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B. For all sums which the insured becomes legally obligated to pay as damages caused by occurrences under Section Coverage A and for all medical expenses caused by accidents under Section Coverage C which can not be attributed only to ongoing operations at a single designated construction project shown in the Schedule above 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products completed Operations Aggregate Limit whichever is applicable and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the products completed operations hazard is provided any payments for damages because of bodily injury or property damage included in the products completed operations hazard will reduce the Products completed Operations Aggregate Limit and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned delayed or abandoned and then restarted or if the authorized contracting parties deviate from plans blueprints designs specifications or timetables the project will still be deemed to be the same construction project. E. The provisions of Section Il Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 Insurance Services Office Inc. 2008 CG 2503 05 09 o
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POLICY NUMBER GLO 3234490 02 POLICY NUMBER GLO 3234490 02 COMMERCIAL GENERAL LIABILITY CG 2504 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED LOCATIONS GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Locations EACH LOCATION OTHER THAN CONSTRUCTION PROJECTS OCCUPIED BY THE NAMED INSURED Information required to complete this Schedule if not shown above will be shown in the Declarations. OTHER THAN CONSTRUCTION PROJECTS OCCUPIED BY THE A. For all sums which the insured becomes legally obligated to pay as damages caused by occurrences under Section Coverage A and for all medical expenses caused by accidents under Section Coverage C which can be attributed only to operations at a single designated location shown in the Schedule above 1. A separate Designated Location General Aggregate Limit applies to each designated location and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Location General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and for medical expenses under Coverage C regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Location General Aggregate Limit for that designated location. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Location General Aggregate Limit for any other designated location shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence Damage To Premises Rented To You and Medical Expense continue to apply. However instead of being subject to the General Aggregate Limit shown in the Declarations such limits will be subject to the applicable Designated Location General Aggregate Limit. CG 2504 05 09 Insurance Services Office Inc. 2008 Page 10f 2 m
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B. For all sums which the insured becomes legally obligated to pay as damages caused by occurrences under Section Coverage A and for all medical expenses caused by accidents under Section Coverage C which can not be attributed only to operations at a single designated location shown in the Schedule above 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products completed Operations Aggregate Limit whichever is applicable and 2. Such payments shall not reduce any Designated Location General Aggregate Limit. C. When coverage for liability arising out of the products completed operations hazard is provided any payments for damages because of bodily injury or property damage included in the products completed operations hazard will reduce the Products completed Operations Aggregate Limit and not reduce the General Aggregate Limit nor the Designated Location General Aggregate Limit. D. For the purposes of this endorsement the Definitions Section is amended by the addition of the following definition Location means premises involving the same or connecting lots or premises whose connection is interrupted only by a street roadway waterway or right of way of a railroad. E. The provisions of Section Il Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 Insurance Services Office Inc. 2008 CG 25 04 05 09 o
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505 Eagleview Boulevard Suite 100 PO Box 636 Exton PA 19341 0636 USA Phone 800327 1414 1610 968 9500 Fax 1610 458 8667 Nancy.rankinxlgroup.com xlgroup.cominsurance XL Group Insurance Reinsurance July 1 2014 Van Dyk Baler Corporation and Lubo USA 78 Halloween Boulevard Stamford CT 06902 Thank you for placing your insurance coverage with the U.S. Incoming Casualty Unit of XL Insurance. g i Nancy Rankin CPCU AU Sr. Underwriter Assistant Vice President Global Incoming XL Group Nancy.Rankinxlgroup.com 505 Eagleview Blvd. Suite 100 Exton PA 19341 0636
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XLGroup nooe YL CLAIM REPORTING INSTRUCTIONS New claims can be reported by phone fax mail or email 24 hours a day seven days a week 365 days a year. Please include if available the name address and phone number for all relevant parties the date and time of loss the location of the loss a description of the loss and any damage information. If reporting by phone please be sure to indicate if the claim involves a fatality serious bodily injury pollution spill or requires immediate response. Phone Fax Phone 1 800 823 7351 Toll Free Fax 1 866 262 9002 Toll Free 1 678 819 7388 Toll Email napropcasclaimnewnoticesxlgroup.com New Claims Notices Email napropcasclaimsxlgroup.com All Other Claims Correspondence USPS Mail XL Group PO Box 614002 Orlando FL 32861 4002 Overnight Mail XL Group 4209 Vineland Road Suite J2 Orlando FL 32811 INSTRUCTIONS FOR REQUESTING LOSS RUNS Due to privacy issues US Incoming Casualty can only honor requests for loss runs when submitted in writing by our broker of record or by the Insured on their company letterhead. To request a copy of loss runs for your policy please submit your request to USIncomingLossRunRequestsxlgroup.com USICR Incoming 102012 2012 X.L. America Inc. All rights reserved.
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COMMERCIAL GENERAL LIABILITY CG P 006 03 05 EXCLUSION SILICA OR SILICA RELATED DUST ADVISORY NOTICE TO POLICYHOLDERS This Notice does NOT form a part of your insurance contract. The Notice is designed to alert you to coverage changes when the exclusion for silica or silica related dust is attached to this policy. If there is any conflict be tween this Notice and the policy including its endorsements the provisions of the policy including its endorse ments apply. Please read your policy and the endorsements attached to your policy carefully. This Notice contains a brief synopsis of the following endorsements CG 21 96 03 05 Silica Or Silica Related Dust Exclusion for use with Commercial General Liability Cov erage Part CG 33 70 03 05 Silica Or Silica Related Dust Exclusion for use with Owners And Contractors Protective Liability Coverage Part and Products Completed Operations Coverage Part CG 33 71 03 05 Silica Or Silica Related Dust Exclusion for use with Railroad Protective Liability Cover age Part When one of the above referenced endorsements is attached to your policy coverage is excluded for bodily injury under Coverage A arising in whole or in part out of the actual alleged threatened or suspected inhalation of or ingestion of silica or silica related dust. In addition coverage is excluded for property damage under Coverage A and personal and advertising injury under Coverage B arising in whole or in part out of actual alleged threat ened or suspected contact with exposure to existence of or presence of silica or silica related dust. The attachment of any of these endorsements may result in a restriction of coverage. CG P 006 03 05 ISO Properties Inc. 2004 Page 1 of 1
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NOTICE TO POLICYHOLDERS LEAD RESTRICTIONS OF COVERAGE This notice has been prepared in conjunction with the implementation of changes to your policy. No coverage is provided by this summary nor can it be construed to replace any provisions of your policy. If there is any conflict between the policy and this summary the provisions of the policy shall prevail. This notice contains a brief explanation of restrictions and clarifications of coverage that are being made in your policy through endorsement. Please read your policy and the endorsements attached to your policy carefully. LEAD EXCLUSION Exclusion of Liability for Hazards of Lead When this endorsement XIL 428 LEAD EXCLUSION is attached to your policy Coverage is excluded for Bodily injury Property damage or Personal and advertising injury for Commercial General Liability Coverage and Products Completed Operations Coverage caused in whole or in part either directly or indirectly o by lead lead paint or lead contamination or o arising out of or incidental to the inhalation ingestion use handling or contact with lead paint or lead contamination. Coverage is also excluded for o the costs of lead or lead paint removal o Property damage or any other injury or damage resulting from such removal. NTL 001 0306 XL America Inc. 2006
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NOTICE TO POLICYHOLDERS ASBESTOS RESTRICTIONS OF COVERAGE This notice has been prepared in conjunction with the implementation of changes to your policy. No coverage is provided by this summary nor can it be construed to replace any provisions of your policy. If there is any conflict between the policy and this summary the provisions of the policy shall prevail. This notice contains a brief explanation of restrictions and clarifications of coverage that are being made in your policy through endorsement. Please read your policy and the endorsements attached to your policy carefully. ASBESTOS EXCLUSION Exclusion of Liability for Hazards of Asbestos When this endorsement XIL 401 ASBESTOS EXCLUSION is attached to your policy Coverage is excluded for Bodily injury Property damage or Personal and advertising injury for Commercial General Liability Coverage and Bodily injury or Property Damage for Products Completed Operations Liability Coverage Part and Owners and Contractors Protective Liability Coverage caused in whole or in part either directly or indirectly by asbestos arising out of inhaling ingesting or prolonged physical exposure to asbestos or goods or products containing asbestos or the use of asbestos from any goods products or structures or the removal of asbestos in constructing or manufacturing any goods products or structures or the manufacture transportation storage handling distribution sale application mining consumption or disposal of asbestos or goods or products containing asbestos. NTL 004 0306 XL America Inc. 2006
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FRAUD NOTICE Arkansas Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. Colorado It is unlawful to knowingly provide false incomplete or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment fines denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false incomplete or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies. District of Columbia WARNING It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment andor fines. In addition an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant. Florida Any person who knowingly and with intent to injure defraud or deceive any insurer files a statement of claim or an application containing any false incomplete or misleading information is guilty of a felony of the third degree. Kansas A fraudulent insurance act means an act committed by any person who knowingly and with intent to defraud presents causes to be presented or prepares with knowledge or belief that it will be presented to or by an insurer purported insurer broker or any agent thereof any written statement as part of or in support of an application for the issuance of or the rating of an insurance policy for personal or commercial insurance or a claim for payment or other benefit pursuant to an insurance policy for commercial or personal insurance which such person knows to contain materially false information concerning any fact material thereto or conceals for the purpose of misleading information concerning any fact material thereto. Kentucky Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information or conceals for the purpose of misleading information concerning any fact material thereto commits a fraudulent insurance act which is a crime. Louisiana Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. Maine It is a crime to knowingly provide false incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment fines or denial of insurance benefits. Maryland Any person who knowingly and willfully presents a false or fraudulent claim for payment of a loss or benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. New Jersey Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties. New Mexico ANY PERSON WHO KNOWINGLY PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR BENEFIT OR KNOWINGLY PRESENTS FALSE INFORMATION IN AN APPLICATION FOR INSURANCE IS GUILTY OF A CRIME AND MAY BE SUBJECT TO CIVIL FINES AND CRIMINAL PENALTIES. olumbia PN CW 010613 Page 10f3 2013 X.L. America Inc. All Rights Reserved. May not be copied without permission.
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NUVIIVE TV FUVLILVLTIAVLUECNO New York General All applications for commercial insurance other than automobile insurance Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading information concerning any fact material thereto commits a fraudulent insurance act which is a crime and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. All applications for automobile insurance and all claim forms Any person who knowingly makes or knowingly assists abets solicits or conspires with another to make a false report of the theft destruction damage or conversion of any motor vehicle to a law enforcement agency the department of motor vehicles or an insurance company commits a fraudulent insurance act which is a crime and shall also be subject to a civil penalty not to exceed five thousand dollars and the value of the subject motor vehicle or stated claim for each violation. Fire Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any false information or conceals for the purpose of misleading information concerning any fact material thereto commits a fraudulent insurance act which is a crime. The proposed insured affirms that the foregoing information is true and agrees that these applications shall constitute a part of any policy issued whether attached or not and that any willful concealment or misrepresentation of a material fact or circumstances shall be grounds to rescind the insurance policy. Ohio Any person who with intent to defraud or knowing that he is facilitating a fraud against an insurer submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud. Oklahoma WARNING Any person who knowingly and with intent to injure defraud or deceive any insurer makes any claim for the proceeds of an insurance policy containing any false incomplete or misleading information is guilty of a felony. Pennsylvania All Commercial Insurance Except As Provided for Automobile Insurance Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading information concerning any fact material thereto commits a fraudulent insurance act which is a crime and subjects such person to criminal and civil penalties. Automobile Insurance Any person who knowingly and with intent to injure or defraud any insurer files an application or claim containing any false incomplete or misleading information shall upon conviction be subject to imprisonment for up to seven years and the payment of a fine of up to 15000. Puerto Rico Any person who knowingly and with the intention of defrauding presents false information in an insurance application or presents helps or causes the presentation of a fraudulent claim for the payment of a loss or any other benefit or presents more than one claim for the same damage or loss shall incur a felony and upon conviction shall be sanctioned for each violation by a fine of not less than five thousand dollars 5000 and not more than ten thousand dollars 10000 or a fixed term of imprisonment for three 3 years or both penalties. Should aggravating circumstances be present the penalty thus established may be increased to a maximum of five 5 years if extenuating circumstances are present it may be reduced to a minimum of two 2 years. PN CW 01 0613 Page 2 of 3 2013 X.L. America Inc. All Rights Reserved. May not be copied without permission.
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NUITIVE TV FULILVLTINVLULCNO Rhode Island Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. Tennessee All Commercial Insurance Except As Provided for Workers Compensation It is a crime to knowingly provide false incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment fines and denial of insurance benefits. Workers Compensation It is a crime to knowingly provide false incomplete or misleading information to any party to a workers compensation transaction for the purpose of committing fraud. Penalties include imprisonment fines and denial of insurance benefits. Utah Workers Compensation Any person who knowingly presents false or fraudulent underwriting information files or causes to be filed a false or fraudulent claim for disability compensation or medical benefits or submits a false or fraudulent report or billing for health care fees or other professional services is guilty of a crime and may be subject to fines and confinement in state prison. Virginia It is a crime to knowingly provide false incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment fines and denial of insurance benefits. Washington It is a crime to knowingly provide false incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment fines and denial of insurance benefits. West Virginia Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. All Other States Any person who knowingly and willfully presents false information in an application for insurance may be guilty of insurance fraud and subject to fines and confinement in prison. In Oregon the aforementioned actions may constitute a fraudulent insurance act which may be a crime and may subject the person to penalties. PN CW 010613 Page 3 0of 3 2013 X.L. America Inc. All Rights Reserved. May not be copied without permission.
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NUITIVE TV FULILVLTINVLULCNO PRIVACY POLICY The XL America Inc. insurance group the Companies believes personal information that we collect about our customers potential customers and proposed insureds referred to collectively in this Privacy Policy as customers must be treated with the highest degree of confidentiality. For this reason and in compliance with the Title V of the Gramm Leach Bliley Act GLBA we have developed a Privacy Policy that applies to all of our companies. For purposes of our Privacy Policy the term personal information includes all information we obtain about a customer and maintain in a personally identifiable way. In order to assure the confidentiality of the personal information we collect and in order to comply with applicable laws all individuals with access to personal information about our customers are required to follow this policy. Our Privacy Promise Your privacy and the confidentiality of your business records are important to us. Information and the analysis of information is essential to the business of insurance and critical to our ability to provide to you excellent cost effective service and products. We understand that gaining and keeping your trust depends upon the security and integrity of our records concerning you. Accordingly we promise that 1. We will follow strict standards of security and confidentiality to protect any information you share with us or information that we receive about you 2. We will verify and exchange information regarding your credit and financial status only for the purposes of underwriting policy administration or risk management and only with reputable references and clearinghouse services 3. We will not collect and use information about you and your business other than the minimum amount of information necessary to advise you about and deliver to you excellent service and products and to administer our business 4. We will train our employees to handle information about you or your business in a secure and confidential manner and only permit employees authorized to use such information to have access to such information 5. We will not disclose information about you or your business to any organization outside the XL insurance group of Companies or to third party service providers unless we disclose to you our intent to do so or we are required to do so by law 6. We will not disclose medical information about you your employees or any claimants under any policy of insurance unless you provide us with written authorization to do so or unless the disclosure is for any specific business exception provided in the law 7. We will attempt with your help to keep our records regarding you and your business complete and accurate and will advise you how and where to access your account information unless prohibited by law and will advise you how to correct errors or make changes to that information and 8. We will audit and assess our operations personnel and third party service providers to assure that your privacy is respected. Collection and Sources of Information We collect from a customer or potential customer only the personal information that is necessary for a determining eligibility for the product or service sought by the customer b administering the product or service obtained and c advising the customer about our products and services. The information we collect generally comes from the following sources e Submission During the submission process you provide us with information about you and your business such as your name address phone number e mail address and other types of personal identification information Quotes We collect information to enable us to determine your eligibility for the particular insurance product and to determine the cost of such insurance to you. The information we collect will vary with the type of insurance you seek Transactions We will maintain records of all transactions with us our affiliates and our third party service providers including your insurance coverage selections premiums billing and payment information claims history and other information related to your account PN CW 02 0505 Page 1 0f 3
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NUVIIVE TV FUVLILVLTIAVLUECNO e Claims If you obtain insurance from us we will maintain records related to any claims that may be made under your policies. The investigation of a claim necessarily involves collection of a broad range of information about many issues some of which does not directly involve you. We will share with you any facts that we collect about your claim unless we are prohibited by law from doing so. The process of claim investigation evaluation and settlement also involves however the collection of advice opinions and comments from many people including attorneys and experts to aid the claim specialist in determining how best to handle your claim. In order to protect the legal and transactional confidentiality and privileges associated with such opinions comments and advice we will not disclose this information to you and Credit and Financial Reports We may receive information about you and your business regarding your credit. We use this information to verify information you provide during the submission and quote processes and to help underwrite and provide to you the most accurate and cost effective insurance quote we can provide. Retention and Correction of Personal Information We retain personal information only as long as required by our business practices and applicable law. If we become aware that an item of personal information may be materially inaccurate we will make reasonable effort to re verify its accuracy and correct any error as appropriate. Storage of Personal Information We have in place safeguards to protect data and paper files containing personal information. Sharing Disclosing of Personal Information We maintain procedures to assure that we do not share personal information with an unaffiliated third party for marketing purposes unless such sharing is permitted by law. Personal information may be disclosed to an unaffiliated third party for necessary servicing of the product or service or for other normal business transactions as permitted by law. We do not disclose personal information to an unaffiliated third party for servicing purposes or joint marketing purposes unless a contract containing a confidentiality non disclosure provision has been signed by us and the third party. Unless a consumer consents we do not disclose consumer credit report type information obtained from an application or a credit report regarding a customer who applies for a financial product to any unaffiliated third party for the purpose of serving as a factor in establishing a consumer s eligibility for credit insurance or employment. Consumer credit report type information means such things as net worth credit worthiness lifestyle information piloting skydiving etc. solvency etc. We also do not disclose to any unaffiliated third party a policy or account number for use in marketing. We may share with our affiliated companies information that relates to our experience and transactions with the customer. Policy for Personal Information Relating to Nonpublic Personal Health Information We do not disclose nonpublic personal health information about a customer unless an authorization is obtained from the customer whose nonpublic personal information is sought to be disclosed. However an authorization shall not be prohibited restricted or required for the disclosure of certain insurance functions including but not limited to claims administration claims adjustment and management detection investigation or reporting of actual or potential fraud misrepresentation or criminal activity underwriting policy placement or issuance loss control andor auditing. Access to Your Information Our employees employees of our affiliated companies and third party service providers will have access to information we collect about you and your business as is necessary to effect transactions with you. We may also disclose information about you to the following categories of person or entities Your independent insurance agent or broker PN CW 02 0505 Page 2 of 3
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NUITIVE TV FULILVLTINVLULCNO An independent claim adjuster or investigator or an attorney or expert involved in the claim Persons or organizations that conduct scientific studies including actuaries and accountants An insurance support organization Another insurer if to prevent fraud or to properly underwrite a risk A state insurance department or other governmental agency if required by federal state or local laws or Any persons entitled to receive information as ordered by a summons court order search warrant or subpoena. Violation of the Privacy Policy Any person violating the Privacy Policy will be subject to discipline up to and including termination. For more information or to address questions regarding this privacy statement please contact your broker. PN CW 02 0505 Page 3 of 3
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NUITIVE TV FULILVLTINVLULENO U.S. TREASURY DEPARTMENT S OFFICE OF FOREIGN ASSETS CONTROL OFAC No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. This Policyholder Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC and possibly the U.S. Department of State. Please read this Policyholder Notice carefully. OFAC administers and enforces sanctions policy based on Presidential declarations of national emergency. OFAC has identified and listed numerous Foreign agents Front organizations Terrorists Terrorist organizations Narcotics traffickers as Specially Designated Nationals and Blocked Persons. This list can be found on the U.S. Department of the Treasury s web site httpwww.treas.gov ofac. The Secretary of the Treasury also has identified a number of entities in the insurance petroleum and petrochemicals industries determined to be owned or controlled by the Iranian government. Business transactions with any of these entities are expressly prohibited. These entities have been added to OFAC s list of Financial Institutions Determined To Be Owned or Controlled by the Government of Iran. This list can be found on the U.S. Department of the Treasury s web site httpwww.treas.govofficesenforcementlists In accordance with OFAC regulations or any applicable regulation promulgated by the U.S. Department of State if it is determined that you or any other insured or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person as identified by OFAC this insurance will be considered a blocked or frozen contract and all provisions of this insurance will be immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract neither payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. PN CW 05 1010 Includes copyrighted material of Insurance Services Office Inc. with its permission. 2010 X.L. America Inc. Al rights reserved. May not be copied without permission.
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NOTICE THIS IS A SURPLUS LINES POLICY AND IS NOT PROTECTED BY THE CONNECTICUT INSURANCE GUARANTY ASSOCIATION OR XL Group SUBJECT TO REVIEW BY THE CONNECTICUT INSURANCE DEPARTMENT. IT IS IMPORTANT THAT YOU READ AND UNDERSTAND THIS POLICY. Regulatory Office Regulatory Office 505 Eagleview Blvd. Ste. 100 Dept Regulatory Exton PA 19341 0636 Telephone 800 688 1840 Telephone 800 688 1840 COMMERCIAL LINES POLICY COMMON POLICY DECLARATIONS COMPANY PROVIDING COVERAGE Indian Harbor Insurance Company POLICY NO. US00009661LI14A RENEWAL OF US00009661LI13A POLICY PERIOD FROM January 1 2014 TO January 1 2015 AT 1201 A.M. Standard Time at your mailing address shown below Named Insured and Address Van Dyk Baler Corporation and Lubo USA 78 Halloween Boulevard Stamford CT 06902 Producer Lockton Companies 444 W 47 St. Kansas City MO 64112 Business Description Distribution Installation Service and Repair of Recycling Machines Form of Business Organization including a Corporation IN RETURN FOR THE PAYMENT OF THE PREMIUM AND SUBJECT TO ALL TERMS OF THIS POLICY WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. This policy consists of the following coverage parts for which a premium is indicated. This premium may be subject to adjustment. PREMIUM Select One Commercial General Liability Coverage Part 246109 Commercial Crime Coverage Part Commercial Inland Marine Coverage Part Commercial Automobile Coverage Part Equipment Breakdown Coverage Part Other Construction 12000 Policy Premium 258109 Select One Premium for Certified Acts of Terrorism Included XA 000 0312 2012 XL America Inc. All Rights Reserved. Page 1 of 2 May not be copied without permission.
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POLICY NO. US00009661LI14A THESE DECLARATIONS TOGETHER WITH ANY APPLICABLE COMMON POLICY CONDITIONS COVERAGE PART DECLARATIONS COVERAGE PART COVERAGE FORMS AND FORMS AND ENDORSEMENTS IF ANY ISSUED TO FORM A PART HEREOF COMPLETE THE ABOVE NUMBERED POLICY. Forms and Endorsements applicable to the policy See forms list Date 6302014 By Camaitle m. Tt Authorized Representative Type Name Camille M. Netta XAI 000 0312 2012 XL America Inc. All Rights Reserved. May not be copied without permission. Page 2 of 2
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GL MP 7000 1104 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS Policy Number US00009661LI14A Effective Date January 1 2014 1201 AM. Standard Time LIMITS OF INSURANCE General Aggregate Limit Other Than Products Completed Operations 2000.000 Products Completed Operations Aggregate Limit 2000.000 Personal and Advertising Injury Limit 1.000.000 Any One Person or Organization Each Occurrence Limit 1.000.000 Damage to Premises Rented to You Limit 100.000 Any One Premises Medical Expense Limit 10.000 Any One Person RETROACTIVE DATE CG 00 02 only This Insurance does not apply to bodily injury property damage or personal and advertising injury which occurs before the Retroactive Date if any shown here Enter Date or None if no Retroactive Date applies BUSINESS DESCRIPTION Form of Business Individual Partnership Joint Venture Trust Limited Liability Company XlOrganization including a Corporation but not including a Partnership Joint Venture or Limited Liability Company Business Description PREMIUM Class Premium Rate Advance Premium Location No. Classification Code Base Prem Ops Prod Co Op Prem Ops Prod Co Ops 001 Machinery or 56650 35160200 s 1.92515 5.07448 67689 178420 Machinery Parts Mfg. Const Policy is subject to audit. Total Advance Premium 67689 178420 Aggregate Limit mit ou Limit XOrganization including a Corporation but not including a Partnership Joint Venture or Limited Liability Company usiness Description Location No. Classification Code 001 Machinery or 56650 Machinery Parts Mfg. Const olicy is subject to audit. Base 35160200 s Prem Ops 1.92515 Prod Co Op 5.07448 Prem Ops 67689 Prod Co Ops 178420 Information omitted if shown elsewhere in the policy. Inclusion of date optional. GL MP 7000 1104 Page 10f 2 Includes copyrighted materialof Insurance Services Office Inc. with ts permission. Copyright Insurance Services Office Inc. 2000.
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LOCATION OF PREMISES Location of All Premises You Own Rent or Occupy Location No. Address 001 All Owned Leased or Occupied Locations FORMS AND ENDORSEMENTS other than applicable Forms and Endorsements shown elsewhere in the policy Forms and Endorsements applying to this Coverage Part and made part of this policy at time of issue See forms list cation No. Address 1 All Owned Leased or Occupied Locations e forms list Information omitted if shown elsewhere in the policy. Inclusion of date optional. GL MP 7000 1104 Page 2 of 2 Includes copyrighted materialof Insurance Services Office Inc. with ts permission. Copyright Insurance Services Office Inc. 2000.
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FORMS SCHEDULE POLICY NUMBER US00009661LI14A POLICY PERIOD 112014 112015 NAMED INSURED Van Dyk Baler Corporation and Lubo USA Name Description XAl 000 0312 COMMERCIAL LINES POLICY COMMON POLICY DECLARATIONS GL MP 7000 1104 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS IL MP 9104 0211 IHIC IN WITNESS INDIAN HARBOR INSURANCE COMPANY IL0017 1198 COMMON POLICY CONDITIONS IL 00 21 09 08 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form CG 00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM CG 03000196 DEDUCTIBLE LIABILITY INSURANCE CG 20 1004 13 ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION CG20110413 ADDITIONAL INSURED MANAGERS OR LESSORS OF PREMISES CG 20150413 ADDITIONAL INSURED VENDORS CG 20260413 ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION ADDITIONAL INSURED LESSOR OF LEASED EQUIPMENT AUTOMATIC STATUS WHEN 0620340413 REQUIRED IN LEASE AGREEMENT WITH YOU CG 21160413 EXCLUSION DESIGNATED PROFESSIONAL SERVICES CG 21471207 EMPLOYMENT RELATED PRACTICES EXCLUSION CG 21671204 FUNGI OR BACTERIA EXCLUSION CG 21730108 EXCLUSION OF CERTIFIED ACTS OF TERRORISM CONDITIONAL EXCLUSION OF TERRORISM RELATING TO DISPOSITION OF FEDERAL cG21870107 TERRORISM RISK INSURANCE ACT CG 219603 05 SILICA OR SILICA RELATED DUST EXCLUSION CG 22430413 EXCLUSION ENGINEERS ARCHITECTS OR SURVEYORS PROFESSIONAL LIABILITY CG22750413 PROFESSIONAL LIABILITY EXCLUSION COMPUTER SOFTWARE CG 24040509 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US XIL 401 0605 1 ASBESTOS EXCLUSION XIL 404 0605 2 NAMED INSURED ENDORSEMENT XIL 424 0605 3 PRIMARY INSURANCE CLAUSE ENDORSEMENT XIL 428 0605 4 LEAD EXCLUSION CG 10 0891 5 EXCLUSION AIRCRAFT PRODUCTS CG 310312 6 BATCH CLAUSE ENDORSEMENT CG 37 0891 7 PUNITIVE DAMAGES EXCLUSION CG 430110 8 SUPPLEMENTARY PAYMENTS WITHIN LIMITS OF INSURANCE IL 01 4009 08 CONNECTICUT CHANGES CIVIL UNION IL 0260 02 10 CONNECTICUT CHANGES CANCELLATION AND NONRENEWAL XL CTSOP 11 10 9 SERVICE OF PROCESS Information Notices CG P 006 03 05 NTL 001 0306 NTL 004 0306 PN CW 01 0613 PN CW 02 0505 PN CW 05 1010 POLICY NUMBER POLICY PERIOD NAMED INSURED Name XAl 000 0312 GL MP 7000 1104 IL MP 9104 0211 IHIC IL0017 1198 IL 00 21 09 08 CG 00010413 CG 03000196 CG 20100413 CG20110413 CG 201504 13 CG 20260413 CG 20340413 CG 21160413 CG 21471207 CG 21671204 CG 21730108 CG 21870107 CG 219603 05 CG 22430413 CG22750413 CG 24040509 XIL 401 0605 XIL 404 0605 XIL 424 0605 XIL 428 0605 CG 10 0891 CG 310312 CG 37 0891 CG 430110 IL 01 4009 08 IL 0260 02 10 XL CTSOP 11 10 XAI 300 10 06 Page 1 of 1 X.L. America Inc.
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IN WITNESS INDIAN HARBOR INSURANCE COMPANY REGULATORY OFFICE 505 EAGLEVIEW BOULEVARD SUITE 100 DEPARTMENT REGULATORY EXTON PA 19341 0636 PHONE 800 688 1840 It is hereby agreed and understood that the following In Witness Clause supercedes any and all other In Witness clauses in this policy. All other provisions remain unchanged. IN WITNESS WHEREOF the Company has caused this policy to be executed and attested and if required by state law this policy shall not be valid unless countersigned by a duly authorized representative of the Company. Sfeaas Seraina Maag President Towt Onn. fortms Toni Ann Perkins Secretary IL MP 9104 0211 IHIC 2011 X.L. America Inc. Al rights reserved. May not be copied without permission.
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IL0017 1198 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declara tions may cancel this policy by mailing or deliv ering to us advance written notice of cancella tion. 2. We may cancel this policy by mailing or deliver ing 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 suffi cient 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 Declarations is authorized to make changes in the terms of this policy with our consent. This policy s terms can be amended or waived only by endorsement issued by us and made a part of this policy.. 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 b. Give you reports on the conditions we find and c. Recommend changes. 2. We are not obligated to make any inspections surveys reports or recommendations and any such actions we do undertake relate only to 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 in surance inspections surveys reports or rec ommendations. 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. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal repre sentative. 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. ned Insured shown in the Declara ncel this policy by mailing or deliv dvance written notice of cancella cel this policy by mailing or deliver st Named Insured written notice of at least efore the effective date of cancel ve cancel for nonpayment of pre efore the effective date of cancel e cancel for any other reason. or deliver our notice to the first ed s last mailing address known to incellation will state the effective ellation. The policy period will end is cancelled we will send the first ed any premium refund due. If we refund will be pro rata. If the first red cancels the refund may be rata. The cancellation will be ef if we have not made or offered a IL0017 1198 Copyright Insurance Services Office Inc. 1998 Page 1 of 1 o
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IL 00 21 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT Broad Form This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply C. Under any Liability Coverage to bodily injury A. Under any Liability Coverage to bodily injury or property damage resulting from hazard or property damage 1 With respect to which an insured under the policy is also an insured under a nucle ar 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 li ability 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. 2 B. Under any Medical Payments coverage to expenses incurred with respect to bodily inju ry resulting from the hazardous properties of nuclear material and arising out of the opera tion of a nuclear facility by any person or or ganization. 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 2 3 The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nu clear facility but if such facility is located within the United States of America its terri tories or possessions or Canada this ex clusion 3 applies only to property dam age to such nuclear facility and any 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. 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 2 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 3 The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nu clear facility but if such facility is located within the United States of America its terri tories or possessions or Canada this ex clusion 3 applies only to property dam age to such nuclear facility and any 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. IL 00 21 09 08 ISO Properties Inc. 2007 Page 1 of 2 m
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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 nucle ar 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 pro cessing fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutoni um or uranium 233 or any combination thereof or more than 250 grams of uranium 235 Any structure basin excavation premises or place prepared or used for the storage or disposal of waste and includes the site on which any of the foregoing is located all operations conducted on such site and all premises used for such operations. Nuclear reactor means any apparatus 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 o
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COMMERCIAL GENERAL LIABILITY CG 00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under Section I Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 2 The bodily injury or property damage occurs during the policy period and Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. c. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. d. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim 3 1 Reports all or any part of the bodily injury or property damage to us or any other insurer 2 Receives a written or verbal demand or 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. CG 000104 13 Insurance Services Office Inc. 2012 Page 1 of 16
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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 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorneys fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and b Such attorneys fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. 2 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
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f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a b At or from any premises site or location which is or was at any time owned or occupied by or rented or loaned to any insured. However this subparagraph does not apply to i Bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or originating from equipment that is used to heat cool or dehumidify the building or equipment that is used to heat water for personal use by the building s occupants or their guests ii Bodily injury or property damage for which you may be held liable if you are a contractor and the owner or lessee of such premises site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not and never was owned or occupied by or rented or loaned to any insured other than that additional insured or i Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire At or from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste Which are or were at any time transported handled stored treated disposed of or processed as waste by or for i Any insured or ii Any person or organization for whom you may be legally responsible or 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 i Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e At or from any premises site or location 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 000104 13 Insurance Services Office Inc. 2012 Page 3 of 16
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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 Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a governmental authority. g. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or b 4 5 Bcdlly 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 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 2 Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you b 3 Page 4 of 16 Insurance Services Office Inc. 2012 CG 00010413
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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 6 That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section lll Limits Of Insurance. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard.. Damage To Your Product Property damage to your product arising out of it or any part of it.. Damage To Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor.. Damage To Impaired Property Or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 A defect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use.. Recall Of Products Work Or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it.. Personal And Advertising Injury Bodily injury arising out of personal and advertising injury.. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. However this exclusion does not apply to liability for damages because of bodily injury. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment.. Recording And Distribution Of Material Or Information In Violation Of Law Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law The CAN SPAM Act of 2003 including any amendment of or addition to such law 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 2 3 CG 000104 13 Insurance Services Office Inc. 2012 Page 5 of 16
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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 e. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section Il Limits Of Insurance. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of personal and advertising injury to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for personal and advertising injury to which this insurance does not apply. We may at our discretion investigate any offense and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and 2 Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to personal and advertising injury caused by an offense arising out of your business but only if the offense was committed in the coverage territory during the policy period. 2. Exclusions This insurance does not apply to 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. b. 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. c. 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. d. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured. e. 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. f. 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. g 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. h. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Page 6 of 16 Insurance Services Office Inc. 2012 CG 00010413
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i. Infringement Of Copyright Patent Trademark Or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trademark trade secret or other intellectual property rights. Under this exclusion such other intellectual property rights do not include the use of another s advertising idea in your advertisement. However this exclusion does not apply to infringement in your advertisement of copyright trade dress or slogan. j. Insureds In Media And Internet Type Businesses Personal and advertising injury committed by an insured whose business is 1 Advertising broadcasting publishing or telecasting 2 Designing or determining content of web sites for others or 3 An Internet search access content or service provider. However this exclusion does not apply to Paragraphs 14.a. b. and c. of personal and advertising injury under the Definitions section. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the insured hosts owns or over which the insured exercises control. I. Unauthorized Use Of Another s Name Or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain name or metatag or any other similar tactics to mislead another s potential customers. m. Pollution Personal and advertising injury arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants at any time. n. Pollution related Any loss cost or expense arising out of any 1 Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. o. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. p. Recording And Distribution Of Material Or Information In Violation Of Law Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law The CAN SPAM Act of 2003 including any amendment of or addition to such law 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 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 2 3 4 CG 000104 13 Insurance Services Office Inc. 2012 Page 7 of 16
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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
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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 c. 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 d. 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 b Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit c Notify any other insurer whose coverage is available to the indemnitee and d Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee and 2 Provides us with written authorization to a Obtain records and other information related to the suit and b Conduct and control the defense of the indemnitee in such suit. So long as the above conditions are met attorneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.2 of Section I 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 000104 13 Insurance Services Office Inc. 2012 Page 9 of 16
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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 b To the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of Paragraph 1a above c For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph 1a or b above or d Arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b Rented to in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees volunteer workers any partner or member if you are a partnership or joint venture or any member if you are a limited liability company. b. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that property and 2 Until your legal representative has been appointed. d. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION Il LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. Page 10 of 16 Insurance Services Office Inc. 2012 CG 00010413
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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 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 3 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 000104 13 Insurance Services Office Inc. 2012 Page 11 of 16
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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 i 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 informaton 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
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b. Those statements are based upon representations you made to us and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this Coverage Part to the first Named Insured this insurance applies a. As if each Named Insured were the only Named Insured and b. Separately to each insured against whom claim is made or suit is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part those rights are transferred to us. The insured must do nothing after loss to impair them. At our request the insured will bring suit or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. SECTION V DEFINITIONS 1. Advertisement means a notice that is broadcast or published to the general public or specific market segments about your goods products or services for the purpose of attracting customers or supporters. For the purposes of this definition a. Notices that are published include material placed on the Internet or on similar electronic means of communication and b. Regarding web sites only that part of a web site that is about your goods products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. Auto means a. A land motor vehicle trailer or semitrailer designed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However auto does not include mobile equipment.. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time.. Coverage territory means a. The United States of America including its territories and possessions Puerto Rico and Canada b. International waters or airspace but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above or c. All other parts of the world if the injury or damage arises out of 1 Goods or products made or sold by you in the territory described in Paragraph a. above The activities of a person whose home is in the territory described in Paragraph a. above but is away for a short time on your business or Personal and advertising injury offenses that take place through the Internet or similar electronic means of communication provided the insured s responsibility to pay damages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to.. Employee includes a leased worker. Employee does not include a temporary worker.. Executive officer means a person holding any of the officer positions created by your charter constitution bylaws or any other similar governing document. 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 000104 13 Insurance Services Office Inc. 2012 Page 13 of 16
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9. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract b. A sidetrack agreement c. Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality e. An elevator maintenance agreement f. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing 2 That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or 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. b 10.Leased worker means a person leased to you by 1 12. 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 f. Vehicles not described in Paragraph a. b. c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. Jie Vit le TIVL alt agreement except in iction or demolition feet of a railroad ed by ordinance to except in connection agreement ontract or agreement iness including an cipality in connection Page 14 of 16 Insurance Services Office Inc. 2012 CG 00010413
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13. 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. 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 b c insured 2 The existence of tools uninstalled equipment or abandoned or unused materials or 3 Products or operations for which the classification listed in the Declarations or in a policy Schedule states that products completed operations are subject to the General Aggregate Limit. 17.Property damage means a. Physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance electronic data is not tangible property. CG 000104 13 Insurance Services Office Inc. 2012 Page 15 of 16
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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 ROMs 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 organizaton whose business or assets you have acquired and 2 Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 22.Your work a. Means 1 Work or operations performed by you or on your behalf and 2 Materials parts or equipment furnished in connection with such work or operations. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your work and 2 The providing of or failure to provide warnings or instructions. Page 16 of 16 Insurance Services Office Inc. 2012 CG 00010413
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POLICY NUMBER US00009661LI14A COMMERCIAL GENERAL LIABILITY CG 03000196 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 OR Property Damage Liability OR Bodily Injury Liability andor 25000 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 The deductible applies to the sum of all loss arising out of bodily injury property damage personal injury advertising injury andor supplementary payments Coverages A and B however caused. It is further agreed that all references in this endorsement to bodily injury liability and property damage liability shall also include ref erence and apply in like manner to personal injury liability advertising injury liability and supplementary payments Coverages A and B. Any amounts paid within the Deductible Amount applicable to each occurrence claim shall reduce the Limit of Liability applicable to each occurrence claim and the Aggregate Limits of Liability under the Policy. A. Our obligation under the Bodily Injury Liability and b. Under Property Damage Liability Coverage Property Damage Liability Coverages to pay dam to all damages sustained by any one per ages on your behalf applies only to the amount of son because of property damage or damages in excess of any deductible amounts c. Under Bodily Injury Liability andor Propert stated in the Schedule above as applicable to Damage Lialilitly CyovsrageyCDmbinedo a such coverages. damages sustained by any one person be B. You may select a deductible amount on either a cause of per claim or a per occurrence basis. Your select Badi P ed deductible applies to the coverage option and m BOdy Y N to the basis of the deductible indicated by the 2 Property damage or placement of the deductible amount in the Sched 3 Bodily injury and property damage ule above. The deductible amount stated in the combined Schedule above applies as follows 1. PER CLAIM BASIS. If the deductible amount as the result of any one occurrence. If damages are claimed for care loss of ser CG 03 00 01 96 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 be cause of bodily injury vices 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. Copyright Insurance Services Office Inc. 1994 Page 1 0of 2 Amount and Basis of Deductible PER CLAIM or PER OCCURRENCE 25000 Page 1 of 2 o
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With respect to property damage person in cludes an organization. 2.PER OCCURRENCE BASIS. If the deducti ble amount indicated in the Schedule above is on a per occurrence basis that deduct ible amount applies as follows a. Under Bodily Injury Liability Coverage to all damages because of bodily injury b. Under Property Damage Liability Coverage to all damages because of property dam age or. 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 occur rence. 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 deducti ble amount.. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification of the action taken you shall promptly reimburse us for such part of the deduct ible amount as has been paid by us. Page 2 of 2 Copyright Insurance Services Office Inc. 1994 CG 03 00 01 96 o
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POLICY NUMBER US00009661LI14A POLICY NUMBER US00009661LI14A COMMERCIAL GENERAL LIABILITY CG 20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Locations Of Covered Operations Any person or organization where required by written contract but only to the extent that the named insured has agreed in writing prior to the occurrence or accident to provide insurance for such persons or organizations and then only with respect to liability for bodily injury or property damage caused by operations performed for such additional insured by or on behalf of the named insured. as required per written contract Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by 1. Your acts or omissions or 2. The acts or omissions of those acting on your behalf in the performance of your ongoing operations for the additional insureds at the locations designated above. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. sured. CG 201004 13 Insurance Services Office Inc. 2012 Page 10of 3
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B. With respect to the insurance afforded to these additional insureds the following additional exclusions apply This insurance does not apply to bodily injury or property damage occurring after 1. Al work including materials parts or equipment furnished in connection with such work on the project other than service maintenance or repairs to be performed by or on behalf of the additional insureds at the location of the covered operations has been completed or 2. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Page 2 of 3 Insurance Services Office Inc. 2012 CG 201004 13
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C. With respect to the insurance afforded to these additional insureds the following is added to Section Ill Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 2010 07 04 ISO Properties Inc. 2004 Page 3 of 3 m
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POLICY NUMBER US00009661LI14A POLICY NUMBER US00009661LI14A COMMERCIAL GENERAL LIABILITY CG 20110413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises Part Leased To You All premises leased to insured Name Of Persons Or Organizations Additional Insured All lessors of leased premises as per schedule on file with the company Additional Premium Included Information required to complete this Schedule if not shown above will be shown in the Declarations. Il premises leased to insured I lessors of leased premises as per schedule on file with the company A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability arising out of the ownership maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions This insurance does not apply to 1. Any occurrence which takes place after you cease to be a tenant in that premises. 2. Structural alterations new construction or demolition operations performed by or on behalf of the persons or organizations shown in the Schedule. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20110413 Insurance Services Office Inc. 2012 Page 1 of 1
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POLICY NUMBER US00009661LI14A POLICY NUMBER US00009661LI14A COMMERCIAL GENERAL LIABILITY CG 20150413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED VENDORS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Vendor Your Products Any person or organization where required by written contract but only to the extent that the named insured has agreed in writing prior to the occurrence or accident to provide insurance for such persons or organizations and then only with respect to liability for bodily injury or property damage caused by operations performed for such additional insured by or on behalf of the named insured. Your products as defined in this policy. 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 any persons or organizations referred to throughout this endorsement as vendor shown in the Schedule but only with respect to bodily injury or property damage arising out of your products shown in the Schedule which are distributed or sold in the regular course of the vendor s business. However 1. The insurance afforded to such vendor only applies to the extent permitted by law and 2. If coverage provided to the vendor is required by a contract or agreement the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. B. With respect to the insurance afforded to these vendors the following additional exclusions apply 1. The insurance afforded the vendor does not apply to a. Bodily injury or property damage for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement b. Any express warranty unauthorized by you c. Any physical or chemical change in the product made intentionally by the vendor d. Repackaging except when unpacked solely for the purpose of inspection demonstration testing or the substitution of parts under instructions from the manufacturer and then repackaged in the original container CG 20150413 Insurance Services Office Inc. 2012 Page 1 of 2
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. Any failure to make such inspections adjustments tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the distribution or sale of the products. Demonstration installation servicing or repair operations except such operations performed at the vendor s premises in connection with the sale of the product. Products which after distribution or sale by you have been labeled or relabeled or used as a container part or ingredient of any other thing or substance by or for the vendor or. Bodily injury or property damage arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However this exclusion does not apply to 1 The exceptions contained in Sub paragraphs d. or f. or 2 Such inspections adjustments tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization from whom you have acquired such products or any ingredient part or container entering into accompanying or containing such products. C. With respect to the insurance afforded to these vendors the following is added to Section Il Limits Of Insurance If coverage provided to the vendor is required by a contract or agreement the most we will pay on behalf of the vendor is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 Insurance Services Office Inc. 2012 CG 201504 13
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POLICY NUMBER US00009661LI14A POLICY NUMBER US00009661LI14A COMMERCIAL GENERAL LIABILITY CG 2026 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Any person or organization where required by written contract but only to the extent that the named insured has agreed in writing prior to the occurrence or accident to provide insurance for such persons or organizations and then only with respect to liability for bodily injury or property damage caused by operations performed for such additional insured by or on behalf of the named insured. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury B. With respect to the insurance afforded to these additional insureds the following is added to Section Ill Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we caused in whole or in part by your acts or omissions or the acts or omissions of those acting on your behalf 1. In the performance of your ongoing operations or 2. In connection with your premises owned by or rented 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. will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 2026 04 13 Insurance Services Office Inc. 2012 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 20340413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED LESSOR OF LEASED EQUIPMENT AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section Il Who Is An Insured is amended to include as an additional insured any persons or organizations from whom you lease equipment when you and such persons or organizations have agreed in writing in a contract or agreement that such persons or organizations be added as an additional insured on your policy. Such persons or organizations is an insured 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 the insurance afforded to such additional insured 1. Only applies to the extent permitted by law and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person s or organization s status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends.. With respect to the insurance afforded to these additional insureds this insurance does not apply to any occurrence which takes place after the equipment lease expires.. With respect to the insurance afforded to these additional insureds the following is added to Section Ill Limits Of Insurance The most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement you have entered into with the additional insured or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20340413 Insurance Services Office Inc. 2012 Page 1 of 1
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POLICY NUMBER US00009661LI14A POLICY NUMBER US00009661LI14A COMMERCIAL GENERAL LIABILITY CG 21160413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION DESIGNATED PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description Of Professional Services 1. All professional services Information required to complete this Schedule if not shown above will be shown in the Declarations. With respect to any professional services shown in the Schedule the following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability This insurance does not apply to bodily injury property damage or personal and advertising injury due to the rendering of or failure to render any professional service. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage or the offense which caused the personal and advertising injury involved the rendering of or failure to render any professional service. CG 211604 13 Insurance Services Office Inc. 2012 Page 1 of 1
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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. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability This insurance does not apply to Bodily injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demo tion evaluation reassignment discipline defamation harassment humiliation dis crimination or malicious prosecution di rected at that person or 2 The spouse child parent brother or sister of that person as a consequence of bodily injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after em ployment of that person Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. 2 Exclusions of Section Coverage B Person al 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 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 c 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 above occurs before employment during employment or after em ployment of that person Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. CG 21471207 ISO Properties Inc. 2006 Page 1 of 1 m
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COMMERCIAL GENERAL LIABILITY CG 21671204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FUNGI OR BACTERIA EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Bodily injury or property damage which would not have occurred in whole or in part but for the actual alleged or threat ened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed con currently or in any sequence to such injury or damage. b. Any loss cost or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxify ing neutralizing remediating or disposing of or in any way responding to or as sessing 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 Person al And Advertising Injury Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Personal and advertising injury which would not have taken place in whole or in part but for the actual alleged or threat ened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed con currently or in any sequence to such injury. b. Any loss cost or expense arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any in sured or by any other person or entity. C. The following definition is added to the Definitions Section Fungi means any type or form of fungus includ ing mold or mildew and any mycotoxins spores scents or byproducts produced or released by fungi. aragraph 2. A Bodily age which vhole or in d or threat of contact or presence or within a ts contents her cause ibuted con such injury ising out of 1 g cleaning g detoxify r disposing to or as o anbaria CG 21671204 ISO Properties Inc. 2003 Page 1 of 1 o
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COMMERCIAL GENERAL LIABILITY CG 21730108 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF CERTIFIED ACTS OF TERRORISM COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR 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. The following exclusion is added This insurance does not apply to TERRORISM Any injury or damage arising directly or indirect ly out of a certified act of terrorism. B. The following definitions are added 1. For the purposes of this endorsement any injury or damage means any injury or damage covered under any Coverage Part to which this endorsement is applicable and includes but is not limited to bodily injury property dam age personal and advertising injury injury or environmental damage as may be defined in any applicable Coverage Part. 2. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in concurrence with the Secretary of State and the Attorney General of the United States to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria con tained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following a. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terror ism Risk Insurance Act and b. The act is a violent act or an act that is dangerous to human life property or infra structure and is committed by an individual or individuals as part of an effort to coerce 2. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in concurrence with the Secretary of State and the Attorney General of the United States to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria con tained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following a. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terror ism Risk Insurance Act and b. The act is a violent act or an act that is dangerous to human life property or infra structure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the con duct of the United States Government by coercion. CG 21730108 ISO Properties Inc. 2007 Page 1 of 1 m
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COMMERCIAL GENERAL LIABILITY CG 21870107 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONDITIONAL EXCLUSION OF TERRORISM RELATING TO DISPOSITION OF FEDERAL TERRORISM RISK INSURANCE ACT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. Applicability Of The Provisions Of This Endorsement 1. The provisions of this endorsement be 3 Redefine terrorism or make insur ance coverage for terrorism subject to provisions or requirements that differ from those that apply to other come applicable commencing on the date when any one or more of the following first occurs. But if your policy meaning the pol icy period in which this endorsement ap plies begins after such date then the pro visions of this endorsement become applicable on the date your policy begins. a. The federal Terrorism Risk Insurance Program Program established by the Terrorism Risk Insurance Act has ter minated with respect to the type of in surance provided under this Coverage Part or Policy or b. A renewal extension or replacement of the Program has become effective with out a requirement to make terrorism coverage available to you and with revi sions that 1 Increase our statutory percentage deductible under the Program for ter rorism losses. That deductible de termines the amount of all certified terrorism losses we must pay in a calendar year before the federal government shares in subsequent payment of certified terrorism loss es. or 2 Decrease the federal government s statutory percentage share in poten tial terrorism losses above such de ductible or types of events or occurrences under this policy.. If the provisions of this endorsement be come applicable such provisions a. Supersede any terrorism endorsement already endorsed to this policy that ad dresses certified acts of terrorism andor other acts of terrorism but only with respect to an incidents of terror ism however defined which results in injury or damage that occurs on or after the date when the provisions of this en dorsement become applicable for claims made policies such an endorse ment is superseded only with respect to an incident of terrorism however de fined that results in a claim for injury or damage first being made on or after the date when the provisions of this en dorsement become applicable and b. Remain applicable unless we notify you of changes in these provisions in re sponse to federal law. 3 Redefine terrorism or make insur ance coverage for terrorism subject to provisions or requirements that differ from those that apply to other types of events or occurrences under this policy. 2. If the provisions of this endorsement be come applicable such provisions a. Supersede any terrorism endorsement already endorsed to this policy that ad dresses certified acts of terrorism andor other acts of terrorism but only with respect to an incidents of terror ism however defined which results in injury or damage that occurs on or after the date when the provisions of this en dorsement become applicable for claims made policies such an endorse ment is superseded only with respect to an incident of terrorism however de fined that results in a claim for injury or damage first being made on or after the date when the provisions of this en dorsement become applicable and b. Remain applicable unless we notify you of changes in these provisions in re sponse to federal law. CG 21870107 ISO Properties Inc. 2005 Page 1 of 3 m
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3. If the provisions of this endorsement do NOT become applicable any terrorism en dorsement already endorsed to this policy that addresses certified acts of terrorism andor other acts of terrorism will con tinue in effect unless we notify you of changes to that endorsement in response to federal law. B. The following definitions are added and apply under this endorsement wherever the term terror ism or the phrase any injury or damage are en closed in quotation marks 1. Terrorism means activities against persons organizations or property of any nature a. That involve the following or preparation for the following 1 Use or threat of force or violence or 2 Commission or threat of a dangerous act or 3 Commission or threat of an act that interferes with or disrupts an electronic communication information or mechan ical system and b. When one or both of the following applies 1 The effect is to intimidate or coerce a government or the civilian population or any segment thereof or to disrupt any segment of the economy or 2 It appears that the intent is to intimidate or coerce a government or to further political ideological religious social or economic objectives or to express or express opposition to a philosophy or ideology. 2. Any injury or damage means any injury or damage covered under any Coverage Part or Policy to which this endorsement is applicable and includes but is not limited to bodily injury property damage personal and advertising injury injury or environmental damage as may be defined in any applicable Coverage Part or Policy. C. The following exclusion is added EXCLUSION OF TERRORISM We will not pay for any injury or damage caused directly or indirectly by terrorism including action in hindering or defending against an actual or ex pected incident of terrorism. Any injury or dam age is excluded regardless of any other cause or event that contributes concurrently or in any se quence to such injury or damage. But this exclu sion applies only when one or more of the fol lowing are attributed to an incident of terrorism 1. The terrorism is carried out by means of the dispersal or application of radioactive material or through the use of a nuclear weapon or de vice that involves or produces a nuclear reac tion nuclear radiation or radioactive contami nation or 2. Radioactive material is released and it ap pears that one purpose of the terrorism was to release such material or 3. The terrorism is carried out by means of the dispersal or application of pathogenic or poi sonous biological or chemical materials or 4. Pathogenic or poisonous biological or chemical materials are released and it appears that one purpose of the terrorism was to release such materials or 5. The total of insured damage to all types of property exceeds 25000000. In determining whether the 25000000 threshold is exceed ed we will include all insured damage sus tained by property of all persons and entities affected by the terrorism and business inter ruption losses sustained by owners or occu pants of the damaged property. For the pur pose of this provision insured damage means damage that is covered by any insurance plus damage that would be covered by any insur ance but for the application of any terrorism exclusions or 6. Fifty or more persons sustain death or serious physical injury. For the purposes of this provi sion serious physical injury means a. Physical injury that involves a substantial risk of death or b. Protracted and obvious physical disfigure ment or c. Protracted loss of or impairment of the function of a bodily member or organ. Page 2 of 3 ISO Properties Inc. 2005 CG 21870107 o
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Multiple incidents of terrorism which occur within a 72 hour period and appear to be carried out in concert or to have a related purpose or common leadership will be deemed to be one incident for the purpose of determining whether the thresholds in Paragraphs C.5. or C.6. are exceeded. With respect to this Exclusion Paragraphs C.5. and C.6. describe the threshold used to measure the magnitude of an incident of terrorism and the circumstances in which the threshold will apply for the purpose of determining whether this Exclusion will apply to that incident. When the Exclusion ap plies to an incident of terrorism there is no cov erage under this Coverage Part or Policy. In the event of any incident of terrorism that is not subject to this Exclusion coverage does not apply to any injury or damage that is otherwise excluded under this Coverage Part or Policy. CG 21870107 ISO Properties Inc. 2005 Page 3 of 3 m
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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 suspected inhalation of or ingestion of sil ica 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 re mediating 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 Person al And Advertising Injury Liability 2. Exclusions 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 exist ence 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 re mediating 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. C. The following definitions are added to the Defini tions Section 1. Silica means silicon dioxide occurring in crystalline amorphous and impure forms sili ca particles silica dust or silica compounds. 2. Silica related dust means a mixture or combi nation of silica and other dust or particles. CG 2196 03 05 ISO Properties Inc. 2004 Page 1 of 1 o
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COMMERCIAL GENERAL LIABILITY CG 22430413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ENGINEERS ARCHITECTS OR SURVEYORS PROFESSIONAL LIABILITY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability This insurance does not apply to bodily injury property damage or personal and advertising injury arising out of the rendering of or failure to render any professional services by you or any engineer architect or surveyor who is either employed by you or performing work on your behalf in such capacity. Professional services include 1. The preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications and 2. Supervisory inspection architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage or the offense which caused the personal and advertising injury involved the rendering of or failure to render any professional services by you or any engineer architect or surveyor who is either employed by you or performing work on your behalf in such capacity. CG 22430413 Insurance Services Office Inc. 2012 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 22750413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PROFESSIONAL LIABILITY EXCLUSION COMPUTER SOFTWARE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. B. With respect to the rendering of or failure to render Exclusions of Section Coverage A Bodily Injury And Property Damage Liability and Section Coverage B Personal And Advertising Injury Liability This insurance does not apply to bodily injury property damage or personal and advertising injury arising out of the rendering of or failure to render any service by you or on your behalf in connection with the selling licensing franchising or furnishing of your computer software including electronic data processing programs designs specifications manuals and instructions. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage or the offense which caused the personal and advertising injury involved the rendering of or failure to render any service described above. any service by you or on your behalf in connection with the selling licensing franchising or furnishing of your computer software including electronic data processing programs designs specifications manuals and instructions Exclusion 2.b. Contractual Liability under Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following 2. Exclusions This insurance does not apply to b. 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. CG 22750413 Insurance Services Office Inc. 2012 Page 1 of 1
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POLICY NUMBER US00009661LI14A POLICY NUMBER US00009661LI14A COMMERCIAL GENERAL LIABILITY CG 24 0405 09 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 As required by written contract. 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. required by written contract. CG 24 04 05 09 Insurance Services Office Inc. 2008 Page 1 of 1 m
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ENDORSEMENT 01 This endorsement effective 1201 a.m. January 1 2014 forms a part of Policy No. US00009661LI14A issued to Van Dyk Baler Corporation and Lubo USA by Indian Harbor Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ASBESTOS EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM This policy does not apply to liability for any injury including bodily injury property damage personal and advertising injury any of which arise out of asbestos including but not limited to 1 inhaling ingesting or prolonged physical exposure to asbestos or goods or products containing asbestos or the use of asbestos from any goods products or structures or the removal of asbestos in constructing or manufacturing any goods products or structures or the manufacture transportation storage handling distribution sale application mining consumption or disposal of asbestos or goods or products containing asbestos. All other terms and conditions remain unchanged. XIL 401 0605 2005 XL America Inc.
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ENDORSEMENT 02 This endorsement effective 1201 a.m. January 1 2014 forms a part of Policy No. US00009661LI14A issued to Van Dyk Baler Corporation and Lubo USA by Indian Harbor Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NAMED INSURED ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM It is agreed that NAMED INSURED of the policy declarations page is amended to include the following Van Dyk Recycling Solutions All other terms and conditions remain unchanged. XIL 404 0605 2005 XL America Inc.
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ENDORSEMENT 03 This endorsement effective 1201 a.m. January 1 2014 forms a part of Policy No. US00009661LI14A issued to Van Dyk Baler Corporation and Lubo USA by Indian Harbor Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE CLAUSE ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS COVERAGE PART Itis agreed that to the extent that insurance is afforded to any Additional Insured under this policy this insurance shall apply as primary and not contributing with any insurance carried by such Additional Insured as required by written contract. All other terms and conditions of this policy remain unchanged. XIL 424 0605 2005 XL America Inc.
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ENDORSEMENT 04 This endorsement effective 1201 a.m. January 1 2014 forms a part of Policy No. US00009661LI14A issued to Van Dyk Baler Corporation and Lubo USA by Indian Harbor Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LEAD EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS COVERAGE PART Itis agreed that SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY and COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY Iltem 2. Exclusions is amended to include the following Lead Bodily injury Property damage or Personal and advertising injury arising out of or alleged to have arisen out of 1 exposure to lead lead paint or any material containing lead or lead paint or 2 the existence removal or abatement of lead lead paint or any material containing lead or lead paint including without limitation a the costs of lead or lead paint removal or b Property damage or any other injury or damage suffered in the course of effecting such removal. All other terms and conditions remain unchanged. XIL 428 0605 2005 XL America Inc.
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Exclusion Aircraft Products This endorsement changes the policy. Please read it carefully. This endorsement modifies insurance provided under the following Commercial General Liability Coverage Part This insurance does not apply to bodily injury or property damage arising out of aircraft products or the grounding of any aircraft. Aircraft products means aircraft including missiles or spacecraft and any ground support or control equipment used therewith and any article furnished by the Insured and installed in aircraft or used in connection with aircraft or for spare parts for aircraft or tooling used for the manufacture thereof including ground handling tools and equipment and also means training aids instructions manuals blueprints engineering or other data engineering or other advice and services and labor relating to such aircraft or articles. Grounding means the withdrawal of one or more aircraft from flight operations or the imposition of speed passenger or load restrictions on any aircraft by reason of the existence of or alleged or suspected existence of any defect fault or condition in such aircraft or any part thereof sold handled or distributed by the Insured or manufactured assembled or processed by any other person or organization according to specifications plans suggestions orders or drawings of the Insured or with tools machinery or other equipment furnished to such persons or organizations by the Insured whether such aircraft so withdrawn are owned or operated by the same or different persons or organizations. This endorsement is part of your policy and takes effect on the effective date of your policy unless another effective date is shown below. Complete only when this endorsement is not prepared with the policy or is not to be effective with the policy Issued to Effective Date of this Endorsement Must be completed always Endorsement Number 05 Policy Number US00009661LI14A Indian Harbor Insurance Company Countersigned by Authorized Representative CG 10 8 91
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Batch Clause Endorsement This endorsement changes the policy. Please read it carefully. This endorsement modifies insurance provided under the following Commercial General Liability Coverage Part Paragraph 1. Insuring Agreement of Coverage A Bodily Injury and Property Damage Liability of Section Coverages is amended to include the following Two or more incidents arising out of a single act cause or occurrence and or a series of related acts causes or occurrences shall be treated as a single occurrence. Such incidents acts causes or occurrences shall be considered to have occurred at the time at which the first such incident act cause or occurrence took place. If the first loss in a series of related losses incurred before inception of the policy then all losses from the same series of related losses are excluded from the policy. In no event shall the assertion of claims based upon two or more incidents acts causes or occurrences as described above increase the limits of insurance available under the applicable policy. Policies issued subsequent to the date of a single occurrence shall not apply to the first incident nor to any claims or suits arising out of the first incident act cause or occurrence. Bodily Injuries andor Property Damages will be deemed to have occurred at the time of loss or when the first loss in the series of related losses rising from the same or related incident act cause or occurrence is first reported to and ascertained by us. This endorsement is part of your policy and takes effect on the effective date of your policy unless another effective date is shown below. Complete only when this endorsement is not prepared with the policy or is not to be effective Must be completed always with the policy Endorsement Number 06 Issued to USA Policy Number US00009661LI14A Effective Date of this Endorsement Indian Harbor Insurance Company Countersigned by Authorized Representative Must be completed always Endorsement Number 06 Policy Number US00009661LI14A Indian Harbor Insurance Company CG 31 3 12
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Exclusion Punitive Damages This endorsement changes the policy. Please read it carefully. This endorsement modifies insurance provided under the following Commercial General Liability Coverage Part This insurance does not apply to a claim of or indemnification for punitive or exemplary damages. If a suit shall have been brought against you for a claim falling within the coverage provided under the policy seeking both compensatory and punitive or exemplary damages then we will afford a defense to such action. We shall not have an obligation to pay for any costs interest statutory damages or fines or penalties attributable to punitive or exemplary damages. This endorsement is part of your policy and takes effect on the effective date of your policy unless another effective date is shown below. Complete only when this endorsement is not prepared with the policy or is not to be effective with the policy Issued to Effective Date of this Endorsement Must be completed always Endorsement Number 07 Policy Number US00009661LI14A Indian Harbor Insurance Company Indian Harbor Insurance Company Countersigned by Authorized Representative CG 37 8 91
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Supplementary Payments Inclusion within Limits of Insurance This endorsement changes the policy. Please read it carefully. This endorsement modifies insurance provided under the following Commercial General Liability Coverage Part Itis agreed that the supplementary payments provision of the policy is amended such that these payments will reduce the Limits of Insurance. This endorsement is part of your policy and takes effect on the effective date of your policy unless another effective date is shown below. Complete only when this endorsement is not prepared with the policy or is not to be effective with the policy Issued to Effective Date of this Endorsement Must be completed always Endorsement Number 08 Policy Number US00009661LI14A Indian Harbor Insurance Company Countersigned by Authorized Representative CG 43 110
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IL 01 40 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONNECTICUT CHANGES CIVIL UNION This endorsement modifies insurance provided under the following COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART A. The term spouse is replaced by the following C. With respect to coverage for the ownership main i.. tenance or use of covered autos provided under S zzlrjlseirugg o a civil union recognized under the Commercial Liability Umbrella Coverage Part. or Farm Umbrella Liability Policy the term family B. Under the Commercial Auto Coverage Part the member is replaced by the following term family member is replaced by the following Family member means a person related to you Family member means a person related to the by blood adoption marriage or civil union recog 1. Individual Named Insured by blood adoption nized under Connecticut law who is a resident of marriage or civil union recognized under Con your household including a ward or foster child. necticut law who is a resident of such Named Insured s household including a ward or foster child or 2. Individual named in the Schedule by blood adoption marriage or civil union recognized under Connecticut law who is a resident of the individual s household including a ward or fos ter child if the Drive Other Car Coverage Broadened Coverage For Named Individual Endorsement is attached. C. With respect to coverage for the ownership main tenance or use of covered autos provided under the Commercial Liability Umbrella Coverage Part or Farm Umbrella Liability Policy the term family member is replaced by the following Family member means a person related to you by blood adoption marriage or civil union recog nized under Connecticut law who is a resident of your household including a ward or foster child. IL 01 40 09 08 ISO Properties Inc. 2007 Page 1 of 1
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INTERLINE IL 02 60 02 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONNECTICUT CHANGES CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following CAPITAL ASSETS PROGRAM OUTPUT POLICY COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART STANDARD PROPERTY POLICY A. The Cancellation Common Policy Condition is replaced by the following Cancellation 1. The first Named Insured shown in the Declara tions may cancel this policy by mailing or delivering to us advance written notice of can cellation. 2. Cancellation of policies in effect for less than 60 days. If this policy has been in effect for less than 60 days and is not a renewal of a policy we is sued we may cancel this policy for any reason by giving you 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. Cancellation of policies in effect for 60 days or more. a. If this policy has been in effect for 60 days or more or this is a renewal of a policy we issued we may cancel this policy by giving you written notice of cancellation at least 1 10 days before the effective date of cancellation if we cancel for one or more of the following reasons a Nonpayment of premium b Conviction of a crime arising out of acts increasing the hazard insured against Discovery of fraud or material misrepresentation by you in obtain ing the policy or in perfecting any claim thereunder Discovery of any willful or reckless act or omission by you increasing the hazard insured against or c d 3. Cancellation of policies in effect for 60 days or more. a. If this policy has been in effect for 60 days or more or this is a renewal of a policy we issued we may cancel this policy by giving you written notice of cancellation at least 1 10 days before the effective date of cancellation if we cancel for one or more of the following reasons a Nonpayment of premium b Conviction of a crime arising out of acts increasing the hazard insured against c Discovery of fraud or material misrepresentation by you in obtain ing the policy or in perfecting any claim thereunder d Discovery of any willful or reckless act or omission by you increasing the hazard insured against or IL 02 60 02 10 Insurance Services Office Inc. 2009 Page 1 of 2 m
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e A determination by the Commission er that continuation of the policy would violate or place us in violation of the law or 2 60 days before the effective date of cancellation if we cancel for one or more of the following reasons a Physical changes in the property which increase the hazard insured against b A material increase in the hazard insured against or c A substantial loss of reinsurance by us affecting this particular line of in surance. b. We may not cancel policies in effect for 60 days or more or renewal policies for any reason other than the reasons described in Paragraph 3.a. above. c. If we cancel for nonpayment of premium you may continue the coverage and avoid the effect of the cancellation by payment in full at any time prior to the effective date of cancellation. d. Notice of cancellation will be delivered or sent by 1 Registered mail 2 Certified mail or 3 Mail evidenced by a United States Post Office certificate of mailing.. We will give notice to you at your last mailing address known to us.. Notice of cancellation will state the specific reason for the cancellation and the effective date of cancellation. The policy period will end on that date. 6. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be ef fective even if we have not made or offered a refund. 7. If notice is mailed proof of mailing will be suffi cient proof of notice.. The following is added and supersedes any other provision to the contrary Nonrenewal 1. If we decide not to renew this policy we will mail or deliver to you a written notice of nonre newal stating the specific reason for nonre newal at least 60 days before the expiration date of this policy. The notice will be sent to your address last known to us. 2. This notice will be delivered or sent by a. Registered mail b. Certified mail or c. Mail evidenced by a certificate of mailing. If notice is mailed proof of mailing is sufficient proof of notice. 3. However we are not required to send this notice if nonrenewal is due to your failure to pay any advance premium required for renew al. 4. With respect to automobile liability insurance policies only your policy shall terminate on the effective date of any other insurance policy you purchase with respect to any automobile des ignated in both policies. Page 2 of 2 Insurance Services Office Inc. 2009 IL 02 60 02 10 o
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ENDORSEMENT 09 This endorsement effective 1201 a.m. January 1 2014 forms a part of Policy No. US00009661LI14A issued to Van Dyk Baler Corporation and Lubo USA by Indian Harbor Insurance Company. SERVICE OF PROCESS The Commissioner of Insurance of the State of Connecticut is hereby designated the true and lawful attorney of the Company upon whom may be served all lawful process in any action suit or proceeding arising out of this policy. The Company further designates Sarah Mims Assistant Secretary 505 Eagleview Boulevard Suite 100 Exton Pennsylvania 19341 0636 as its agent in Connecticut to whom such process shall be forwarded by the Commissioner of Insurance. For lllinois exposures the Insurer further designates the Director of the lllinois Division of Insurance and his successors in office as its true and lawful attorney upon whom may be served any lawful process in any action suit or proceeding instituted by or on behalf of the insured or any beneficiary hereunder arising out of an lllinois exposure and this contract of insurance. All other terms and conditions of this policy remain unchanged. Authorized Representative XL CTSOP 11 10 2010 X.L. America Inc. All Rights Reserved. May not be copied without permission.
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MNEMC INSURANCE EMC PROPERTY CASUALTY COMPANY PRIOR POLICY 4D9 43 19 GENERAL LIABILTITY DECLARATIONS POLICY PERIOD FROM 010318 TO 010319 POLICY NUMBER 4D9 43 109 19 NAMED INSURED PRODUCER PAC 211 LLC LOCKTON COMPANIES LLC 1606 N 197TH ST 13710 FNB PKWY STE 400 ELKHORN NE 68022 6407 OMAHA NE 68154 5298 AGENT HB 8210 AGENT PHONE 402970 6100 DIRECT BILL JACK H. STRUYK CLAIM REPORTING 888362 2255 SERVICING CARRIER 402951 8300 THIS POLICY RENEWAL IS OFFERED CONTINGENT UPON THE RECEIPT OF PAYMENT WHICH IS DUE ON 010318. INSURED IS LLC BUSINESS DESC REAL ESTATE DEVELOPMENT EACH OCCURRENCE LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT 300000 ANY ONE PREMISES MEDICAL EXPENSE LIMIT 10000 ANY ONE PERSON PERSONAL AND ADVERTISING INJURY LIMIT 1000000 ANY ONE PERSON OR ORGANIZATION GENERAL AGGREGATE LIMIT 2000000 PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT 2000000 COVERAGES PROVIDETD PREMIUM SEE ATTACHED SCHEDULE FOR LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED. FORMS APPLICABLE CG00010413 CG21060514 CG21471207 CG21700115 G21760115 CG7001A1012 CG70031013 CG71661013 CG7174.31013 CG71910814 CG75551013 CG76440209 IL00210502 IL02590907 IL70280515 IL7131A0401 118021 0488 IL8383.2A0115 IL8384A0108 IL85760909 IL87450317 DATE OF ISSUE 112917 BPP FORM CG7000A ED. 08 99 BPP 102017 003 MB 4D94319 1901 GENERAL LIABILTITY D E POLICY PERIOD FROM 010318 TO 010319 1606 N 197TH ST ELKHORN NE 68022 6407 DIRECT BILL 13710 FNB PKWY STE 400 OMAHA NE 68154 5298 AGENT HB 8210 AGENT PHONE 402970 6100 JACK H. STRUYK CLAIM REPORTING 888362 2255 DIRECT BILL EACH OCCURRENCE LIMIT DAMAGE TO PREMISES RENTED TO YOU LIMIT MEDICAL EXPENSE LIMIT PERSONAL AND ADVERTISING INJURY LIMIT GENERAL AGGREGATE LIMIT 1000 00 300 00 10 00 1000 00 TOTAL ESTIMATED POLICY PREMIUM 453.00 CG21760115 CG7001A1012 CG70031013 CG71661013 CG7174.31013 CG71910814 CG75551013 CG76440209 IL00210502 IL02590907 IL70280515 IL7131A0401 IL80210488 IL8383.2A0115 IL8384A0108 IL85760909 ILB7450317
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MNEMC INSURANCE EMC PROPERTY CASUALTY COMPANY POLICY NUMBER 4D9 43 19 19 PAC 211 LLC EFF DATE 010318 EXP DATE 010319 GENERATL L Cc ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION ADDITIONAL INFORMATION PREMIUM CG0001 04 13 COMMERCIAL GEN LIABILITY COV FORM CG2106 05 14 EXCL ACCESS DISCL OF CONFID PERSONAL CG2147 12 07 EXCL EMPLOYMENT RELATED PRACTICES CG2170 01 15 CAP LOSSES FROM CERT ACTS TERRORISM CG2176 01 15 EXCL PUNITIVE DMGS ACTS OF TERRORISM CG7001A 10 12 GENERAL LIABILITY SCHEDULE CG7003 10 13 GL QUICK REFERENCE OCCURRENCE CG7166 10 13 AI DESIG PERS ORG PRIM NONCONTRIBTRY NAME OF ADDITIONAL INSURED PERSON S OR ORGANIZATIONS ANY OR ALL PERSONS OR ORG. SUBJECT TO A WRITTEN CONTRACT REQUIRING SUCH AN ADDITIONAL INSURED AGREEMENT CG7174.3 10 13 AUTOMATIC AI CONST CONT INCL COMP OP CG7191 08 14 GENERAL LIAB ESSENTIAL EXTENSION CG7555 10 13 BLKT WAIV SUBRO WRITTEN CONT AGREE CG7644 02 09 CONTRACTORS OCCURRENCE DEFINITION IL0021 05 02 NUCLEAR ENERGY LIAB EXCL BROAD FORM IL0259 09 07 NE CHANGES CANCELLATION NONRENEWAL IL7028 05 15 ASBESTOS EXCLUSION IL7131A 04 01 COMML POLICY ENDORSEMENT SCHEDULE IL8021 04 88 ASBESTOS NOTICE IL8383.2A 01 15 DISCL PURSUANT TERRSM RISK INS. ACT 4 IL8384A 01 08 TERRORISM NOTICE IL8576 09 09 MEDICARE IMPT NOTICE TO POLICYHOLDER IL8745 03 17 IMPORTANT NOTICE TO POLICYHOLDERS DATE OF ISSUE 112917 FORM IL7131A ED. 04 01 003 MB 4D94319 1901 EDITION CG7174.3 CG7191 CG7555 CG7644 IL0021 IL0259 IL7028 IL7131A IL8021 IL8383.2A IL8384A IL8576 IL8745 10 13 08 14 10 13 02 09 05 02 09 07 05 15 04 01 04 88 01 15 01 08 09 09 03 17 EXCL ACCESS DISCL OF CONFID PERSONAL EXCL EMPLOYMENT RELATED PRACTICES CAP LOSSES FROM CERT ACTS TERRORISM EXCL PUNITIVE DMGS ACTS OF TERRORISM GENERAL LIABILITY SCHEDULE GL QUICK REFERENCE OCCURRENCE AI DESIG PERS ORG PRIM NONCONTRIBTRY NAME OF ADDITIONAL INSURED PERSON S OR ORGANIZATIONS ANY OR ALL PERSONS OR ORG. SUBJECT TO A WRITTEN CONTRACT REQUIRING SUCH AN ADDITIONAL INSURED AGREEMENT AUTOMATIC AI CONST CONT INCL COMP OP GENERAL LIAB ESSENTIAL EXTENSION BLKT WAIV SUBRO WRITTEN CONT AGREE CONTRACTORS OCCURRENCE DEFINITION NUCLEAR ENERGY LIAB EXCL BROAD FORM NE CHANGES CANCELLATION NONRENEWAL ASBESTOS EXCLUSION COMML POLICY ENDORSEMENT SCHEDULE ASBESTOS NOTICE DISCL PURSUANT TERRSM RISK INS. ACT TERRORISM NOTICE MEDICARE IMPT NOTICE TO POLICYHOLDER IMPORTANT NOTICE TO POLICYHOLDERS
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MNEMC INSURANCE EMC PROPERTY CASUALTY COMPANY POLICY NUMBER 4D9 43 19 19 PAC 211 LLC EFF DATE 010318 EXP DATE 010319 TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent DATE OF ISSUE 112917 FORM IL8384A 01 08 003 MB 4D94319 1901 PAC 211 LLC EFF DATE 010318 EXP DATE 0103 TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent TERRORTISM NOTTICE This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act as amended. Attached you will find a disclosure which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE For additional information please contact your agent
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NE INSURANCE EMC PROPERTY CASUALTY COMPANY POLICY NUMBER 4D9 43 19 19 PAC 211 LLC EFF DATE 010318 EXP DATE 010319 THIS DISCLOSURE IS ATTACHED TO YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS DISLOSURE DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. SCHEDUTLE Terrorism Premium Certified Acts 4.00 A. Disclosure Of Premium In accordance with the federal Terrorism Risk Insurance Act we are required to provide you with a notice disclosing the portion of your premium if any attributable to coverage for terrorism acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this disclosure or in the policy Declarations. B. Disclosure Of Federal Participation In Payment Of Terrorism Losses The United States Government Department of the Treasury will pay a share of terrorism losses insured under the federal program. For losses occurring in 2015 the federal share equals 85 of that portion of the amount of such insured losses that exceeds the applicable insurer retention. Beginning on January 1 2016 the federal share will decrease by one percentage point per calendar year until equal to 80 of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. C. Cap On Insurer Participation In Payment Of Terrorism Losses If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. The following statement is required to be part of the disclosure notice in MISSOURI The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your policy carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Includes copyrighted material of ISO Properties Inc. with its permission DATE OF ISSUE 112917 FORM IL8383.2A01 15 003 MB 4D94319 1901 THIS DISCLOSURE IS ATTACHED TO YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS DISLOSURE DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. SCHEDUTLE Terrorism Premium Certified Acts 4.00 A. Disclosure Of Premium In accordance with the federal Terrorism Risk Insurance Act we are required to provide you with a notice disclosing the portion of your premium if any attributable to coverage for terrorism acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this disclosure or in the policy Declarations. B. Disclosure Of Federal Participation In Payment Of Terrorism Losses The United States Government Department of the Treasury will pay a share of terrorism losses insured under the federal program. For losses occurring in 2015 the federal share equals 85 of that portion of the amount of such insured losses that exceeds the applicable insur retention. Beginning on January 1 2016 the federal share will decrease by one percentage point per calendar year until equal to 80 that portion of the amount of such insured losses that exceeds the applicable insurer retention. However if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year the Treasury sha not make any payment for any portion of the amount of such losses that exceeds 100 billion. C. Cap On Insurer Participation In Payment Of Terrorism Losses If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calend year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasur The following statement is required to be part of the disclosure notice in MISSOURI The premium above is for certain losses resulting from certified acts terrorism as covered pursuant to coverage provisions limitations and exclusions in this policy. You should read the definition in your poli carefully but generally speaking certified acts of terrorism are acts that exceed 5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Includes copyrighted material of ISO Properties Inc. with its permission SCHEDUTLE i m Certified Acts 4.00 th the federal Terrorism Risk Insurance Act we are side you with a notice disclosing the portion of any attributable to coverage for terrorism acts the Terrorism Risk Insurance Act. The portion of ributable to such coverage is shown in the Schedule ire or in the policy Declarations. deral Participation In Payment Of Terrorism Losses s Government Department of the Treasury will pay In Payment Of Terrorism Losses
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MNEMC INSURANCE EMC PROPERTY CASUALTY COMPANY POLICY NO 4D9 43 19 PAC 211 LLC EFF DATE 010318 EXP DATE 010319 GENERAL LIABILITY SCHEDUTLE PRODUCTS COMPL OPS ALL OTHER CODE NO.EXPOSURE CLASSIFICATION RATE ADVANCE PREM RATE ADVANCE PREM LOCATION 001 47051 REAL ESTATE DEVELOPMENT PROPERTY 4 PREMIUM BASIS EACH ACRE EXPOSURE 4.68 SUBLINE 334 87509 PRIMARY ADDITIONAL INSURED CG7166 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 ADDITIONAL INTEREST 1 334 ANY OR ALL PERSONS OR ORG. 87780 CONSTRUCTION CONTRACTS INCLUDING COMPLETED OPERATIONS BLANKET ADDL INSUREDS PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87786 BLANKET WAIVER OF SUBROGATION SEE FORM CG7555 PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87793 INCREASE MEDICAL PAYMENTS PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 87830 CONTRACTORS OCCURRENCE DEFINITION PREMIUM BASIS FLAT CHARG EXPOSURE 1 SUBLINE 334 DATE OF ISSUE 112917 BPP CONTINUED FORM CG7001A ED.10 12 BPP 102017 003 MB 4D94319 1901 1P nan nan nan nan 0.68 ONAL INSURED S 334 EREST 1 334. OF SUBROGATION 5 AL PAYMENTS
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MNEMC INSURANCE PAGE 2 EMC PROPERTY CASUALTY COMPANY POLICY NO 4D9 43 19 PAC 211 LLC EFF DATE 010318 EXP DATE 010319 19 SCHEDUTLE POLICY LEVEL COVERAGES PREMIUM FOR CERTIFIED ACTS OF TERRORISM 4.00 TOTAL ESTIMATED POLICY PREMIUM 453.00 1 OTHER THAN NOT FOR PROFIT 2 NOT FOR PROFIT 3 INCLUDING PRODUCTS AND OR COMPLETED OPERATIONS UNLESS OTHERWISE EXCLUDED 4 PRODUCTS COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT 5 A 250 PD DEDUCTIBLE PER CLAIM APPLIES TO CUSTOMERS AUTOS UNLESS OTHERWISE DESIGNATED BY THIS CLASSIFICATION CODE 6 FOR SPRAY PAINTING OPERATIONS A PD DEDUCTIBLE OF 250 PER CLAIM APPLIES UNLESS A HIGHER DEDUCTIBLE IS OTHERWISE DESIGNATED FOR THIS CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED RATED LOCATIONS LOC 001 21201 PACIFIC ST ELKHORN NE 68022 2026 DATE OF ISSUE 112917 BPP FORM CG7001A ED.10 12 BPP 102017 003 MB 4D94319 1901 GENERAL L CLASSIFICATION CODE LOCATION OF ALL PREMISES OWNED RENTED OR OCCUPIED RATED LOCATIONS LOC 001 21201 PACIFIC ST ELKHORN NE 68022 2026
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MNEMC INSURANCE EMC PROPERTY CASUALTY COMPANY POLICY NO 4D9 43 19 PAC 211 LLC TRANSACTION RENEWAL01 PRIOR POL 4D9 43 19 TRANSACTION INFORMATION POLICY TERM 01032018 TO 01032019 TRANS DATE 01032018 ACCOUNT NAME PAC 211 LLC CO BR AGENT H B8210 ACCOUNT MAILING STATE NE PROGRAM FINANCING N BILLING METHOD D CDB AUDIT FREQUENCY N PROFIT SHARE Y SIC 6552 Subdividers and Developers Nec NAICS 237210 Land Subdivision ACCOUNT ORIGINAL EFF DATE 07032013 TYPE OF POLICY MONOLINE 10 ACCOUNT FEIN TRANS PREMIUM 453.00 POLICY ID BA COMMISSION 15.0 PREMIUM 453.00 ACCOUNT DOMICILE STATE NE DATE OF ISSUE 112917 BPP STAT GL BPP 102017 003 MB 4D94319 1901 AC 211 LLC TRANSACTION INFORMATIOI PRIOR POL 4D9 43 TRANSACTION INFORMATION POLICY TERM 01032018 TO 01032019 ACCOUNT NAME PAC 211 LLC ACCOUNT MAILING STATE NE FINANCING N AUDIT FREQUENCY N SIC 6552 Subdividers and Developers Nec NAICS 237210 Land Subdivision ACCOUNT ORIGINAL EFF DATE 07032013 ACCOUNT FEIN POLICY ID BA COMMISSION 15.0 TRANS DATE 0103201 CO BR AGENT H B8210 PROGRAM BILLING METHOD D CD PROFIT SHARE Y TYPE OF POLICY MONOL TRANS PREMIUM PREMIUM 19 8 B INE 1 453.00 453.00 1IUM
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COMMERCIAL GENERAL LIABILITY CG 00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under Section I Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 2 The bodily injury or property damage occurs during the policy period and Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. c. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. d. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim 1 Reports all or any part of the bodily injury or property damage to us or any other insurer Receives a written or verbal demand or claim for damages because of the bodily injury or property damage or 3 Becomes aware by any other means that bodily injury or property damage has occurred or has begun to occur. e. Damages because of bodily injury include damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. 3 2 CG 00010413 Insurance Services Office Inc. 2012 Page 1 0f 16
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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
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f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a At or from any premises site or location which is or was at any time owned or occupied by or rented or loaned to any insured. However this subparagraph does not apply to i Bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or originating from equipment that is used to heat cool or dehumidify the building or equipment that is used to heat water for personal use by the building s occupants or their guests ii Bodily injury or property damage for which you may be held liable if you are a contractor and the owner or lessee of such premises site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not and never was owned or occupied by or rented or loaned to any insured other than that additional insured or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire b At or from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste c Which are or were at any time transported handled stored treated disposed of or processed as waste by orfor i Any insured or ii Any person or organization for whom you may be legally responsible or d At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the pollutants are brought on or to the premises site or location in connection with such operations by such insured contractor or subcontractor. However this subparagraph does not apply to i Bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or released as part of the operations being performed by such insured contractor or subcontractor ii Bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contractor or subcontractor or Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations if the operations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. iii CG 00010413 Insurance Services Office Inc. 2012 Page 3 of 16
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2 Any loss cost or expense arising out of any a Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or b Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a governmental authority. g. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed wunder any insured contract for the ownership maintenance or use of aircraft or watercraft or 4 5 Bodily injury or property damage arising out of a The operaton of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definiton of mobile equipment. h. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. i. War Bodily injury or property damage however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. j. Damage To Property Property damage to 1 Property you own rent or occupy including any costs or expenses incurred by you or any other person organization or entity for repair replacement enhancement restoration or maintenance of such property for any reason including prevention of injury to a person or damage to another s property Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you b 3 2 Page 4 of 16 Insurance Services Office Inc. 2012 CG 00010413
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4 Personal property in the care custody or control of the insured 5 That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the property damage arises out of those operations or That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section Il Limits Of Insurance. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard. 6. Damage To Your Product Property damage to your product arising out of it or any part of it.. Damage To Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor.. Damage To Impaired Property Or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 A defect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use.. Recall Of Products Work Or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it.. Personal And Advertising Injury Bodily injury arising out of personal and advertising injury.. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. However this exclusion does not apply to liability for damages because of bodily injury. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment.. Recording And Distribution Of Material Or Information In Violation Of Law Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or CG 00010413 Insurance Services Office Inc. 2012 Page 5 of 16
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4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section Il Limits Of Insurance. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of personal and advertising injury to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for personal and advertising injury to which this insurance does not apply. We may at our discretion investigate any offense and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section lll Limits Of Insurance and 2 Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. b. This insurance applies to personal and advertising injury caused by an offense arising out of your business but only if the offense was committed in the coverage territory during the policy period. 2. Exclusions This insurance does not apply to Knowing Violation Of Rights Of Another Personal and advertising injury caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising injury.. Material Published With Knowledge Of Falsity Personal and advertising injury arising out of oral or written publication in any manner of material if done by or at the direction of the insured with knowledge of its falsity.. Material Published Prior To Policy Period Personal and advertising injury arising out of oral or written publication in any manner of material whose first publication took place before the beginning of the policy period.. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured.. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement.. Breach Of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s advertising idea in your advertisement.. Quality Or Performance Of Goods Failure To Conform To Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your advertisement.. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Page 6 of 16 Insurance Services Office Inc. 2012 CG 00010413
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i. Infringement Of Copyright Patent Trademark Or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trademark trade secret or other intellectual property rights. Under this exclusion such other intellectual property rights do not include the use of another s advertising idea in your advertisement. However this exclusion does not apply to infringement in your advertisement of copyright trade dress or slogan. j Insureds In Media And Internet Type Businesses Personal and advertising injury committed by an insured whose business is 1 Advertising broadcasting publishing or telecasting 2 Designing or determining content of web sites for others or 3 An Internet search access content or service provider. However this exclusion does not apply to Paragraphs 14.a. b. and c. of personal and advertising injury under the Definitions section. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the insured hosts owns or over which the insured exercises control. I. Unauthorized Use Of Another s Name Or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain name or metatag or any other similar tactics to mislead another s potential customers. m. Pollution Personal and advertising injury arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants at any time. n. Pollution related Any loss cost or expense arising out of any 1 Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. o. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. p. Recording And Distribution Of Material Or Information In Violation Of Law Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or 4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. 3 CG 00010413 Insurance Services Office Inc. 2012 Page 7 of 16
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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
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g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance.. If we defend an insured against a suit and an indemnitee of the insured is also named as a party to the suit we will defend that indemnitee if all of the following conditions are met a. The suit against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an insured contract b. This insurance applies to such liability assumed by the insured. The obligation to defend or the cost of the defense of that indemnitee has also been assumed by the insured in the same insured contract o. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the insured and the indemnitee and f. The indemnitee 1 Agrees in writing to a Cooperate with us in the investigation settlement or defense of the suit Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit b c Notify any other insurer whose coverage is available to the indemnitee and d Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee and 2 Provides us with written authorization to a Obtain records and other information related to the suit and b Conduct and control the defense of the indemnitee in such suit. So long as the above conditions are met attorneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.2 of Section Coverage A Bodily Injury And Property Damage Liability such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the limits of insurance. Our obligation to defend an insured s indemnitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above or the terms of the agreement described in Paragraph f. above are no longer met. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. c. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. CG 00010413 Insurance Services Office Inc. 2012 Page 9 of 16
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2. Each of the following is also an insured a. Your volunteer workers only while performing duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a partnership joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees or volunteer workers are insureds for 1 Bodily injury or personal and advertising injury a To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company to a coemployee while in the course of his or her employment or performing duties related to the conduct of your business or to your other volunteer workers while performing duties related to the conduct of your business To the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of Paragraph 1a above For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph 1a or b above or Arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b Rented to in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees volunteer workers any partner or member if you are a partnership or joint venture or any member if you are a limited liability company. b. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. b c d c. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that property and 2 Until your legal representative has been appointed. d. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION Il LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. Page 10 of 16 Insurance Services Office Inc. 2012 CG 00010413
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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
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4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance 1 This insurance is excess over a Any of the other insurance whether primary excess contingent or on any other basis i That is Fire Extended Coverage Builder s Risk Installation Risk or similar coverage for your work ii That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner iii That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner or iv If the loss arises out of the maintenance or use of aircraft autos or watercraft to the extent not subject to Exclusion g. of Section I Coverage A Bodily Injury And Property Damage Liability. b Any other primary insurance available to you covering liability for damages arising out of the premises or operations or the products and completed operations for which you have been added as an additional insured. 2 When this insurance is excess we will have no duty under Coverages A or B to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be entitted to the insured s rights against all those other insurers. 3 When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of a The total amount that all such other insurance would pay for the loss in the absence of this insurance and b The total of all deductible and self insured amounts under all that other insurance. 4 We will share the remaining loss if any with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. 6. Representations By accepting this policy you agree a. The statements in the Declarations are accurate and complete Page 12 of 16 Insurance Services Office Inc. 2012 CG 00010413
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b. Those statements are based upon representations you made to us and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this Coverage Part to the first Named Insured this insurance applies a. As if each Named Insured were the only Named Insured and b. Separately to each insured against whom claim is made or suit is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part those rights are transferred to us. The insured must do nothing after loss to impair them. At our request the insured will bring suit or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. SECTION V DEFINITIONS 1. Advertisement means a notice that is broadcast or published to the general public or specific market segments about your goods products or services for the purpose of attracting customers or supporters. For the purposes of this definition a. Notices that are published include material placed on the Internet or on similar electronic means of communication and b. Regarding web sites only that part of a web site that is about your goods products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. Auto means a. A land motor vehicle trailer or semitrailer designed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However auto does not include mobile equipment.. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time.. Coverage territory means a. The United States of America including its territories and possessions Puerto Rico and Canada b. International waters or airspace but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above or c. All other parts of the world if the injury or damage arises out of 1 Goods or products made or sold by you in the territory described in Paragraph a. above The activities of a person whose home is in the territory described in Paragraph a. above but is away for a short time on your business or Personal and advertising injury offenses that take place through the Internet or similar electronic means of communication provided the insured s responsibility to pay damages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to.. Employee includes a leased worker. Employee does not include a temporary worker.. Executive officer means a person holding any of the officer positions created by your charter constitution bylaws or any other similar governing document.. Hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be.. lmpaired property means tangible property other than your product or your work that can not be used or is less useful because a. It incorporates your product or your work that is known or thought to be defective deficient inadequate or dangerous or b. You have failed to fulfill the terms of a contract or agreement if such property can be restored to use by the repair replacement adjustment or removal of your product or your work or your fulfilling the terms of the contract or agreement. 2 3 CG 00010413 Insurance Services Office Inc. 2012 Page 13 of 16
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9. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract b. A sidetrack agreement c. Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality e. An elevator maintenance agreement f. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or 3 Under which the insured if an architect engineer or surveyor assumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. 2 10.Leased worker means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker. 11.Loading or unloading means the handling of property a. After it is moved from the place where it is accepted for movement into or onto an aircraft watercraft or auto b. While it is in or on an aircraft watercraft or auto or c. While it is being moved from an aircraft watercraft or auto to the place where it is finally delivered but loading or unloading does not include the movement of property by means of a mechanical device other than a hand truck that is not attached to the aircraft watercraft or auto. 12.Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment a. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads b. Vehicles maintained for use solely on or next to premises you own or rent c. Vehicles that travel on crawler treads d. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers e. Vehicles not described in Paragraph a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types 1 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers f. Vehicles not described in Paragraph a. b. c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. Page 14 of 16 Insurance Services Office Inc. 2012 CG 00010413
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However self propelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos 1 Equipment designed primarily for a Snow removal b Road maintenance but not construction or resurfacing or c Street cleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and 3 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered autos. 13.Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. 14.Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution c. The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies committed by or on behalf of its owner landlord or lessor d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services e. Oral or written publication in any manner of material that violates a person s right of privacy f. The use of another s advertising idea in your advertisement or g. Infringing upon another s copyright trade dress or slogan in your advertisement. 15.Pollutants mean any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals and waste. Waste includes materials to be recycled reconditioned or reclaimed. 16.Products completed operations hazard a. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 Products that are still in your physical possession or 2 Work that has not yet been completed or abandoned. However your work will be deemed completed at the earliest of the following times a When all of the work called for in your contract has been completed. b When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. c When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. b. Does not include bodily injury or property damage arising out of 1 The transportation of property unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you and that condition was created by the loading or unloading of that vehicle by any insured 2 The existence of tools uninstalled equipment or abandoned or unused materials or 3 Products or operations for which the classification listed in the Declarations or in a policy Schedule states that products completed operations are subject to the General Aggregate Limit. 17.Property damage means a. Physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance electronic data is not tangible property. CG 00010413 Insurance Services Office Inc. 2012 Page 15 of 16
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As used in this definition electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMSs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. 18.Suit means a civil proceeding in which damages because of bodily injury property damage or personal and advertising injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 19.Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. 20.Volunteer worker means a person who is not your employee and who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other compensation by you or anyone else for their work performed for you. 21.Your product a. Means 1 Any goods or products other than real property manufactured sold handled distributed or disposed of by a You b Others trading under your name or c A person or organizaton whose business or assets you have acquired and 2 Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 22.Your work a. Means 1 Work or operations performed by you or on your behalf and 2 Materials parts or equipment furnished in connection with such work or operations. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your work and 2 The providing of or failure to provide warnings or instructions. Page 16 of 16 Insurance Services Office Inc. 2012 CG 00010413
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COMMERCIAL GENERAL LIABILITY CG 2106 0514 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA RELATED LIABILITY WITH LIMITED BODILY INJURY EXCEPTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.p. of Section Coverage A As used in this exclusion electronic data Bodily Injury And Property Damage Liability is replaced by the following 2. Exclusions This insurance does not apply to p. Access Or Disclosure Of Confidential Or Personal Information And Data related Liability Damages arising out of 1 Any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information or The loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of that which is described in Paragraph 1 or 2 above. However unless Paragraph 1 above applies this exclusion does not apply to damages because of bodily injury. means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. B. The following is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or organization s confidential or personal information As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. B. The following is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or organization s confidential or personal information. CG 21060514 Insurance Services Office Inc. 2013 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21471207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYMENT RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability This insurance does not apply to Bodily injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demo tion evaluation reassignment discipline defamation harassment humiliation dis crimination or malicious prosecution di rected at that person or 2 The spouse child parent brother or sister of that person as a consequence of bodily injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after em ployment of that person Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. 2 B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Per sonal And Advertising Injury Liability This insurance does not apply to Personal and advertising injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demo tion evaluation reassignment discipline defamation harassment humiliation dis crimination or malicious prosecution di rected at that person or 2 The spouse child parent brother or sister of that person as a consequence of personal and advertising injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after em ployment of that person Whether the insured may be liable as an em ployer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. 2 CG 21471207 ISO Properties Inc. 2006 Page 1 of 1 a
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COMMERCIAL GENERAL LIABILITY CG 21700115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following 1. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. B. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. B. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. CG 21700115 Insurance Services Office Inc. 2015 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21760115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF PUNITIVE DAMAGES RELATED TO A CERTIFIED ACT OF TERRORISM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. The following exclusion is added This insurance does not apply to TERRORISM PUNITIVE DAMAGES Damages arising directly or indirectly out of a certified act of terrorism that are awarded as punitive damages. B. The following definition is added Certified act of terrorism means an act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following 1. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion.. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. C. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. CG 21760115 Insurance Services Office Inc. 2015 Page 1 of 1
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