under this policy. Authorized Agent LD2872c 0805 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 of 2 | 2 |
NEBRASKA CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 51 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation Condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. We may cancel this policy by mailing by registered certified or first class mail to the first Named Insured at the Insured s last known mailing address written notice of cancellation stating the reasons for cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 60 days before the effective date of cancellation if cancellation is for any other reason. If sent by First Class Mail a United States Postal Services certificate of mailing shall be sufficient proof of receipt of notice on the third calendar day after the date of the certificate. If this policy has been in effect for 60 days or more or is a renewal of a policy written through us we may cancel this policy only for one or more of the following reasons Nonpayment of premium The policy was obtained through a material misrepresentation You submit a fraudulent claim under this policy Violation by you of any of the terms and conditions of this policy The risk originally accepted has substantially increased o o0 T W Certification to the Director of Insurance of our loss of reinsurance which provided coverage to us for all or a substantial part of the underlying risk insured or g. The determination by the Director of Insurance that the continuation of the policy could place us in violation of the Nebraska Insurance laws. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficient proof of notice. LD2S74a 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. Page 10f 2 with its permission | 2 |
II. The following Condition supersedes any other provisions to the contrary NONRENEWAL A If we decide not to renew this policy we will mail by registered certified or first class mail written notice of nonrenewal stating the reasons for nonrenewal to the first Named Insured at the Insured s last known mailing address at least 60 days prior to the expiration date of this policy. If sent by First Class Mail a United States Postal Service certificate of mailing shall be sufficient proof of receipt of notice on the third calendar day after the date of the certificate. Authorized Agent LD2S74a 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. Page 2 of 2 with its permission | 2 |
NEVADA CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 52 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Tssued By Name of Insurance Company ACE American Insurance Company Tnsert the policy number. The remainder of the information s 0 be completed only when this endorsement is fssued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The following are added to the CANCELLATION Condition A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 30 days before the effective date of cancellation if we cancel for any other reason. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice. 7.A.MID TERM CANCELLATION If this policy has been in effect for 70 days or more or if this policy is a renewal of a policy we issued we may cancel this policy only for one or more of the following reasons 1. Nonpayment of premium 2. Conviction of the insured of a crime arising out of acts increasing the hazard insured against 3. Discovery of fraud or material misrepresentation in obtaining the policy or in presenting a claim thereunder 4. Discovery of an act or omission or a violation of any condition of the policy which occurred after the first effective date of the current policy and substantially and materially increases the hazard insured against 5. A material change in the nature or extent of the risk occurring after the first effective date of the current policy which causes the risk of loss to be substantially and materially increased beyond that contemplated at the time the policy was issued or last renewed 6. A determination by the commissioner that continuation of our present volume of premiums would jeopardize our solvency or be hazardous to the interests of our policyholders creditors or the public LD3507a 0201 Printed in the U.S.A. Includes copyrighted material of Insurance Services Office Inc. Page 1 of 2 with its permission Includes copyrighted material of Insurance Services Office Inc. with its permission Page 1 of 2 | 2 |
7. A determination by the commissioner that the continuation of the policy would violate or place us in violation of any provision of the code. B. ANNIVERSARY CANCELLATION If this policy is written for a term longer than one year we may cancel for any reason at an anniversary by mailing or delivering written notice of cancellation to the first Named Insured at the last mailing address known to us at least 60 days before the anniversary date. The following Condition supersedes any other provision to the contrary NONRENEWAL A. If we elect not to renew this policy we will mail or deliver to the first Named Insured shown in the Declarations a notice of intention not to renew at least 60 days before the agreed expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. B. We need not provide this notice if 1. You have accepted replacement coverage. 2. You have requested or agreed to nonrenewal or 3. This policy is expressly designated as nonrenewable. NOTICES A. Notice of cancellation or nonrenewal in accordance with I. and Il. above will be mailed first class or certified or delivered to the first Named Insured at the last mailing address known to us and will state the reason for cancellation or nonrenewal. B. We will also provide a copy of the notice of cancellation for both policies in effect less than 70 days and policies in effect 70 days or more to the agent who wrote the policy. Authorized Agent LD3507a 0201 Printed in the U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 0f 2 | 2 |
NEW JERSEY CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 53 Policy Symbol Policy Number. Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. Any cancellation or non renewal provisions contained in the policy to which this endorsement is attached are deleted and replaced by the following I. Pursuant to New Jersey law this policy can not be cancelled or nonrenewed for any underwiting reason or guideline which is arbitrary capricious or unfairly discriminatory or without adequate prior notice to the insured. The under writing reasons or guidelines that an insurer can use to cancel or nonrenew this policy are maintained by the in surer in writing and will be furnished to the insured andor the insured s lawful representative upon written request. A. CANCELLATION 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. If this policy has been in effect for less than 60 days we may cancel this policy by mailing or delivering to the first Named Insured and any person entitled to notice under this policy written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for 1 Nonpayment of premium or 2 Existence of a moral hazard as defined in N.J.A.C. 111 20.2f as follows a The risk danger or probability that the insured will destroy or permit to be destroyed the insured property for the purpose of collecting the insurance proceeds. Any change in the circumstances of an insured that will increase the probability of such a destruction may be considered a moral hazard and b The substantial risk danger or probability that the character circumstances or personal habits of the insured may increase the possibility of loss or liability for which an insurer will be held responsible. Any change in the character or circumstances of an individual corporate partnership or other insured that will increase the probability of such a loss or liability may be considered a moral hazard. b. 30 days before the effective date of cancellation if we cancel for any other reason. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice. LD2876 Page 10of 3 | 2 |
7. Cancellation of Policies in Effect For 60 Days or More. a. If this policy has been in effect for 60 days or more or is a renewal of a policy we issued we may cancel this policy only for one or more of the following reasons Nonpayment of premium Existence of a moral hazard as defined in N.J.A.C. 111 20.2f 3 Material misrepresentation or nondisclosure to us of a material fact at the time of acceptance of the risk 4 Increased hazard or material change in the risk assumed which we could not have reasonably contemplated at the time of assumption of the risk 5 Substantial breaches of contractual duties conditions or warranties that materially affect the nature andor insurability of the risk 6 Lack of cooperation from the insured on loss control matters materially affecting insurability of the risk 7 Fraudulent acts against us by the insured or its representative that materially affect the nature of the risk insured Loss of or reduction in available insurance capacity 9 Material increase in exposure arising out of changes in statutory or case law subsequent to the issuance of the insurance contract or any subsequent renewal 10 Loss of or substantial changes in applicable reinsurance 1 Failure by the insured to comply with any Federal State or local fire health safety or building or construction regulation law or ordinance with respect to an insured risk which substantially increases any hazard insured against within 60 days of written notification of a violation of any such law regulation or ordinance 12 Failure by the insured to provide reasonable and necessary underwriting information to us upon written request therefor and a reasonable opportunity to respond 13 Agency termination provided a. We document that replacement coverage at comparable rates and terms has been provided to the first Named Insured and we have informed the first Named Insured in writing of the right to continue coverage with us or b. We have informed the first Named Insured in writing of the right to continue coverage with us and the first Named Insured has agreed in writing to the cancellation or nonrenewal based on the termination of the first Named Insured s appointed agent. 14 Any other reasons in accordance with our underwriting guidelines for cancellation of commercial lines coverage. If we cancel this policy based on paragraph 7.a.1 or 2 above we will mail a written notice stating the reason for cancellation to the first Named Insured and any person entitled to notice under this policy at least 10 days before the effective date of cancellation. For cancellation due to the nonpayment of premium the notice will state the effect of nonpayment by the due date. Cancellation for nonpayment of premium will not be effective if payment of the amount due is made before the effective date set forth in the notice. If we cancel this policy for any other reason listed above we will mail a written notice stating the reason for cancellation to the first Named Insured and any person entitled to notice under this policy not more than 120 days nor less than 30 days before the effective date of such cancellation. Notice will be sent to the last mailing addresses known to us by 1 Certified mail or 2 First class mail if we have obtained from the post office a date stamped proof of mailing showing names and addresses. LD2876 Page 2 of 3 | 2 |
d. We need not send notice of cancellation if you have 1 Replaced coverage elsewhere or 2 Specifically requested termination. B. NONRENEWAL 1. We may elect not to renew this policy for any reason permitted to cancel it. If we elect not to renew this policy we will mail a notice of nonrenewal stating the reasons for nonrenewal to the first Named Insured at least 30 days but not more than 120 days before the expiration date of this policy. If this policy does not have a fixed expiration date it shall be deemed to expire annually on the anniversary of its inception. This notice will be sent to the first Named insured at the last mailing address known to us by a. Certified mail or b. First class mail if we have obtained from the post office a date stamped proof of mailing showing the first Named Insured s name and address. We need not mail or deliver this notice if you have a. Replaced coverage elsewhere or b. Specifically requested termination. Authorized Agent LD2876 Page 3 of 3 | 2 |
NEW YORK CHANGES Named Insured Forward Air Corporation Endorsement Number 54 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Tssued By Name of Insurance Company ACE American Insurance Company insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies all insurance provided under the following COMMERCIAL UMBRELLA LIABILITY POLICY CONTRACTUAL INDEMNITY COVERAGE PART OCCURRENCE CORRIDOR CONTRACTUAL INDEMNITY COVERAGE PART SLIDING ATTACHMENT CONTRACTUAL INDEMNITY COVERAGE PART DEDUCTIBLE REIMBURSEMENT EXCESS BUSINESS AUTOMOBILE POLICY EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS CATASTROPHE LIABILITY POLICY EXCESS LIABILITY POLICY EXCESS TRUCKERS LIABILITY POLICY The Legal Action Against Us Condition is replaced by the following Legal Action Against Us a. Except as provided in Paragraph b. no person or organization has a right under this Coverage Part 1 Tojoin us as a party or otherwise bring us into a suit asking for damages from an insured or 2 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. b. With respect to bodily injury claims if we deny coverage or do not admit liability because an insured or the injured person someone acting for the injured person or other claimant fails to give us written notice as soon as practicable then the injured person someone acting for the injured person or other claimant may bring an action against us provided the sole question is whether the denial of coverage or nonadmission of liability is based on the failure to provide timely notice. However the injured person someone acting for the injured person or other claimant may not bring an action if within 60 days after we deny coverage or do not admit liability we or an insured 1 Brings an action to declare the rights of the parties under the policy and 2 Names the injured person someone acting for the injured person or other claimant as a party to the action. ALL25213 1008 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 1 of 2 | 2 |
The following provision is added and supersedes any provision to the contrary Failure to give notice to us as required under this Coverage Part shall not invalidate any claim made by the insured injured person or any other claimant unless the failure to provide such timely notice has prejudiced us. However no claim made by the insured injured person or other claimant will be invalidated if it shall be shown not to have been reasonably possible to give such timely notice and that notice was given as soon as was reasonably possible thereafter. Authorized Agent ALL25213 1008 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 of 2 | 2 |
NEW YORK CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 55 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation Condition is replaced by the following 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. Cancellation Of Policies In Effect 60 Days Or Less We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least 1 30 days before the effective date of cancellation if we cancel for any reason not included in Paragraph 2.a. 2 below. 2 15 days before the effective date of cancellation if we cancel for any of the following reasons a Nonpayment of premium b Conviction of a crime arising out of acts increasing the hazard insured against c Discovery of fraud or material misrepresentation in the obtaining of the policy or in the e 9 presentation of a claim After issuance of the policy or after the last renewal date discovery of an act or omission or a violation of any policy condition that substantially and materially increases the hazard insured against and that occurred subsequent to inception of the current policy period Material physical change in the property insured occurring after issuance or last annual renewal anniversary date of the policy that results in the property becoming uninsurable in accordance with our objective uniformly applied underwriting standards in effect at the time the policy was issued or last renewed or material change in the nature or extent of the risk occurring after issuance or last annual renewal anniversary date of the policy that causes the risk of loss to be substantially and materially increased beyond that contemplated at the time the policy was issued or last renewed Required pursuant to a determination by the Superintendent that continuation of our present premium volume would jeopardize our solvency or be hazardous to the interest of our policyholders our creditors or the public A determination by the Superintendent that the continuation of the policy would violate or would place us in violation of any provision of the Insurance Code or LD2877C 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc.. with its permission Page 1 of 3 | 2 |
h Where we have reason to believe in good faith and with sufficient cause that there is a probable risk of danger that the insured will destroy or permit to be destroyed the insured property for the purpose of collecting the insurance proceeds. If we cancel for this reason you may make a written request to the Insurance Department within 10 days of receipt of this notice to review our cancellation decision. Also we will simultaneously send a copy of this cancellation notice to the Insurance Department. b. For More Than 60 Days If this policy has been in effect for more than 60 days or if this policy is a renewal or continuation of a policy we issued we may cancel only for any of the reasons listed in Paragraph 2.a. 2 above provided we mail the first Named Insured written notice at least 15 days before the effective date of cancellation. We will mail or deliver our notice including the reason for cancellation to the first Named Insured at the address shown in the policy and to the authorized agent or broker. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. However when the premium is advanced under a premium finance agreement the cancellation refund will be pro rata. Under such financed policies we will be entitled to retain a minimum earned premium of 10 of the total policy premium or 60 whichever is greater. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficient proof of notice. If one of the reasons for cancellation in Paragraph 2.a. 2 exists we may cancel this entire policy even if the reason for cancellation pertains only to a new coverage or endorsement initially effective subsequent to the original issuance of this policy. Il. The following Conditions supersede any other provisions to the contrary. 1. NONRENEWAL If we decide not to renew this policy we will send notice as provided in Paragraph 3. below. 2. CONDITIONAL RENEWAL If we conditionally renew this policy subject to a a. Change of limits b. Change of type of coverage c. Reduction of coverage d. Increased deductible e. Addition of exclusion or f. Increased premiums in excess of 10 exclusive of any premium increase due to and commensurate with insured value added or increased exposure units or as a result of experience rating loss rating retrospective rating or audit we will send notice as provided in Paragraph 3. below. 3. NOTICES OF NONRENEWAL AND CONDITIONAL RENEWAL a. If we decide not to renew this policy or to conditionally renew this policy as provided in Paragraphs 1. and 2. above we will mail or deliver written notice to the first Named Insured shown in the Declarations at least 60 but more than 120 days before 1 The expiration date or 2 The anniversary date if this is a continuous policy. LD2S77C 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. Page 2 of 3 with its permission Page 2 0f 3 | 2 |
b. Notice will be mailed or delivered to the first Named Insured at the address shown in the policy and to the authorized agent or broker. If notice is mailed proof of mailing will be sufficient proof of notice. c. Notice will include the specific reasons for nonrenewal or conditional renewal including the amount of any premium increase for conditional renewal and description of any other changes. d. If we violate any of the provisions of Paragraphs C.3.a. b. or c. above by sending the first Named Insured an incomplete or late conditional renewal notice or a late nonrenewal notice 1 Coverage will remain in effect at the same terms and conditions of this policy at the lower of the current rates or the prior period s rates until 60 days after such notice is mailed or delivered unless the first Named Insured during this 60 day period has replaced the coverage or elects to cancel. On or after the expiration date of this policy coverage will remain in effect at the same terms and conditions of this policy for another policy period at the lower of the current rates or the prior period s rates unless the first Named Insured during this additional policy period has replaced the coverage or elects to cancel. e. We will not send you notice of nonrenewal or conditional renewal if you your authorized agent or broker or another insurer of yours mails or delivers notice that the policy has been replaced or is no longer desired. Authorized Agent LD2877C 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc.. with its permission Page 30f3 | 2 |
NORTH CAROLINA CANCELLATION AND NONRENEWAL Named Insured Forward Air Corporation Endorsement Number 56 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Tssued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation Condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. POLICIES IN EFFECT LESS THAN 60 DAYS If this policy has been in effect for less than 60 days we may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 15 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 30 days before the effective date of cancellation if we cancel for any other reason. 3. CANCELLATION OF POLICIES IN EFFECT FOR 60 DAYS OR MORE If this policy has been in effect for 60 days or more or is a renewal of a policy we issued we may cancel this policy prior to the a. Expiration of the policy term or b. Anniversary date stated in the policy only for one or more of the following reasons 1 Nonpayment of premium 2 An act or omission by the insured or his or her representative that constitutes material misrepresentation or nondisclosure of a material fact in obtaining this policy continuing this policy or presenting a claim under this policy 3 Increased hazard or material change in the risk assumed that could not have been reasonably contemplated by the parties at the time of assumption of the risk 4 Substantial breach of contractual duties conditions or warranties that materially affects the insurability of the risk 5 A fraudulent act against us by the insured or his or her representative that materially affects the insurability of the risk 6 Willful failure by the insured or his or her representative to institute reasonable loss control measures that materially affect the insurability of the risk after written notice by us 7 Loss of facultative reinsurance or loss of or substantial changes in applicable reinsurance as provided in G.S.58 41 30 8 Conviction of the insured of a crime arising out of acts that materially affect the insurability of the risk LD2S78b 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. Page 1 of 2 with its permission Includes copyrighted material of Insurance Services Office Inc. with its permission Page 1 of 2 | 2 |
9 A determination by the Commissioner of Insurance that the continuation of the policy would place us in violation of the laws of North Carolina or 10You fail to meet the requirements contained in our corporate charter articles of incorporation or by laws when we are a company organized for the sole purpose of providing members of an organization with insurance coverage in North Carolina. We will mail or deliver written notice of cancellation to the first Named Insured at least a 15 days before the effective date of cancellation if we cancel for nonpayment of premium or b 30 days before the effective date of cancellation if we cancel for any other reason. 4. Cancellation for nonpayment of premium will not become effective if you pay the premium amount due before the effective date of cancellation. 5. We may also cancel this policy for any reason not stated above provided we obtain your prior written consent. Il. The following conditions are added and supersedes any other conditions to the contrary NONRENEWAL A. If we elect not to renew this policy we will mail or deliver to the First Named Insured shown in the Declarations written notice of nonrenewal at least 45 days prior to the 1. Expiration of the policy if this policy has been written for one year or less or 2. Anniversary date of the policy if this policy has been written for more than one year or for an indefinite term. B. We need not mail or deliver the notice of nonrenewal if you have 1. Insured property covered under this policy under any other insurance policy 2. Accepted replacement coverage or 3. Requested or agreed to nonrenewal of this policy. C. If notice is mailed proof of mailing will be sufficient proof of notice. D. The written notice of cancellation or nonrenewal will 1. Be mailed or delivered to the first Named Insured and any designated mortgagee or loss payee at their addresses shown in the policy or if not indicated in the policy at their last known addresses and 2. State the reason or reasons for cancellation or nonrenewal. Authorized Agent Includes copyrighted material of Insurance Services Office Inc. Page 2 of 2 with its permission LD2878b 0201 Printed in U.S.A. Page 2 of 2 | 2 |
OHIO CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 57 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. With respect to a policy which has been in effect for more than 90 days or is a renewal of a policy we issued the CANCELLATION Condition is replaced by the following A. We may cancel this policy only for one or more of the following reasons except as provided in paragraph F. below. 1. Nonpayment of premium 2. Discovery of fraud or material misrepresentation in the procurement of the insurance or with respect to any claims submitted thereunder 3. Discovery of a moral hazard or willful or reckless acts or omissions on your part which increases any hazard insured against 4. The occurrence of a change in the individual risk which substantially increases any hazard insured against after the insurance coverage has been issued or renewed except to the extent the insurer could reasonably have foreseen the change or contemplated the risk in writing the contract 5. Loss of applicable reinsurance or a substantial decrease in applicable reinsurance if the Superintendent has determined that reasonable efforts have been made to prevent the loss of or substantial decrease in the applicable reinsurance or to obtain replacement coverage o Failure of an insured to correct material violations of safety codes or to comply with reasonable written loss control recommendation or 7. A determination by the Superintendent of Insurance that the continuation of the policy would create a condition that would be hazardous to the policyholders or the public. B. We will mail written notice of cancellation to the first Named Insured and agent if any at the last mailing addresses known to us. Proof of mailing will be sufficient proof of notice. C. We will mail the notice of cancellation at least 1. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or 2. 30 days before the effective date of cancellation if we cancel for a reason stated in B.2. through B.7. above. D. 1. The notice of cancellation will state the effective date of cancellation. The policy period will end on that date. LD2S80c 0706 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 1 of 2 | 2 |
2. The notice will also contain the date of the notice and the policy number and will state the reason for cancellation. E. Policies written for a term of more than one year or on a continuous basis may be cancelled by us for any reason at an anniversary date upon 30 days written notice of cancellation. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. F. The cancellation will be effective even if we have not made or offered a refund. 1ll. The following Condition supersedes any other provisions to the contrary. NONRENEWAL A. If we elect not to renew this policy we will mail written notice of nonrenewal to the first Named Insured and agent if any at the last mailing addresses known to us. The notice will contain the date of the notice and the policy number and will state the expiration date of the policy. We will mail the notice of nonrenewal at least 30 days before the expiration date of the policy. Proof of mailing will be sufficient proof of notice. Authorized Agent LD2S80c 0706 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 of 2 | 2 |
OKLAHOMA CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 58 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The CANCELLATION condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 45 days before the effective date of cancellation if we cancel for any other reason. After coverage has been in effect for more than 45 business days or after the effective date of a renewal of this policy no notice of cancellation will be issued by us unless it is based on at least one of the following reasons 1 Nonpayment of premium 2 Discovery of fraud or material misrepresentation in the procurement of the insurance or with respect to any claims submitted under it 3 Discovery of willful or reckless acts or omissions by you that increase any hazard insured against 4 The occurrence of a change in the risk that substantially increases any hazard insured against after insurance coverage has been issued or renewed s A violation of any local fire health safety building or construction regulation or ordinance with respect to any covered property or its occupancy that substantially increases any hazard insured against G A determination by the Insurance Commissioner that the continuation of the policy would place us in violation of the insurance laws of this state t Your conviction of a crime having as one of its necessary elements an act increasing any hazard insured against or 8 Loss of or substantial changes in applicable reinsurance. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. LD2S81c 1006 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 10of 3 | 2 |
5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice. The following conditions are added and supersedes any provisions to the contrary. NONRENEWAL A. If we elect not to renew this policy we will mail or deliver written notice of nonrenewal to the first Named Insured at least 45 days before 1. The expiration date of the policy or 2. An anniversary date of this policy if it is written for a term longer than one year or with no fixed expiration date. B. Any notice of nonrenewal will be mailed or delivered to the first Named Insured at the last mailing address known to us. C. If notice is mailed 1. It will be considered to have been given to the first Named Insured on the day it is mailed. 2. Proof of mailing will be sufficient proof of notice. D. If notice of nonrenewal is not mailed or delivered at least 45 days before the expiration date or an anniversary date of this policy coverage will remain in effect until 45 days after notice is given. Earned premium for such extended period of coverage will be calculated pro rata based on the rates applicable to the expiring policy. E. We will not provide notice of nonrenewal if 1. We or another company within the same insurance group have offered to issue a renewal policy or 2. You have obtained replacement coverage or have agreed in writing to obtain replacement coverage. F. If we have provided the required notice of nonrenewal as described in A. above and thereafter extend the policy for a period of 90 days or less we will not provide an additional nonrenewal notice with respect to the period of extension. PREMIUM OR COVERAGE CHANGES AT RENEWAL 1. If we elect to renew this policy we will give written notice of any premium increase change in deductible or reduction in limits or coverage to the first Named Insured at the last mailing address known to us. 2. Any such notice will be mailed or delivered to the first Named Insured at least 45 days before a. The expiration date of this policy or b. An anniversary date of this policy if it is written for a term longer than one year or with no fixed expiration date. 3. If notice is mailed a. It will be considered to have been given to the first Named Insured on the day it is mailed. b. Proof of mailing will be sufficient proof of notice. 4. If the first Named Insured accepts the renewal the premium increase or coverage changes will be effective the day following the prior policy s expiration or anniversary date. LD2S81c 1006 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 of 3 | 2 |
If notice is not mailed or delivered at least 45 days before the expiration date or anniversary date of this policy the premium deductible limits and coverage in effect prior to the changes will remain in effect until a. 45 days after notice is given or b. The effective date of replacement coverage obtained by the insured whichever occurs first. If the first Named Insured then elects not to renew any earned premium for the resulting extended period of coverage will be calculated pro rata at the lower of the new rates or rates applicable to the expiring policy. We will not provide notice of the following a. Changes in a rate or plan filed with or approved by the State Board for Property Casualty Rates or filed pursuant to the Property and Casualty Competitive Loss Cost Rating Act and applicable to an entire class of business b. Changes which are based upon the altered nature or extent of the risk insured. c. Changes in policy forms filed with or approved by the Insurance Commissioner and applicable to an entire class of business. Authorized Agent Includes copyrighted material of Insurance Services Office Inc. Page 3 of 3 with its permission LD2S81c 1006 Page 3 of 3 | 2 |
OREGON CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 59 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation Condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. a. f this policy has been in effect for fewer than 60 days and is not a renewal policy we may cancel for any reason. b. If this policy has been in effect for 60 days or more or is a renewal policy we may cancel only for one or more of the following reasons 1. 2. 6. Nonpayment of premium Fraud or material misrepresentation made by you or with your knowledge in obtaining the policy continuing the policy or in presenting a claim under the policy Substantial increase in the risk of loss after insurance coverage has been issued or renewed including but not limited to an increase in exposure due to rules legislation or court decision Substantial breach of contractual duties conditions or warranties Determination by the commissioner that the continuation of a line of insurance or class of business to which the policy belongs will jeopardize our solvency or will place us in violation of the insurance laws of Oregon or any other state or Loss or decrease in reinsurance covering the risk. c. If this policy has been in effect for 60 days or more or is a renewal policy we may cancel for any other reason approved by the commissioner by rule. We will mail or deliver to the first Named Insured written notice of cancellation stating the reason for cancellation. Cancellation will not be effective until at least 10 working days after the first Named Insured receives our notice. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficient proof of notice. LD2882a 0201 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 1 of 2 | 2 |
The following Conditions supersedes any other provisions to the contrary. NONRENEWAL We may elect not to renew this policy by mailing or delivering to the first Named Insured at the last mailing address known to us written notice of nonrenewal before the A. Expiration date of the policy or B. Anniversary date of the policy if the policy is written for a term of more than one year or without a fixed expiration date. However if this policy is issued for a term of more than one year and for additional consideration the premium is guaranteed we may not refuse to renew the policy at its anniversary date. Nonrenewal will not be effective until at least 30 days after the first Named Insured receives our notice. MAILING OF NOTICES If notice of cancellation or nonrenewal is mailed a post office certificate of mailing will be conclusive proof that the first Named Insured received the notice on the third calendar day after the date of the certificate of mailing. Authorized Agent LD2882a 0201 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 of 2 | 2 |
PENNSYLVANIA CHANGES CANCELLATION AND NONRENEWAL Named Insured Forward Air Corporation Endorsement Number 60 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Tssued By Name of Insurance Company ACE American Insurance Company insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. The CANCELLATION Condition is replaced by the following CANCELLATION A The first Named Insured shown in the Declarations may cancel this policy by mailing or giving notice of cancellation. CANCELLATION OF POLICIES IN EFFECT FOR LESS THAN 60 DAYS We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least 30 days before the effective date of cancellation. CANCELLATION OF POLICIES IN EFFECT FOR 60 DAYS OR MORE If this policy has been in effect for 60 days or more or if this policy is a renewal of a policy we issued we may cancel this policy only for one or more of the following reasons 1. You have made a material misrepresentation which affects the insurability of the risk. Notice of cancellation will be mailed or delivered at least 15 days before the effective date of cancellation. 2. You have failed to pay a premium when due whether the premium is payable directly to us or our agents or indirectly under a premium finance plan or extension of credit. Notice of cancellation will be mailed at least 15 days before the effective date of cancellation. 3. A condition factor or loss experience material to insurability has changed substantially or a substantial condition factor or loss experience material to insurability has become known during the policy period. Notice of cancellation will be mailed or delivered at least 60 days before the effective date of cancellation. 4. Loss of reinsurance or a substantial decrease in reinsurance has occurred which loss or decrease at the time of cancellation shall be certified to the Insurance Commissioner as directly affecting inforce policies. Notice of cancellation will be mailed or delivered at least 60 days before the effective date of cancellation. 5. Material failure to comply with policy terms conditions or contractual duties. Notice of cancellation will be mailed or delivered at least 60 days before the effective date of cancellation. 6. Other reasons that the Insurance Commissioner may approve. Notice of cancellation will be mailed or delivered at least 60 days before the effective date of cancellation. This policy may also be cancelled from inception upon discovery that the policy was obtained through fraudulent statements omissions or concealment of facts material to the acceptance of the risk or to the hazard assumed by us. D. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the specific reasons for cancellation. LD2S83a 201 Printed in U.S.A. Page 1 of 2 | 2 |
G. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata and will be returned within 10 business days after the effective date of cancellation. If the first Named Insured cancels the refund may be less than pro rata and will be returned within 30 days after the effective date of cancellation. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed it will be by registered or first class mail. Proof of mailing will be sufficient proof of notice. The following supersedes any provisions to the contrary A NONRENEWAL If we decide not to renew this policy we will mail or deliver written notice of nonrenewal stating the specific reasons for nonrenewal to the first Named Insured at least 60 days before the expiration date of the policy. INCREASE PR PREMIUM If we increase your renewal premium we will mail or deliver to the first Named Insured 1. Written notice of our intent to increase the premium at least 60 days before the effective date of the premium increase and Any notice of nonrenewal or renewal premium increase will be mailed or delivered to the first Named Insured s last known address. If notice is mailed it will be by registered or first class mail. Proof of mailing will be sufficient proof of notice. Authorized Agent LD2S83a 201 Printed in U.S.A. Page 2 of 2 | 2 |
SOUTH CAROLINA CHANGES CANCELLATION NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 61 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. A. The Cancellation Condition is replaced by the following 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured and the agent if any written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 30 days before the effective date of cancellation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured s and agent s last known addresses. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice. 7. Cancellation Of Policies In Effect For 120 Days Or More If this policy has been in effect for 120 days or more or is a renewal or continuation of a policy we issued we may cancel this policy only for one or more of the following reasons a. Nonpayment of premium b. Material misrepresentation of fact which if known to us would have caused us not to issue the policy c. Substantial change in the risk assumed except to the extent that we should reasonably have foreseen the change or contemplated the risk in writing the policy d. Substantial breaches of contractual duties conditions or warranties or e. Loss of our reinsurance covering all or a significant portion of the particular policy insured or where continuation of the policy would imperil our solvency or place us in violation of the insurance laws of South Carolina. Prior to cancellation for reasons permitted in this Item e. we will notify the Commissioner in writing at least 60 days prior to such cancellation and the Commissioner will within 30 days of such notification approve or disapprove such action. Any notice of cancellation will state the precise reason for cancellation. LD2S86b 0810 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 2 | 2 |
B. The following is added and supersedes any provisions to the contrary Nonrenewal 1. However we will not refuse to renew a policy issued for a term of more than one year until expiration of its full term if anniversary renewal has been guaranteed by additional premium consideration. 2. If we decide not to renew this policy we will a. Mail or deliver written notice of nonrenewal to the first Named Insured and agent if any before 1 The expiration date of this policy if the policy is written for a term of one year or less or 2 An anniversary date of this policy if the policy is written for a term of more than one year or for an indefinite term and b. Provide at least 1 60 days notice of nonrenewal when nonrenewal is to become effective between November 1 and May 31 or 2 90 days notice of nonrenewal when nonrenewal is to become effective between June 1 and October 31. 3. Any notice of nonrenewal will be mailed or delivered to the first Named Insured s and agent s last known addresses. If notice is mailed proof of mailing will be sufficient proof of notice. 4. Any notice of nonrenewal will state the precise reason for nonrenewal. Authorized Representative LD2S86b 0810 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 2 of 2 | 2 |
TENNESSEE CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 62 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. The Cancellation Condition is replaced by the following 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or. b. 30 days before the effective date of cancellation if we cancel for any other reason. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. The refund will be pro rata if a. We cancel or b. The policy is cancelled at the request of a premium finance company that has financed this policy under a premium finance agreement. The refund may be less than pro rata if the first Named Insured cancels the policy. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficient proof of notice. If this policy has been in effect for 60 days or more or if this policy is a renewal of a policy we issued we may cancel this policy only for one or more of the following reasons a. Nonpayment of premium including any additional premium calculated in accordance with our current rating manual justified by a physical change in the insured property or a change in its occupancy or use b. Your conviction of a crime increasing any hazard insured against c. Discovery of fraud or material misrepresentation on the part of either of the following 1. You or your representative in obtaining this insurance or 2. You in pursuing a claim under this policy d. Failure to comply with written loss control recommendations e. Material change in the risk which increases the risk of loss after we issued or renewed insurance coverage LD2S88a 0201 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 1 of 2 | 2 |
f. Determination by the insurance commissioner that the continuation of the policy would jeopardize our solvency or would place us in violation of the insurance laws of Tennessee or any other state g. Your violation or breach of any policy terms or conditions or h. Other reasons that are approved by the insurance commissioner. Notice of cancellation will state the reason for cancellation. The following Conditions supersede any provisions to the contrary NONRENEWAL 1. If we decide not to renew this policy we will mail or deliver written notice of nonrenewal to the first Named Insured and agent at least 60 days before the expiration date unless a. We have offered to issue a renewal policy or b. You have obtained replacement coverage or have agreed in writing to obtain replacement coverage. 2. Any notice of nonrenewal will be mailed or delivered to the first Named Insured s and agent s addresses shown in the policy. If notice is mailed proof of mailing will be sufficient proof of notice. PREMIUMS Whenever an insurance policy which is financed with a premium finance company is cancelled the insurer shall return within 30 days after the effective date of the cancellation whatever gross unearned premiums are due under the insurance policy directly to the premium finance company for the account of the first Named Insured. Authorized Agent LD2S88a 0201 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 of 2 | 2 |
TEXAS CHANGES CANCELLATION AND NONRENEWAL PROVISIONS FOR CASUALTY LINES AND COMMERCIAL PACKAGE POLICIES Named Insured Endorsement Number Forward Air Corporation 63 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XsL G71095824 04012018 to 04012019 Tssued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. I. The Cancellation Condition is replaced by the following 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation stating the reason for cancellation at least 10 days before the effective date of cancellation. However if this policy covers a condominium association and the condominium property contains at least one residence or the condominium declarations conform with the Texas Uniform Condominium Act then the notice of cancellation as described above will be provided to the First Named Insured 30 days before the effective date of cancellation. We will also provide 30 days written notice to each unit owner to whom we issued a certificate or memorandum of insurance by mailing or delivering the notice to each last mailing address known to us. The permissible reasons for cancellation are as follows a. If this policy has been in effect for 60 days or less we may cancel for any reason except that under the provisions of the Texas Insurance Code we may not cancel this policy solely because the policyholder is an elected official. b. If this policy has been in effect for more than 60 days or if it is a renewal or continuation of a policy issued by us we may cancel only for one or more of the following reasons 1 Fraud in obtaining coverage 2 3 Anincrease in hazard within the control of the insured which would produce an increase in rate Failure to pay premiums when due 4 Loss of our reinsurance covering all or part of the risk covered by the policy or 5 If we have been placed in supervision conservatorship or receivership and the cancellation is approved or directed by the supervisor conservator or receiver. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice. The following Condition supersedes any provision to the contrary NONRENEWAL 1. We may elect not to renew this policy except that under the provisions of the Texas Insurance Code we may not refuse to renew this policy solely because the policyholder is an elected official. LD2S89a 0201 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 10f 2 | 2 |
This Paragraph 2. applies unless the policy qualifies under Paragraph 3. below. If we elect not to renew this policy we may do so by mailing or delivering to the first Named Insured at the last mailing address known to us written notice of nonrenewal stating the reason for nonrenewal at least 60 days before the expiration date. If notice is mailed or delivered less than 60 days before the expiration date this policy will remain in effect until the 61st day after the date on which the notice is mailed or delivered. Earned premium for any period of coverage that extends beyond the expiration date will be computed pro rata based on the previous year s premium. If this policy covers a condominium association and the condominium property contains at least one residence or the condominium declarations conform with the Texas Uniform Condominium Act then we will mail or deliver written notice of nonrenewal at least 30 days before the expiration or anniversary date of the policy to a. The first Named Insured and b. Each unit owner to whom we issued a certificate or memorandum of insurance. We will mail or deliver such notice to each last mailing address known to us. If notice is mailed proof of mailing will be sufficient proof of notice. The transfer of a policyholder between admitted companies within the same insurance group is not considered arefusal to renew. LD2S89a 0201 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 of 2 | 2 |
UTAH CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 64 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. The Cancellation Condition is replaced by the following 1. 8. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for Nonpayment of premium. b. 30 days before the effective date of cancellation if we cancel for any other reason. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficient proof of notice. If this policy has been in effect for more than 60 days or if this is a renewal of a policy we issued we may cancel this policy only for one or more of the following reasons a. Nonpayment of premium b. Material misrepresentation c. Substantial change in the risk assumed unless we should reasonably have foreseen the change or contemplated the risk when entering the contract or d. Substantial breaches of contractual duties conditions or warranties. Notice of cancellation must be delivered or mailed by first class mail. The following Condition supersedes any provisions to the contrary NONRENEWAL 1. If we elect to not renew this policy we will mail by first class mail written notice of nonrenewal to the first Named Insured at the last mailing address known to us at least 30 days before the expiration or anniversary date of this policy. We need not mail this notice if a. You have accepted replacement coverage b. You have requested or agreed to nonrenewal or c. This policy is expressly designated as nonrenewable. If notice is mailed proof of mailing is sufficient proof of notice. Authorized Agent Includes copyrighted material of Insurance Services Office Inc. Page 1 of 1 with its permission LD2890b 0201 Printed in U.S.A Page 1 of 1 | 2 |
VIRGINIA CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 65 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation of nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation Condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. We may cancel this Policy by mailing or delivering to the first Named Insured written notice of cancellation stating the reason for cancellation at least a. 15 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 45 days before the effective date of cancellation if we cancel for any other reason. We will send written notice in accordance with Virginia Law or deliver written notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this Policy is cancelled we will send the first Named Insured any premium refund due. The cancellation will be effective even if we have not made or offered a refund. The following provisions govern calculation of return premium. a. We will compute return premium pro rata and round to the next higher whole dollar when this Policy is cancelled 1 Atourrequest 2 Because you no longer have a financial or insurable interest in the property or business operation that is the subject of insurance 3 And rewritten by us or a member of our company group or 4 After the first year if it is a prepaid policy written for a term of more than one year. b. When this Policy is cancelled at your request except when Paragraph a.2 a.3 or a.4 applies we will return 90 of the pro rata unearned premium rounded to the next higher whole dollar. However when such cancellation takes place during the first year of a multiyear prepaid policy we will return the full annual premium for the subsequent years. In addition earned premium will not be less than our policy writing minimum premium. LD2892d 1215 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 0of 2 | 2 |
II. The following is added and supersedes any other provision to the contrary NONRENEWAL A If we elect not to renew this Policy we will mail or deliver a notice of nonrenewal to the first Named Insured shown in the Declarations stating the reason for nonrenewal at least 1. 15 days before the expiration date if the nonrenewal is due to nonpayment of premium or 2. 45 days before the expiration date if the nonrenewal is for any other reason.. We will send written notice in accordance with Virginia Law or deliver written notice of nonrenewal to the first Named Insured s last mailing address known to us. If notice is mailed proof of mailing will be sufficient proof of notice. Authorized Representative LD2892d 1215 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 2 of 2 | 2 |
WASHINGTON CHANGES CANCELLATION AND NONRENEWAL Named Insured Forward Air Corporation Endorsement Number 66 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Tssued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. The Cancellation Condition is replaced by the following A. You may cancel this policy by mailing or delivering to us advance written notice of cancellation. B. We may cancel this coverage part by mailing or delivering to the first Named Insured the first Named Insured s agent or broker and any other person shown in this policy to have an interest in any loss which may occur under this policy written notice of cancellation including the actual reason for the cancellation to the last mailing addresses known to us at least 1. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or 2. 45 days before the effective date of cancellation if we cancel for any other reason. C. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. D. If this policy is cancelled we will send the Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund will be at least 90 of the pro rata refund. The cancellation will be effective even if we have not made or offered a refund. E. If notice is mailed proof of mailing will be sufficient proof of notice. The following Condition supersedes any condition to the contrary When We Do Not Renew We may elect not to renew this coverage part by mailing or delivering written notice of nonrenewal to the First Named Insured the first Named Insured s agent or broker and any other person shown in this policy to have an interest in any loss which may occur under this policy at the last mailing addresses known to us provided that we give at least 45 days written notice of nonrenewal including the actual reason for nonrenewal. Otherwise we will renew this coverage part unless A. The Named Insured fails to pay the renewal premium after we have expressed our willingness to renew including a statement of the renewal premium to the first Named Insured and the first Named Insured s agent or broker at least 20 days before the expiration date or B. Other coverage acceptable to the insured has been procured prior to the expiration date of the policy. Authorized Agent LD2893 392 Printed in U.S.A. Page 1 of 1 | 2 |
WASHINGTON CHANGES DEFENSE COSTS Named Insured Forward Air Corporation Endorsement Number 67 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Issued By Name of Insurance Company ACE American Insurance Company insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY Solely with respect to claims made or suits brought in the state of Washington the following is added to Paragraph 1.a. Insuring Agreement of Section Coverages and applies to any other provision in the policy that sets forth a duty to defend If we initially defend an insured or pay for an insured s defense but later determine that none of the claims for which we provided a defense or defense costs are covered under this insurance we have the right to reimbursement for the defense costs we have incurred. The right to reimbursement under this provision will only apply to the costs we have incurred after we notify you in writing that there may not be coverage and that we are reserving our rights to terminate the defense or the payment of defense costs and to seek reimbursement for defense costs. Authorized Representative XS38020 1113 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 1 | 2 |
WEST VIRGINIA CHANGES CANCELLATION AND NONRENEWAL Named Insured Forward Air Corporation Endorsement Number 68 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Tssued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation Condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 30 days before the effective date of cancellation if we cancel for any other reason. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficient proof of notice. Authorized Agent LD2894a 0201 Printed in U.S.A. Page 1 of 1 | 2 |
WISCONSIN CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 69 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. The Cancellation Condition is replaced by the following 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least 10 days before the effective date of cancellation. If this policy has been in effect for less than 60 days and is not a renewal policy we may cancel for any reason. If this policy has been in effect for 60 days or more or is a renewal of a policy we issued except as provided in Paragraph 7. below we may cancel this policy only for one or more of the following reasons a. The policy was obtained by material misrepresentation b. There has been a substantial change in the risk we originally assumed except to the extent that we should have foreseen the change or considered the risk in writing the policy c. There have been substantial breaches of contractual duties conditions or warranties or d. Nonpayment of premium. If this policy has been in effect for 60 days or more or is a renewal of a policy we issued the notice of cancellation will state the reason for cancellation. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficient proof of notice. If this policy is written for a term of more than one year or has no fixed expiration date we may cancel this policy for any reason by mailing or delivering to the first Named Insured written notice of cancellation at least 60 days before the anniversary date of the policy. Such cancellation will be effective on the policy s anniversary date. We may cancel this policy because of the termination of an insurance marketing intermediary s contract with us only if the notice of cancellation contains an offer to continue the policy with us if we receive a written request from the first Named Insured prior to the date of cancellation. The following Conditions supersede any other provisions to the contrary 1. Nonrenewal a. If we elect not to renew this policy we will mail or deliver written notice of nonrenewal to the first Named Insured s last mailing address known to us. We may elect not to renew for any reason the notice will state the reason for nonrenewal. We will mail or deliver the notice at least 60 days before the expiration date of this policy. LD2595a 02101 Ptd in U.S.A. Includes copyrighted material of Insurance Services Office Inc. Page 1 of 2 With its permission Page 1 of 2 | 2 |
We need not mail or deliver the notice if 1 You have insured elsewhere 2 You have accepted replacement coverage 3 You have requested or agreed to nonrenewal of this policy or 4 This policy is expressly designated as nonrenewable. b. We may refuse to renew this policy because of the termination of an insurance marketing intermediary s contract with us only if the notice of nonrenewal contains an offer to renew the policy with us if we receive a written request from the first Named Insured prior to the renewal date. c. If you fail to pay the renewal or continuation premium by the premium due date this policy will terminate on the policy expiration or anniversary date if we have 1 Given you written notice of the renewal or continuation premium not more than 75 days nor less than 10 days prior to the due date of the premium and 2 Stated clearly in the notice the effect of nonpayment of premium by the due date. Anniversary Alteration If this policy is written for a term of more than one year or has no fixed expiration date we may alter the terms or premiums of this policy by mailing or delivering written notice of less favorable terms or premiums to the first Named Insured s last mailing address known to us. We will mail by first class mail or deliver this notice at least 60 days prior to the anniversary date. If we notify the first Named Insured within 60 days prior to the anniversary date the new terms or premiums will not take effect until 60 days after the notice was mailed or delivered. The notice will include a statement of the first Named Insured s right to cancel. The first Named Insured may elect to cancel the policy at any time during the 60 day period in accordance with Paragraph 1. of the Cancellation Common Policy Condition. If the first Named Insured elects to cancel the policy during the 60 day period return premiums or additional premium charges will be calculated proportionately on the basis of the old premiums. Renewal With Altered Terms If we elect to renew this policy but on less favorable terms or at higher premiums we will mail or deliver written notice of the new terms or premiums to the first Named Insured s last mailing address known to us. We will mail by first class mail or deliver this notice at least 60 days prior to the renewal date. If we notify the first Named Insured within 60 days prior to the renewal date the new terms or premiums will not take effect until 60 days after the notice was mailed or delivered. The notice will include a statement of the first Named Insured s right to cancel. The first Named Insured may elect to cancel the renewal policy at any time during the 60 day period return premiums or additional premium charges will be calculated proportionately on the basis of the old premiums. We need not mail or deliver this notice if the only change adverse to you is a premium increase that a. Isless than 25 and is generally applicable to the class of business to which this policy belongs or b. Results from a change based on your action that alters the nature or extent of the risk insured against including but not limited to a change in the classification or the units of exposure or increased policy coverage. Authorized Agent LD2895a 0201 Ptdin U.S.A. Includes copyrighted material of Insurance Services Office Inc. With its permission Page 2 0f 2 | 2 |
Starr Indemnity Liability Company Starr Indemnity Liability Company Commercial Casualty Impairment Liability Program Claim Reporting Guidelines Please Send All Commercial Casualty Impairment Loss Notices To Gallagher Bassett 333 Research Court Norcross GA 30092 Claims E mail tnwclaimstnwinc.com Claims Fax 800 748 6159 After hours emergency call service 855 782 7750 Our preferred method of reporting is by email but Loss Notices may be submitted via certified mail or faxed. If immediate attention is needed e mailing or faxing the Loss Notice andor Claim or Litigation information is strongly recommended. If you have a claim related question and need to contact Gallagher Bassett by telephone please do so at 855 782 7750. Consult Your Policy For Loss Reporting Requirements Your policy states when to report a loss and details the information to be submitted with a First Notice of Loss. This is often found in the General Conditions section although it may be changed by an endorsement. Additionally the following information documentation will always be helpful in assisting us with our evaluation. Citing Starr Indemnity Liability Company policy or claim number in all correspondence. Providing a copy of any suit demand for arbitration or mediation a governmental agency notice claim letter or any similar notice. Sending a copy of any internal reports related to the loss. Forwarding copies of status reports prepared by your defense counsel andor your claim handler if the case has been pending for a period of time. Our claim s administrator will always acknowledge each First Notice of Loss initiate contact to open lines of communication and will request any additional information that may be needed. Our formal claims acknowledgment will identify the person responsible for handling your reported Claim and their specific contact information. If you have questions or would like to discuss a specific loss with one of our Claims Team members please feel free to contact us. Thank you. Starr Indemnity Liability Company Starr Indemnity Liability Company Commercial Casualty Impairment Liability Program Claim Reporting Guidelines Please Send All Commercial Casualty Impairment Loss Notices To Gallagher Bassett 333 Research Court Norcross GA 30092 Claims E mail thwclaimstnwinc.com Claims Fax 800 748 6159 After hours emergency call service 855 782 7750 Our preferred method of reporting is by email but Loss Notices may be submitted via certified mail or faxed. If immediate attention is needed e mailing or faxing the Loss Notice andor Claim or Litigation information is strongly recommended. If you have a claim related question and need to contact Gallagher Bassett by telephone please do so at 855 782 7750. Consult Your Policy For Loss Reporting Requirements Your policy states when to report a loss and details the information to be submitted with a First Notice of Loss. This is often found in the General Conditions section although it may be changed by an endorsement. Additionally the following information documentation will always be helpful in assisting us with our evaluation.. Citing Starr Indemnity Liability Company policy or claim number in all correspondence.. Providing a copy of any suit demand for arbitration or mediation a governmental agency notice claim letter or any similar notice.. Sending a copy of any internal reports related to the loss.. Forwarding copies of status reports prepared by your defense counsel andor your claim handler if the case has been pending for a period of time. Our claim s administrator will always acknowledge each First Notice of Loss initiate contact to open lines of communication and will request any additional information that may be needed. Our formal claims acknowledgment will identify the person responsible for handling your reported Claim and their specific contact information. If you have questions or would like to discuss a specific loss with one of our Claims Team members please feel free to contact us. Thank you. Starr Indemnity Liability Company Commercial Casualty Impairment Liability Program Claim Reporting Guidelines Please Send All Commercial Casualty Impairment Loss Notices To Gallagher Bassett 333 Research Court Norcross GA 30092 Claims E mail thwclaimstnwinc.com Claims Fax 800 748 6159 After hours emergency call service 855 782 7750 Our preferred method of reporting is by email but Loss Notices may be submitted via certified mail or faxed. If immediate attention is needed e mailing or faxing the Loss Notice andor Claim or Litigation information is strongly recommended. If you have a claim related question and need to contact Gallagher Bassett by telephone please do so at 855 782 7750. Consult Your Policy For Loss Reporting Requirements Your policy states when to report a loss and details the information to be submitted with a First Notice of Loss. This is often found in the General Conditions section although it may be changed by an endorsement. Additionally the following information documentation will always be helpful in assisting us with our evaluation.. Citing Starr Indemnity Liability Company policy or claim number in all correspondence.. Providing a copy of any suit demand for arbitration or mediation a governmental agency notice claim letter or any similar notice.. Sending a copy of any internal reports related to the loss.. Forwarding copies of status reports prepared by your defense counsel andor your claim handler if the case has been pending for a period of time. Our claim s administrator will always acknowledge each First Notice of Loss initiate contact to open lines of communication and will request any additional information that may be needed. Our formal claims acknowledgment will identify the person responsible for handling your reported Claim and their specific contact information. If you have questions or would like to discuss a specific loss with one of our Claims Team members please feel free to contact us. Thank you. | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 FLORIDA AMENDMENT NOTICE OF CANCELLATION FOR THIRD PARTIES Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies the insurance coverage forms listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policyies carefully. Auto Dealers Coverage Form Business Auto Coverage Form Business Auto Physical Damage Coverage Form Commercial General Liability Coverage Form Contractor s Pollution Liability Coverage Form Electronic Data Liability Coverage Form Excess Liability Policy Form Garage Coverage Form Liquor Liability Coverage Form Motor Carrier Coverage Form Owners And Contractors Protective Liability Coverage Form Coverage For Operations Of Designated Contractor Pollution Liability Coverage Form Designated Sites Products Completed Operations Liability Coverage Form Product Withdrawal Coverage Form Professional Liability Coverage Form Railroad Protective Liability Coverage Form Site Pollution Liability Coverage Form Special Protective And Highway Liability Policy New York Department Of Transportation Truckers Coverage Form Underground Storage Tank Policy Designated Tanks. Itis agreed that in the event the Insurer cancels the policy for any reason other than non payment of premium the First Named Insured must within five 5 days of receiving the notice of cancellation provide the Insurer either directly or through the retail broker with a written list of certificate holders Schedule that the First Named Insured is contractually obligated to notify in the event that the policy is cancelled. The Schedule must specify the name and current email address of a contact for each certificate holder. The Insurer will provide notice of cancellation to the certificate holders listed in the Schedule by email. The Insurer agrees to provide such notice of cancellation at the premium computed in accordance with our rules and rates. The Insurer s failure to provide such notice will neither extend the policy cancellation nor negate cancellation of the policy nor will this failure result in obligation or liability of any kind upon the Insurer its agents or representatives. This endorsement does not affect in any way coverage provided under this policy the cancellation of this policy or the effective date of cancellation. The following definitions apply to this endorsement 1. First Named Insured means the named insured shown in the Declarations Page of this policy. 2. Insurer means the insurance company shown in the header on the Declarations Page of this policy. 3. Schedule means the written list of certificate holders. All other terms and conditions of this Policy remain unchanged. SIIL 102 FL 1014 Page 1 of 1 Copyright Starr Indemnity Liability Company. Al rights reserved. Includes copyrighted material of ISO Properties Inc. used with its permission. | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 FLORIDA COMMERCIAL GENERAL LIABILITY DECLARATIONS POLICY NO 1000305120181 RENEWAL OF NO 1000305120171 NAMED INSURED MAILING ADDRESS Checkers Drive In Restaurants Inc. 4300 W Cypress St Ste 600 Tampa FL 33607 PRODUCER S NAME MAILING ADDRESS Joseph M Agnello 444 W 47th Street Suite 900 Kansas City MO 64112 POLICY PERIOD From September 30 2018 to September 30 2019 at 1201 A.M. Standard Time at your mailing address shown above. FORM OF BUSINESS INDIVIDUAL PARTNERSHIP JJOINT VENTURE JLIMITED LIABILITY COMPANY X ORGANIZATION INCLUDING A CORPORATION BUT NOT INCLUDING A PARTNERSHIP JOINT VENTURE OR LIMITED LIABILITY COMPANY DESCRIPTION OF BUSINESS Fast Food Restaurants IEATION OF ALL PREMISES YOU OWN RENT OR OCCUPY ON FILE WITH IN RETURN FOR THE PAYMENT OF THE PREMIUM AND SUBJECT TO ALL THE TERMS OF THIS POLICY WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. POLICY PREMIUM 279698 Premium for Certified Acts of Terrorism Coverage 13319 Included in Policy Premium MINIMUM PREMIUM 251728 MINIMUM EARNED PREMIUM 69925 SCHEDULE OF STATE TAXES FEES AND SURCHARGES IF APPLICABLE See Attached Schedule State Taxes Fees and Surcharges shown are in addition to the above referenced Policy Premium. ENDORSEMENTS ATTACHED TO THIS POLICY SEE ATTACHED FORMS SCHEDULE GCGL 001 FL D 0813 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. Page 10f3 | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS AND COVERAGE FORMS AND ANY ENDORSEMENTS COMPLETE THE ABOVE NUMBERED POLICY. Date Issued October 25 2018 LIMITS OF INSURANCE EACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT 1000000 ANY ONE PREMISE MEDICAL EXPENSE LIMIT ANY ONE PERSON 0 ANY ONE PERSON PERSONAL ADVERTISING INJURY LIMIT 1000000 ANY ONE PERSON OR ORGANIZATION GENERAL AGGREGATE 2000000 PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT 2000000 MIT RETROACTIVE DATE CG 00 02 ONLY THIS INSURANCE DOES NOT APPLY TO BODILY INJURY PROPERTY DAMAGE OR PERSONAL AND ADVERTISING INJURY WHICH OCCURS BEFORE THE RETROACTIVE DATE IF ANY SHOWN BELOW. RETROACTIVE DATE NONE ENTER DATE OR NONE IF NO RETROACTIVE DATE APPLIES. CLASSIFICATION AND PREMIUM RATE ADVANCE PREMIUM CLASSIFICATION CODE PREMIUM Prem Ops Prod Comp Prem Ops Prod Comp NO. BASE Ops Ops ON FILE WITH COMPANY FOR THE LOCATIONS Total 279698 A AREA M ADMISSIONS 0 TOTAL OPERATING EXPENSES P PAYROLL S GROSS SALES T OTHER U UNITS EACH AUDIT PERIOD IF APPLICABLE X ANNUALLY SEMI ANNUALLY QUARTERLY MONTHLY GCGL 001 FL D 0813 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. Page 20f3 | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 ADDRESS OF INSURER AND ITS AUTHORIZED AGENTS FOR NOTICES UNDER THIS POLICY A. Claims Related Notices New Claims can be reported to Address Gallagher Bassett 333 Research Court tnwclaimstnwinc.com Norcross GA 30092 Claims Fax Number 800 748 6159 Claims Phone Number 855 782 7750 After hours emergency service call 855 782 7750 B. All Other Notices i To the Insurer Starr Indemnity Liability Comg 399 Park Avenue 8 Floor Address 333 Research Court Norcross GA 30092 Starr Indemnity Liability Company 399 Park Avenue 8 Floor New York NY 10022 THIS POLICY CONTAINS AGGREGATE LIMITS REFER TO SECTION IIl. LIMITS OF INSURANCE OF THE APPLICABLE COVERAGE PARTS FOR DETAILS The foregoing discloses all hazards insured hereunder known to exist at the inception date of this Policy unless otherwise stated herein by endorsement on this Policy. BY ek S S AUTHORIZED REPRESENTATIVE COUNTERSIGNED October 25 2018 DATE GCGL 001 FL D 0813 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. Page 30f3 | 2 |
Schedule of State Taxes Fees and Surcharges Page Schedule of State Taxes Fees and Surcharges If Applicable GCGL 001 FL D 0813 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. Page 1 of 1 | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 INTERLINE SIIL0000 1212 SIGNATURE PAGE In witness whereof we as officers of the stock Company designated on the Declarations Page have caused this policy to be executed and attested. If required by state law this policy shall not be valid unless countersigned by our authorized representative. Qe Gl Steve Blakey President MEM Nehemiah E. Ginsburg Senior Counsel and Senior Vice President SIIL 0000 1212 Page 1 of 1 Copyright Starr Indemnity Liability Company. Al rights reserved. Includes copyrighted material of ISO Properties Inc. used with its permission. | 2 |
Starr Indemnity Liability Company POLICYHOLDER NOTICE SIPN026 1117 IMPORTANT NOTICE TO POLICYHOLDER FLORIDA To present inquiries about coverage andor to obtain assistance in resolving any complaints You may call Starr Indemnity Liability Insurance Company s toll free telephone number at 1 866 519 2522 You may also write the company at Starr Indemnity Liability Company Attn Legal Department 399 Park Avenue New York NY 10022 You may contact the Florida Office of Insurance Regulation for assistance on resolving any complaints at 200 East Gaines Street Tallahassee FL 32399 Web Address www.floir.com Phone 877 693 5236 SIPN 026 1117 Page 1 of 1 | 2 |
IL P 0010104 U.S. TREASURY DEPARTMENT S OFFICE OF FOREIGN ASSETS CONTROL OFAC ADVISORY NOTICE TO POLICYHOLDERS No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. This Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC. Please read this Notice carefully. The Office of Foreign Assets Control OFAC administers and enforces sanctions policy based on Presidential declarations of national emergency. OFAC has identified and listed numerous Foreign agents Front organizations Terrorists Terrorist organizations and Narcotics traffickers as Specially Designated Nationals and Blocked Persons. This list can be located on the United States Treasury s web site httpwww.treas.gov ofac. In accordance with OFAC regulations if it is determined that you or any other insured or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person as identified by OFAC this insurance will be considered a blocked or frozen contract and all provisions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract no payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. IL P 0010104 ISO Properties Inc. 2004 Page 1 of 1 | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This policy includes all the forms and endorsements listed in the Schedule below SCHEDULE OF FORMS AND ENDORSEMENTS Claim Reporting Guidelines CLAIMS RPT 0000 Florida Amendment Notice of Cancellation For Third Parties SIIL 102 FL 1014 Florida Commercial General Liability Declarations GCGL 001 FL D 0813 Signature Page SIIL 0000 1212 Important Notice To Policyholder Florida SIPN 026 1117 U.S. Treasury Department s Office Of Foreign Assets Control OFAC IL P 001 01 04 Advisory Notice To Policyholders Schedule of Forms Endorsements PC 101 0209 Common Policy Conditions IL00 17 1198 Nuclear Energy Liability Exclusion Endorsement Broad Form IL 00 21 09 08 Disclosure Pursuant To Terrorism Risk Insurance Act IL 09 850115 Commercial General Liability Coverage Form CG 00010413 Employee Benefits Liability Insurance Claims Made Basis OG 188 0412 Florida Changes Cancellation And Nonrenewal CG 02200312 Earlier Notice of Cancellation Provided by Us CG 02241093 Additional Insured Owners Lessees Or Contractors Scheduled Person CG201004 13 Or Organization Additional Insured State Or Governmental Agency Or Subdivision Or CG 20130413 Political Subdivision Permits Or Authorizations Relating To Premises Additional Insured Vendors CG 20150413 CG 20130413 CG 20150413 PC 101 0209 Page 10f3 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Additional Insured Mortgagee Assignee Or Receiver Additional Insured Designated Person Or Organization Additional Insured Designated Person Or Organization Exclusion Access or Disclosure of Confidential or Personal Information and Data Related Liability With Limited Bodily Injury Exception Not Included Exclusion Coverage C Medical Payments Employment Related Practices Exclusion Total Pollution Exclusion With A Building Heating Cooling And Dehumidifying Equipment Exception And A Hostile Fire Exception Fungi Or Bacteria Exclusion Exclusion of Other Acts of Terrorism Committed Outside the United States Cap on Losses from Certified Acts of Terrorism Extended Reporting Period for Terrorism Coverage Waiver of Transfer of Rights of Recovery Against Others to Us Products Completed Operations Hazard Redefined Composite Rating Plan Premium Endorsement Notice and Knowledge of an Occurrence Endorsement Amendment of Other Insurance Primary and Non Contributory Condition Broad Form Named Insured Extension Schedule of Named Insureds Unintentional Errors and Omissions Endorsement Amendment of Limits of Insurance Per Project or Per Location Aggregate Limit CG 20180413 CG 20260413 CG 20260413 CG 210705 14 CG 21351001 CG 21471207 CG 21651204 CG 21671204 CG21710115 CG 219307 04 CG 24 04 05 09 CG 24 07 0196 0 G 100 1109 0 G 102 1014 OG 104 1014 0 G 107 0411 0 G 111 0611 0 G 112 0312 0 G 114 0711 0 G 139 0711 CG 20180413 CG 20260413 CG 20260413 CG 210705 14 CG 21351001 CG 21471207 CG 21651204 PC 101 0209 Page 20f3 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Bodily Injury Definition Extension Endorsement Alienated Premises Endorsement Fellow Employee Exclusion Deleted Incidental Medical Malpractice Endorsement Newly Acquired or Formed Entities Personal and Advertising Injury Definition Extension Endorsement Self Insured Retention Endorsement Per Occurrence Additional Insured Where Required Under Contract or Agreement Additional Insured Designated Person or Organization OG 144 0312 0 G 158 0412 0 G 169 0412 0 G 170 0412 0 G 172 0412 OG 174 0412 0 G 179 0412 OG 184 0412 OG 213 04 1014 All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Sl mp Steve Blakey President Nehen Ihowial Limstlios Nehemiah E. Ginsburg General Counsel PC 101 0209 Page 30f3 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. | 2 |
IL0017 1198 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 30 days before the effective date of cancellation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy s terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspections And Surveys 1. We have the right to a. Make inspections and surveys at any time b. Give you reports on the conditions we find and c. Recommend changes. 2. We are not obligated to make any inspections surveys reports or recommendations and any such actions we do undertake relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions a. Are safe or healthful or b. Comply with laws regulations codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us but also to any rating advisory rate service or similar organization which makes insurance inspections surveys reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections surveys reports or recommendations we may make relative to certification under state or municipal statutes ordinances or regulations of boilers pressure vessels or elevators. E. Premiums The first Declarations 1. Is responsible for the payment of all premiums and 2. Will be the payee for any return premiums we pay. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. Named Insured shown in the IL0017 1198 Copyright Insurance Services Office Inc. 1998 Page 1 of 1 | 2 |
IL 00 21 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVI RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply A. Under any Liability Coverage to bodily injury or property damage 1 With respect to which an insured under the policy is also an insured under a nuclear energy liability policy issued by Nuclear Energy Liability Insurance Association Mutual Atomic Energy Liability Underwriters Nuclear Insurance Association of Canada or any of their successors or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability or Resulting from the hazardous properties of nuclear material and with respect to which a any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954 or any law amendatory thereof or b the insured is or had this policy not been issued would be entitled to indemnity from the United States of America or any agency thereof under any agreement entered into by the United States of 2. America or any agency thereof with any person or organization. B. Under any Medical Payments coverage to expenses incurred with respect to bodily injury resulting from the hazardous properties of nuclear material and arising out of the operation of a nuclear facility by any person or organization. 2 ERAGE PART C. Under any Liability Coverage to bodily injury or property damage resulting from hazardous properties of nuclear material if 1 The nuclear material a is at any nuclear facility owned by or operated by or on behalf of an insured or b has been discharged or dispersed therefrom 2 The nuclear material is contained in spent fuel or waste at any time possessed handled used processed stored transported or disposed of by or on behalf of an insured or The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nuclear facility but if such facility is located within the United States of America its territories or possessions or Canada this exclusion 3 applies only to property damage to such nuclear facility and any property thereat. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source material special nuclear material or by product material. 3 C. Under any Liability Coverage to bodily injury or property damage resulting from hazardous properties of nuclear material if 1 The nuclear material a is at any nuclear facility owned by or operated by or on behalf of an insured or b has been discharged or dispersed therefrom 2 The nuclear material is contained in spent fuel or waste at any time possessed handled used processed stored transported or disposed of by or on behalf of an insured or 3 The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nuclear facility but if such facility is located within the United States of America its territories or possessions or Canada this exclusion 3 applies only to property damage to such nuclear facility and any property thereat.. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source material special nuclear material or by product material. IL 00 21 09 08 ISO Properties Inc. 2007 Page 1 of 2 | 2 |
packaging waste c Any equipment or device used for the processing fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 d Any structure basin excavation premises or place prepared or used for the storage or disposal of waste and includes the site on which any of the foregoing is located all operations conducted on such site and all premises used for such operations. Nuclear reactor means any apparatus designed or used to sustain nuclear fission in a self supporting chain reaction or to contain a critical mass of fissionable material. Property damage includes all forms of radioactive contamination of property. Source material special nuclear material and by product material have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. Spent fuel means any fuel element or fuel component solid or liquid which has been used or exposed to radiation in a nuclear reactor. Waste means any waste material a containing by product material other than the tailings or wastes produced by the extraction or concentration of uranium or thorium from any ore processed primarily for its source material content and b resulting from the operation by any person or organization of any nuclear facility included under the first two paragraphs of the definition of nuclear facility. Nuclear facility means a Any nuclear reactor b Any equipment or device designed or used for 1 separating the isotopes of uranium or plutonium 2 processing or utilizing spent fuel or 3 handling processing or Page 2 of 2 ISO Properties Inc. 2007 IL 00 21 09 08 | 2 |
IL 09 8501 15 POLICY NUMBER 1000305120181 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SCHEDULE SCHEDULE PART Terrorism Premium Certified Acts 13319 This premium is the total Certified Acts premium attributable to the following Coverage Parts Coverage Forms andor Policyies Commercial General Liability Coverage Form Employee Benefits Liability Coverage Form Additional information if any concerning the terrorism premium SCHEDULE PART Il Federal share of terrorism losses 85 Year 2015 Refer to Paragraph B. in this endorsement. Federal share of terrorism losses 84 Year 2016 Refer to Paragraph B. in this endorsement. Federal share of terrorism losses 83 Year 2017 Refer to Paragraph B. in this endorsement. Federal share of terrorism losses 82 Year 2018 Refer to Paragraph B. in this endorsement. Federal share of terrorism losses 81 Year 2019 Refer to Paragraph B. in this endorsement. Federal share of terrorism losses 80 Year 2020 Refer to Paragraph B. in this endorsement. Information required to complete this Schedule if not shown above will be shown in the Declarations. his premium is the total Certified Acts premium attributable to the following Coverage Parts overage Forms andor Policyies ommercial General Liability Coverage Form mployee Benefits Liability Coverage Form dditional information if any concerning the terrorism premium 85 84 83 82 81 80 Year Year Year Year Year Year 2015 2016 2017 2018 2019 2020 IL 09 8501 15 Insurance Services Office Inc. 2015 Page 1 of 2 | 2 |
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 terrorist acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this endorsement 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 a percentage as shown in Part Il of the Schedule of this endorsement or in the policy Declarations of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion.. Cap On Insurer Participation In Payment Of Terrorism Losses If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. Page 2 of 2 Insurance Services Office Inc. 2015 IL 09 85 01 15 | 2 |
COMMERCIAL GENERAL LIABILITY CG 00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM arious provisions in this policy restrict coverage. ead the entire policy carefully to determine rights uties and what is and is not covered. hroughout this policy the words you and your efer to the Named Insured shown in the Declarations nd any other person or organization qualifying as a lamed Insured under this policy. The words we us and our refer to the company providing this 1surance. he word insured means any person or organization ualifying as such under Section I Who Is An nsured. dther words and phrases that appear in quotation narks have special meaning. Refer to Section V Definitions. SECTION COVERAGES OVERAGE A BODILY INJURY AND PROPERTY AMAGE LIABILITY. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section Il Limits Of Insurance and Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. 2 3 Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. c. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. d. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim 1 Reports all or any part of the bodily injury or property damage to us or any other insurer 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. 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 Il Limits Of Insurance and Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 The bodily injury or property damage occurs during the policy period and 2 CG 00010413 Insurance Services Office Inc. 2012 Page 1 0of 15 | 0 |
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. d. Workers Compensation And Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law. e. Employer s Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a 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. 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 t i Bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or originating from equipment that is 2. Exclusions This insurance does not apply to a. Expected Or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Contractual Liability Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the absence of the contract or agreement or 2 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorneys fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and b Such attorneys fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. 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 Page 2 of 15 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
b c d i 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 Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire At or from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste Which are or were at any time transported handled stored treated disposed of or processed as waste by or for i Any insured or ii Any person or organization for whom you may be legally responsible or At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by such insured contractor or subcontractor. However this subparagraph does not apply to i Bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or released as part of the operations being performed by such insured contractor or subcontractor i Bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the operations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. 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 CG 00010413 Insurance Services Office Inc. 2012 Page 3 of 15 | 1 |
wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured 4 Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or 5 Bodily injury or property damage arising out of a The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definition of mobile equipment. h. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any 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 b 3 Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. Damage To Property Property damage to 1 Property you own rent or occupy including any costs or expenses incurred by you or any other person organization or entity for repair replacement enhancement restoration or maintenance of such property for any reason including prevention of injury to a person or damage to another s property Premises you sell give away or abandon if the property damage arises out of any part of those premises Property loaned to you 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 6 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. 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 2 3 fa ffice Inc. 2012 CG 00010413 Page 4 of 15 Insurance Services Office Inc. 2012 | 1 |
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 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 Il Limits Of Insurance and 2 Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to personal and advertising injury caused by an offense arising out of your business but only if the offense was committed in the coverage territory during the policy period. CG 00010413 Insurance Services Office Inc. 2012 Page 5 of 15 | 1 |
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.. 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.. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the insured hosts owns or over which the insured exercises control.. Unauthorized Use Of Another s Name Or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain name or metatag or any other similar tactics to mislead another s potential customers.. 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.. 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. Page 6 of 15 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
o. War reasc Personal and advertising injury however b. We will ma caused arising directly or indirectly out of fault. Thest 1 War including undeclared or civil war applicable N N 3. reasonable 2 Warlike action by a military force including Fi. action in hindering or defending against an 4 S td ale actual or expected attack by any accident government sovereign or other authority 2 Necessa using military personnel or other agents or dental 3 Insurrection rebellion revolution usurped devices power or action taken by governmental 3 Necessa authority in hindering or defending against professic any of these. 2. Exclusions p Recording And Distribution Of Material Or Information In Violation Of Law Personal and advertising injury arising We will not pay a. Any Insure directly or indirectly out of any action or To any insu omission that violates or is alleged to violate b. Hired Persc 1 The Telephone Consumer Protection Act To a person TCPA including any amendment of or any insured addition to such law c. Injury On N 2 The CAN SPAM Act of 2003 including any To a perso amendment of or addition to such law you oifvn 3 The Fair Credit Reporting Act FCRA and occupies. any amendment of or addition to such law. including the Fair and Accurate Credit d. Workers C Transactions Act FACTA or To a persor 4 Any federal state or local statute Ir g m ordinance or regulation other than the worersy pe TCPA CAN SPAM Act of 2003 or FCRA oW Or 5 simn and their amendments and additions that addresses prohibits or limits the printing e. Athletics A dissemination disposal collecting To a person recording sending transmitting or participa communicating or distribution of material or games spo information.. Products C COVERAGE C MEDICAL PAYMENTS Included 1. Insuring Agreement operations a. We will pay medical expenses as described g. Coverage below for bodily injury caused by an accident Excluded ur.. SUPPLEMENTAR 1 On premises you own or rent AND B 2 On ways next to premises you own or rent 1. We will pay or investigate or 3 Because of your operations insured we defe provided that a. All expense a The accident takes place in the b. Up to 25 coverage territory and during the because of policy period arising out b The expenses are incurred and reported the Bodily Ir to us within one year of the date of the do not have accident and c. The cost of c The injured person submits to only for bo examination at our expense by limit of inst physicians of our choice as often as we these bonds CG 00010413 Insurance Services Office Inc. 2012 b. reasonably require. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for 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.. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured.. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies.. 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.. Athletics Activities To a person injured while practicing instructing or participating in any physical exercises or games sports or athletic contests.. Products Completed Operations Hazard Included within the products completed operations hazard.. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS COVERAGES A AND B 1. We will pay with respect to any claim we investigate or settle or any suit against an insured we defend a. b. All expenses we incur. 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.. 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. Page 7 of 15 | 1 |
. 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.. All court costs taxed against the insured in the suit. However these payments do not include attorneys fees or attorneys expenses taxed against the insured.. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment interest based on that period of time after the offer.. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid 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 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. This insurance applies to such liability assumed by the insured. The obligation to defend or the cost of the defense of that indemnitee has also been assumed by the insured in the same insured contract. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the insured and the indemnitee and. The indemnitee 1 Agrees in writing to a Cooperate with us in the 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 Notify any other insurer whose coverage is available to the indemnitee and b c 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. 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 s Office Inc. 2012 CG 00010413 Page 8 of 15 Insurance Services Office Inc. 2012 | 1 |
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 b To the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of Paragraph 1a above c 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 d Arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b Rented to in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees 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. 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. int venture or limited nanagers if you are but only for acts ployment by you or ated to the conduct er none of these ser workers are onal and advertising ners or members if ip or joint venture f you are a limited 0 a coemployee se of his or her rming duties related our business or to er workers while lated to the conduct i parent brother or coemployee or s a consequence of ve. any obligation to Or repay someone lamages because of in Paragraph 1a or her providing or professional health operty used by care custody or hich physical control r any purpose by loyees volunteer r member if you are venture or any a limited liability your employee or organization while anager. ion having proper property if you die arising out of the hat property and sentative has been if you die but only as such. That all your rights and 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. 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 Insurance Services Office Inc. 2012 Page 9 of 15 CG 00010413 Page 9 of 15 | 1 |
Premises Rented To You Limit is the most we will pay under Coverage A for damages because of property damage to any one premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence Offense Claim Or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or an offense which may result in a claim. To the extent possible notice should include 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured persons and witnesses and 3 The nature and location of any injury or damage arising out of the occurrence or offense. b. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part a. To join us as a party or otherwise bring us into a suit asking for damages from an insured or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settiement means a settlement and release of liability signed by us the insured and the claimant or the claimant s legal representative. 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 s Office Inc. 2012 CG 00010413 Page 10 of 15 Insurance Services Office Inc. 2012 | 1 |
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 entitled to the insured s rights against all those other insurers. 3 When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of a The total amount that all such other insurance would pay for the loss in the absence of this insurance and b The total of all deductible and self insured amounts under all that other insurance. 4 We will share the remaining loss if any with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the 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 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 CG 00010413 Insurance Services Office Inc. 2012 Page 11 of 15 | 1 |
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. 3. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time. 4. 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. 5. Employee includes a leased worker. Employee does not include a temporary worker. 6. Executive officer means a person holding any of the officer positions created by your charter constitution bylaws or any other similar governing document. 7. Hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be. 2 3 Page 12 of 15 Insurance Service 8. Impaired property means tangible property other than your product or your work that can not be used or is less useful because a. It incorporates your product or your work that is known or thought to be defective deficient inadequate or dangerous or b. You have failed to fulfill the terms of a contract or agreement if such property can be restored to use by the repair replacement adjustment or removal of your product or your work or your fulfilling the terms of the contract or agreement. 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 2 That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Giving directions or instructions or Insurance Services Office Inc. 2012 CG 00010413 | 1 |
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. 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 13. 14 15. f. Vehicles not described in Paragraph a. b. c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However self propelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos 1 Equipment designed primarily for a Snow removal b Road maintenance but not construction or resurfacing or c Street cleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and 3 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered autos. Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution c. The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies committed by or on behalf of its owner landlord or lessor d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services e. Oral or written publication in any manner of material that violates a person s right of privacy f. The use of another s advertising idea in your advertisement or g. Infringing upon another s copyright trade dress or slogan in your advertisement. Pollutants mean any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals and CG 00010413 Insurance Services Office Inc. 2012 Page 13 of 15 | 1 |
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. 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. As used in this definition electronic data means c information fa created or us computer sof applications s CD ROMs tap devices or any electronically ct 18.Suit means a because of b personal and insurance appli a. An arbitrat damages ar must submi or b. Any other proceeding claimed anc our consent 19.Temporary w furnished to y employee or short term work 20.Volunteer wor your employee and acts at the duties determir salary or other else for their we 21.Your product a. Means 1 Any goc property distribute a You b Othe A busin and 2 Containe parts or with sucl b. Includes 1 Warranti time wit durability product 2 The prc warnings c. Does not ir property rel others but n 22.Your work a. Means 1 Work or Page 14 of 15 Insurance Services Office Inc. 2012 information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. 18.Suit means a civil proceeding in which damages because of bodily injury property damage or personal and advertising injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 19.Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. 20.Volunteer worker means a person who is not your employee and who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other compensation by you or anyone else for their work performed for you. 21.Your product a. Means 1 Any goods or products other than real property manufactured sold handled distributed or disposed of by a You b Others trading under your name or c A person or organization whose business or assets you have acquired and 2 Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 22.Your work a. Means 1 Work or operations performed by you or on CG 00010413 | 1 |
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. CG 00010413 Insurance Services Office Inc. 2012 Page 15 of 15 | 1 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Employee Benefits Liability Insurance Claims Made Basis Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM NOTICE EXCEPT TO SUCH EXTENT AS MAY OTHERWISE BE PROVIDED HEREIN THE COVERAGE OF THIS ENDORSEMENT IS GENERALLY LIMITED TO LIABILITY FOR ONLY THOSE CLAIMS THAT ARE FIRST MADE AGAINST THE INSURED DURING THE POLICY PERIOD AND REPORTED IN WRITING TO THE INSURER PURSUANT TO THE TERMS HEREIN. PLEASLE READ THIS ENDORSEMENT CAREFULLY AND DISCUSS THE COVERAGE THEREUNDER WITH YOUR INSURANCE AGENT OR BROKER. NOTICE THE LIMIT OF INSURANCE AVAILABLE TO PAY JUDGMENTS OR SETTLEMENTS SHALL BE REDUCED BY AMOUNTS INCURRED BY US FOR LEGAL DEFENSE. EMPLOYEE BENEFITS LIABILITY INSURANCE PROVIDES CLAIMS MADE COVERAGE Please read carefully ADDITIONAL DECLARATIONS ITEMS 1 LIMIT OF INSURANCE FOR EMPLOYEE BENEFITS LIABILITY INSURANCE Any payments made pursuant to this endorsement will be subject to and erode the General Aggregate Limit of the policy to which this endorsement is attached. 1000000 Each Wrongful Act or Series Of Related Wrongful Acts Limit 2 SELF INSURED y 5000 Each Wrongful act or series of related Wrongful acts. If applicable RETENTION then the insurance provided by this endorsement will only apply in excess Applicable if checked of the listed Self Insured Retention hereinafter Retained Limit. Additionally we shall have the right but not the duty to defend any suit against the Insured seeking damages on account of a Wrongful act or series of related Wrongful acts. 3 DEDUCTIBLE Each Wrongful act or series of related Wrongful acts. If Applicable if applicable then the Deductible is subject to the terms and conditions of checked the Deductible Endorsement Form A Form No. that is attached to the policy under Endorsement No. 4 RETROACTIVE DATE 09302016 5 ESTIMATED ANNUAL PREMIUM 1750 0 G 188 0412 Page 10f9 Copyright C. V. Starr Company and Starr Indemnity Liability Company. Allrights reserved. ode the General Applicable if checked DEDUCTIBLE Applicable if checked suit Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 A. For the purpose of coverage provided by this endorsement only SECTION COVERAGES is amended with the addition of the following COVERAGE EMPLOYEE BENEFITS LIABILITY 1. Insuring Agreement a. We will pay the Insured for those sums which the Insured shall become legally obligated to pay as damages because of any claim made against the Insured due to any Wrongful act of the Insured or any other person for whose acts the Insured is legally liable in the administration of the employee benefit program of the Insured. Except with respect to a Retained Limit as indicated in Item 2 of the Additional Declarations we have the right and duty to defend any suit against the Insured seeking damages on account of such negligent act error or omission even if any of the allegations of the suit are groundless false or fraudulent and we may make such investigation and settlement of any claim or suit as we deem expedient. However we will have no duty to defend the insured against any suit seeking damages to which this insurance does not apply. But The amount we will pay for damages is limited as described in Section D. 1. of this endorsement headed Limits of Insurance the amounts we pay for allocated loss adjustment expenses will reduce the Limit of Insurance available as provided under Section D. 1. of this endorsement headed 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 settlements or allocated loss adjustment expenses. n No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Section C. of this endorsement. The insurance provided by this endorsement applies to damages only if 1 the damages did not occur before the Retroactive Date if any shown in Item 4. of the Additional Declarations or after the end of the policy period and 2 the claim for damages covered by this endorsement is first made against the insured in accordance with Paragraph c. below during the policy period or an Extended Reporting Period we provide under Section E. 2. Optional Extended Reporting Period. A claim seeking damages will be deemed to have been made at the earlier of the following times 1 When notice of such claim is received and recorded by any insured or by us whichever comes first or 2 When we make settlement in accordance with Paragraph 1.a. above A claim received and recorded by the insured 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 employee because of any Wrongful act or series of related Wrongful acts including damages claimed by such employee s dependents and beneficiaries will be deemed to have been made at the time the first of those claims is made against any 0 G 188 0412 Page 20f 9 V. Starr Company anc demnity Liability Company. Al rights reserved. Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 insured. 2. Exclusions This endorsement does not apply to a. Dishonest Fraudulent Criminal Or Malicious Act. Damages arising out of any intentional dishonest. fraudulent criminal or malicious act error or omission committed by any insured including the willful or reckless violation of any statute. b. Bodily Injury Property Damage Or Personal And Advertising Injury Bodily injury property damage or personal and advertising injury. c. Failure To Perform A Contract Damages arising out of failure of performance of contract by any insurer. d. Insufficiency Of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the employee benefit program. e. Inadequacy Of Performance Of Investment Advice Given With Respect To Participation Any claim based upon i 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 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. ERISA Damages for which any insured is liable because of liability imposed on a fiduciary by the Employee Retirement Income Security Act of 1974 as now or hereafter amended or by any similar federal state or local laws. 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 collectible insurance. Taxes. Fines or Penalties Taxes fines or penalties including those imposed under the internal Revenue Code or any similar state or local law. Employment Practices 0 G 188 0412 Page 30f 9 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Damages arising out of wrongful termination of employment discrimination or other employment related practices. k. Failure to Maintain Insurance on Bond Any claim made against the Insured based on or attributable to any failure or omission on the part of the Insured to effect and maintain insurance or bonding for Plan Property or Assets. B. For purposes of the coverage provided by this endorsement only Section Il Who Is An Insured is deleted in its entirety and replaced with the following Insured as used in this endorsement means the Named Insured provided that a if the Named Insured is designated as an individual the insurance applies only to the conduct of a business of which he is the sole proprietor and b the unqualified word Insured also includes the following A If the Named Insured is or includes a partnership or joint venture any partner or member thereof but only with respect to his liability as such B. Any executive officer director or stockholder of the Named Insured while acting within the scope of his duties as such C. Any employee provided such employee is authorized to act in the administration of the Employee Benefits Program of the Named Insured. C. For the purposes of the coverage provided by this endorsement only SECTION SUPPLEMENTARY PAYMENTS COVERAGES A AND B is deleted in its entirety and replaced with the following ALLOCATED LOSS ADJUSTMENT EXPENSES EMPLOYEE BENEFITS LIABILITY COVERAGE a. If a Retention Amount is shown in Item 2. of the Additional Declarations above you are responsible for all Allocated Loss Adjustment Expenses we pay as Supplementary Payments according to the election indicated by an X below. If no election is indicated election i. shall apply. i AllAllocated Loss Adjustment Expenses up to the Retained Limit. However the most you are responsible for with respect to damages and Allocated Loss Adjustment Expenses combined shall not exceed the Retained Limit. ii. AllAllocated Loss Adjustment Expenses. iii. A part of Allocated Loss Adjustment Expenses. That part will be calculated by dividing the smaller of the Retained Limit or the damages you pay by the damages we pay. If we pay no damages you are responsible for all Allocated Loss Adjustment Expenses up to the applicable Retained Limit and of all remaining Allocated Loss Adjustment Expenses. iv. No Allocated Loss Adjustment Expenses. b. If a Deductible Amount is shown in Item 3. of the Additional Declarations above you must reimburse us for all Allocated Loss Adjustment Expense we pay as Supplementary Payments according to the election indicated in the Deductible Endorsement that is referred to in Item 3 of the Additional Declarations. c. With regard to either a Retained Limit or a Deductible 1 your duty to pay for Allocated Loss Adjustment Expenses applies separately to each Wrongful 0 G 188 0412 Page 4 of 9 Copyright C. V. Starr Company Indemnity Liability Company. Al ights reserved. Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 act or series of related Wrongful acts committed in the administration of the employee benefit program of the Insured and 2 All payments made by us for Allocated Loss Adjustment Expenses will be within the Limits of Insurance as provided under Section D. 1. of this endorsement headed Limits of Insurance. D. For the purposes of the coverage provided by this endorsement Section Ill Limits Of Insurance is revised as follows 1. Limits Of Insurance a. The Limits of Insurance shown in the Additional Declarations 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 Wrongful act or series of related Wrongful acts or 5 Benefits included in your employee benefit program. b. The General Aggregate Limit as described in Section lll Limits Of Insurance 2. is amended to include the following paragraph d. All damages and all associated allocated loss adjustment expenses that we pay because of a Wrongful act or series of related Wrongful acts committed in the administration of the employee benefit program of the Insured. c. Subject to the General Aggregate Limit the Each Wrongful Act or Series Of Related Wrongful Acts Limit as stated in Item 1. of the Additional Declarations is the most we will pay for all damages and all associated allocated loss adjustment expenses due to any one Wrongful act or series of related Wrongful acts committed in the administration of the employee benefit program of the Insured. However the amount paid under this endorsement 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 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. Retention Amount If a Retention Amount is shown in Item 2. of the Additional Declarations above the Limits of Insurance for the Coverage provided by this endorsement will apply in excess of the Retained Limit as stated in Item 2. of the Additional Declarations. Subject to additional Allocated Loss Adjustment Expenses the Retained Limit is the most an insured will pay for all damages due to any one Wrongful act or series of related Wrongful acts committed in the administration of the employee benefit program of the Insured. 0 G 188 0412 Page 5 0f 9 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 3. Deductible If a Deductible Amount is shown in Item 3. of the Additional Declarations above you must reimburse us for all damages due to any one Wrongful act or series of related Wrongful acts committed in the administration of the employee benefit program of the Insured and any Allocated Loss Adjustment Expense we pay as Supplementary Payments according to the terms and conditions as provided for in the Deductible Endorsement that is referred to in Item 3 of the Additional Declarations. E. For the purpose of coverage provided by this endorsement only. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS is amended with the addition of the following conditions 1. PREMIUM The premium stated in the ADDITIONAL DECLARATIONS is an estimated premium only. Upon termination of each annual period of this endorsement the Insured on request will furnish us a statement of the total number of employees at the end of the period. The earned premium shall be computed on the average of the number of employees at the end of the coverage period and that stated in the ADDITIONAL DECLARATIONS. If the earned premium thus computed exceeds the estimated premium paid the Insured shall pay the excess to us if less we shall return to the Insured the unearned portion paid by such Insured. OPTIONAL EXTENDED REPORTING ENDORSEMENT The coverage under the Employee Benefits Liability Endorsement may end because one of us chooses to cancel it or not renew it. If this is not the result of non payment of the premium then you have the right to purchase an Extended Reporting Period Endorsement. The Extended Reporting Period does not extend the policy period or change the scope of coverage provided. It only extends the time to report covered claims that were first committed before the end of the policy period but not before the Retroactive Date if any shown in the Schedule. The claim must first be made against an Insured and reported to us within 3 years after the Employee Benefits Liability Endorsement ends and while the reporting endorsement is in effect. To obtain this reporting endorsement you must request it in writing and pay the additional premium within 30 days after this agreement ends. If we do nt receive written notice and payment within this period the Extended Reporting Period will not go into effect. Additionally you may not exercise this right at a later date. We ll sell you this endorsement for the additional premium. This additional premium will not exceed 200 of the annual premium for the Employee Benefits Liability Endorsement. Once you pay the premium we ca nt cancel the endorsement. We will determine the additional premium taking into account the following a. The exposures insured b. Previous types and amounts of insurance c. Limits of Liability available under the Employee Benefit Liability Insurance for future payment of damages and d. Other related factors. The Extended Reporting Period endorsement applicable to this coverage shall set forth the terms not inconsistent with this Section applicable to the Extended Reporting Period including a provision to the effect that the insurance afforded for claims first received during such period is excess over any other valid and collectible insurance available under policies in force after the Extended Reporting Period starts. 0 G 188 0412 Page 6 of 9 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 The optional Extended Reporting Endorsement does not reinstate or increase the Limits of Liability applicable to any claim to which The Employee Benefits Liability Endorsement applies. 3. CONFORMITY WITH STATUTE Terms of this endorsement which are in conflict with the statute of the state wherein this endorsement is issued are hereby amended to conform to such statutes. F. Special Conditions relating to the Retained Limit if applicable 1. With respect to the coverage provided by this endorsement only Section IV Commercial General Liability Conditions 2. Duties in the Event of Occurrence Offense claim or Suit a. is amended to read A. Periodic Notices on a annual basis you must provide us with a written summary loss run of all wrongful acts claims or suits which have or may result in payments within the Retained Limit. This written summary must show 1. The date of the wrongful act and 2. Adescription of the damage and 8. The amount paid or reserved including allocated loss adjustment expense resulting from the wrongful act claim or suit. Individual Notices of a wrongful act in addition to the Periodic Notices provided for in A. above you must see to it that we are notified as soon as practicable of any wrongful act which may result in a claim. Knowledge of a wrongful act by your agent your servant or your employee will not in itself constitute knowledge to you unless the Director of Risk Management or one with similar or equivalent title or his her designee at the address shown in the policy declarations will have received such notice. To the extent possible notice should include how when and where the wrongful act took place and the nature of any damage arising out of the wrongful act. You must provide us with any and all additional information material andor data subsequent to the original notice as it becomes available. 2. Claims Administration A. You will employ and pay without any reimbursement from us a firm acceptable to us for the purpose of providing claim services Claims Administrator. In the event of cancellation expiration or revision of the contract between you and the self insurance service company you will notify us within ten 10 days of the cancellation expiration or revision. B. Loss settlements made by you or the Claims Administrator will be within the terms conditions and limits of the policy. C. There will be no reduction of the Retained Limit because of payment of claims or suits arising from claims or suits for which coverage is not afforded to by the policy. 0 G 188 0412 Page 7 of 9 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 3. Bankruptcy Your bankruptcy insolvency inability to pay failure to pay or refusal to pay the Retained Limit will not increase our obligations under the policy. In the event there is insurance whether or not applicable to an wrongful act claim or suit within the Retained Limit you will continue to be responsible for the full amount of the Retained Limit before the limits of insurance under this policy apply. In no case will we be required to pay the Retained Limit or any portion thereof. Our obligations will attach only when the entire amount of the Retained Limit has been paid and then only in excess of the Retained Limit and not in excess of the total limit of insurance adjusted for any reduction in the aggregate limit of our liability. G. For the purpose of coverage provided by this endorsement only SECTION V DEFINITIONS is amended with the addition of the following definitions 1. Administration shall mean A. Giving counsel to employees with respect to the Employee benefit program B. Interpreting the Employee benefit program C. Handling of records in connection with the Employee benefit program Effective enroliment termination or cancellation of employees under the Employee benefit program provided all are acts which are authorized by the Named Insured. 2. Allocated Loss Adjustment Expenses means all fees for service of process and court costs and court expenses pre and post judgement interest attorneys fees cost of undercover operative and detective services costs of employing experts costs for legal transcripts copies of any public records and costs of depositions and court reported or recorded statements costs and expenses of subrogation and any similar fee cost or expense reasonably chargeable to the investigation negotiation settiement or defense of a loss or a claim or suit against you or to the protection and perfection of your or our subrogation rights. Allocated Loss Adjustment Expenses shall not include our general overhead the salary and employee benefits of any of our employees nor the fees of any attorney who is our employee or under our permanent retainer nor the fees of any attorney we retain to provide counsel to us about our obligations if any under any policy issued by us or our affiliated company ies with respect to a claim or suit against you. 3. Cafeteria plans means plans authorized by applicable law to allow employees to elect to pay for certain benefits with pre tax dollars. 4. 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. 5. Employee benefit program means a program providing some or all of the following benefits to employees of the Insured whether provided through a cafeteria plan or otherwise a group life insurance group accident or health insurance dental vision and hearing plans provided that no one other than an employee of the Insured may subscribe to such benefits and such benefits are made generally available to those employees of the Insured who satisfy the plan s eligibility requirements b profit sharing plans employee savings plans pension plans employee stock subscription plans provided that no one other than an employee of the Insured may subscribe to such benefits and such benefits are made generally available to all employees of the Insured who are eligible under the plan for such benefits c workmen s compensation unemployment insurance social security benefits disability benefits 0 G 188 0412 Page 8.0f 9 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 d Vacation plans including buy and sell programs leave of absence programs including military maternity family and civil leave tuition assistance plans transportation and health club subsidies and e Any other similar benefits designated in the Schedule or added thereto by endorsement. 6. Wrongful act means any actual or alleged negligent act error or omission in the administration of the Employee Benefits Plan. H For the purpose of coverage provided by this endorsement only Definitions 5. and 18. in SECTION V DEFINITIONS are replaced by the following 5.Employee means a person actively employed formerly employed on leave of absence or disabled or retired. Employee includes a leased worker. Employee does not include a temporary worker. 18. Suit means a civil proceeding in which damages 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 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. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Qen w Ihanial Lolors President Steve Blakey Nehemiah E. Ginsburg General Counsel Iofoninl Lolors Nehemiah E. Ginsburg General Counsel 0 G 188 0412 Page 9 0f 9 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission. | 2 |
COMMERCIAL GENERAL LIABILITY CG 022003 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA CHANGES CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraph 2. of the Cancellation Common Policy Condition is replaced by the following 3 Failure to comply with underwriting requirements established by the insurer 2. Cancellation Of Policies In Effect a. For 90 Days Or Less If this policy has been in effect for 90 days or less we may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation accompanied by the reasons for cancellation at least 1 10 days before the effective date of cancellation if we cancel for nonpayment of premium or 2 20 days before the effective date of cancellation if we cancel for any other reason except we may cancel immediately if there has been A material misstatement or misrepresentation or b A failure to comply with the underwriting requirements established by the insurer. b. For More Than 90 Days If this policy has been in effect for more than 90 days we may cancel this policy only for one or more of the following reasons 1 Nonpayment of premium 2 The policy was obtained by a material misstatement within 90 days of the effective date of coverage 4 A substantial change in the risk covered by the policy or The cancellation is for all insureds under such policies for a given class of insureds. If we cancel this policy for any of these reasons we will mail or deliver to the first Named Insured written notice of cancellation accompanied by the reasons for cancellation at least a 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b 45 days before the effective date of cancellation if we cancel for any of the other reasons stated in Paragraph 2.b. G B. Paragraph 3. of the Cancellation Common Policy Condition is replaced by the following 3. We will mail or deliver our notice to the first Named Insured at the last mailing address known to us. CG 02200312 Insurance Services Office Inc. 2011 Page 1 of 2 | 2 |
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