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COMMERCIAL GENERAL LIABILITY CG 24 0405 09 POLICY NUMBER 1000305120181 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization Any person or organization requiring a waiver of transfer of rights of recovery pursuant to the terms of any contract or agreement you enter into with such person or organization. Information required to complete this Schedule if not shown above will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV Conditions We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 Insurance Services Office Inc. 2008 Page 1 of 1 | 2 |
POLICY NUMBER 1000305120181 COMMERCIAL GENERAL LIABILITY CG 24 07 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRODUCTS COMPLETED OPERATIONS HAZARD REDEFINED This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE POLICY NUMBER 1000305120181 VllEUVLRE Description of Premises and Operations Any premises or operation to whom you have provided products or completed operations If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. Paragraph a. of the definition of Products completed operations hazard in the DEFINITIONS Section is replaced by the following Products completed operations hazard a. Includes all bodily injury and property damage that arises out of your products if the bodily injury or property damage occurs after you have relinquished possession of those products. With respect to bodily injury or property damage arising out of your products manufactured sold handled or distributed 1. On from or in connection with the use of any premises described in the Schedule or 2. In connection with the conduct of any operation described in the Schedule when conducted by you or on your behalf CG 24 07 01 96 Copyright Insurance Services Office Inc. 1994 Page 1 of 1 | 2 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Composite Rating Plan Premium Endorsement 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. Commercial General Liability Coverage Form Business Auto Coverage Form The Class Code Premium Basis and Rate section of the Policy Declarations is changed to apply as follows A. The premium for this policy will be computed upon a composite basis as shown below in accordance with our rules rates rating plans premiums and minimum premiums and the other policy terms. Premium Coverage Type Estimated Basis Composite Estimated Minimum Deposit CGL or BAS or NS of Premium Rates Premium Premium Premium CGL NS 311431000 0.8981 279698 251728 279698 Totals 279698 251728 279698 B. The Composite Rates shown above apply per 1000 of Sales a basis of premium type defined below or on page 2 of this endorsement. C. If no number or no basis of premium type is inserted for Commercial General Liability Insurance CGL Coverage the rate shall apply per 1000 of Sales or for Business Auto Insurance BA Coverage the rate shall apply per 1 Unit where Unit means a powered covered auto. D. IfSales is selected as the basis of premium such Sales will include both foreign and domestic sales and sales by one named insured to another unless otherwise indicated by x below X Sales do NOT include foreign sales. Sales do NOT include sales by one named insured to another. E. IfUnits is selected as the basis of premium a Unit is an. F. Other Basis of Premium Type Define herein or in Exceptions on Page 3 G. DEFINITIONS OF BASIS OF PREMIUM TYPE Subject to Exceptions if any described below 1. Admissions means the total number of persons other than you your partners and your employees admitted during the policy period to events conducted on premises you own rent lease or otherwise control whether on paid admission tickets complimentary tickets or passes. 0 G 100 1109 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 2. Cost means the total cost to you for all work performed for you during the policy period by independent contractors and their subcontractors at all levels including the cost of all labor materials equipment and supplies furnished used or delivered for use in the execution of such work whether furnished by the owner by contractors or subcontractors at any level including but not limited to all fees allowances bonuses and commissions either made paid or due as well as taxes other than taxes which you collect as a separate item and remit directly to a governmental division. 3. Receipts means the gross amount of money you have charged others for work that you your partners your employees your contractors and subcontractors at all levels have performed during the policy period including taxes other than taxes which you collect as a separate item and remit directly to a governmental division. 4. Remuneration or Payroll means all of the money or the substitute for money earned during the policy period by you if you are the proprietor of the insured business by all partners if you are a partnership or by all members if you are a Limited Liability Company and by all your employees for their services to you during the policy period subject to the following Total Gross Remuneration or Payroll without limitation or Determined and limited in accordance with our Workers Compensation Insurance Manual s rules respectively for the states in which you have employment or Determined and limited in accordance with our General Liability Insurance Manual s rules respectively for the states in which you have employment. 5. Sales means the gross amount of money you or others trading in your name have charged for all goods and services you or they have sold or distributed during the policy period including charges for delivery installation service and repair and including taxes other than taxes which you or such others collect as a separate item and remit directly to a governmental division. 6. Units means the number of items of the types specified in this endorsement. a. Units that you hold for use in your business shall mean half the sum of their number at the policy s inception and their number at its expiration or termination if terminated then pro rated by the fraction of an annual period that the policy remained in effect. b. Units that you sell to others whether for your own account or the account of another shall mean the total number of such units that you sell during the policy term. 7. Other Definitions a. Subject is a Premium Type that is subject to adjustment under a retrospective rating plan described in an endorsement attached to the policy. Subject is signified on Page 1 by a Premium Type S. b. Non Subject is a Premium Type that is NOT subject to adjustment under a retrospective rating plan described in an endorsement attached to the policy. Non Subject is signified on Page 1 by a Premium Type NS. c. Exceptions 0 G 100 1109 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 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 0 G 100 1109 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 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Notice and Knowledge of an Occurrence Endorsement Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the Commercial General Liability Coverage Part It is hereby agreed that SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 2. Duties In The Event Of Occurrence Offense Claim Or Suit paragraph a. is deleted in its entirety and replaced by the following 2. Duties In The Event of Occurrence Offense Claim Or Suit a. You your insurance manager or any other person designated by you and listed in the Scheduled Positions Persons schedule below must see to it that we or our authorized agents are notified promptly of an occurrence or offense which may result in a claim. Scheduled Positions Persons 1 Corporate Risk Manager 2 Manager 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. Notwithstanding knowledge of either an i occurrence or i offense which may result in a claim by your agent servant or employee is not considered knowledge by you unless your insurance manager or any other person designated by you and listed in the Scheduled Positions Persons schedule above has received notice of same from your agent servant or employee. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY 2 0y Qe m Ihnsial. Biralvs Steve Blakey President Nehemiah E. Ginsburg General Counsel 0 G 102 1014 Page 1 of 1 V. Starr Company an demnity Liability Company. All rights reserved. Ihosial Lolors Nehemiah E. Ginsburg General Counsel Page 1 of 1 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 Amendment of Other Insurance 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 Commercial General Liability Coverage Form It is hereby agreed that SECTION IV Commercial General Liability Conditions 4. Other Insurance b. Excess Insurance is amended to read b. Excess Insurance This insurance is excess over any of the other insurance whether primary excess contingent or on any other basis 1 Unless such insurance is specifically purchased to apply as excess of this policy or 2 you are obligated by contract to provide primary insurance. When this insurance is excess we will have no duty under Coverage A or B to defend any claim or suit that any other insurer has a duty to defend. If no other insurer defends we will undertake to do so but we will be entitled to the insured s rights against all those other insurers. When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of 1 The total amount that all such other insurance would pay for the loss in the absence of this insurance and 2 The total of all deductible and self insured amounts under all that other insurance. We will share the remaining loss if any with any other insurance that is not 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. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Sl mp Y Steve Blakey President Nehen Jilouial Linelry Nehemiah E. Ginsburg General Counsel 0 G 104 1014 Page 1 of 1 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 Primary and Non Contributory Condition 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 Commercial General Liability Coverage Part A. SECTION IV CONDITIONS condition 4. Other Insurance is amended as follows 1. The following is added to paragraph 4.a. of the Other Insurance condition This insurance is primary insurance as respects our coverage to the additional insured where the written contract or written agreement requires that this insurance be primary and non contributory. In that event we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured is a Named Insured. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY ez w J Steve Blakey Presidnt Nehen Hilowal R Nehemiah E. Ginsburg General Counsel 0 G 107 0411 Page 1 of 1 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 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Broad Form Named Insured 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. Commercial General Liability Coverage Form Policy Declarations Named Insured is revised to include Named Insured means the person or organization first named as the Named Insured on the Declarations Page of this policy the First Named Insured. Named Insured also includes 1 any other person or organization named as a Named Insured on the Declarations Page 2 any subsidiary associated affiliated allied or acquired company or corporation including subsidiaries thereof of which any insured named as the Named Insured on the Declarations Page has more than 50 ownership interest in or exercises management or financial control over at the inception date of this policy or perform substantially similar operations as the first named insured. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Sl mp Steve Blakey President Nehen mz 2 MW Nehemiah E. Ginsburg General Counsel 0 G 111 0611 Page 1 of 1 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 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY EXTENSION SCHEDULE OF NAMED INSUREDS 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 Commercial General Liability Coverage Form Liquor Liability Coverage Form Owners and Contractors Protective Liability Coverage Form Products Completed Operations Liability Coverage Form Railroad Protective Liability Coverage Form This policy provides coverage for the first Named Insured shown on the declarations page and the following Named Insureds Checkers Holdings Inc. Checkers of Puerto Rico Inc. Checkers Rally s Restaurants Inc. Official Burger of Tampa Bay Inc. Rally s of Ohio Inc. Checkerco Inc. Checkers Rally s Restaurant Services LLC All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Steve Blakey Presidnt Nehen Ihowial Zimsliow Nehemiah E. Ginsburg General Counsel 0 G 112 0312 Page 1 of 1 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 Unintentional Errors and Omissions Endorsement 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. Commercial General Liability Coverage Form Section IV Commercial General Liability Conditions 6. Representations is amended by adding The unintentional failure by you or any Insured to provide accurate and complete representations as of the inception of the policy will not prejudice the coverages afforded by this policy. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY ez w J Steve Blakey Presidnt Nehen Hilowal R Nehemiah E. Ginsburg General Counsel 0 G 114 0711 Page 1 of 1 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 Amendment of Limits of Insurance Per Project or Per Location Aggregate Limit 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. Your policy is amended to include either a Per Project General Aggregate Limit a Per Location General Aggregate Limit or a Per Project and Per Location General Aggregate Limit. Please select only one of the following 1 Per Project General Aggregate Limit X1 Per Location General Aggregate Limit 2000000 1 Per Project and Per Location General Aggregate Limit 1 Overall Policy Aggregate Limit 2000000 IF NEITHER OF THESE BOXES ARE CHECKED THIS ENDORSEMENT IS VOID. IF MORE THAN ONE OF THE THESE BOXES ARE CHECKED THIS ENDORSEMENT IS VOID. 1. SECTION Il LIMITS OF INSURANCE is amended to include the following 1. The Limits of Insurance 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. Persons or organizations making claims or bringing suits. 4. 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. 5. Subject to 2 above the Personal and Advertising Injury Limit is the most we will pay under 0 G 139 0711 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 Coverage B for the sum of all damages because of all personal and advertising injury sustained by any one person or organization. 6. Subject to 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. 7. Subject to 5 above the Damage to Premises Rented to You Limit is the most we will pay under Coverage A 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 by the owner. 8. Subject to 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. 9. Subject to 2 4 5 6 andor 7 above the Per Project Aggregate Limit is the most we will pay under Coverages A B and C combined for the sum of a. Damages under Coverage A b. Damages under Coverage B and c. Medical expenses under Coverage C arising out of the any single Location described above. 10. Subjectto 2 4 5 6 andor 7 above the Per Location Aggregate Limit is the most we will pay under Coverages A B and C combined for the sum of d. Damages under Coverage A e. Damages under Coverage B and f. Medical expenses under Coverage C arising out of the any single Location described above. 11. The Overall Policy Aggregate is the most we will pay in any policy period regardless of number of projects or locations. 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. The Limits of Insurance shown in the Declarations are deleted in their entirety and replaced by the Limits of Insurance set forth below. Limits of Insurance General Aggregate Limit 2000000 Each Occurrence Limit 1000000 Products Completed Operations Aggregate Limit 2000000 Personal Advertising Injury Limit 1000000 Damage to Premises Rented to You 1000000 Medical Expense Limit 0 Overall Policy Aggregate Limit Capped At 10000000 0 G 139 0711 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 IV. SECTION V DEFINITIONS is amended to include the following 23. Location means premises involving the same or connecting lots or premises whose connection is interrupted only by a street roadway waterway or right of way railroad. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Sl mp J Steve Blakey President Nehen Jilouial Linelry Nehemiah E. Ginsburg General Counsel 0 G 139 0711 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 |
Starr Indemnity Liability Company Dallas TX 1 866 519 2522 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ CAREFULLY BODILY INJURY DEFINITION EXTENSION ENDORSEMENT 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 PART COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section V Definitions 3. Bodily injury is amended to read 3. Bodily injury means physical injury sickness ordisease including death resulting from any of these or the following when accompanied by physical injury sickness or disease mental anguish shock or emotional distress. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Steve Blakey Presidnt Nehen mz 2 MW Nehemiah E. Ginsburg General Counsel 0 G 144 0312 Page 1 of 1 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 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Alienated Premises Endorsement 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. Commercial General Liability Coverage Form SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2. Exclusions j. Damage to Property 2 is deleted in its entirety. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY ez w J Steve Blakey Presidnt Nehen Hilowal R Nehemiah E. Ginsburg General Counsel 0 G 158 0412 Page 1 of 1 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 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Fellow Employee Exclusion Deleted 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. Commercial General Liability Coverage Form Delete any fellow employee exclusion as respects employee and add the following SECTION Il WHO IS AN INSURED 2. a. 1 a is amended to read 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 or to your other volunteer workers while performing duties related to the conduct of your business. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Steve Blakey Presidnt Nehen Ihowial Linstlios Nehemiah E. Ginsburg General Counsel 0 G 169 0412 Page 1 of 1 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 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Incidental Medical Malpractice Endorsement 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. Commercial General Liability Coverage Form SECTION V DEFINITIONS is amended to add Incidental Medical Malpractice Injury means Bodily Injury arising out of the rendering of or failure to render the following services a. medical surgical dental x ray or nursing service or treatment or the furnishing of food or beverages in connection therewith or b. the furnishing or dispensing of drugs or medical dental or surgical supplies or appliances. SECTION Il WHO IS AN INSURED 2. a. 1 d is deleted in its entirety and replaced with the following d Arising out of his or her providing or failing to provide professional health care services except for bodily injury arising out of Incidental Medical Malpractice Injury by any physician dentist nurse or other medical practitioner employed or retained by you. However the insurance provided hereunder to such persons will not apply to liability arising out of services performed outside of the scope of their duties as your employees. Any series of continuous repeated or related acts will be treated as the occurrence of a single negligent professional healthcare service. The Coverage provided by this endorsement does not apply to you or any insured if you are engaged in the business or occupation of providing any of the services described in the definition of Incidental Medical Malpractice Injury. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY ez w J Steve Blakey Presidnt Nehen Hilowal B Nehemiah E. Ginsburg General Counsel 0 G 170 0412 Page 1 of 1 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 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Newly Acquired or Formed Entities 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. Commercial General Liability Coverage Form SECTION Il WHO IS AN INSURED 3. is amended as 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 120 day after you acquire or form the organization or to the end of the policy period whichever is earlier. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Sl mp J Steve Blakey President Nehen Jilouial Lty Nehemiah E. Ginsburg General Counsel 0 G 172 0412 Page 1 of 1 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 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Personal and Advertising Injury Definition Extension Endorsement 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. Commercial General Liability Coverage Form SECTION V DEFINITIONS 14. Personal injury and Advertising injury is amended to read Personal injury and advertising injury means injury including consequential bodily injury humiliation mental anguish or shock arising out of one or more of the following offenses a. b. False arrest detention or imprisonment Malicious prosecution 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 by or in behalf of its owner landlord or lessor Oral or written publication of material in any manner that slanders or libels a person or organization or disparages a person s or organization s goods products or services or Oral or written publication in any manner of material that violates a person s right of privacy. The use of another s advertising idea in your advertisement or Infringing upon another s copyright trade dress slogan trademark service mark or trade name in your advertisement. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY ez w J Steve Blakey President Nehen Jihosial. Binilry Nehemiah E. Ginsburg General Counsel 0 G 174 0412 Page 1 of 1 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 SELF INSURED RETENTION ENDORSEMENT per occurrence 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 INSURING AGREEMENTS SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. INSURING AGREEMENT paragraph a. is deleted in its entirety and replaced with the following a. We will pay on behalf of the Insured those sums in excess of the Retained Limit 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 but not the duty to defend any suit seeking those damages. We may at our discretion and expense participate with you in the investigation of any occurrence and the defense or settlement of any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in SECTION IIl LIMITS OF INSURANCE and 2 Our right to defend if we so exercise it ends when we have exhausted 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 ALLOCATED LOSS ADJUSTMENT EXPENSES COVERAGES A AND B. SECTION COVERAGES COVERAGE B PERSONAL AND ADVERTISING INJURY 1. Insuring Agreement paragraph a. is deleted in its entirety and replaced with the following a. We will pay on behalf of the Insured those sums in excess of the Retained Limit that thelnsured becomes legally obligated to pay as damages because of personal and advertising injury to which this insurance applies. We will have the right but not the duty to defend any suit seeking those damages. We may at our discretion and expense participate with you in the investigation of any occurrence or offense and the defense or settlement of 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 to defend if we so exercise it ends when we have exhausted the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. 0 G 179 0412 Page10f5 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 No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under ALLOCATED LOSS ADJUSTMENT EXPENSES COVERAGES A AND B. SECTION COVERAGES COVERAGE C MEDICAL PAYMENTS Section 1. Insuring Agreement paragraph a. is deleted in its entirety and replaced with the following a. We will pay medical expenses in excess of the Retained Limit as described below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that 1 The accident takes place in the coverage territory and during the policy period 2 The expenses are incurred and reported to us within one year of the date of the accident and 8 The injured person submits to examination at our expense by physicians of our choice as often as we reasonably require. ALLOCATED LOSS ADJUSTMENT EXPENSES COVERAGES A AND B SECTION COVERAGES SUPPLEMENTARY PAYMENTS COVERAGES A AND B is deleted in its entirety and replaced with the following ALLOCATED LOSS ADJUSTMENT EXPENSES COVERAGES A AND B Allocated Loss Adjustment Expenses we pay will not reduce the Limits of Insurance. You are responsible for the payment of Allocated Loss Adjustment Expenses incurred according to the election indicated by an X below. X A. 100 of the total Allocated 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. B. 100 of the total Allocated Loss Adjustment Expenses. C. Allor part of the Allocated Loss Adjustment Expenses determined according tothe following i. If we incur NO obligation under the policy to pay damages resulting from a claim you are responsible for all Allocated Loss Adjustment Expenses up to the applicable Retained Limit plus 100.0 of all remaining Allocated Loss Adjustment Expenses. ii. If we DO incur an obligation under the policyies to pay damages resulting from a claim you will be responsible for a percentage of Allocated Loss Adjustment Expenses. That percentage shall be determined by dividing the Retained Limit paid by the total damages paid subject to the Limits of Insurance. D. NoAllocated Loss Adjustment Expenses Your duty to pay for Allocated Loss Adjustment Expenses applies separately to each occurrence for bodily injury or property damage or to each offense for personal and advertising injury. 0 G 179 0412 Page 2015 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 lll. LIMITS OF INSURANCE SECTION Il Limits of Insurance is amended to add the following The Limits of Insurance for each of the Coverages provided by this policy will apply in excess of a Self Insured Retention referred throughout as the Retained Limit. The Retained Limit applying only to damages for occurrences or offenses covered under this policy is 250000 per occurrence or offense. Subject to additional Allocated Loss Adjustment Expenses the Retained Limit is the most an insured will pay for A. The sum of all damages under Coverage B because of all personal and advertising injury sustained by any one person or organization or B. The sum of all damages under Coverage A and medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. IV. 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 occurrence 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 Limits of Insurance adjusted for any reduction in the aggregate limit of our liability. V. NOTICE PROVISIONS Section IV Commercial General Liability Conditions 2. Duties in the Event of Occurrence Offense Claim or Suit is deleted in its entirety and replaced with the following a. Periodic Notices on a annual basis you must provide us with a written summary lossrun of all occurrences offenses claims or suits which have or may result in payments within the Retained Limit. This written summary must show 1. The date and location of the occurrence and 2. The names and addresses of the injured persons or identification of the damaged property and 3. A description of the injury or damage and 4 The amount paid or reserved including Allocated Loss Adjustment Expense resulting from the occurrence offense claim or suit. b. Individual Notices of an offense or an occurrence in addition to the periodic notices provided for in section a. above you must see to it that we are notified as soon as practicable of any occurrence or offense which may result in a claim. Knowledge of an occurrence or an offense 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 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured persons and witnesses and 0 G 179 0412 Page3of5 V. Starr Company a jemnity Liability Company. Al rights reserved. Page3of5 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 The nature and location of any injury or damage arising out of the occurrence or offense including but not limited to a afatality b paralysis of any part of the body c a major extremity or multiple minor extremity amputations d abrain or brain stern injury f partial or total blindness g loss or impairment of hearing h a heart attack e severe burns or disfigurement i reserves that exceed 50 of the Retained Limit. As respects the above categories You must provide us with any and all additional information material andor data subsequent to the original notice as it becomes available. V1. SPECIAL CONDITIONS SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 2. Duties in the Event of Occurrence Offense Claim or Suit is amended to add the following a. You will employ and pay without any reimbursement from us a firm acceptable to us for the purpose of providing claim services the Claims Administrator. In the event of cancellation expiration or revision of the contract between you and the Claims Administrator you will notify us within ten 10 days of such cancellation expiration or revision. b. Loss settliements 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 suitsarising from claims or suits for which coverage is not afforded by the policy. VII. DEFINITIONS SECTION V DEFINITIONS is amended to include the following additional definitions 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 settlement 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 companyies with respect to a claim or suit against you or to exercise our right to participate in the investigation of any occurrence subject to this endorsement and the defense of any claim or suit that may result. 0 G 179 0412 Pagedof5 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 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 0 G 179 0412 Page 5015 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 WHERE REQUIRED UNDER CONTRACT OR AGREEMENT 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 SECTION Il WHO IS AN INSURED is amended to include as an additional insured Any person or organization to whom you become obligated to include as en additional insured under this policy as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy but only with respect to liability arising out of your operations or premises owned by or rented to you. However the insurance provided will not exceed the lesser of. The coverage andor limits of this policy or. The coverage andor limits required by said contract or agreement. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Qen w Ihanial Znalirs President Steve Blakey Nehemiah E. Ginsburg General Counsel mz 2 MW Nehemiah E. Ginsburg General Counsel 0 G 184 0412 Page 1 of 1 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 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Jefferies Finance LLC As Their Interests May Appear As Administrative Agent for Lenders 520 Madison Avenue New York NY 10022 Information required to complete this Schedule if not shown above will be shown in the Declarations. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by your acts or omissions or the acts or omissions of those acting on your behalf A. In the performance of your ongoing operations or B. In connection with your premises owned by or rented to you. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY B B Steve Blakey Presidnt Nehen Jihosial. Binilos Nehemiah E. Ginsburg General Counsel 0 G 213 04 1014 Page 1 of 1 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 |
GLOBAL INDEMNITY GROUP LLC PRIVACY NOTICE We at Global Indemnity Group Inc. which includes Diamond State Insurance Company Penn America Insurance Company Penn Patriot Insurance Company Penn Star Insurance Company United National Insurance Company and our affiliated companies and subsidiaries are required to protect our customers nonpublic personal financial information. We collect your nonpublic personal financial information from the following sources Information obtained from you including information from your application such as name address telephone number social security number assets and income. Information about transactions and experiences such as your premium payment and claims history. Information from a consumer reporting agency such as your credit history. WE DO NOT DISCLOSE YOUR NONPUBLIC PERSONAL FINANCIAL INFORMATION EXCEPT AS PERMITTED OR REQUIRED BY LAW. WE RESERVE THE RIGHT HOWEVER TO CHANGE THIS POLICY AT ANY TIME. SHOULD THIS POLICY CHANGE WE WILL GIVE AFFECTED CUSTOMERS AN OPPORTUNITY TO DIRECT THAT THEIR NONPUBLIC PERSONAL FINANCIAL INFORMATION NOT BE DISCLOSED. We maintain electronic physical and procedural safeguards that comply with Federal regulations to protect your nonpublic personal financial information. We limit access to your nonpublic personal financial information to those employees who need to know that information to perform their job responsibilities. We disclose nonpublic personal financial information of former customers to affiliated and nonaffiliated third parties as permitted by law. Page 1 of 1 NAA105 112019 | 2 |
REQUEST FOR ADDITIONAL INFORMATION OPTIONAL RETAIL AGENT NAME RETAIL AGENT PHONE Lockton Companies Kansa 816 960 9756 816 960 9756 REQUIRED INSURED S PHONE IAA101 082019 | 2 |
GLOBAL INDEMNITY GROUP American Reliable Insurance Company Diamond State Insurance Company Penn America Insurance Company Penn Star Insurance Company Penn Patriot Insurance Company United National Insurance Company CLAIMS REPORTING PROCEDURES Your Global Indemnity team is committed to providing a quality claims service. In the event of a claim or a potential claim there are three convenient ways to report the claim immediately. Report a Claim e Online www.globalindemnity.com e Call 800 788 4780 available 247 e Email claimsglobalindemnity.com Where to Send Supporting Documentation e Email claimsglobalindemnity.com o Fax 610 660 8885 e Mail Global Indemnity Group Claims P.O. Box 532 Willow Grove PA 19090 NAA169 092018 Page 1 of 1 | 2 |
0 Penn America Group Group X oy X CYBER LIABILITY RESOURCES NOTICE Congratulations on safeguarding your business by purchasing our Cyber Liability coverage. Your purchase of this coverage also includes access to our comprehensive resource website Penn America Group s NAS CyberNET which helps you and your organization prevent or mitigate the risk and impact of a cyber security breach. The site includes but is not limited to Cyber Training Courses Sample Policies Procedures and Vendor Agreements Step by Step Guidance on Implementing an Incident Response Plan Data Security Best Practices Risk Assessments Fitness Checklist State Federal Regulations Industry Specific Data Protection To access please go to httpspenn.nascybernet.com and login with the following username and password Username marketingpennamerica.com Password Cyber123 NAA223102017 Page1of1 | 2 |
K COMMERCIAL LINES COMMON POLICY DECLARATIONS MN0 INSURANCE IS PROVIDED BY THE COMPANY DESIGNATED BY AN Stock PENN AMERICA INSURANCE COMPANY Company Group X x X X PENN STAR INSURANCE COMPANY PAV0214338 PENN PATRIOT INSURANCE COMPANY Renewal of Number State Control Number Bala Cynwyd Pennsylvania 19004 2305 Rewrite of Number This insurance contract is issued pursuant to the. Nevada Ir Iz b ither i ised POLICY NUMBER PAV0214437 by et tner the suparision of tho cepeltmenl of 1. NAMED INSURED WS DYNOCO PETROLEUM MANAGEMENT LLC e s o it ol st e canimct DBA PER FORM L1201 not covered by the Nevada Insurance Guaranty Association Act. MAILING ADDRESS 4129 W Cheyenne Avenue AN Wlooe Davis D. Moore License 2305 North Las Vegas NV 89032 2. POLICY PERIOD From October 1 2020 To October 1 2021 at 1201 AM. Standard Time at your mailing address shown above. 3. FORM OF BUSINESS Limited Liability Company OTHER DESC 4. BUSINESS DESCRIPTION GAS STATION GROCERY STORES HOTEL RESTAURANTS AND BUILDI 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. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. 5. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. PREMIUM Commercial General Liability Coverage Part 10186.00 Commercial Property Coverage Part NOT COVERED Commercial Crime Coverage Part NOT COVERED Commercial Inland Marine Coverage Part NOT COVERED Professional Liability Coverage Part NOT COVERED Liquor Liability Coverage Part 513.0 Commercial Umbrella Coverage Part NOTCOVERED Owners Contractors Protective Coverage Part NOT COVERED TRIA NOT COVERED 6. TOTAL PREMIUM PAYABLE AT INCEPTION 10.699.00 Policy Fee 225.00 Inspection Fee 150.00 Surplus Lines Tax 387.59 Filing Fee 44.30 Other TOTAL 11505.89 7. FORMS AND ENDORSEMENTS MADE A PART OF THIS POLICY AT THE TIME OF ISSUE Omits applicable Forms and Endorsements if shown in specific Coverage Part Coverage Form Declarations. THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS COVERAGE PART DECLARATIONS COVERAGE PART COVERAGE FORMS AND FORMS AND ENDORSEMENTS IF ANY ISSUED TO FORM A PART THEREOF COMPLETE THE ABOVE NUMBERED POLICY. 02505 Worldwide Facilities LLC 725 South Figueroa Street Los Angeles CA 90017 Dz 11052020 1100092016 Page 10f 1 Agency Code INSURANCE IS PROVIDED BY THE COMPANY DI PENN AMERICA INSURANCE COME X PENN STAR INSURANCE COMPAN PENN PATRIOT INSURANCE COMP ber Bala Cynwyd Pennsylvania 190 ber PAV0214437 SURED WS DYNOCO PETROLEUM MANAGEMENT LLC PER FORM IL1201 DDRESS 4129 W Cheyenne Avenue North Las Veaas. NV 89032 art Page 1 of 1 | 2 |
COMMERCIAL LINES COMMON POLICY DECLARATIONS SCHEDULE OF FORMS AND ENDORSEMENTS POLICY NUMBER NAMED INSURED PAV0214437 WS Dynoco Petroleum Management LLCPer Form IL1201 Form Endorsement No. Edition Date COMMON POLICY NAA223 10 17 CYBER LIABILITY RESOURCES NOTICE S1100 09 16 PENN AMERICA COMMON POLICY DECLARATIONS IL0017 11 98 COMMON POLICY CONDITIONS IL0021 09 08 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT IL0115 01 10 NV CHANGES DOMESTIC PARTNERSHIP IL1201 11 85 POLICY CHANGES EAA230 02 15 SERVICE OF SUIT EAA100 01 12 IN WITNESS CLAUSE EAAl46 12 09 TERRORISM EXCLUSION 81003 08 91 MINIMUM EARNED PREMIUM S2002 08 02 COMBINED PROVISIONS ENDORSEMENT 2033 03 14 LEAD CONTAMINATION EXCLUSION 1L0003 09 08 CALCULATION OF PREMIUM 1L0985 01 15 DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT ABER CYBER LIABILITY RESOURCES NOTICE PENN AMERICA COMMON POLICY DECLARATIONS COMMON POLICY CONDITIONS NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT NV CHANGES DOMESTIC PARTNERSHIP POLICY CHANGES SERVICE OF SUIT IN WITNESS CLAUSE TERRORISM EXCLUSION MINIMUM EARNED PREMIUM COMBINED PROVISIONS ENDORSEMENT LEAD CONTAMINATION EXCLUSION CALCULATION OF PREMIUM DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT COMMERCIAL GENERAL LIABILITY 82000 06 01 82001 10 13 CG0001 04 13 82005 06 14 52038 12 93 52045 10 14 52053 11 97 CG2008 04 13 82099 05 04 CG0300 01 96 CG2028 12 19 82113 10 07 CG2029 12 19 CG4012 12 19 CG2101 12 19 CG2107 05 14 GL COVERAGE PART DECLARATIONS SUPPLEMENTAL GL DEC 1 CGL COVERAGE FORM ASSAULT OR BATTERY GENERAL LIABILITY EXCLUSION WARRANTY NON OWNED AUTOMOBILES NON OWNED AND HIRED AUTO LIABILITY EMPLOYEE BENEFITS LIABILITY COVERAGE AI USERS OF GOLFMOBILES CROSS LIABILITY EXCLUSION DEDUCTIBLE LIABILITY INSURANCE AI LESSOR OF LEASED EQUIPMENT AUTO EXCLUSION AI GRANTOR OF FRANCHISE EXCLUSION ALL HAZARDS IN CONNECTION WITH AN ELECTRONIC SMOKING DEVICE ITS VAPOR COMPONENT PARTS EQUIPMENT AND ACCESSORIES EXCLUSION ATHLETIC OR SPORTS PARTICIPANTS EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA RELATED LIABILITY LIMITED BODILY INJURY EXCEPTION NOT INCLUDED EXCLUSION UNMANNED AIRCRAFT EMPLOYMENT RELATED PRACTICES EXCL AMENDMENT OF LIQUOR LIABILITY EXCLUSION TOTAL POLLUTION EXCLUSION WITH A HOSTILE FIRE EXCEPTION LIMITATION OF COVERAGE TO INSURED PREMISES CG2101 CG2107 06 15 12 07 04 13 09 99 01 96 CG2109 CG2147 CG2150 CG2155 CG2806 Page 1 of 2 1007 12 2000 | 2 |
COMMERCIAL LINES COMMON POLICY DECLARATIONS SCHEDULE OF FORMS AND ENDORSEMENTS POLICY NUMBER PAV0214437 NAMED INSURED WS Dynoco Petroleum Management LLCPer Form IL1201 Form Endorsement No. Edition Date CG2132 CG2167 CG2196 CG2416 CG2426 EPA1631 EPA1650 EPA1772 EPA1797 EPA1833 EPA1333 EPA1941 CG4014 58000 CG0033 CG0305 58001 EPA1834 05 09 12 04 03 05 12 07 04 13 01 18 02 11 01 17 04 17 01 18 03 18 03 19 12 19 11 97 04 13 01 96 06 05 01 18 FOR USE WITH LIQUOR POLICIES COMMUNICABLE DISEASE EXCLUSION FUNGI OR BACTERIA EXCLUSION SILICA OR SILICA RELATED DUST EXCLUSION CANOES OR ROWBOATS AMENDMENT OF INSURED CONTRACT DEFINITION TOTAL EXCLUSION PROFESSIONAL SERVICES INFESTATION AND VERMIN EXCLUSION EXCLUSION SWIMMING POOL CYBER LIABILITY INSURANCE ENDORSEMENT NONCOOPERATION WITH AUDIT EXCLUSION FIREARMS AND OTHER WEAPONS AMUSEMENTS OR ACTIVITIES EXCLUSION CANNABIS EXCLUSION LIQUOR LIABILITY COVERAGE FORM DECLARATIONS LIQUOR LIABILITY COVERAGE FORM OCCURRENCE VERSION DEDUCTIBLE LIABILITY INSURANCE FOR USE WITH LIQUOR POLICIES ASSAULT OR BATTERY LIQUOR LIABILITY EXCLUSION NONCOOPERATION WITH AUDIT ABER Page 2 of 2 1007 12 2000 | 2 |
IL0017 1198 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation b. Give you reports on the conditions we find 1. The first Named Insured shown in the Declara tions may cancel this policy by mailing or de livering to us advance written notice of cancel lation. 2. We may cancel this policy by mailing or deliv ering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancel lation if we cancel for nonpayment of pre mium or b. 30 days before the effective date of cancel lation 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 ef fective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be suf ficient proof of notice.. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declara tions 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.. Examination Of Your Books And Records We may examine and audit your books and rec ords 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 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 in surability and the premiums to be charged. We do not make safety inspections. We do not un dertake 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 recom mendations we may make relative to certifica tion under state or municipal statutes ordi nances or regulations of boilers pressure ves sels or elevators. E. Premiums The first Named Insured shown in the Declara tions 1. Is responsible for the payment of all premiums and 2. Will be the payee for any return premiums we pay.. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named in sured. If you die your rights and duties will be trans ferred to your legal representative but only while acting within the scope of duties as your legal rep resentative. Until your legal representative is ap pointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. IL0017 1198 Copyright Insurance Services Office Inc. 1998 Page 1 of 1 a | 2 |
IL 00 21 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART This endorsement modifies insurance provided under the following OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply A. Under any Liability Coverage to bodily injury or property damage 1 With respect to which an insured under the policy is also an insured under a nuc lear energy liability policy issued by Nuclear Energy Liability Insurance Association Mu tual 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 re quired to maintain financial protection pur suant to the Atomic Energy Act of 1954 or any law amendatory thereof or b the in sured is or had this policy not been issued would be entitled to indemnity from the United States of America or any agency thereof under any agreement entered into by the United States of America or any agency thereof with any person or organi zation. B. Under any Medical Payments coverage to expenses incurred with respect to bodily in jury resulting from the hazardous properties of nuclear material and arising out of the op eration of a nuclear facility by any person or organization. 2 C. Under any Liability Coverage to bodily injury or property damage resulting from hazard ous properties of nuclear material if 1 The nuclear material a is at any nuclear facility owned by or operated by or on be half of an insured or b has been dis charged or dispersed therefrom The nuclear material is contained in spent fuel or waste at any time pos sessed handled used processed stored transported or disposed of by or on behalf of an insured or The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nuc lear facility but if such facility is located within the United States of America its terri tories or possessions or Canada this ex clusion 3 applies only to property dam age to such nuclear facility and any property thereat. 3. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source material spe cial nuclear material or by product material. C. Under any Liability Coverage to bodily injury or property damage resulting from hazard ous properties of nuclear material if 1 The nuclear material a is at any nuclear facility owned by or operated by or on be half of an insured or b has been dis charged or dispersed therefrom The nuclear material is contained in spent fuel or waste at any time pos sessed handled used processed stored transported or disposed of by or on behalf of an insured 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 nuc lear facility but if such facility is located within the United States of America its terri tories or possessions or Canada this ex clusion 3 applies only to property dam age to such nuclear facility and any property thereat.. As used in this endorsement Hazardous properties includes radioactive toxic or explosive properties. Nuclear material means source material spe cial nuclear material or by product material. 5 ISO Properties Inc. 2007 Page 1 of 2 o IL 00 21 09 08 | 2 |
Source material special nuclear material and by product material have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. Spent fuel means any fuel element or fuel com ponent solid or liquid which has been used or ex posed to radiation in a nuclear reactor. Waste means any waste material a containing by product material other than the tailings or wastes produced by the extraction or concentra tion of uranium or thorium from any ore processed primarily for its source material content and b resulting from the operation by any person or or ganization of any nuclear facility included under the first two paragraphs of the definition of nuc lear facility. Nuclear facility means a Any nuclear reactor b Any equipment or device designed or used for 1 separating the isotopes of uranium or plutonium 2 processing or utilizing spent fuel or 3 handling processing or packag ing waste c Any equipment or device used for the processing fabricating or alloying of spe cial nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of pluto nium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 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 radioac tive contamination of property. Page 2 of 2 ISO Properties Inc. 2007 IL 00 21 09 08 | 2 |
ILo11501 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEVADA CHANGES DOMESTIC PARTNERSHIP This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. All references to spouse shall include an individual who is in a domestic partnership recognized under Nevada law. B. Under the Commercial Auto Coverage Part the term family member is replaced by the following Family member means a person related to the 1. Individual Named Insured by blood adoption marriage or domestic partnership recognized under Nevada law who is a resident of such Named Insured s household including a ward or foster child or 2. Individual named in the Schedule by blood adoption marriage or domestic partnership recognized under Nevada law who is a resi dent of the individual s household including a ward or foster child if the Drive Other Car Coverage Broadened Coverage For Named Individual Endorsement is attached. C. With respect to coverage for the ownership main tenance or use of covered autos provided under the Commercial Liability Umbrella Coverage Part the term family member is replaced by the follow ing Family member means a person related to you by blood adoption marriage or domestic partner ship recognized under Nevada law who is a resi dent of your household including a ward or foster child. C. With respect to coverage for the ownership main tenance or use of covered autos provided under the Commercial Liability Umbrella Coverage Part the term family member is replaced by the follow ing Family member means a person related to you by blood adoption marriage or domestic partner ship recognized under Nevada law who is a resi dent of your household including a ward or foster child. IL01150110 Insurance Services Office Inc. 2009 Page 1 of 1 m | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number POLICY NUMBER POLICY CHANGES EFFECTIVE PAV0214437 10012020 COMPANY Penn Star Insurance Company NAMED INSURED WS Dynoco Petroleum Management LLCPer Form IL1201 AUTHORIZED REPRESENTATIVE COVERAGE PARTS AFFECTED Commercial General Liability CHANGES NAMED INSUREDS WS Dynoco Petroleum Management LLC Adams Family Trust 1993 Trust WS Dynoco Petroleum Management LLC DBA Wesley s WS Dynoco Il LLC Glendale Gas Management LLC Moapa Town Center surance Company Commercial General Liability NAMED INSUREDS WS Dynoco Petroleum Management LLC Adams Family Trust 1993 Trust WS Dynoco Petroleum Management LLC DBA Wesley s WS Dynoco Il LLC Glendale Gas Management LLC Moapa Town Center Authorized Representative Signature nc. 1983 Page 1 of 1 o 5 Inc. 1983 Copyright Insurance Services Office Inc. 1983 Copyright ISO Commercial Risk Services Inc. 1983 IL12011185 DZ | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SERVICE OF SUIT CLAUSE This endorsement modifies insurance provided under the following ALL COVERAGE PARTS IN THIS POLICY We appoint the highest State official in charge of insurance affairs Commissioner of Insurance Director of Insurance Insurance Commissioner Executive Secretary Superintendent of Insurance or such other official title as designated by the State of the State of Nevada and his successor or successors in office as his and their duly authorized deputies as our true and lawful attorney in and for the aforesaid State upon whom all lawful process may be served in any action suit or proceeding instituted in the said State by or on behalf of any insured or beneficiary against us arising out of this insurance policy provided a copy of any process suit complaint or summons is sent by certified or registered mail to Stephen Ries Esquire Penn Star Insurance Company Three Bala Plaza East Suite 300 Bala Cynwyd PA 19004 EAA230 022015 Page 1 of 1 | 2 |
In Witness Clause In Witness Whereof we have caused this policy to be executed and attested and if required by state law this policy shall not be valid unless countersigned by our authorized representative. S Executive Vice President EAA100 012012 Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TERRORISM EXCLUSION This endorsement modifies insurance provided under the following ALL PARTS OF THE POLICY Notwithstanding any other provision of this policy to the contrary this insurance does not apply to any loss cost expense damage injury or economic detriment whether arising by contract operation of law or otherwise whether or not concurrent or in any sequence with any other cause or event that in any way form or manner directly or indirectly arises out of results from or is caused by terrorism and also including any action taken in hindering or defending against terrorism. Terrorism means any act of force or violence or other illegal means whether actual alleged or threatened by any person persons group private or governmental entity or entities or any other type of organization of any nature whatsoever whether the identity of which is known or unknown that appears to be for political religious racial ethnic ideological ecological or social purposes objectives or motives and that causes or appears to be intended to cause 1. alarm fright fear of danger concern or apprehension for public safety 2. the interference or disruption of an electronic communication information or mechanical system 3. the intimidation or coercion of the civilian population or any governmental body or 4. the alteration of the policies foreign or domestic of any governmental body This exclusion does not affect the applicability of and is in addition to any exclusion of war warlike or military action whether or not specifically denominated as such. EAA146 122009 Page 1 of 1 | 2 |
Stock Company Stock X COMMERCIAL GENERAL LIABILITY COVERAGE PART Gompany I IEA DECLARATIONS Group 4 X POLICY NUMBERPAV0214437 1. NAMED INSURED WS DYNOCO PETROLEUM MANAGEMENT LLCPER FORM IL120 2 LIMITS OF INSURANCE INSURANCE APPLIES ONLY FOR COVERAGE FOR WHICH A LIMIT OF INSURANCE IS SHOWN. General Aggregate Limit Other than Products Completed Operations. 2000000 Products Completed Operations Aggregate Limit 2000000 Each Occurrence Limit 1000000 Personal Advertising Injury Limit 1000000 Damage to Premises Rented to You Limit 100000 any one premises Medical Expense Limit 5000 any one person 3. LOCATIONS of all premises you Own Rent or Occupy Address City State Zip No. 1 1 2300 E Glendale Bivd Moapa NV 89025 PREMIUM BASIS RATES ADVANCE PREMIUM 4 CLASS Code Exposure Prod CO All Other Prod CO AllOther If Classifications are Numbered the coverage applies to the corresponding Location No. No. 1 Bldg 1 13454 0 1297924 0.265 3.462 344.00 4493.00 Gasoline Stations self service No. 1 Bldg 1 13673 s 1327282 0.052 3.041 69.00 4036.00 Grocery Stores No. 1 Bldg 1 45192 s 83273 Incl 7.371 Included 614.00 Hotels and Motels without pools or beaches less than four stories PRODUCTS COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT No. 1 Bldg 1 61217 a 1500 Incl 80.846 Included 121.00 Buildings or Premises bank or office mercantile or manufacturing maintained by the insured lessor s risk onlyOther than Not For Profit No. 1 Bldg 1 e 2 Incl 50.000 Included 100.00 Additional Insured If Classifications are Numbered the coverage applies o the corresponding Location No TOTAL 10186.00 gross sales per 1000 c total cost per 1000 m admissions per 1000 each p payroll per 1000 a area per 1000sq. ft. units other 5. Policy may be AUDITABLE t see classification notes in company or ISO Commercial Lines Manual 6. SPECIFIC GENERAL LIABILITY FORMS ENDORSEMENTS As per 1007 12 00 This page alone does not provide coverage and must be attached to a Commercial Lines Common Policy Declarations Common Policy Conditions Coverage Part Coverage Forms and any other applicable forms and endorsements. 2000 0601 Page 1 of 1 | 2 |
Stock Company x COMMERCIAL GENERAL LIABILITY COVERAGE PART I IEA SUPPLEMENTAL DECLARATIONS POLICY NUMBER PAV0214437 NAMED INSURED WS Dynoco Petroleum Management LLCPer Form I1L1201 NO. LOCATIONS of all premises you Own Rent or Occupy CLASS PREMIUM BASIS. Code Exposure e 1 RATES Prod CO All Other Incl 150.000 ADVANCE PREMIUM Prod CO All Other Included 150.00 CLASS Bidg 1 Non Owned Auto Liability nan nan nan nan 200.0 Bidg 1 Employee Benefits Liability Coverage Incl nan nan nan nan 200.0 Included nan nan nan nan 59.0 Bld 1 21100 Cyber Oil Gas EXCL Flat Excluded Total Premium This Page See Form 2000 Accumulative Total for Total Premium m admissions per 1000 each u units s gross sales per 1000 c total cost per 1000 m admissions per 1000 each p payroll per 1000 a area per 1000 sq. ft. u units Policy may be AUDITABLE SPECIFIC GENERAL LIABILITY FORMS ENDORSEMENTS This page alone does not provide coverage and must be attached to a Commercial Lines Common Policy Declarations Common Policy Conditions Coverage Part Coverage Forms and any other applicable forms and endorsements. 2001 10 2013 Page 2 of 2 | 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 Il Who Is An sured. dther words and phrases that appear in quotation narks have special meaning. Refer to Section V efinitions. SECTION COVERAGES OVERAGE A BODILY INJURY AND PROPERTY JAMAGE 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. b. This insurance applies to bodily injury and property damage only if 2 The bodily injury or property damage occurs during the policy period and Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. 3 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 Il Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section 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 CG 00010413 Insurance Services Office Inc. 2012 Page 1 of 16 | 0 |
2. Exclusions This insurance does not apply to a. Expected Or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Contractual Liability Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the absence of the contract or agreement or 2 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorneys fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and Such attorneys fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. b This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in a The supervision hiring employment training or monitoring of others by that insured or b Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol if the occurrence which caused the bodily injury or property damage involved that which is described in Paragraph 1 2 or 3 above. However this exclusion applies only if you are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages. For the purposes of this exclusion permitting a person to bring alcoholic beverages on your premises for consumption on your premises whether or not a fee is charged or a license is required for such activity is not by itself considered the business of selling serving or furnishing alcoholic beverages.. Workers Compensation And Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law.. Employer s Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a Employment by the insured or b Performing duties related to the conduct of the insured s business or 2 The spouse child parent brother or sister of that employee as a consequence of Paragraph 1 above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. Page 2 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a Ator from any premises site or location which is or was at any time owned or occupied by or rented or loaned to any insured. However this subparagraph does not apply to i Bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or originating from equipment that is used to heat cool or dehumidify the building or equipment that is used to heat water for personal use by the building s occupants or their guests ii Bodily injury or property damage for which you may be held liable if you are a contractor and the owner or lessee of such premises site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not and never was owned or occupied by or rented or loaned to any insured other than that additional insured or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire b At or from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste c Which are or were at any time transported handled stored treated disposed of or processed as waste by or for i Any insured or ii Any person or organization for whom you may be legally responsible or d At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by such insured contractor or subcontractor. However this subparagraph does not apply to i Bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or released as part of the operations being performed by such insured contractor or subcontractor ii Bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e Ator from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the operations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. CG 00010413 Insurance Services Office Inc. 2012 Page 3 of 16 | 1 |
2 Any loss cost or expense arising out of any a Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or b Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a governmental authority. g. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or 4 5 Bodily injury or property damage arising out of a The 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 definiton of mobile equipment. h. Mobile Equipment Bodily injury or property damage arising out of b 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. i. War Bodily injury or property damage however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these.. Damage To Property Property damage to 1 Property you own rent or occupy including any costs or expenses incurred by you or any other person organization or entity for repair replacement enhancement restoration or maintenance of such property for any reason including prevention of injury to a person or damage to another s property Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you 3 2 Page 4 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
4 Personal property in the care custody or control of the insured 5 That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the property damage arises out of those operations or That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section Il Limits Of Insurance. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard. 6. Damage To Your Product Property damage to your product arising out of it or any part of it.. Damage To Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor.. Damage To Impaired Property Or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 A defect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use.. Recall Of Products Work Or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it.. Personal And Advertising Injury Bodily injury arising out of personal and advertising injury.. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. However this exclusion does not apply to liability for damages because of bodily injury. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMSs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment.. Recording And Distribution Of Material Or Information In Violation Of Law Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or CG 00010413 Insurance Services Office Inc. 2012 Page 5 of 16 | 1 |
4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section Ill Limits Of Insurance. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as 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. 2. Exclusions This insurance does not apply to a. Knowing Violation Of Rights Of Another Personal and advertising injury caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising injury.. Material Published With Knowledge Of Falsity Personal and advertising injury arising out of oral or written publication in any manner of material if done by or at the direction of the insured with knowledge of its falsity.. Material Published Prior To Policy Period Personal and advertising injury arising out of oral or written publication in any manner of material whose first publication took place before the beginning of the policy period.. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured.. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement.. Breach Of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s advertising idea in your advertisement.. Quality Or Performance Of Goods Failure To Conform To Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your advertisement.. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Page 6 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
i. Infringement Of Copyright Patent Trademark Or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trademark trade secret or other intellectual property rights. Under this exclusion such other intellectual property rights do not include the use of another s advertising idea in your advertisement. However this exclusion does not apply to infringement in your advertisement of copyright trade dress or slogan.. Insureds In Media And Internet Type Businesses Personal and advertising injury committed by an insured whose business is 1 Advertising broadcasting publishing or telecasting Designing or determining content of web sites for others or 3 An Internet search access content or service provider. However this exclusion does not apply to Paragraphs 14.a. b. and c. of personal and advertising injury under the Definitions section. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the insured hosts owns or over which the insured exercises control.. Unauthorized Use Of Another s Name Or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain name or metatag or any other similar tactics to mislead another s potential customers. m. Pollution Personal and advertising injury arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants at any time. 2 n. Pollution related Any loss cost or expense arising out of any 1 Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. o. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. p. Recording And Distribution Of Material Or Information In Violation Of Law Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or 4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. 3 CG 00010413 Insurance Services Office Inc. 2012 Page 7 of 16 | 1 |
COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that a The accident takes place in the coverage territory and during the policy period b The expenses are incurred and reported to us within one year of the date of the accident and c The injured person submits to examination at our expense by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for 1 First aid administered at the time of an accident 2 Necessary medical surgical X ray and dental services including prosthetic devices and 3 Necessary ambulance hospital professional nursing and funeral services. 2. Exclusions We will not pay expenses for bodily injury a. Any Insured To any insured except volunteer workers. b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d. Workers Compensation And Similar Laws To a person whether or not an employee of any insured if benefits for the bodily injury are payable or must be provided under a workers compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing instructing or participating in any physical exercises or games sports or athletic contests. f. Products Completed Operations Hazard Included within the products completed operations hazard. g. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS COVERAGES A AND B 1. We will pay with respect to any claim we investigate or settle or any suit against an insured we defend a. All expenses we incur. b. Up to 250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. c. The cost of bonds to release attachments but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from work. e. All court costs taxed against the insured in the suit. However these payments do not include attorneys fees or attorneys expenses taxed against the insured. f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment interest based on that period of time after the offer. Page 8 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance.. If we defend an insured against a suit and an indemnitee of the insured is also named as a party to the suit we will defend that indemnitee if all of the following conditions are met a. The suit against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an insured contract b. This insurance applies to such liability assumed by the insured. The obligation to defend or the cost of the defense of that indemnitee has also been assumed by the insured in the same insured contract. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the insured and the indemnitee and f. The indemnitee 1 Agrees in writing to a Cooperate with us in the investigation settlement or defense of the suit Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit Notify any other insurer whose coverage is available to the indemnitee and d Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee and 2 Provides us with written authorization to a Obtain records and other information related to the suit and b Conduct and control the defense of the indemnitee in such suit. o b c So long as the above conditions are met attorneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.2 of Section Coverage A Bodily Injury And Property Damage Liability such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the limits of insurance. Our obligation to defend an insured s indemnitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above or the terms of the agreement described in Paragraph f. above are no longer met. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. c. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. CG 00010413 Insurance Services Office Inc. 2012 Page 9 of 16 | 1 |
2. Each of the following is also an insured a. Your volunteer workers only while performing duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a partnership joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees or volunteer workers are insureds for 1 Bodily injury or personal and advertising injury a To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company to a coemployee while in the course of his or her employment or performing duties related to the conduct of your business or to your other volunteer workers while performing duties related to the conduct of your business To the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of Paragraph 1a above For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph 1a or b above or Arising out of his or her providing or failing to provide professional health care services. b c d 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.. 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 lil LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. Page 10 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
3. The Products Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. 4. Subject to Paragraph 2. above the Personal And Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all personal and advertising injury sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above whichever applies the Each Occurrence Limit is the most we will pay for the sum of a. Damages under Coverage A and b. Medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to Paragraph 5. above the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of property damage to any one premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence Offense Claim Or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or an offense which may result in a claim. To the extent possible notice should include 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured persons and witnesses and 3 The nature and location of any injury or damage arising out of the occurrence or offense. b. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent.. Legal Action Against Us No person or organization has a right under this Coverage Part a. To join us as a party or otherwise bring us into a suit asking for damages from an insured or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us the insured and the claimant or the claimant s legal representative. CG 00010413 Insurance Services Office Inc. 2012 Page 11 of 16 | 1 |
4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance 1 This insurance is excess over a Any of the other insurance whether primary excess contingent or on any other basis i That is Fire Extended Coverage Builder s Risk Installation Risk or similar coverage for your work ii That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner iii That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner or iv If the loss arises out of the maintenance or use of aircraft autos or watercraft to the extent not subject to Exclusion g. of Section I Coverage A Bodily Injury And Property Damage Liability. b Any other primary insurance available to you covering liability for damages arising out of the premises or operations or the products and completed operations for which you have been added as an additional insured. 2 When this insurance is excess we will have no duty under Coverages A or B to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be 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 Page 12 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
b. Those statements are based upon representations you made to us and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this Coverage Part to the first Named Insured this insurance applies a. As if each Named Insured were the only Named Insured and b. Separately to each insured against whom claim is made or suit is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part those rights are transferred to us. The insured must do nothing after loss to impair them. At our request the insured will bring suit or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. SECTION V DEFINITIONS 1. Advertisement means a notice that is broadcast or published to the general public or specific market segments about your goods products or services for the purpose of attracting customers or supporters. For the purposes of this definition a. Notices that are published include material placed on the Internet or on similar electronic means of communication and b. Regarding web sites only that part of a web site that is about your goods products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. Auto means a. A land motor vehicle trailer or semitrailer designed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However auto does not include mobile equipment.. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time.. Coverage territory means a. The United States of America including its territories and possessions Puerto Rico and Canada International waters or airspace but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above or c. All other parts of the world if the injury or damage arises out of 1 Goods or products made or sold by you in the territory described in Paragraph a. above The activities of a person whose home is in the territory described in Paragraph a. above but is away for a short time on your business or Personal and advertising injury offenses that take place through the Internet or similar electronic means of communication provided the insured s responsibility to pay damages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to.. Employee includes a leased worker. Employee does not include a temporary worker.. Executive officer means a person holding any of the officer positions created by your charter constitution bylaws or any other similar governing document. L4 2 3. Hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be.. Impaired property means tangible property other than your product or your work that can not be used or is less useful because a. It incorporates your product or your work that is known or thought to be defective deficient inadequate or dangerous or b. You have failed to fulfill the terms of a contract or agreement if such property can be restored to use by the repair replacement adjustment or removal of your product or your work or your fuffilling the terms of the contract or agreement. CG 00010413 Insurance Services Office Inc. 2012 Page 13 of 16 | 1 |
9. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract b. A sidetrack agreement c. Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality e. An elevator maintenance agreement That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or 3 Under which the insured if an architect engineer or surveyor assumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. 2 10. 1 12 Leased worker means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker..Loading or unloading means the handling of property a. After it is moved from the place where it is accepted for movement into or onto an aircraft watercraft or auto b. While it is in or on an aircraft watercraft or auto or c. While it is being moved from an aircraft watercraft or auto to the place where it is finally delivered but loading or unloading does not include the movement of property by means of a mechanical device other than a hand truck that is not attached to the aircraft watercraft or auto. Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment a. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads b. Vehicles maintained for use solely on or next to premises you own or rent c. Vehicles that travel on crawler treads d. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers e. Vehicles not described in Paragraph a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types 1 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers Vehicles not described in Paragraph a. b. c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. Page 14 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
1 14. 15. However self propelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos 1 Equipment designed primarily for a Snow removal b Road maintenance but not construction or resurfacing or c Street cleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and 3 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered autos..Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution c. The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies committed by or on behalf of its owner landlord or lessor d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services e. Oral or written publication in any manner of material that violates a person s right of privacy f. The use of another s advertising idea in your advertisement or g. Infringing upon another s copyright trade dress or slogan in your advertisement. Pollutants mean any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals and waste. Waste includes materials to be recycled reconditioned or reclaimed. 16.Products completed operations hazard a. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 Products that are still in your physical possession or 2 Work that has not yet been completed or abandoned. However your work will be deemed completed at the earliest of the following times a When all of the work called for in your contract has been completed. b When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. 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 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 3 b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance electronic data is not tangible property. CG 00010413 Insurance Services Office Inc. 2012 Page 15 of 16 | 1 |
18. 19. 20. 21. As used in this definition electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMSs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. Suit means a civil proceeding in which damages because of bodily injury property damage or personal and advertising injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. Volunteer worker means a person who is not your employee and who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other compensation by you or anyone else for their work performed for you. Your product a. Means 1 Any goods or products other than real property manufactured sold handled distributed or disposed of by a You b Others trading under your name or c A person or organization whose business or assets you have acquired and 2 Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 22.Your work a. Means 1 Work or operations performed by you or on your behalf and 2 Materials parts or equipment furnished in connection with such work or operations. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your work and 2 The providing of or failure to provide warnings or instructions. Page 16 of 16 Insurance Services Office Inc. 2012 CG 00010413 | 1 |
MINIMUM EARNED PREMIUM CANCELLATIONS AND AUDITS It is hereby understood and agreed that in the event of cancellation of coverage by the insured. the minimum earned premium under this policy shall be 25 of the policy premium. It is further understood the minimum earned premium of this policy shall be. 100 of the policy premium if the policy is in effect for the full term and the audit shows a lower exposure than estimated. 1003 891 Page 1 of 1 | 2 |
A Group X COMBINED PROVISIONS ENDORSEMENT This endorsement modifies insurance provided under the following Commercial General Liability Coverage Part. Commercial Professional Liability Coverage Part Liquor Liability Coverage Form In consideration of the premium charged it is agreed that the following special provisions apply to this policy. PUNITIVE DAMAGES EXCLUSION It is part of the conditions of this policy that the Company shall not be liable for any damages awarded against an insured as punitive or exemplary damages. ASBESTOS EXCLUSION In consideration of the premium charged it is hereby understood and agreed that this policy will not provide coverage meaning indemnification or defense costs arising out of Asbestos or any asbestos related bodily injury or property damage or Any alleged act error omission or duty involving asbestos its use exposure presence existence detection removal elimination transportation disposal or avoidance or The use exposure presence existence detection removal elimination or avoidance of asbestos in any environment building or structure. EARTH MOVEMENT EXCLUSION In consideration of the premium charged it is understood and agreed that this policy specifically excludes and does not extend to or provide coverage or indemnity for any claim of liability for bodily injury or property damage caused by resulting from attributable or contributed to or aggravated by the subsidence or movement of land as a result of earthquake landslide mudflow earth sinking or shifting resulting from aggravated by or contributed to by operations of the named insured or any subcontractor of the named insured. 2002 0802 Page 1 of 1 | 2 |
K M ASSAULT OR BATTERY GI GENERAL LIABILITY EXCLUSION THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL LIABILITY UMBRELLA COVERAGE FORM COMMERCIAL EXCESS LIABILITY COVERAGE FORM In consideration of the premium charge it is understood and agreed that this insurance does not apply to liability for damages because of bodily injury property damage personal and advertising injury medical expense arising out of an assault battery or physical altercation that occurs in on near or away from an insured s premises 1 Whether or not caused by at the instigation of or with the direct or indirect involvement of an insured an insured s employees patrons or other persons in on near or away from an insured s premises or 2 Whether or not caused by or arising out of an insured s failure to properly supervise or keep an insured s premises in a safe condition or 3 Whether or not caused by or arising out of any insured s act or omission in connection with the prevention suppression failure to warn of the assault battery or physical altercation including but not limited to negligent hiring training andor supervision. 4 Whether or not caused by or arising out of negligent reckless or wanton conduct by an insured an insured s employees patrons or other persons. DEFINITIONS For purposes of this endorsement Assault means any attempt or threat to inflict injury to another including any conduct that would reasonably place another in apprehension of such injury. Battery means the intentional or reckless physical contact with or any use of force against a person without his or her consent that entails some injury or offensive touching whether or not the actual injury inflicted is intended or expected. The use of force includes but is not limited to the use of a weapon. Physical altercation means a dispute between individuals in which one or more persons sustain bodily injury arising out of the dispute. Al other terms conditions and definitions of the Policy otherwise apply. ASSAULT OR BATTERY GENERAL LIABILITY EXCLUSION 2005 0614 Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LEAD CONTAMINATION EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL UMBRELLA LIABILITY COVERAGE PART In consideration of the premium charged it is hereby understood and agreed that this policy will not provide coverage meaning indemnification or defense costs arising out of Bodily Injury Property Damage Personal Injury Advertising Injury Medical Payments or any other damages because of liability alleged liability or occurrence resulting from caused by arising out of or in any way connected with The existence of lead the removal of lead the testing for lead or exposure to lead in any form which is or has at any time been present in on or near the insured s premises or at any location at which the insured is working or has worked in connection with such existence. removal or testing. 1 Whether or not caused by at the instigation of or with the direct or indirect involvement of the insured the insured s employees or other persons on the insured s premises or work site or 2 Whether or not caused by or arising out of the insured s failure to properly supervise or keep the work site in a safe condition. 2033 032014 Page 1 of 1 | 2 |
WARRANTY NON OWNED AUTOMOBILES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART ENDORSEMENT HIRED AUTO AND NON OWNED AUTO LIABILITY In consideration of the premium charged it is hereby understood and agreed that coverage is not provided for non owned auto liability unless auto liability coverage is maintained on the non owned automobile for at least the following limits Bodily Injury 100000 per person300000 per accident Property Damage 50000 per accident Page 1 of 1 20381293 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO AND NON OWNED AUTO LIABILITY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Insurance is provided only with respect to those coverages for which a specific Limit of Liability and Premium are shown Coverage Limit of Liability Premium Non Owned Auto Liability 1000000 150 Hired Auto Liability General Aggregate Limit If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. A. HIRED AUTO LIABILITY The insurance provided under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY SECTION I COVERAGES applies to bodily injury or property damage arising out of the maintenance or use of a hired auto by you or your employees in the course of your business. B. NON OWNED AUTO LIABILITY The insurance provided under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY SECTION I COVERAGES applies to bodily injury or property damage arising out of the use of a non owned auto by any person other than you in the course of your business. C. With respect to all Coverages provided by this endorsement 1. Subparagraphs b. c. e g. h. j k. I m. and n. of paragraph 2. Exclusions of COVERAGE A BODI LY INJURY AND PROPERTY DAMAGE LIABILITY SECTION I COVERAGES do not apply. 2. The following exclusions are added to paragraph 2. Exclusions of COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY SECTION I COVERAGES This insurance does not apply to a. 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. b. 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 1 Whether the insured may be liable as an employer or in any other capacity and 2 To any obligation to share damages with or repay someone else who must pay the damages be cause of the injury. erage 52045 10 2014 Includes copyrighted material of ISO Commercial Risk Services Inc. with its permission. Copyright ISO Commercial Risk Services Inc. Page 1 of 3 | 2 |
This exclusion does not apply to 1 Liability assumed by the insured under an insured contract or 2 Bodily Injury to domestic employees not entitled to workers compensation benefits. c. Property damage to 1 Property owned or being transported by or rented or loaned to the insured or 2 Property in the care custody or control of the insured. D. WHO IS AN INSURED SECTION II WHO IS AN INSURED is deleted with respect to all Coverages provided under this endorsement and replaced by the following 1. Each of the following is an insured under this insurance to the extent set forth below a. You. b. Any other person using a hired auto with your permission. c. With respect to a non owned auto any partner or executive officer of yours but only while such non owned auto is being used in your business. d. Any other person or organization but only with respect to their liability because of acts or omissions of an insured under paragraphs 1. 2. or 3. above. of the following is an insured a. Any person engaged in the business of his or her employer with respect to bodily injury to any co employee of such person injured in the course of employment b. Any partner or executive officer with respect to any auto owned by such partner or officer or a member of his or her household c. Any person while employed in or otherwise engaged in performing duties related to the conduct of an auto business other than an auto business you operate d. The owner or lessee of whom you are a sublessee of a hired auto or the owner of a non owned auto or any agent or employee of any such owner or lessee e. Any person or organization with respect to the conduct of any current or past partnership or joint ven ture that is not shown as a Named Insured in the Declarations. E. For the purposes of this endorsement only the following is added to the definition of Insured Contract in SECTION V DEFINITIONS g. That part of any contract or agreement entered into as part of your business pertaining to the rental or lease by you or any of your employees of any auto. However such contract or agreement shall not be considered an insured contract to the extent that it obligates you or any of your em ployees to pay for property damage to any auto rented or leased by you or any of your employ ees. F. For the purposes of this endorsement only the following definitions are added to the SECTION V DEFINITIONS 1. Auto business means the business or occupation of selling repairing servicing storing or parking au tos. Hired auto means any auto you lease hire rent or borrow. This does not include any auto you lease hire rent or borrow from any of your employees your partners or your executive officers or members of their households. Non owned auto means any auto you do not own lease hire rent or borrow which is used in connec tion with your business. This includes autos owned by your employees your partners or your execu 52045 10 2014 Includes copyrighted material of ISO Commercial Risk Services Inc. with its permission. Copyright ISO Commercial Risk Services Inc. Page 2 of 3 | 2 |
tive officers or members of their households but only while used in your business or your personal af fairs. G. LIMITS OF INSURANCE FOR HIRED AUTO AND NON OWNED AUTO LIABILITY With respect to HIRED AUTO AND NON OWNED AUTO LIABILITY only SECTION Il LIMITS OF IN SURANCE is deleted and replaced by the following 1. Regardless of the number of hired autos non owned autos insureds premiums paid claims made or vehicles involved in the accident the most we will pay for all damages resulting from any one accident is the General Aggregate Limit shown in this endorsement. 2. Any amount paid by or for anyone legally responsible for an accident will reduce only the amount of damages to be paid and does not reduce our limit of insurance. 3. Any amount paid under this insurance will reduce any amount an insured may be paid under COVER AGE A SECTION COVERAGES. 52045 10 2014 Includes copyrighted material of ISO Commercial Risk Services Inc. with its permission. Copyright ISO Commercial Risk Services Inc. Page 3 of 3 | 2 |
EMPLOYEE BENEFITS LIABILITY COVERAGE This endorsement modifies insurance provided under the following Commercial General Liability Coverage Part In addition to words and phrases contained in the Commercial General Liability Coverage Form other words and phrases that appear in quotation marks have special meaning. Refer to Paragraph E. ADDITIONAL DEFINITIONS of this endorsement. The definitions of words and phrases coverage territory insured and suit contained in Paragraph E. apply in place of their definitions stated elsewhere in the policy but only as respects coverage under this endorsement. The provisions of this endorsement apply only as respects Employee Benefit Liability Coverage afforded hereunder. SCHEDULE COVERAGE LIMITS OF INSURANCE ADVANCE PREMIUM Employee Benefits Programs 1000000 each employee 200.00 1000000 aggregate A. COVERAGE 1. Insuring Agreement 2. Exclusions We will pay those sums that the insured becomes legally obligated to pay as damages because of any negligent act error or omission of the insured or of any other person for whose acts the insured is a. legally liable. The negligent act error or omission must be committed in the administration of your employee benefit program This insurance does not apply to Loss arising our of any dishonest fraudulent criminal or malicious act or omission committed by any insured during the policy period. No other obligation or liability to pay sums b. Bodily injury or property damage or personal injury or perform acts or services is covered unless explicitly provided for under SUPPLEMENTARY PAYMENTS of this endorsement. c. Loss arising out of failure of performance of contract by an insurer The negligent act error or omission must take place in the coverage territory. We will have the right and duty to defend any suit d. seeking those damages. But Loss arising out of an insufficiency of funds to meet any obligations under any plan included in the employee benefit program a. The amount we will pay for damages is limited as described in Paragraph C. LIMITS OF INSURANCE.. Any claim or suit based upon b. We may at our discretion investigate any report of a negligent 1 failure of any investment to perform as represented by act error or omission and settle any claim or suit that may any insured or result and 2 advice given to any person to participate or not to c. Tender of policy limits does not release the company of its duty participate in any plan included in the employee benefit to defend. program. f. Loss arising out of your failure to comply 20531197 Page 10f3 | 2 |
with the mandatory provisions of any law concerning workers compensation unemployment insurance social security or disability benefits Loss for which the insured is liable because of liability imposed on a fiduciary by the Employee Retirement Security Act of 1974 as now or hereafter amended or Loss or damage for which benefits have accrued under the terms of an employee benefit plan to the extent that such benefits are available from funds accrued by the insured for such benefits or from collectible insurance notwithstanding the insured s act error or omission in administering the plan which precluded the claimant from receiving such benefits. Supplementary Payments We will pay with respect to any claim or suit we defend a. Al expenses we incur. b. 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. c. Allreasonable expensed 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 100 a day because of time off from work. d. Al costs taxed against the insured in the suit. e. Pre judgment interest awarded against the insured on that part of the judgment we pay.. Allinterest on the full amount of any judgement 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. B.WHO IS AN INSURED 1. If you are designated in the Declarations as a. Anindividual you and your spouse are insureds but only with respect to the conduct of a business 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. Alimited 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. 2. Each of the following is also an insured a. Each of your partners executive officers and employees who is authorized to administer your employee benefit program. b. 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 endorsement. 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 be deemed to be a Named Insured if there is no similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 90 t day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage under this provision does not apply to any negligent act error or omission that occurred 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 or joint venture that is not shown as a Named Insured in the Declarations. C. LIMITS OF INSURANCE The Limits of Insurance shown in the Schedule and the rules below fix the most we will pay regardless of the number of Insureds Claims made or suits brought Persons or organizations making claims or bringing suits Acts errors or omissions which result in loss or Plans included in your employee benefit program. Poo0 o The Aggregate Limit is the most we will pay for all damages because of acts errors or omissions committed in the administration of your employee benefit program. Subject to the Aggregate Limit the Each Employee Limit is the most we will pay for all damages sustained by any one employee including the employee s dependents and beneficiaries because of acts errors or omissions committed in the administrations of your employee benefit program. If the policy period is for a term in excess of one year the Aggregate Limit of Insurance shall apply separately to each consecutive annual period. y claim or suit we defend ase attachments but only for bond able limit of insurance. We do not ds. incurred by the insured at our request ation or defense of the claim or suit rnings up to 100 a day because of insured in the suit. arded against the insured on that part vrhichr yi urrlan to be a Named that organizatior a. Coverage L day after yc the policy p b. Coverage L negligent a acquired or No person or or conduct of any not shown as a ent that is within 20531197 Page 20f 3 | 2 |
3. D. DEDUCTIBLE Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of 1000 deductible applicable to Each Employee. The limit of insurance applicable to Each Employee will be reduced by the amount of this deductible. The Aggregate Limit shall not be reduced by the application of such deductible amount. The deductible amount applies to all damages sustained by an employee because of an act error or omission covered by this insurance. The terms of this insurance including those with respect to a. Ourright and duty to defend any suits seeking those damages and b. Your duties in the event of an act error or omission claim or suit apply imespective of the application of the deductible amount. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon nofification of the action taken you shall promptly reimburse us for such part of the deductible amount as has been paid by us. E. ADDITIONAL DEFINITIONS Administration means a. Counseling employees including their dependents and beneficiaries with respect to the employee benefit program b. Handling records in connection with the employee benefit program or c. Effecting or terminating any employee s participation in a plan included in the employee benefit program. Coverage territory means the United States of America including its territories and possessions Puerto Rico and Canada. Employee benefit program means the following plans a. Group life insurance group accident or health insurance profit sharing plans pension plans and stock subscription plans provided that no one other than an employee may subscribe to such insurance or plans b. Unemployment insurance social security benefits workers compensation and disability benefits c. Any other similar plan designated in the Schedule or added thereto by endorsement. Insured means any person or organization qualifying as such under Paragraph B. WHO IS AN INSURED. Profit sharing plans means only such plans that are equally available to all full time employees. Stock subscription plans means only such plans that are equally available to all full time employees. Suit means a civil proceeding in which damages because of an act error or omission to which this insurance applies are alleged. Suit includes an arbitration proceeding alleging such damages to which you must submit with our consent. F. ADDITIONAL CONDITION Item 2. Duties In The Event of Occurrence Claim or Suit Paragraphs a.and b. of Section IV Commercial General Liability Coverage Form are inapplicable to this endorsement and replaced by the following Duties in the Event of Act Error or Omission Claim or Suit. a. Youmustsee to it that we are notified as soon as practicable of an act error or omission which may result in a claim. Notice should include 1 Whatthe act error or omission was and when it occurred 2 The names and addresses of any employees who may suffer damages as a result of the act error or omission. b. Ifaclaimis received by any insured you must 1 Immediately record the specifics of the claim 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 as soon as practicable. 20531197 Page 30f 3 | 2 |
COMMERCIAL GENERAL LIABILITY CG 20080413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED USERS OF GOLFMOBILES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section Il Who Is An Insured is amended to B. For the purposes of this endorsement golfmobile include as an additional insured any persons means a motorized conveyance that is using or legally responsible for the use of 1. Designed to carry up to four persons on a golf golfmobiles loaned or rented to others by you or courge for the punypoge of playng golf and 9 any of your concessionaires but only for their N N liability arising out of the use of the golfmobiles. 2. Not built or modified after manufacture to exceed a speed of 25 miles per hour on level ground. CG 20080413 Insurance Services Office Inc. 2012 Page 1 of 1 | 2 |
A Group THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CROSS LIABILITY EXCLUSION This endorsement modifies insurance provided under the following Commercial General Liability Coverage Part It is understood and agreed that coverage provided herein does not apply to liability for bodily injury property damage personal or advertising injury by an insured covered by this policy against any other insured. 20990504 Page 1 0of 1 | 2 |
POLICY NUMBER PAV0214437 POLICY NUMBER PAV0214437 COMMERCIAL GENERAL LIABILITY CG 03 00 0196 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE SCHEDULE Coverage Amount and Basis of Deductible PER CLAIM or PER OCCURRENCE Bodily Injury Liability 500 OR Property Damage Liability 500 OR Bodily Injury Liability andor Property Damage Liability Combined If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. APPLICATION OF ENDORSEMENT Enter below any limitations on the application of this endorsement. If no limitation is entered the deductibles apply to damages for all bodily injury and property damage however caused Amount and Basis of Deductible PER CLAIM or PER OCCURRENCE 500 500 A. Our obligation under the Bodily Injury Liability and Property Damage Liability Coverages to pay damages on your behalf applies only to the amount of damages in excess of any deductible amounts stated in the Schedule above as appli cable to such coverages. B. You may select a deductible amount on either a per claim or a per occurrence basis. Your se lected deductible applies to the coverage option and to the basis of the deductible indicated by the placement of the deductible amount in the Schedule above. The deductible amount stated in the Schedule above applies as follows 1. PER CLAIM BASIS. If the deductible amount indicated in the Schedule above is on a per claim basis that deductible applies as follows a. Under Bodily Injury Liability Coverage to all damages sustained by any one person because of bodily injury b. Under Property Damage Liability Cover age to all damages sustained by any one person because of property damage or c. Under Bodily Injury Liability andor Property Damage Liability Coverage Combined to all damages sustained by any one person because of 1 Bodily injury 2 Property damage or 3 Bodily injury and property damage combined as the result of any one occurrence. If damages are claimed for care loss of serv ices or death resulting at any time from bodily injury a separate deductible amount will be applied to each person making a claim for such damages. With respect to property damage person in cludes an organization. CG 03 00 01 96 Copyright Insurance Services Office Inc. 1994 Page 1 of 2 a | 2 |
2. PER OCCURRENCE BASIS. If the deductible amount indicated in the Schedule above is on a per occurrence basis that deductible amount applies as follows a. Under Bodily Injury Liability Coverage to all damages because of bodily injury b. Under Property Damage Liability Cover age to all damages because of property damage or c. Under Bodily Injury Liability andor Property Damage Liability Coverage Combined to all damages because of 1 Bodily injury 2 Property damage or 3 Bodily injury and property damage combined as the result of any one occurrence regard less of the number of persons or organizations who sustain damages because of that occurrence. C. The terms of this insurance including those with respect to 1. Our right and duty to defend the insured against any suits seeking those damages and 2. Your duties in the event of an occurrence claim or suit apply irrespective of the application of the de ductible amount. D. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification of the action taken you shall promptly reimburse us for such part of the deductible amount as has been paid by us. Page 2 of 2 Copyright Insurance Services Office Inc. 1994 CG 03 000196 a | 2 |
POLICY NUMBER PAv0214437 POLICY NUMBER PAv0214437 COMMERCIAL GENERAL LIABILITY CG 20281219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED LESSOR OF LEASED EQUIPMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Amerigas Propane 3807 S. 1600 E Circle 7 B Saint George UT 84790 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by your maintenance operation or use of equipment leased to you by such persons or organizations. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds this insurance does not apply to any occurrence which takes place after the equipment lease expires.. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable limits of insurance whichever is less. This endorsement shall not increase the applicable limits of insurance. nerigas Propane 07 S. 1600 E Circle 7 B Saint George UT 84790 CG 20281219 Insurance Services Office Inc. 2018 Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO EXCLUSION THIS ENDORSEMENT CHANGES THE POLICY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion 2. of SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY Aircraft Auto Or Watercraft is deleted in its entirety and replaced with the following This insurance does not apply to Bodily injury or property damage arising out of the ownership maintenance or use by any person or entrustment to others of any aircraft auto or watercraft. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved an aircraft auto or watercraft. Use includes operation and loading or unloading. 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 Bodily injury or property damage arising out of the operation of any of the equipment listed in paragraph f.2 or f.3 of the definition of mobile equipment. 2113 1007 Page 1 of 1 | 2 |
POLICY NUMBER PAV0214437 POLICY NUMBER PAV0214437 COMMERCIAL GENERAL LIABILITY CG20291219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED GRANTOR OF FRANCHISE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Names Of Persons Or Organizations Treasure Franchise Company LLC Tesoro Refining Marketing Company LLC BP West Coast Products LLC c o AMCS P.O. Box 129 Conway AR 72033 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to their liability as grantor of a franchise to you. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable limits of insurance whichever is less. This endorsement shall not increase the applicable limits of insurance. AMCS P.O. Box 129 Conway AR 72033 CG 20291219 Insurance Services Office Inc. 2018 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG40121219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ALL HAZARDS IN CONNECTION WITH AN ELECTRONIC SMOKING DEVICE ITS VAPOR COMPONENT PARTS EQUIPMENT AND ACCESSORIES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART. The following exclusion is added This insurance does not apply to Electronic Smoking Device Bodily injury property damage or personal and advertising injury arising out of the following 1. The design manufacture distribution sale maintenance use or repair of a. An electronic smoking device or b. Any component part of or equipment or accessory designed for use with an electronic smoking device including but not limited to a mouthpiece tube tank connector atomizer cartomizer clearomizer coil battery charger cartridge liquid flavoring solutions of any kind or ingredients therein 2 The actual alleged threatened or suspected inhalation of contact with exposure to existence of or presence of vapor delivered from an electronic smoking device or 3. Any component part of or equipment or accessory designed for use with an electronic smoking device including but not limited to those items listed in Paragraph A.1.b. of this endorsement and in connection with the actual alleged threatened or suspected inhalation of contact with exposure to existence of or presence of vapor delivered from an electronic smoking device.. The following definition is added Electronic smoking device means a battery powered device that delivers a vaporized inhalable substance through a mouthpiece. Electronic smoking devices include but are not limited to battery powered 1. Cigarettes. Pipes. Cigars. Hookahs and. Vaporizers other than steam or mist inhalers. oA wN CG40121219 Insurance Services Office Inc. 2018 Page 1 of 1 | 2 |
POLICY NUMBER PAV0214437 POLICY NUMBER PAV0214437 COMMERCIAL GENERAL LIABILITY CG 21011219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ATHLETIC OR SPORTS PARTICIPANTS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description Of Operations Gas Station Grocery Stores Hotel Restaurants and Building LRO Information required to complete this Schedule if not shown above will be shown in the Declarations. The following is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability With respect to any operations shown in the Schedule this insurance does not apply to bodily injury to any person arising out of practicing for or participating in any sports or athletic contest or exhibition that you sponsor. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury involved practicing for or participating in any sports or athletic contest or exhibition that you sponsor. s Station Grocery Stores Hotel Restaurants and Building LRO CG 21011219 Insurance Services Office Inc. 2018 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG 21070514 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA RELATED LIABILITY LIMITED BODILY INJURY EXCEPTION NOT INCLUDED COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.p. of Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following 2. Exclusions This insurance does not apply to p. Access Or Disclosure Of Confidential Or Personal Information And Data related Liability Damages arising out of 1 Any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information or The loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of that which is described in Paragraph 1 or 2 above. 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. This endorsement modifies insurance provided under the following B. The following is added to Paragraph 2. Exclusions of Section Covi Personal And Advertising Injury Liabil 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or organization s confidential or personal information. ge B CG 21070514 Insurance Services Office Inc. 2013 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG 210906 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION UNMANNED AIRCRAFT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.g. Aircraft Auto Or Watercraft under This Paragraph g.2 applies even if the Section Coverage A Bodily Injury And claims against any insured allege Property Damage Liability is replaced by the negligence or other wrongdoing in the following supervision hiring employment training 2. Exclusions or monitoring of others by that insured if L the occurrence which caused the This insurance does not apply to bodily injury or property damage g. Aircraft Auto Or Watercraft involved the ownership maintenance 1 Unmanned Aircraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. Use includes operation and loading or unloading. This Paragraph g.1 applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. Aircraft Other Than Unmanned Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft other than unmanned aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. 2 use or entrustment to others of any aircraft other than unmanned aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This Paragraph g.2 does not apply to a A watercraft while ashore on premises you own or rent b A watercraft you do not own that is i Less than 26 feet long and ii Not being used to carry persons or property for a charge c Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or This Paragraph g.2 applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft other than unmanned aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This Paragraph g.2 does not apply to a A watercraft while ashore on premises you own or rent b A watercraft you do not own that is i Less than 26 feet long and ii Not being used to carry persons or property for a charge c Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or d CG 21090615 Insurance Services Office Inc. 2014 Page 1 of 2 | 2 |
e Bodily injury or property damage arising out of i 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 ij The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definition of mobile equipment. B. The following exclusion is added to Paragraph 2. Exclusions of Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Unmanned Aircraft Personal and advertising injury arising out of the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the offense which caused the personal and advertising injury involved the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. This exclusion does not apply to a. The use of another s advertising idea in your advertisement or b. Infringing upon another s copyright trade dress or slogan in your advertisement. C. The following definition is added to the Definitions section Unmanned aircraft means an aircraft that is not 1. Designed 2. Manufactured or 3. Modified after manufacture to be controlled directly by a person from within or on the aircraft. Page 2 of 2 Insurance Services Office Inc. 2014 CG 21090615 | 2 |
COMMERCIAL GENERAL LIABILITY CG 21471207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYMENT RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability This insurance does not apply to Bodily injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demo tion evaluation reassignment discipline defamation harassment humiliation dis crimination or malicious prosecution di rected at that person or 2 The spouse child parent brother or sister of that person as a consequence of bodily injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after em ployment of that person 2 Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Per sonal And Advertising Injury Liability This insurance does not apply to Personal and advertising injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demo tion evaluation reassignment discipline defamation harassment humiliation dis crimination or malicious prosecution di rected at that person or 2 The spouse child parent brother or sister of that person as a consequence of personal and advertising injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after em ployment of that person 2 Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. CG 21471207 ISO Properties Inc. 2006 Page 1 of 1 o | 2 |
COMMERCIAL GENERAL LIABILITY CG 21500413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF LIQUOR LIABILITY EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following replaces Exclusion c. under Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to 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 including causing or contributing to the intoxication of any person because alcoholic beverages were permitted to be brought on your premises for consumption on your premises The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 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 2 3 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. This exclusion applies only if you 1 Manufacture sell or distribute alcoholic beverages 2 Serve or furnish alcoholic beverages for a charge whether or not such activity a Requires a license b Is for the purpose of financial gain or livelihood 3 Serve or furnish alcoholic beverages without a charge if a license is required for such activity or 4 Permit any person to bring any alcoholic beverages on your premises for consumption on your premises. 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. This exclusion applies only if you 1 Manufacture sell or distribute alcoholic beverages 2 Serve or furnish alcoholic beverages for a charge whether or not such activity a Requires a license b Is for the purpose of financial gain or livelihood 3 Serve or furnish alcoholic beverages without a charge if a license is required for such activity or 4 Permit any person to bring any alcoholic beverages on your premises for consumption on your premises. CG 21500413 Insurance Services Office Inc. 2012 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG 215509 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION WITH A HOSTILE FIRE EXCEPTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion f. under Paragraph 2. Exclusions of Sec tion Coverage A Bodily Injury And Property Damage Liability is replaced by the following This insurance does not apply to f. Pollution 1 Bodily injury or property damage which would not have occurred in whole or part but for the actual alleged or threatened discharge dispersal seepage migration release or es cape of pollutants at any time. This exclusion does not apply to bodily injury or property damage arising out of heat smoke or fumes from a hostile fire unless that hostile fire occurred or originated a Atany premises site or location which is or was at any time used by or for any insured or others for the handling storage dis posal processing or treatment of waste or b At any premises site or location on which any insured or any contractors or subcon tractors working directly or indirectly on any insured s behalf are performing operations to test for monitor clean up remove contain treat detoxify neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a Request demand order or statutory or b regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a govern mental authority for damages because of testing for monitoring cleaning up remov ing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. CG 21 5509 99 Copyright Insurance Services Office Inc. 1998 Page 1 of 1 a | 2 |
POLICY NUMBER PAV0214437 LICY NUMBER PAV0214437 COMMERCIAL GENERAL LIABILITY CG 28 06 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITATION OF COVERAGE TO INSURED PREMISES This endorsement modifies insurance provided under the following LIQUOR LIABILITY COVERAGE PART SCHEDULE Description and Location of Insured Premises 2300 E. Glendale Blvd. Moapa NV 89025 If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. A. This insurance only applies to damages arising out of your insured premises. B. The following definition is added to the DEFINITIONS Section Insured premises means 1. The premises shown in the Schedule and 2. Any premises you acquire during the policy period for use in manufacturing distributing selling serving or furnishing alcoholic beverages if a. You notify us within 30 days after the acquisition and b. You have no other valid and collectible insurance applicable to the loss. CG 28 06 01 96 Copyright Insurance Services Office Inc. 1994 Page 1 of 1 a | 2 |
COMMERCIAL GENERAL LIABILITY CG 21320509 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMUNICABLE DISEASE EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Communicable Disease Bodily injury or property damage arising out of the actual or alleged transmission of a com municable disease. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the a. Supervising hiring employing training or monitoring of others that may be infected with and spread a communicable disease b. Testing for a communicable disease c. Failure to prevent the spread of the dis ease or d. Failure to report the disease to authorities. Exclusions of Section Coverage B Per sonal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Communicable Disease Personal and advertising injury arising out of the actual or alleged transmission of a commu nicable disease. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the a. Supervising hiring employing training or monitoring of others that may be infected with and spread a communicable disease b. Testing for a communicable disease c. Failure to prevent the spread of the dis ease or d. Failure to report the disease to authorities. CG 21320509 Insurance Services Office Inc. 2008 Page 1 of 1 o | 2 |
COMMERCIAL GENERAL LIABILITY CG 21671204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FUNGI OR BACTERIA EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Bodily injury or property damage which would not have occurred in whole or in part but for the actual alleged or threatened in halation of ingestion of contact with expo sure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed concurrently or in any sequence to such injury or damage. b. Any loss cost or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. This exclusion does not apply to any fungi or bacteria that are are on or are contained in a good or product intended for bodily consump tion. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Per sonal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Personal and advertising injury which would not have taken place in whole or in part but for the actual alleged or threat ened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed con currently or in any sequence to such injury. b. Any loss cost or expense arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. C. The following definition is added to the Definitions Section Fungi means any type or form of fungus includ ing mold or mildew and any mycotoxins spores scents or byproducts produced or released by fungi. CG 21671204 I1SO Properties Inc. 2003 Page 1 of 1 a | 2 |
COMMERCIAL GENERAL LIABILITY CG 2196 03 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SILICA OR SILICA RELATED DUST EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Silica Or Silica Related Dust a. Bodily injury arising in whole or in part out of the actual alleged threatened or sus pected inhalation of or ingestion of silica or silica related dust. b. Property damage arising in whole or in part out of the actual alleged threatened or suspected contact with exposure to ex istence of or presence of silica or silica related dust. c. Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing contain ing treating detoxifying neutralizing reme diating or disposing of or in any way re sponding to or assessing the effects of silica or silica related dust by any in sured or by any other person or entity. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Per sonal And Adverti ing Injury Liabil 2. Exclusions C. The following definitions are added to the Defil This insurance does not apply to Silica Or Silica Related Dust a. Personal and advertising injury arising in whole or in part out of the actual alleged threatened or suspected inhalation of in gestion of contact with exposure to exis tence of or presence of silica or silica related dust. b. Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing contain ing treating detoxifying neutralizing reme diating or disposing of or in any way re sponding to or assessing the effects of silica or silica related dust by any in sured or by any other person or entity. tions Section 1. Silica means silicon dioxide occurring in crystalline amorphous and impure forms sil ica particles silica dust or silica compounds.. Silica related dust means a mixture or combi nation of silica and other dust or particles. CG 2196 03 05 1SO Properties Inc. 2004 Page 1 of 1 a | 2 |
COMMERCIAL GENERAL LIABILITY CG24161207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANOES OR ROWBOATS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Exclusion g. of Section Coverage A Bodily 2. Section Il Who Is An Insured is amended to Injury And Property Damage Liability does not include as an insured any person or organization apply to bodily injury or property damage aris legally responsible for the use of any such canoe ing out of any canoe or rowboat owned or used by or rowboat you own provided the actual use is or rented to the insured. with your permission. CG 24161207 1SO Properties Inc. 2006 Page 1 of 1 | 2 |
COMMERCIAL GENERAL LIABILITY CG24260413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF INSURED CONTRACT DEFINITION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART The definition of insured contract in the Definitions section is replaced by the following Insured contract means Paragraph f. does not include that part of any contract or agreement 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 provided the bodily injury or property damage is caused in whole or in part by you or by those acting on your behalf. However such part of a contract or agreement shall only be considered an insured contract to the extent your assumption of the tort liability is permitted by law. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or 3 Under which the insured if an architect engineer or surveyor assumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. CG 24260413 Insurance Services Office Inc. 2012 Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL EXCLUSION PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART I. The following is added to Paragraph 2. Exclusions of SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE and to Paragraph 2. Exclusions of SECTION COVERAGE B PERSONAL AND ADVERTISING INJURY This insurance does not apply to Professional Services Bodily injury property damage or personal and advertising injury arising out of the rendering of or failure to render professional services. Il. The following is added to SECTION V DEFINITIONS Professional services means an occupation or business engaged in by the insured involving or requiring specialized education and knowledge and includes associated clerical and administrative functions. EPA1631012018 Page 1 of 1 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INFESTATION AND VERMIN EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART This insurance does not apply to bodily injury advertising injury property damage or personal and 1. Arising directly or indirectly out of the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of wild animals birds vermin insects rodents or feces from any of the foregoing regardless of whether any other cause event material or product contributed concurrently or in any sequence to any bodily injury property damage or personal and advertising injury Il. Caused or alleged to have been caused by the removal eradication detoxification remediation or decontamination of wild animals birds vermin insects rodents or feces from any of the foregoing or property containing wild animals birds vermin insects rodents or feces from any of the foregoing I1l. Any loss cost or expenses arising out of any A. Abating testing for monitoring cleaning removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of wild animals birds vermin insects or rodents B. Request demand order or statutory or regulatory requirement that any insured take any of the actions described in lll. A above or C. Demand claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of wild animals birds vermin insects or rodents IV. Any loss cost or expense arising out of or sustained during any supervision instructions warnings recommendations or advice given or which was or should have been given in connection with Il or lll above or V. Any loss cost or expense arising out of or sustained during any period of time when as a direct result of any type of action described in II Ill or IV above habitation of ingress to or egress from any real or personal property was thereby prevented. This exclusion will apply without regard to the source or sources of the wild animals birds vermin insects or rodents or the basis of the insured s liability. This exclusion includes defects or negligence in design construction or materials or any other event EPA1650 022011 Page 10f 2 | 2 |
conduct or misconduct which may have or is claimed to have precipitated caused or acted jointly concurrently or in any sequence with wild animals birds vermin insects or rodents in causing the bodily injury property damage or personal and advertising injury. EPA1650 022011 Page 2 of 2 | 2 |
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION SWIMMING POOL This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability This insurance does not apply to Bodily injury or property damage arising out of the ownership maintenance operation existence or use of any swimming pool whether such use is authorized or unauthorized. EPA1772 012017 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 1 | 2 |
CYBER LIABILITY INSURANCE ENDORSEMENT COVERAGE PROVIDES CLAIMS MADE COVERAGE. PLEASE READ THE ENTIRE FORM CAREFULLY. POLICY NUMBER PAV0214437 ENDORSEMENT EFFECTIVE DATE 10012020 RETROACTIVE DATE 10012018 SCHEDULE Coverage Agreements Limits Multimedia Liability Coverage 50000 Each Claim Aggregate Security and Privacy Liability Coverage 50000 Each Claim Aggregate Privacy Regulatory Defense and Penalties Coverage 50000 Each Claim Aggregate PCI DSS Assessment Coverage 50000 Each Claim Aggregate Privacy Breach Response Costs Notification Expenses and 50000 Each Claim Aggregate Breach Support and Credit Monitoring Expenses Coverage Proactive Privacy Breach Responses Costs Sublimit 50000 Each Claim Aggregate Voluntary Notification Expenses Sublimit 50000 Each Claim Aggregate Network Asset Protection Coverage 50000 Each Claim Aggregate Cyber Extortion Coverage 50000 Each Claim Aggregate Cyber Terrorism Coverage 50000 Each Claim Aggregate BrandGuard Coverage 50000 Each Claim Aggregate 50000 Annual Aggregate Limit This endorsement amends your policy to provide Cyber Liability insurance on a Claims Made and Reported basis. Read the entire endorsement carefully to determine your rights and duties and what is and is not covered. Company as used in this endorsement means the Company providing this insurance. All words and phrases in this endorsement that appear in quotation marks have special meaning. Refer to Section V DEFINITIONS. To the extent any words or phrases used in this endorsement are also defined elsewhere in the policy such definitions do not apply or give meaning to the words or phrases used in this endorsement. The Limits of Insurance are specified in the Schedule above. Such limits are in addition to and will not erode the limits of insurance provided elsewhere in the policy. Defense costs paid under this endorsement are included in and will erode the limits shown in the Schedule. EPA1797 042017 Page 1 of 24 | 2 |
SECTION COVERAGE AGREEMENTS A MULTIMEDIA LIABILITY COVERAGE Subject to the limits shown in the Schedule the Company will pay damages including liability assumed under contract which an insured becomes legally obligated to pay and related defense costs because of a claim for a multimedia peril provided that W Such claim is first made against the insured during the endorsement period 2 Such claim is reported to the Company no later than sixty 60 days after the claim is first made against the insured and 3 The multimedia peril takes place or first commences on or after the retroactive date. SECURITY AND PRIVACY LIABILITY COVERAGE Subject to the limits shown in the Schedule the Company will pay damages including liability assumed under contract which an insured becomes legally obligated to pay and related defense costs because of a claim for a security and privacy wrongful act provided that W Such claim is first made against the insured during the endorsement period 2 Such claim is reported to the Company no later than sixty 60 days after the claim is first made against the insured and 3 The security and privacy wrongful act takes place or first commences on or after the retroactive date. PRIVACY REGULATORY DEFENSE AND PENALTIES COVERAGE Subject to the limits shown in the Schedule the Company will pay regulatory fines and penalties and regulatory compensatory awards which an insured becomes legally obligated to pay and related defense costs because of a claim for a security breach or privacy breach provided that W Such claim is first made against the insured during the endorsement period Such claim is reported to the Company no later than sixty 60 days after the claim is first made against the insured and 3 The security breach or privacy breach takes place or first commences on or after the retroactive date. PCI DSS ASSESSMENT COVERAGE Subject to the limits shown in the Schedule the Company will pay PCI DSS assessments which an insured becomes legally obligated to pay and related defense costs because of a claim for a security breach or privacy breach provided that W Such claim is first made against the insured during the endorsement period 2 Such claim is reported to the Company no later than sixty 60 days after the claim is first made against the insured and 3 The security breach or privacy breach takes places or first commences on or after the retroactive date. EPA1797 042017 Page 2 of 24 | 2 |
PRIVACY BREACH RESPONSE COSTS NOTIFICATION EXPENSES AND BREACH SUPPORT AND CREDIT MONITORING EXPENSES COVERAGE Subject to the limits shown in the Schedule the Company will pay reasonable and necessary privacy breach response costs notification expenses and breach support and credit monitoring expenses which you incur as a direct result of an adverse media report security breach or privacy breach provided that 1 2 3 The adverse media report security breach or privacy breach takes place or first commences on or after the retroactive date An insured first discovers the adverse media report security breach or privacy breach during the endorsement period and You report the adverse media report security breach or privacy breach to the Company no later than sixty 60 days from the date an insured first discovers the adverse media report security breach or privacy breach. NETWORK ASSET PROTECTION COVERAGE 1 2 Data Recovery Subject to the limits shown in the Schedule the Company agrees to pay digital assets loss and special expenses which you incur as a direct result of a covered cause of loss that causes damage alteration corruption distortion theft misuse or destruction of your digital assets provided that a The covered cause of loss takes place or first commences on or after the retroactive date b An insured first discovers the covered cause of loss during the endorsement period c You report the covered cause of loss to the Company no later than sixty 60 days from the date an insured first discovers the covered cause of loss and d You provide clear evidence that the digital assets loss and special expenses directly resulted from the covered cause of loss. The Company will pay digital assets loss and special expenses for a period of up to twelve 12 months following the discovery of the damage to or alteration corruption distortion theft misuse or destruction of your digital assets. Non Physical Business Interruption and Extra Expense Subject to the limits shown in the Schedule the Company agrees to pay income loss interruption expenses and special expenses which you incur during the period of restoration but after the waiting period as a direct result of a covered cause of loss that causes a total or partial interruption degradation in service or failure of an insured computer system provided that a The covered cause of loss takes place or first commences on or after the retroactive date b An insured first discovers the covered cause of loss during the endorsement period c You report the covered cause of loss to the Company no later than sixty 60 days from the date an insured first discovers the covered cause of loss and d You provide clear evidence that the digital assets loss and special expenses directly resulted from the covered cause of loss. CYBER EXTORTION COVERAGE 2 EPA1797 042017 Page 3 of 24 | 2 |
Subject to the limits shown in the Schedule the Company agrees to pay cyber extortion expenses and cyber extortion monies which you incur as a direct result of a cyber extortion threat provided that W Such cyber extortion threat is first made against an insured during the endorsement period 2 You report the cyber extortion threat to the Company no later than sixty 60 days from the date the cyber extortion threat is made against an insured and 3 You provide clear evidence that the cyber extortion expenses and cyber extortion monies directly resulted from the cyber extortion threat. The insured shall not incur cyber extortion expenses or cyber extortion monies without the Company s prior consultation and written authorization. You must make every reasonable effort to notify local law enforcement authorities and the Federal Bureau of Investigation or any similar equivalent foreign agency before surrendering any cyber extortion monies in response to a cyber extortion threat. CYBER TERRORISM COVERAGE Subject to the limits shown in the Schedule the Company agrees to pay income loss interruption expenses and special expenses which you incur during the period of restoration but after the waiting period as a direct result of an act of cyber terrorism that causes a total or partial interruption degradation in service or failure of an insured computer system provided that W The act of cyber terrorism takes place or first commences on or after the retroactive date 2 An insured first discovers the act of cyber terrorism during the endorsement period 3 You report the act of cyber terrorism to the Company no later than sixty 60 days from the date an insured first discovers the act of cyber terrorism and 4 You provide clear evidence that the income loss interruption expenses and special expenses directly resulted from the act of cyber terrorism. BRANDGUARD COVERAGE Subject to the limits shown in the Schedule the Company will reimburse you for provable and ascertainable brand loss which you sustain during the period of indemnity but after the waiting period as a direct result of an adverse media report or notification provided that W The adverse media report or notification results from a privacy breach or security breach that takes place or first commences on or after the retroactive date You discover the brand loss during the endorsement period 3 You report the brand loss to the Company no later than sixty 60 days from the date you first discover the brand loss and 4 You provide clear evidence that the brand loss directly resulted from the adverse media report or notification. EPA1797 042017 Page 4 of 24 | 2 |
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