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PW15-014 - Amendment - #2 - R.F. Duncan and Associates, Inc. - S. 224th St. Improvements - 05/04/2016
pig ij�/ i Records 0 ENT W n 5 Fk I N C T p M r ` Document CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Ir Vendor Name: R. F. Duncan and Associates, Inc. I '` Vendor Number: JD Edwards Number Contract Number: ° This is assigned by City Clerk's Office Project Name: S. 224th Street Improvements Description: ❑ Interlocal Agreement ❑ Change Order 0 Amendment ❑ Contract El Other: Contract Effective Date: 5/4/15 Termination Date: 12/30/16 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Ingrid Willms-Dixon Department: Engineering Contract Amount: $0.00 Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Change the contract name from The Granges Company^to R. F. Duncan and Associates, Inc. As of 08/27/14 i �i KENT W A S H I N O T O N AMENDMENT NO. 2 NAME OF CONSULTANT OR VENDOR: R. F. Duncan and Associates, Inc. (The Granger Company a subsiduary of R. F. Duncan and Associates) CONTRACT NAME & PROJECT NUMBER: S. 224th Street Improvements ORIGINAL AGREEMENT DATE: January 15, 2015 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: The scope of work remains the same, however the name of the Contractor performing the services under the Agreement shall be revised from The Granger Company to R. F. Duncan and Associates, Inc. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are modified as follows: Original Contract Sum, $5,600.00 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $5,600.00 including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $5,600.00 AMENDMENT - 1 OF 2 Original Time for Completion 12/31/15 (insert date) Revised Time for Completion under 12/31/16 prior Amendments (insert date) Ac1d'1 Days Required for this 0 calendar days Amendment Revised Time for Completion 12/31/16 (insert date) The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of alll claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. CONSULTANT/VENDOR: CITY OF KENT: U f�� By: B v': (sitnature) V V(signature) Print: Name: 'I t, Print Name: Timothy J. LaPorte, R.E. Its 1A 1-4. Its Public Works Director (title) DATE: DATE: /2--O/L . ....... APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department (In this field,you may enter the electrcnic filevath where the contract has been saved) AMENDMENT - 2 OF 2 I t CERTIFICATE OF LIABILITY INSURANCE DATE(MMrDOryrrV) ACORO 03/2512016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONT PRODUCER NAMEACT Judy Land Duncan &Associates Insurance Brokers IAICPHONE - 360-352-7688 AIC No: 360-943.6304 P.O. Box 1458-2111 Harrison Ave NW ADDRESS: Judy@duncanins.com Olympia,WA 98502 INSURER(S)AFFORDING COVERAGE NAIC0 INSURER A: Ohio Security Insurance Company 531311 INSURED INSURER 8: R. F. Duncan&Associates, Inc INSURERC: P 0 Box 12300 INSURERD: Olympia,WA 98508 INSURERE: INSURER F COVERAGES CERTIFICATE NUMBER: 00000000-0 REVISION NUMBER: 1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY``PAID CLAIMS. INSR TYPE OF INSURANCE A POLICY NUMBER MMMDNYVFY f MMIDDlYYY EXIP LTR Y LIMITS A X COMMERCIAL GENERAL LIABILITY Y N BLS 17 66696377 05/0812016 j 05108/2017 EACH OCCURRENCE S 11000,000 CLAIMS-MADE 1-X-1 OCCUR PREMISES Ea occurrence $ 1,000,000 MED EXP(Any one person) $ __ _ 15,000__ - -- PERSONAL&AOV INJURY $ 1,000,000 I GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY LJ JECTPRO-- F]LOC PRODUCTS-COMP/OPAGG $ 2,000,000_ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident S UMBRELLA UA OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE S DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STAT TE I ER ANY PROPRIETORIPARTNERIEXECUTIVE ❑ NIA E.L.EACH ACCIDENT S OFFiCERWEMBER EXCLUDED? (Mandatory in NH) _E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Additional Remarks Schedule,may be attached if more space Is required) RE:All projects under contract between insured and certificate holder City of Kent is named as an additioinal insured in regard to the General Liability coverages above per form CG 88 10 04 13 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Kent ACCORDANCE WITH THE POLICY PROVISIONS. 400 West Gowe Kent,WA 98032 AUTHORIZED REPRESENTATIVE C/' JAL 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Printed by JAL on March 25,2016 at 10:25AM CERTIFICATE OF LIABILITY INSURANCE Nationwide On Your Side ti DATE: 04/07/2016 PRODUCER: INSURED: ACCEPTANCE INSURANCE AGENCY OF TENNESSEE,INC. RF DUNCAN AND ASSOCIATES INC 1780 TOWN AND COUNTRY DR SUITE 107 PO BOX 12300 NORCO,CA 92860 OLYMPIA, WA 98508 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the term and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COMPANY A:NATIONWIDE42889 COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MMIDDIYY) DATE(MMIDDIYY) AUTOMOBILE LIABILITY COMBINED SINGLE $ v SCHEDULEDAUTOS LIMIT(ea.accident) 1,000,000 ❑ HIRED AUTOS 1910777 10/03/2015 10/03/2016 BODILY INJURY(Per $ ❑ NON-OWNED AUTOS person)BODILY INJURY(Per $ ❑ accident) PROPERTY DAMAGE $ (Per accident) DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES!SPECIAL ITEMS 2011 DODGE RAM 1500 QUAD 1D7RV1GT0BS545210 DUNCAN , RICHARD---DUNCAN ,ZACHARY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED R S NTATIVE AABSCVE3510114 ILIA Administrators Insurance Services ASPEN APPRAISAL AND VALUATION PROFESSIONAL LIABILITY INSURANCE POLICY DECLARATIONS ASI"EN All E'RICAN INSURANCE COWANY (A stock insurance company herein called the "Company") 175 Capitol Blvd. Suite 100 Rocky Hill. (.,,r 06067 Date Issued Policy Number Previous Policy Number 08/03/2015 AA1002412-01 THIS IS A CLAIMS MADE AND REPORTED POLICY, COVERAGE IS LIMITED TO LIABILITY FOR ONLY THOSE CLAIMS THAT ARE FIRST MADE AGAINST THE INSURED DURING THE POLICY PERIOD AND THEN REPORT- ED TO THE COMPANY IN WRITING NO LATER THAN SIXTY(60) DAYS AFTER EXPIRATION OR TERMINATION OF THIS POLICY, OR DURING THE EXTENDED REPORTING PERIOD, IF APPLICABLE, FOR A WRONGFUL ACT COMMITTED ON OR AFTER THE RETROACTIVE DATE AND BEFORE THE END OF THE POLICY PERIOD, PLEASE READ THE POLICY CAREFULLY. Item 1. Customer ID: 149215 Narned Insured: DUNCAN, RF AND ASSOCIATES INC. Richard F. Duncan 909 West Bay Drive NW Olympia, WA 98502 2. Policy Period- From: 07/21/2015 To: 07/21/2016 12:01 A.M. StandardTirne at the address stated in I above. 3. Deductible: $1,000 Each Claim 4. Retroactive Date: 07/21/2014 5. Inception Date: 07/21/2015 6. Limits of Liability: A. $1,000,000 Each Claim B. $2,000,000 Aggregate 7. Mail all notices, including notice of Claim, to: LIA Administrators& Insurance Services 1600 Anacapa Street Santa Barbara, California 93 101 (800) 334-0652; Fax: (805) 962-0652 8. Annual Premium- $1,164.00 9. Forms attached at issue: LIA002 (12/14) ASPCO0020110 LIAWA (11/14) LIA012 (12/14) LIA013 (10/14) This Declarations Page,together with tire,completedand signed Policy Application including all attachments and exhibits thereto,and the Policy shall constitute the contract between the Named Insured and t 08/03/2015 13Y Date LIA-00 I (12/14) Aspen American Insurance Company Underwritten by Victoria Select Insurance Company 22901 Millcreek Blvd, Cleveland, OH 44122-5728 1-800-888-8424 Nationwide' On Your Side- POLICY NUMBER POLICY PERIOD: 10/03/2015 TO: 10/03/2016 1910777 NAME OF ADDITIONAL INSURED NAMED INSURED AND MAILING ADDRESS CITY OF KENT, WASHINGTON RIF DUNCAN AND ASSOCIATES INC 400 W GOWE PO BOX 12300 KENT WA 98032-0 OLYMPIA, WA 98508 This endorsement char es the policy effective on the inception date of poliSy unless another date is indicated below: 03/23/2016 tJNJE t6 AGENT OF RECORD ACCEPTANCE INSURANCE AGENCY OF TENNESSEE, INC. 12:01 AM Standard time at the Named Insured's Mailing Address (Authorized Representative) ADDITIONAL INSURED ENDORSEMENT The person or organization named below is a person insured with respect to such liability coverage as is afforded by the policy but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree with you that insurance provided by this agreement will be primary for any power unit specifically described on the declarations page. The adcIftional insured is not required to pay for any premiums stated in the policy or earned from the policy. Any return premium, if applicable,shall be paid to you. You are authorized to act for the additional insured in all matters pertaining to this insurance. We will mail the additional insured notice of any cancellation of this policy. If the cancellation is by us,we well give appropriate notice to the additional insured. Name of Person or organization: CITY OF KENT, WASHINGTON 400 W GOWE KENT WA 98032-0 This premium associated with this endorsement will be retained by us regardless of any early termination of this endorsement or the policy. \ SIGNATURE OF AUTHORIZED REPRESEN'TATIV�X "ate:03/23/2016 TIME:1:15PM AA89CVC5350610 i t APPRAISAL AND VALUATION PROFESSIONAL LIABILITY INSURANCE POLICY ASPEN Named Insured:DUNCAN,RF AND ASSOCIATES INC. Policy Number: AAI002412-01 Richard F.Duncan Effective Date: 01/01/201 G Customer ID: 148215/GC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NAME CHANGE ENDORSEMENT In consideration of the premium charged,it is agreed that the coverage provided by this Policy is amended as follows: Item 1 of the Declarations Page is amended to read as follows: Customer ID: 148215 Named Insured: DUNCAN,RF AND ASSOCIATES INC. Granger Company Richard F.Duncan 909 Nest Bay Drive NW Olympia,WA 98502 All other terms,conditions,and exclusions of this Policy remain unchanged. Aspen American Insurance Company Page 1 of 1 LIA130(10/14) 4/1/201G Liberty Mutual. INSURANCE Policyholder Information Named Insured &Mailing Address Agent Mailing Address& Phoine No. R F DUNCAN & ASSOCIATES, INC (360) 352-7588 PO 13OX 12300 DUNCAN & ASSOCIATES INS BRKRS OLYMPIA, WA 98508 PO 13OX 1458 OLYMPIA, WA 98507-1458 Dear Policyholetei We know you work hard to build your business. We work together with your agent, DUNCAN & ASSOCIATES INS BRICKS (360) 352-7588 to help protect the things you care about, Thank YOU .for selecting us. m '. Enclosed are Your insurance documents consisting of Im General Liability To find your specific coverages, limits of liability, and premium, please refer to your Declarations page(s). If you have any questions or changes that may affiect, your insurance needs, please contact your Agent at (360) 352-7588 Verify that all information is correct If you have any changes, please contact your Agent at (360) 352-7588 Reminders In case of a claim, call your Agent or 1-800-362-0000 You Need To Know CONTINUED ON NEXT PAGE To report a claim, call your Agent or 1-800-362-0000 DS 70 20 01 08 You Need To Know - continued . NOTICE(S) TO POLICYHOLDERS) The Important Notice(s) to Policyholder(s) provide a general explanation of changes in coverage to your policy. The Important Notice(s) to Policyholder(s) is not a part of your insurance policy and it does not alter policy provisions or conditions. Only the provisions of your policy determine the scope of your insurance protection. It is important that you read your policy carefully to determine your rights, duties and what is and is not covered. FORM NUMBER TITLE NP 72 42 07 13 Certified Acts of Terrorism Notice NP 74 44 09 06 U.S. Treasury Department's Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders NP 74 50 01 07 Important Audit Information NP 89 71 09 10 Important Policyholder Information Concerning Billing Practices Liberty Northwest NP 93 53 01 14 Important Notice Regarding the Expiration of the Terrorism Risk Insurance Act and the Reduction in Coverage for Terrorism Losses . This policy will be direct billed. You may choose to combine any number of policies on one bill with your billing account. Please contact your agent for more information. N 05/08/15 R F DUNCAN & ASSOCIATES, INC BLS (16) 56 69 63 77 From 05/08/2015 To 05/08/2016 PO BOX 12300 OLYMPIA, WA 98508 (360) 352-7588 DUNCAN & ASSOCIATES INS BRKRS PO BOX 1458 OLYMPIA, WA 98507-1458 TERRORISM INSURANCE PREMIUM NOTICE s This notice contains important information about the Terrorism Risk Insurance Act and its effect on your policy. Please read it carefully. THE TERRORISM RISK INSURANCE ACT The Terrorism Risk Insurance Act, including all amendments ("TRIA" or the "Act"), establishes a program to spread the risk of catastrophic losses from certain acts of terrorism between insurers and the federal government. If an individual insurer's losses from a "certified act of terrorism" exceed a specified deduct- ible amount, the government will reimburse the insurer for 85% of losses paid in excess of the deductible, but only if aggregate industry losses from such an act exceed $100 million. An insurer that has met its insurer deductible is not liable for any portion of losses in excess of $100 billion per year. Similarly, the federal government is not liable for any losses covered by the Act that exceed this amount. If aggregate insured losses exceed $100 billion, losses up to that amount may be pro-rated, as determined by the Secretary of the Treasury. MANDATORY OFFER OF COVERAGE FOR "CERTIFIED ACTS OF TERRORISM" AND DISCLOSURE OF PRE- MIUM TRIA requires insurers to make coverage available for any loss that occurs within the United States (or outside of the U.S. in the case of U.S. missions and certain air carriers and vessels), results from a"certified act of terrorism" AND that is otherwise covered under your policy. s A "certified act of terrorism" means: Any 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 (i) to be an act of terrorism; (ii) to be a violent act or an act that is dangerous to - (1) human life; (II) property; or (III) infrastructure; (iii) to have resulted in damage within the United States, or outside of the United States in the case of- (1) an air carrier (as defined in section 40102 of title 49, United States Code) or United States flag vessel (or a vessel based principally in the United States, on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States); or (11) the premises of a United States mission; and (iv) to have been 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. NP 72 42 07 13 Page 1 of 2 REJECTING TERRORISM INSURANCE COVERAGE-WHAT YOU MUST DO We have included in your policy coverage for losses resulting from "certified acts of terrorism" as defined above. THE PREMIUM CHARGE FOR THIS COVERAGE APPEARS ON THE DECLARATIONS PAGE OF THE POLICY AND DOES NOT INCLUDE ANY CHARGES FOR THE PORTION OF LOSS COVERED BY THE FEDERAL GOV- ERNMENT UNDER THE ACT. IF YOU CHOOSE TO REJECT THIS COVERAGE, PLEASE CHECK THE BOX BELOW, SIGN THE ACKNOWL- EDGMENT, AND RETURN THIS FORM TO THE ADDRESS BELOW: Please ensure any resection is received within thirty (30) days of the effective date of your Policy. Before making a decision to reject terrorism insurance, refer to the Disclaimer for Standard Fire Policy States located at the end of this Notice. ❑ I hereby reject this offer of coverage. I understand that by rejecting this offer, I will have no coverage for losses arising from a"certified acts of terrorism" and my policy will be endorsed accordingly. Policyholder/Applicant's Signature Print Name Date Signed Named Insured Policy Number R F DUNCAN & ASSOCIATES, INC BLS (16) 56 69 63 77 Policy Effective/Expiration Date From 05/08/2015 To 05/08/2016 IF YOU REJECTED THIS COVERAGE, PLEASE RETURN THIS FORM TO: Attn: Commercial Lines Division -Terrorism PO Box 66400 London, KY 40742-6400 Note: Certain states (currently CA, GA, IA, IL, ME, MO, NY, NC, NJ, OR, RI, WA, WI and WV) mandate coverage for loss caused by fire following a"certified act of terrorism" in certain types of insurance policies. If you reject TRIA coverage in these states on those policies, you will not be charged any additional premium for that state mandated coverage. The summary of the Act and the coverage under your policy contained in this notice is necessarily general in nature. Your policy contains specific terms, definitions, exclusions and conditions. In case of any $ conflict, your policy language will control the resolution of all coverage questions. Please read your policy s carefully. If you have any questions regarding this notice, please contact your agent. a NP 72 42 07 13 Page 2 of 2 NP74440906 U.S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL ("OFAC") ADVISORY NOTICE TO POLICYHOLDERS No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. This Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC. Please read this Notice carefully. Please refer any questions you may have to your insurance agent. The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy, based on Presiden- "s tial declarations of "national emergency". OFAC has identified and listed numerous: • Foreign agents; • Front organizations; • Terrorists; • Terrorist organizations; and • Narcotics traffickers; as "Specially Designated Nationals and Blocked Persons". This list can be located on the United States Treasury's web site -http//www.treas.gov/ofac. In accordance with OFAC regulations, if it is determined that you or any other insured, or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person, as identified by OFAC, this insurance will be considered a blocked or frozen contract and all provisions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract, no payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. © 2011 Liberty Mutual Insurance.All rights reserved. NP 74 44 09 06 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 1 NP 74 50 01 07 Important Notice Notice to Policyholders This explanation is not a part of your insurance policy, and it does not alter any of its provisions or conditions. Please refer any questions you may have to your insurance agent. We would like to thank you for being a policyholder. We appreciate your business. If your policy contains a condition stating it is subject to a premium audit we would like to take this opportunity to explain how the audit process works and answer the most common questions we receive from our policyholders. The information in this notice will make it easier for you to prepare for your audit. Insurance Premium Audit Facts Audits can benefit our policyholders by allowing us to collect the appropriate amount of premium for each policy. Most commercial policies are written based on estimated or fluctuating exposure bases. At the end of the policy term an audit will determine the actual exposure bases and the premium will be adjusted accord- ingly. A company representative will conduct the audit. The premium auditor will examine and audit records that relate to your policy. The records necessary to complete the audit will vary, based on the coverages you have. Types of records that may be requested for your audit include, but are not limited to: • Payroll Records, including 941 forms • Sales Journals or income statements • General Ledger • Cash Disbursements Journal • Subcontractor Certificates Keeping accurate and complete records will allow the auditor to properly classify and allocate your expo- sures correctly. Often there are allowable credits available according to insurance manual classification and rating rules. The premium auditor will be able to give you the credits, to which you are entitled, if your records provide the necessary details. Providing the records your auditor needs can save you time and money as well as expedite the audit process. How Audits are Conducted Audits are handled in different ways, depending on the types of coverages you may have. We conduct audits in the following ways: Physical Audit - An auditor will contact you and set up a convenient time to personally come to your business and review your records. Phone Audit -Forms will be mailed to you, explaining what is necessary to complete a phone audit. The phone auditor will contact you or your bookkeeper for this information. Voluntary Audit - Forms will be mailed to you for completion. We will provide you with contact information if you need assistance in completing the forms. N P 74 50 01 07 Completing the audit Many states have enacted legislation that governs the time in which an audit must be completed, billed and paid. This applies to audits for cancelled policies as well as regular audits. In order to comply with state regulations, it is important to make your records available for audit when our representative contacts you. We will make every effort to complete the audit within a reasonable time after the close of the policy period stated in your policy. Frequently Asked Questions Q:What if I use subcontractors? A: Subcontractors are factored in to the audit process. Subcontractors who do not have insurance are treated as though they are your employees at the time of the audit. If your subcontractor furnishes you with a certificate of liability or workers' compensation insurance, your insurance cost for that subcontractor could be less. See your policy for details on limits of insurance required for certificates. Q: 1 have no employees and work alone. Does the insurance company still need to complete an audit? A: Yes. The auditor will need to verify you worked alone by examining business records that may include tax filings, disbursements, and check stubs. g Q: Do I need an audit if I have cancelled my policy or am no longer insured with you? "s A: An audit may still be necessary even if you no longer have an active policy with us. The audit would cover the time period for which you were insured by us. Other factors that may determine if an audit is necessary include the time the policy was in effect and the amount of premium involved. Q: If I use leased employees but the leasing company carries the liability, are the leased employees excluded from my General Liability policy? tr A: No. The manual rules stipulate that all leased employees are covered on the insured's policy. Q: Is it necessary to keep records on any casual labor I use? A: Yes. Casual labor payroll is examined during the audit. Q: What happens if I do not comply with the audit and fail to provide all necessary records and verifica- tion? A: It's important to provide the necessary information in order to complete the audit. If you fail to do so, your policy may be cancelled or nonrenewed. You may also receive an estimated audit statement based on increased policy exposure estimates due to non- compliance of audit. If you would like additional information about the policy audit process, your independent agent can assist $ you. The Premium Audit Department is also available to answer any questions you may have regarding this process. Please contact us at 1-888-224-9246 or via E-mail at PremiumAuditServices@libertymutual.com N P 74 50 01 07 NP 89 71 09 10 IMPORTANT POLICYHOLDER INFORMATION CONCERNING BILLING PRACTICES Dear Valued Policyholder: This insert provides you with important information about our policy billing practices that may affect you. Please review it carefully and contact your agent if you have any questions. Premium Notice: We will mail you a policy Premium Notice separately. The Premium Notice will provide you with specifics regarding your agent, the account and policy billed, the billing company, payment plan, policy number, transaction dates, description of transactions, charges/credits, policy amount balance, mini- mum amount, and payment due date. This insert explains fees that may apply to and be shown on your Premium Notice. Available Premium Payment Plans: • Annual Payment Plan: When this plan applies, you have elected to pay the entire premium amount balance shown on your Premium Notice in full. No installment billing fee applies when the Annual Payment Plan applies. • Installment Payment Plan: When this plan applies, you have elected to pay your policy premium in installments (e.g.: quarterly or monthly installments - Installment Payment Plans vary by state). As noted below, an installment fee may apply when the Installment Payment Plan applies. The Premium Payment Plan that applies to your policy is shown on the top of your Premium Notice. Please contact your agent if you want to change your Payment Plan election. Installment Payment Plan Fee: If you elected to pay your premiums in installments using the Installment Premium Payment Plan, an installment billing fee applies to each installment bill. The installment billing charge will not apply, however, if you pay the entire balance due when you receive the bill for the first installment. Because the amount of the installment charge varies from state to state, please consult your Premium Notice for the actual fee that applies. Dishonored Payment Fee: Your financial institution may refuse to honor the premium payment withdrawal request you submit to us due to insufficient funds in your account or for some other reason. If that is the case, and your premium payment withdrawal request is returned to us dishonored, a payment return fee will apply. Because the amount of the return fee varies from state to state, please consult your Premium Notice for the actual fee that applies. Late Payment Fee: If we do not receive the minimum amount due on or before the date or time the payment is due, as indicated on your Premium Notice, you will receive a policy cancellation notice effective at a future date that will also reflect a late payment fee charge. Issuance of the cancellation notice due to $ non-payment of a scheduled installment(s) may result in the billing and collection of all or part of any outstanding premiums due for the policy period. Late Payment Fees vary from state to state and are not applicable in some states. Special Note: Please note that some states do not permit the charging of certain fees. Therefore, if your state does not allow the charging of an Installment Payment Plan, Dishonored Payment or Late Payment Fee,the disallowed fee will not be charged and will not be included on your Premium Notice. EFT-Automatic Withdrawals Payment Option: When you select this option, you will not be sent Premium Notices and, in most cases, will not be charged installment fees. For more information on our EFT-Auto- matic Withdrawals payment option, refer to the attached policyholder plan notice and enrollment sheet. Once again, please contact your agent if you have any questions about the above billing practice informa- tion. Thank you for selecting us to service your insurance needs. NP 89 71 09 10 © 2010 Liberty Mutual Insurance Company.All rights reserved. Page 1 of 1 NP93530114 IMPORTANT NOTICE REGARDING THE EXPIRATION OF THE TERRORISM RISK INSURANCE ACT AND THE REDUCTION IN COVERAGE FOR TERRORISM LOSSES PLEASE READ THIS NOTICE CAREFULLY This is to notify you of a reduction in coverage for terrorism losses under your insurance policy when the Terrorism Risk Insurance Act ("TRIA") expires, which is scheduled to occur on December 31, 2014. This notice DOES NOT apply to Workers Compensation insurance. TRIA, as amended, is a temporary program that spreads losses from government "certified" acts of terror- ism between insurers and the federal government. In summary, TRIA requires insurers to make coverage for "certified acts of terrorism" available, and to pay losses from "certified acts of terrorism" up to a deductible amount. If an individual insurer's losses exceed this amount, the government will reimburse the insurer for 85%of losses paid in excess of the deductible. s Policyholders have the option to accept or reject this coverage. TRIA will expire on December 31, 2014, unless Congress and the President act to extend it. Otherwise, after 2014, the federal government will no longer "certify" acts of terrorism or reimburse losses caused by "certified acts of terrorism." ry If you purchase coverage for "certified acts of terrorism," and TRIA expires on or after December 31, 2014, your insurance coverage will be reduced. After the date TRIA expires, where permitted by state law, you will no longer have insurance for losses from acts of terrorism that directly or indirectly involve nuclear or radioactive agents or materials, or pathogenic or poisonous biological or chemical agents or materials ("NBCR"). If you elect not to purchase coverage for "certified acts of terrorism," and TRIA expires on or after Decem- ber 31, 2014, losses caused by any terrorist act will be excluded from your policy, where permitted by state law. Some states, including New York and Florida, may not approve or allow the use of certain exclusions related to acts of terrorism. Therefore, exclusions for losses caused by acts of terrorism may not apply in all states. s © 2014 Liberty Mutual Insurance NP 93 53 01 14 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 1 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company BLS (16) 56 69 63 77 Mutual. Policy Period: INSURANCE From 05/08/2015 To 05/08/2016 Common Policy Declarations 12:01 am Standard Time at Insured Mailing Location Named Insured&Mailing Address Agent Mailing Address&Phone No. R F DUNCAN & ASSOCIATES, INC (360) 352-7588 PO BOX 12300 DUNCAN & ASSOCIATES INS BRKRS OLYMPIA, WA 98508 PO BOX 1458 OLYMPIA, WA 98507-1458 Named Insured Is:CORPORATION " Named Insured Business Is: REAL ESTATE APPRAISER In return for the payment of the premium, and subject to all the terms of this policy, rve agree with you to provide the insurance as stated in this policy. s SUMMARY OF COVERAGE PARTS AND CHARGES This policy consists of this Common Policy Declarations page, Common Policy Conditions, Coverage Parts (which consist of coverage forms and other applicable forms and endorsements, if any, issued to form a part of them) and any other forms and endorsements issued to be part of this policy. COVERAGE PART CHARGES Commercial General Liability $250.00 Total Charges for all of the above coverage parts: S250.00 Certified Acts of Terrorism Coverage: $1.00 (Included) Note: This is not a bill $ IMPORTANT MESSAGES a . This policy is auditable. Please refer to the conditions of the policy for details or contact your agent. Servicing Office Western Washington and Issue Date 05/08/15 Authorized Representative To report a claim, call your Agent or 1-800-362-0000 DS 70 21 01 08 05/08/15 56696377 WW DPRO 235 NCAFPPNO INSURED COPY 002037 PAGE 11 OF 60 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company BLS (16) 56 69 63 77 Mutual. Policy Period: INSURANCE From 05/08/2015 To 05/08/2016 Common Policy Declarations 12:01 am Standard Time at Insured Mailing Location Named Insured Agent R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DUNCAN & ASSOCIATES INS BRKRS POLICY FORMS AND ENDORSEMENTS This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CG 00 01 04 13 Commercial General Liability Coverage Form - Occurrence CG 01 81 05 08 Washington Changes CG 01 97 12 07 Washington Changes - Employment-Related Practices Exclusion CG 21 06 05 14 Exclusion - Access Or Disclosure Of Confidential Or Personal Information And Data-Related Liability - With Limited Bodily Injury Exception CG 21 70 01 08 Cap on Losses From Certified Acts of Terrorism CG 21 76 01 08 Exclusion of Punitive Damages Related to a Certified Act of Terrorism CG 22 24 04 13 Exclusion - Inspection, Appraisal and Survey Companies CG 24 26 04 13 Amendment of Insured Contract Definition CG 26 77 1204 Washington - Fungi or Bacteria Exclusion CG 3221 01 07 Washington Conditional Exclusion of Terrorism Involving Nuclear, Biological or Chemical Terrorism (Relating to Disposition of Federal Terrorism Risk Insurance Act) CG 84 99 08 09 Non-Cumulation Liability Limits Same Occurrence CG 88 1004 13 Commercial General Liability Extension CG 88 77 12 08 Medical Expense At Your Request Endorsement CG 89 27 1009 Washington Exclusion - Asbestos IL 01 23 11 13 Washington Changes - Defense Costs $ IL 01 46 08 10 Washington Common Policy Conditions s IL 01 98 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form) N In witness whereof, we have caused this policy to be signed by our authorized officers. DIA 9- Dexter Legg Paul Condrin Secretary President To report a claim, call your Agent or 1-800-362-0000 DS 70 21 01 08 05/08/15 56696377 LNW_DPRO 235 NCAFPPNO INSURED COPY 002037 PAGE 12 OF 60 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company BLS (16) 56 69 63 77 Mutual. Policy Period: INSURANCE Commercial General Liability From 05/08/2015 To 05/08/2016 12:01 am Standard Time Declarations at Insured Mailing Location Basis:Occurrence Named Insured Agent R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DUNCAN & ASSOCIATES INS BRKRS �-- SUMMARY OF LIMITS AND CHARGES Commercial DESCRIPTION LIMIT General Each Occurrence Limit 1,000,000 Liability Damage To Premises Rented To You Limit (Any One Premises) 11000,000 Limits of s Insurance Medical Expense Limit (Any One Person) 15,000 Personal and Advertising Injury Limit 1,000,000 General Aggregate Limit (Other than Products - Completed Operations) 2,000,000 Products - Completed Operations Aggregate Limit 2,000,000 Explanation of DESCRIPTION PREMIUM Charges General Liability Schedule Totals 169.00 Policy Writing Minimum Premium Adjustment 80.00 Certified Acts of Terrorism Coverage 1.00 Total Advance Charges: $250.00 Note. This is not a hill a n To report a claim, call your Agent or 1-800-362-0000 DS 70 22 01 08 05/08/15 56696377 LNW_DPRO 235 NCAFPPNO INSURED COPY 002037 PAGE 13 OF 60 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company BLS (16) 56 69 63 77 Mutual. Policy Period: INSURANCE Commercial General Liability From 05/08/2015 To 05/08/2016 12:01 am Standard Time Declarations Schedule at Insured Mailing Location Named Insured Agent R F DUNCAN & ASSOCIATES, INC (360) 352-7588 DUNCAN & ASSOCIATES INS BRKRS SUMMARY OF CLASSIFICATIONS - BY LOCATION 0001 909 West Bay Dr NW, OLYMPIA, WA 98502 Insured: R F DUNCAN & ASSOCIATES, INC CLASSIFICATION - 96317 Inspection And Appraisal Companies - Inspecting For Insurance Or Valuation Purposes Products-Completed Operations Are Subject To The General Aggregate Limit. RATED/PER COVERAGE DESCRIPTION PREMIUM BASED ON- Executive Officers 1,000 PREMIUM Premise/Operations 17,800 Dollars Of Payroll 9.187 $164.00 Minimum Premium Adjustment $5.0 0 Total. Included CLASSIFICATION- 96317 Inspection And Appraisal Companies - Inspecting For Insurance Or Valuation Purposes Products-Completed Operations Are Subject To The General Aggregate Limit. RATED/PER COVERAGE DESCRIPTION PREMIUM BASED ON- Employees Payroll 1,000 PREMIUM Premise/Operations Dollars Of Payroll - if any 9.187 Total. Commercial General Liability Schedule Total $169.00 To report a claim, call your Agent or 1-800-362-0000 DS 70 23 01 08 05/08/15 56696377 LNW_DPRO 235 NCAFPPNO INSURED COPY 002037 PAGE 14 OF 60 COMMERCIAL GENERAL LIABILITY CG 00 01 04 13 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. b. This insurance applies to "bodily injury" Read the entire policy carefully to determine and "property damage" only if: rights, duties and what is and is not covered. (1) The "bodily injury" or "property Throughout this policy the words "you" and damage" is caused by an "occur- "your" refer to the Named Insured shown in the rence" that takes place in the "cov- Declarations, and any other person or organiza- erage territory'; tion qualifying as a Named Insured under this (2) The "bodily injury" or "property policy. The words "we", "us" and "our" refer to damage" occurs during the policy the company providing this insurance. period; and The word "insured" means any person or organi- (3) Prior to the policy period, no insured zation qualifying as such under Section II -Who Is listed under Paragraph 1. of Section An Insured. II - Who Is An Insured and no "em- Other words and phrases that appear in quotation ployee" authorized by you to give or marks have special meaning. Refer to Section V - receive notice of an "occurrence" or Definitions. claim, knew that the "bodily injury" or "property damage" had occurred, s SECTION I -COVERAGES in whole or in part. If such a listed COVERAGE A - BODILY INJURY AND PROPERTY insured or authorized "employee" DAMAGE LIABILITY knew, prior to the policy period, that 1. Insuring Agreement the "bodily injury" or "property dam- age" occurred, then any continu- a. We will pay those sums that the insured ation, change or resumption of such becomes legally obligated to pay as dam- "bodily injury" or "property dam- ages because of "bodily injury" or "prop- age" during or after the policy period erty damage" to which this insurance ap- will be deemed to have been known plies. We will have the right and duty to prior to the policy period. defend the insured against any "suit" c. "Bodily injury" or "property damage" seeking those damages. However, we which occurs during the policy period will have no duty to defend the insured and was not, prior to the policy period, against any "suit" seeking damages for known to have occurred by any insured "bodily injury" or "property damage" to which this insurance does not apply. We listed under Paragraph 1. of Section II - may, at our discretion, investigate any Who Is An Insured or any "employee" au- "occurrence" and settle any claim or thorized by you to give or receive notice "suit" that may result. But: of an "occurrence" or claim, includes any continuation, change or resumption of (1) The amount we will pay for damages that "bodily injury" or that dam- e is limited as described in Section III - age" after the end of the policy period. Limits Of Insurance; and d. "Bodily injury" or "property damage" (2) Our right and duty to defend ends will be deemed to have been known to when we have used up the applica- have occurred at the earliest time when ble limit of insurance in the payment any insured listed under Paragraph 1. of of judgments or settlements under Section II - Who Is An Insured or any Coverages A or B or medical ex- "employee" authorized by you to give or penses under Coverage C. receive notice of an "occurrence" or No other obligation or liability to pay claim: sums or perform acts or services is cov- (1) Reports all, or any part, of the "bod- ered unless explicitly provided for under ily injury" or "property damage" to Supplementary Payments - Coverages A us or any other insurer; and B. (2) Receives a written or verbal demand or claim for damages because of the "bodily injury" or "property dam- age'; or CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 17 £L b0 W 00 90 Zl,0Z "OUI '80L40 saolnaaS eouemsul p LI, jo Z aBed ao :ssau -lsnq s,painsul ay; ;o ;onpuoo ay; o; pe;elaj sal;np 6ulwuo}Jad (q) •paBolle jo :pajnsul ay; Aq ;uawAoldw3 (e) aje salldde eouemsul sly; yoigm :;o asmoo ay; ul pue ;o ;no 6ul o; se6ewep yolynn ul 6ulpaao -sue pamsul ay; ;o „eaAoldwa„ uy (�) -oad uol;nlosai a;ndslp anl;eu -ia;le Jo plo a ;sule6e Aped ;ey; :o; „funful Allpo8„ ;o asua;ap jo} aie sasuedxe uol; A;lllgel3 s,jaAoidw3 •a -e6llll pue sea; sAawolle yonS (q) 'Mel iellwls Aue Jo pue :joea;uoo pamsul„ awes noel uol;esuadwoo ;uawAoldwoun jo s;l} ey; ul pawnsse ueaq osle sey -aueq A;lllgeslp 'uol;esuedwoo sie)pom asua;ep s/CIjed ;ey; ';o ;soo ay; e aapun pamsul ay; ;o uol;e6llgo Aub' jo; ao 'jo; Aped yons o; A3!I!ge1j (e) sme-1 :papinad '„96ewep Alfa JellwlS puy uol;esuadwoo ,sja)laoM 'p -dad„ ao „tinful Allpoq„ ;o asneoaq $ -seBeia se6ewep eq o; powaap aae pamsul -neq olloyoole 6ulyslwn; jo 6ulnaas '6ul ue uey; jay;o Alied a ao; ao Aq paimo -Iles jo ssaulsnq ay; poieplsuoo ;las;l Aq -ul sesuadxa uol;e6l;ll tiessaoau pue ;ou sl 'A;lnl;oe yons jo; paalnbei sl asueo seal sAeuio;;e elgeuoseei '„;oea; -II a ao pa6ieyo sl eej a ;ou ao jay;eynn -uoo pamsul„ ue ul pawnsse A;lllge 'saslwaid inoA uo uol;dwnsuoo jo} 'sesl -II ;o sasodmd ay; ao; AloloS •;uaw m-ward op( uo seBejanaq olloyoole 6uljq -aai6e jo ;oei;uoo ay; ;o uol;noexe o; uosaad a 6uippied 'uolsnloxa sly; ay) o; ;uenbesgns sm000 „a6ewep Al ;o sasodmd ay; jod •sebeianaq olloyoole -iadad„ jo „Ajnful Allpoq„ ay; papin 6ul4slwn; jo 6ulnwes 16ulllas '6ul;nqu;slp -oad '„;oei;uoo pamsul„ ue sl ;ey; '6uun;oe;nuew ;o ssaulsnq ay; ul aie noA ;uawaoiBe Jo ;oea;uoo a ul pawnssy (Z) 11 Aluo salldde uolsnloxa sly; 'aanannoH Jo :;uaw •anoge (£) ao (Z) '(l,) ydej6 -99i6e jo ;oei;uoo ay; ;o eouesge -eyed ul paglaosap sl yolynn ;ey; panlon ay; ul BAey pinonn pamsul ay; ;eyl (l,) -ul '„a6ewep Apedad„ io „Ajnful Allpoq„ :se6ewep ay; pasneo yolynn „eou9jjn000„ ay; 11 ao; Al!llgell o; Aldde ;ou saop uolsnloxa :loyoole ;o aousngul ay; slyl ';ueweei6e jo ;oei;uoo a uw AGlllgell japun aq Aew ;ey; uosaad Aue ;o uol;dwnsse ay; jo uoseei Aq se6ewep o; ;oedsai y;lnn uol;eliodsuei; Aed o; pale61lgo sl pamsul ay; yolynn apinad o; 6ullle; ao 6ulpinad (q) jo; „96ewep Atiodad„ jo „/tinful AIIpoe. jo :pamsul ;ey; Aq siay;o fi4l1fge13 len;oei;uoo -q 10 6uuo;luow jo 6uluwej; ';uew •A:padoid ao suos -Aoldwe 'finny 'uolslnaadns ayl (e) -jad ;oa;oad o; aoao; algeuoseei ;o asn :ul 6ulopbuoana Jay;o ay; wa; 6uglnsai „Ajnfui Lllpoq„ o; Ald jo aouafllbeu 9691le pamsul Aue ;sule6e -de ;ou saop uolsnloxa slyl •pamsul ay; swlelo ay; )l uana salldde uolsnloxa slyl ;o ;ulodpue;s ay; wa; popua;ul ao pa;oad •sa6eJanaq olloyoole ;o asn jo -xa „96ewep Apedad„ jo „tinful Allpo8„ uol;nqu;slp '};l6 'ales ay; o; 6ul;ela tinful popuejul io pa;oadx3 -e uol;eln6ai jo eoueulpio 'a;n;e;s Aub (£) :0; Aldde ;ou saop eouemsul slyl ao :loyoole ;o suolsnlox3 -Z eouengul ay; japun ao e6e 6uhluljp ,,,tinful Allpoq„ le6al ay; japun uosaad a o; safe ay; woe; awl; Aue ;e 6ul;lnsei y;eep -aanaq olloyoole ;o 6ulyslwn; ayl (Z) Jo sa0ln.ias ;o ssol 'aJeo Jo; u01lezlue6Jo :uosaad Aue}o uol;eo Jo uosied Aue Aq powlelo se6ewep apnlo -lxo;ul ay; o; ful;ngla;uoo jo 6ulsne0 (L) -ui „/tinful Al!poq„ ;o asneoaq safewed -a :;o u0seal -in000 o; Aq elgell play eq Aew pamsul Aue yolyn^ un6eq sey jo paaan000 sey „aBewep Jo; „96ewep Aliedad„ jo „Anful AIppOS„ A:pedad„ ao „funful Al!poq„ ;ey; f4l1!gel-1 jonbl-1 o sueow aay;o Aue Aq oJeme sawooae (£) (2) The spouse, child, parent, brother or (iii) "Bodily injury" or "property sister of that "employee" as a con- damage" arising out of heat, sequence of Paragraph (1) above. smoke or fumes from a This exclusion applies whether the in- "hostile fire"; sured may be liable as an employer or in (b) At or from any premises, site or any other capacity and to any obligation location which is or was at any to share damages with or repay someone time used by or for any insured else who must pay damages because of or others for the handling, stor- the injury. age, disposal, processing or This exclusion does not apply to liability treatment of waste; assumed by the insured under an "in- (c) Which are or were at any time sured contract". transported, handled, stored, f. Pollution treated, disposed of, or pro- (1) "Bodily injury" or "property dam- cessed as waste by or for: age" arising out of the actual, al- (i) Any insured; or " leged or threatened discharge, (ii) Any person or organization dispersal, seepage, migration, re- for whom you may be legal- lease or escape of "pollutants": ly responsible; or (a) At or from any premises, site or (d) At or from any premises, site or R location which is or was at any location on which any insured or s time owned or occupied by, or any contractors or subcontrac- rented or loaned to, any insured. tors working directly or indirect- However, this subparagraph ly on any insured's behalf are does not apply to: performing operations if the (i) "Bodily injury" if sustained "pollutants" are brought on or to within a building and caused the premises, site or location in by smoke, fumes, vapor or connection with such operations soot produced by or origi- by such insured, contractor or nating from equipment that subcontractor. However, this is used to heat, cool or de- subparagraph does not apply to: humidify the building, or (i) "Bodily injury" or "property equipment that is used to damage" arising out of the heat water for personal use, escape of fuels, lubricants or by the building's occupants other operating fluids which or their guests; are needed to perform the (ii) "Bodily injury" or "property normal electrical, hydraulic damage" for which you may or mechanical functions be held liable, if you are a necessary for the operation contractor and the owner or of "mobile equipment" or 9 lessee of such premises, site its parts, if such fuels, or location has been added lubricants or other operating to your policy as an addi- fluids escape from a vehicle tional insured with respect part designed to hold, store to your ongoing operations or receive them. This excep- performed for that addition- tion does not apply if the al insured at that premises, "bodily injury" or "property site or location and such damage" arises out of the premises, site or location is intentional discharge, not and never was owned or dispersal or release of the occupied by, or rented or fuels, lubricants or other op- loaned to, any insured, other erating fluids, or if such fu- than that additional insured; els, lubricants or other oper- or ating fluids are brought on or to the premises, site or lo- cation with the intent that they be discharged, dis- persed or released as part of CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 3 of 17 the operations being per- g, Aircraft, Auto Or Watercraft formed by such insured, "Bodily injury" or "property damage" contractor or subcontractor; arising out of the ownership, mainten- (ii) "Bodily injury" or "property ance, use or entrustment to others of any damage" sustained within a aircraft, "auto" or watercraft owned or building and caused by the operated by or rented or loaned to any release of gases, fumes or insured. Use includes operation and vapors from materials "loading or unloading". brought into that building in This exclusion applies even if the claims connection with operations against any insured allege negligence or being performed by you or other wrongdoing in the supervision, hir- on your behalf by a contrac- ing, employment, training or monitoring for or subcontractor; or of others by that insured, if the "occur- (III) "Bodily injury" or "property rence" which caused the "bodily injury" damage" arising out of heat, or "property damage" involved the own- smoke or fumes from a ership, maintenance, use or entrustment "hostile fire". to others of any aircraft, "auto" or water- (e) At or from any premises, site or craft that is owned or operated by or location on which any insured or rented or loaned to any insured. any contractors or subcontrac- This exclusion does not apply to: tors working directly or indirect- (1) A watercraft while ashore on prem- ly on any insured's behalf are ises you own or rent; performing operations if the op- erations are to test for, monitor, (2) A watercraft you do not own that is: clean up, remove, contain, treat, (a) Less than 26 feet long; and detoxify or neutralize, or in any (b) Not being used to carry persons way respond to, or assess the ef- or property for a charge; fects of, "pollutants". (3) Parking an "auto" on, or on the ways (2) Any loss, cost or expense arising out next to, premises you own or rent, of any: provided the "auto" is not owned by (a) Request, demand, order or statu- or rented or loaned to you or the in- tory or regulatory requirement sured; that any insured or others test (4) Liability assumed under any "in- for, monitor, clean up, remove, sured contract" for the ownership, contain, treat, detoxify or neu- maintenance or use of aircraft or tralize, or in any way respond to, watercraft; or or assess the effects of, "pollu- (5) "Bodily injury" or "property dam- tants'; or age" arising out of: (b) Claim or suit by or on behalf of a (a) The operation of machinery or governmental authority for dam- equipment that is attached to, or ages because of testing for, monitoring, cleaning up, remov- part of, a land vehicle that would qualify under the definition of ing, containing, treating, detox- "mobile equipment" if it were ifying or neutralizing, or in any not subject to a compulsory or way responding to, or assessing financial responsibilitylaw or the effects of, "pollutants". other motor vehicle insurance However, this paragraph does not law where it is licensed or princi- apply to liability for damages be- pally garaged; or cause of "property damage" that the (b) The operation of any of the ma- insured would have in the absence of chinery or equipment listed in such request, demand, order or stat- Paragraph f.(2) or f.(3) of the utory or regulatory requirement, or such claim or "suit" by or on behalf definition of mobile equip- ment". of a governmental authority. Page 4 of 17 0 Insurance Services Office, Inc., 2012 CG 00 01 04 13 h. Mobile Equipment (6) That particular part of any property "Bodily injury" or "property damage" that must be restored, repaired or re- arising out of: placed because "your work" was in- (1) The transportation of "mobile equip- correctly performed on it. ment" by an "auto" owned or oper- Paragraphs (1), (3) and (4) of this exclu- ated by or rented or loaned to any sion do not apply to "property damage" insured; or (other than damage by fire) to premises, (2) The use of "mobile equipment" in, or including the contents of such premises, while in practice for, or while being rented to you for a period of seven or prepared for, any prearranged rac- fewer consecutive days. A separate limit ing, speed, demolition, or stunting of insurance applies to Damage To Prem- ises Rented To You as described in Sec- activity. tion III -Limits Of Insurance. I. War Paragraph (2) of this exclusion does not Bodily injury or "property damage", apply if the premises are "your work" N however caused, arising, directly or indi- and were never occupied, rented or held rectly, out of: for rental by you. (1) War, including undeclared or civil Paragraphs (3), (4), (5) and (6) of this ex- war; clusion do not apply to liability assumed (2) Warlike action by a military force, in- under a sidetrack agreement. cluding action in hindering or de- Paragraph (6) of this exclusion does not fending against an actual or expect- apply to "property damage" included in ed attack, by any government, the "products-completed operations haz- sovereign or other authority using and". military personnel or other agents; k. Damage To Your Product or (3) Insurrection, rebellion, revolution, "Property damage" to "your product" usurped power, or action taken by arising out of it or any part of it. governmental authority in hindering 1. Damage To Your Work or defending against any of these. "Property damage" to "your work" aris- j. Damage To Property ing out of it or any part of it and included "Property damage" to: in the �� "products-completed operations hazard". (1) Property you own, rent, or occupy, This exclusion does not apply if the including any costs or expenses in- damaged work or the work out of which curred by you, or any other person, the damage arises was performed on organization or entity, for repair, re- your behalf by a subcontractor. placement, enhancement, restora- tion or maintenance of such property m. Damage To Impaired Property Or Prop- for any reason, including prevention erty Not Physically Injured s of injury to a person or damage to "Property damage" to "impaired proper- $ another's property; ty" or property that has not been phys- (2) Premises you sell, give away or ically injured, arising out of: abandon, if the "property damage" (1) A defect, deficiency, inadequacy or arises out of any part of those prem- dangerous condition in "your prod- ises; uct" or "your work"; or (3) Property loaned to you; (2) A delay or failure by you or anyone (4) Personal property in the care, custo- acting on your behalf to perform a dy or control of the insured; contract or agreement in accordance (5) That particular part of real property with its terms. on which you or any contractors or This exclusion does not apply to the loss subcontractors working directly or of use of other property arising out of indirectly on your behalf are per- sudden and accidental physical injury to forming operations, if the "property "your product" or "your work" after it damage" arises out of those oper- has been put to its intended use. ations; or CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 5 of 17 n. Recall Of Products, Work Or Impaired (4) Any federal, state or local statute, or- Property dinance or regulation, other than the Damages claimed for any loss, cost or ex- TCPA, CAN-SPAM Act of 2003 or pense incurred by you or others for the FCRA and their amendments and ad- loss of use, withdrawal, recall, inspec- ditions, that addresses, prohibits, or tion, repair, replacement, adjustment, re- limits the printing, dissemination, moval or disposal of: disposal, collecting, recording, send- (1) "Your product"; ing, transmitting, communicating or distribution of material or informa- (2) "Your work"; or tion. (3) "Impaired property"; Exclusions c. through n. do not apply to dam- if such product, work, or property is with- age by fire to premises while rented to you or drawn or recalled from the market or temporarily occupied by you with permission from use by any person or organization of the owner. A separate limit of insurance because of a known or suspected defect, applies to this coverage as described in Sec- deficiency, inadequacy or dangerous tion III -Limits Of Insurance. condition in it. COVERAGE B - PERSONAL AND ADVERTISING o. Personal And Advertising Injury " INJURY LIABILITY "Bodily injury" arising out of "personal and advertising injury . 1. Insuring Agreement p. Electronic Data a. We will pay those sums that the insured becomes legally obligated to pay as dam- Damages arising out of the loss of, loss ages because of "personal and advertis- of use of, damage to, corruption of, in- ing injury" to which this insurance ap- ability to access, or inability to manipu- plies. We will have the right and duty to late electronic data. defend the insured against any "suit' However, this exclusion does not apply seeking those damages. However, we to liability for damages because of "bod- will have no duty to defend the insured ily injury". against any "suit' seeking damages for As used in this exclusion, electronic data "personal and advertising injury" to means information, facts or programs which this insurance does not apply. We stored as or on, created or used on, or may, at our discretion, investigate any of- transmitted to or from computer soft- fense and settle any claim or "suit' that ware, including systems and applications may result. But: software, hard or floppy disks, CD-ROMs, (1) The amount we will pay for damages tapes, drives, cells, data processing de- is limited as described in Section III - vices or any other media which are used Limits Of Insurance; and with electronically controlled equipment. (2) Our right and duty to defend end q. Recording And Distribution Of Material when we have used up the applica- Or Information In Violation Of Law ble limit of insurance in the payment $ "Bodily injury" or "property damage" of judgments or settlements under arising directly or indirectly out of any ac- Coverages A or B or medical ex- tion or omission that violates or is al- penses under Coverage C. leged to violate: No other obligation or liability to pay (1) The Telephone Consumer Protection sums or perform acts or services is cov- Act (TCPA), including any amend- ered unless explicitly provided for under ment of or addition to such law; Supplementary Payments - Coverages A (2) The CAN-SPAM Act of 2003, includ- and B. ing any amendment of or addition to b. This insurance applies to "personal and such law; advertising injury" caused by an offense (3) The Fair Credit Reporting Act (FCRA), arising out of your business but only if and any amendment of or addition to the offense was committed in the "cov- such law, including the Fair and Ac- erage territory" during the policy period. curate Credit Transactions Act (FACTA); or Page 6 of 17 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 2. Exclusions I. Infringement Of Copyright, Patent, This insurance does not apply to: Trademark Or Trade Secret a. Knowing Violation Of Rights Of Another "Personal and advertising injury" arising "Personal and advertising injury" caused out of the infringement of copyright, pat- by or at the direction of the insured with ent, trademark, trade secret or other in- the knowledge that the act would violate tellectual property rights. Under this ex- the rights of another and would inflict clusion, such other intellectual property rights do not include the use of another's personal and advertising injury". advertising idea in your "advertisement". b. Material Published With Knowledge Of However, this exclusion does not apply Falsity to infringement, in your "advertisement", "Personal and advertising injury" arising of copyright, trade dress or slogan. out of oral or written publication, in any j, Insureds In Media And Internet Type manner, of material, if done by or at the Businesses fi direction of the insured with knowledge � Personal and advertising injury com- of its falsity. mitted by an insured whose business is: c. Material Published Prior To Policy Period "Personal and advertising injury" arising (1) Advertising, broadcasting, publish- out of oral or written publication, in any ing or telecasting; manner, of material whose first publica- (2) Designing or determining content of s tion took place before the beginning of web sites for others; or the policy period. (3) An Internet search, access, content d. Criminal Acts or service provider. "Personal and advertising injury" arising However, this exclusion does not apply out of a criminal act committed by or at to Paragraphs 14.a., b. and c. of "person- the direction of the insured. al and advertising injury" under the Defi- e. Contractual Liability nitions section. "Personal and advertising injury" for For the purposes of this exclusion, the which the insured has assumed liability placing of frames, borders or links, or ad- in a contract or agreement. This exclu- vertising, for you or others anywhere on sion does not apply to liability for dam- the Internet, is not by itself, considered ages that the insured would have in the the business of advertising, broadcast- absence of the contract or agreement. ing, publishing or telecasting. f. Breach Of Contract k. Electronic Chatrooms Or Bulletin Boards "Personal and advertising injury" arising "Personal and advertising injury" arising out of a breach of contract, except an im- out of an electronic chatroom or bulletin plied contract to use another's advertis- board the insured hosts, owns, or over ing idea in your "advertisement". which the insured exercises control. g. Quality Or Performance Of Goods - Fail- 1. Unauthorized Use Of Another's Name Or $ ure To Conform To Statements Product "Personal and advertising injury" arising "Personal and advertising injury" arising out of the failure of goods, products or out of the unauthorized use of another's services to conform with any statement name or product in your e-mail address, of quality or performance made in your domain name or metatag, or any other advertisement". similar tactics to mislead another's po- tential customers. h. Wrong Description Of Prices m. Pollution "Personal and advertising injury" arising "Personal and advertising injury" arising out of the wrong description of the price out of the actual, alleged or threatened of goods, products or services stated in discharge, dispersal, seepage, migration, your advertisement". release or escape of "pollutants" at any time. CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 7 of 17 n. Pollution-related (4) Any federal, state or local statute, or- Any loss, cost or expense arising out of dinance or regulation, other than the any: TCPA, CAN-SPAM Act of 2003 or (1) Request, demand, order or statutory FCRA and their amendments and ad- or regulatory requirement that any ditions, that addresses, prohibits, or insured or others test for, monitor, limits the printing, dissemination, clean up, remove, contain, treat, de- disposal, collecting, recording, send- toxify or neutralize, or in any way re- ing, transmitting, communicating or spond to, or assess the effects of, distribution of material or informa- tion. "pollutants"; or COVERAGE C-MEDICAL PAYMENTS (2) Claim or suit by or on behalf of a governmental authority for damages 1. Insuring Agreement because of testing for, monitoring, a. We will pay medical expenses as de- cleaning up, removing, containing, scribed below for "bodily injury" caused treating, detoxifying or neutralizing, by an accident: or in any way responding to, or as- (1) On premises you own or rent; sessing the effects of, "pollutants". (2) On ways next to premises you own o. War or rent; or "Personal and advertising injury", how- (3) Because of your operations; ever caused, arising, directly or indirect- provided that: ly, out of: (1) War, including undeclared or civil (a) The accident takes place in the "coverage territory" and during war; the policy period; (2) Warlike action by a military force, in- (b) The expenses are incurred and cluding action in hindering or de- reported to us within one year of fending against an actual or expect- the date of the accident; and ed attack, by any government, sovereign or other authority using (c) The injured person submits to military personnel or other agents; examination, at our expense, by or physicians of our choice as often as we reasonably require. (3) Insurrection, rebellion, revolution, usurped power, or action taken by b. We will make these payments regardless governmental authority in hindering of fault. These payments will not exceed or defending against any of these. the applicable limit of insurance. We will p. Recording And Distribution Of Material pay reasonable expenses for: Or Information In Violation Of Law (1) First aid administered at the time of "Personal and advertising injury" arising an accident; directly or indirectly out of any action or (2) Necessary medical, surgical, X-ray omission that violates or is alleged to vio- and dental services, including pros- late: thetic devices; and (1) The Telephone Consumer Protection (3) Necessary ambulance, hospital, pro- Act (TCPA), including any amend- fessional nursing and funeral ser- ment of or addition to such law; vices. (2) The CAN-SPAM Act of 2003, includ- 2. Exclusions ing any amendment of or addition to We will not pay expenses for "bodily injury": such law; a. Any Insured (3) The Fair Credit Reporting Act (FCRA), To any insured, except "volunteer and any amendment of or addition to workers". such law, including the Fair and Ac- b. Hired Person curate Credit Transactions Act (FACTA); or To a person hired to do work for or on behalf of any insured or a tenant of any insured. Page 8 of 17 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 c. Injury On Normally Occupied Premises g. All interest on the full amount of any To a person injured on that part of prem- judgment that accrues after entry of the ises you own or rent that the person nor- judgment and before we have paid, of- mally occupies. fered to pay, or deposited in court the part of the judgment that is within the ap- d. Workers' Compensation And Similar plicable limit of insurance. Laws These payments will not reduce the limits of To a person, whether or not an "employ- insurance. ee" of any insured, if benefits for the „ 2. If we defend an insured against a suit and "bodily injury" are payable or must be an indemnitee of the insured is also named as provided under a workers' compensation a party to the , we will defend that or disability benefits law or a similar law. suit indemnitee if all of the following conditions e. Athletics Activities are met: To a person injured while practicing, in- a. The "suit" against the indemnitee seeks structing or participating in any physical damages for which the insured has as- exercises or games, sports, or athletics sumed the liability of the indemnitee in a contests. contract or agreement that is an "insured f. Products-Completed Operations Hazard contract"; Included within the "products-completed b. This insurance applies to such liability operations hazard". assumed by the insured; g g. Coverage A Exclusions c. The obligation to defend, or the cost of Excluded under Coverage A. the defense of, that indemnitee, has also SUPPLEMENTARY PAYMENTS - COVERAGES A been assumed by the insured in the same AND B "insured contract"; 1. We will pay, with respect to any claim we in- d. The allegations in the "suit" and the in- formation we know about the "occur- insured or settle, or any "suit" against an rence" are such that no conflict appears insured we defend: to exist between the interests of the in- a. All expenses we incur. sured and the interests of the b. Up to $250 for cost of bail bonds required indemnitee; because of accidents or traffic law viola- e. The indemnitee and the insured ask us to tions arising out of the use of any vehicle conduct and control the defense of that to which the Bodily Injury Liability Cov- indemnitee against such "suit" and agree erage applies. We do not have to furnish that we can assign the same counsel to these bonds. defend the insured and the indemnitee; c. The cost of bonds to release attachments, and but only for bond amounts within the ap- f. The indemnitee: plicable limit of insurance. We do not (1) Agrees in writing to: have to furnish these bonds. d. All reasonable expenses incurred by the (a) Cooperate with us in the inves- s insured at our request to assist us in the of ati thong settlement or defense investigation or defense of the claim or of the suit ; "suit", including actual loss of earnings (b) Immediately send us copies of up to $250 a day because of time off from any demands, notices, sum- work. monses or legal papers received e. All court costs taxed against the insured in connection with the "suit"; in the "suit". However, these payments (c) Notify any other insurer whose do not include attorneys' fees or attor- coverage is available to the neys' expenses taxed against the in- indemnitee; and sured. (d) Cooperate with us with respect f. Prejudgment interest awarded against to coordinating other applicable the insured on that part of the judgment insurance available to the we pay. If we make an offer to pay the indemnitee; and applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. CG 00 01 04 13 m Insurance Services Office, Inc., 2012 Page 9 of 17 (2) Provides us with written authoriza- e. A trust, you are an insured. Your trustees tion to: are also insureds, but only with respect (a) Obtain records and other infor- to their duties as trustees. mation related to the "suit"; and 2. Each of the following is also an insured: (b) Conduct and control the defense a. Your "volunteer workers" only while per- of the indemnitee in such "suit". forming duties related to the conduct of So long as the above conditions are met, at- your business, or your "employees", oth- torneys' fees incurred by us in the defense of er than either your "executive officers" (if that indemnitee, necessary litigation ex- you are an organization other than a part- penses incurred by us and necessary litiga- nership, joint venture or limited liability tion expenses incurred by the indemnitee at company) or your managers (if you are a our request will be paid as Supplementary limited liability company), but only for Payments. Notwithstanding the provisions of acts within the scope of their employ- Paragraph 2.b.(2) of Section I - Coverage A - ment by you or while performing duties Bodily Injury And Property Damage Liability, related to the conduct of your business. such payments will not be deemed to be However, none of these "employees" or damages for "bodily injury" and "property "volunteer workers" are insureds for: damage" and will not reduce the limits of in- (1) "Bodily injury" or "personal and ad- surance. vertising injury": Our obligation to defend an insured's (a) To you, to your partners or indemnitee and to pay for attorneys' fees and members (if you are a partner- necessary litigation expenses as Supplemen- ship or joint venture), to your tary Payments ends when we have used up members (if you are a limited li- the applicable limit of insurance in the pay- ability company), to a co-"em- ment of judgments or settlements or the con- ployee" while in the course of ditions set forth above, or the terms of the his or her employment or per- agreement described in Paragraph f. above, forming duties related to the are no longer met. conduct of your business, or to SECTION II -WHO IS AN INSURED your other "volunteer workers" 1. If you are designated in the Declarations as: while performing duties related to the conduct of your business; a. An individual, you and your spouse are insureds, but only with respect to the (b) To the spouse, child, parent, brother or sister of that co- "em- conduct of a business of which you are t ployee or volunteer worker he sole owner. as a consequence of Paragraph b. A partnership or joint venture, you are an (1)(a) above; insured. Your members, your partners, (c) For which there is any obligation and their spouses are also insureds, but only with respect to the conduct of your to share damages with or repay business. someone else who must pay $ damages because of the injury c. A limited liability company, you are an described in Paragraph (1)(a) or insured. Your members are also in- (b) above; or sureds, but only with respect to the con- (d) Arising out of his or her provid- duct of your business. Your managers are insureds, but only with respect to their sional health care services. or failing to provide profes- duties as your managers. sio d. An organization other than a partnership, (2) "Property damage" to property: joint venture or limited liability company, (a) Owned, occupied or used by; you are an insured. Your "executive of- (b) Rented to, in the care, custody or ficers" and directors are insureds, but control of, or over which phys- only with respect to their duties as your ical control is being exercised for officers or directors. Your stockholders any purpose by; are also insureds, but only with respect you, any of your "employees", "vol- to their liability as stockholders. unteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). Page 10 of 17 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 b. Any person (other than your "employee" b. Damages under Coverage A, except dam- or "volunteer worker"), or any organiza- ages because of "bodily injury" or "prop- tion while acting as your real estate man- erty damage" included in the "products- ager. completed operations hazard"; and c. Any person or organization having prop- c. Damages under Coverage B. er temporary custody of your property if 3. The Products-Completed Operations Aggre- you die, but only: gate Limit is the most we will pay under (1) With respect to liability arising out of Coverage A for damages because of "bodily the maintenance or use of that prop- injury" and "property damage" included in erty; and the "products-completed operations hazard". (2) Until your legal representative has 4. Subject to Paragraph 2. above, the Personal been appointed. And Advertising Injury Limit is the most we d. Your legal representative if you die, but will pay under Coverage B for the sum of all only with respect to duties as such. That damages because of all "personal and adver- representative will have all your rights tising injury" sustained by any one person or and duties under this Coverage Part. organization. 3. Any organization you newly acquire or form, 5. Subject to Paragraph 2. or 3. above, which- other than a partnership, joint venture or ever applies, the Each Occurrence Limit is the limited liability company, and over which you most we will pay for the sum of: maintain ownership or majority interest, will a. Damages under Coverage A; and qualify as a Named Insured if there is no oth- b. Medical expenses under Coverage C er similar insurance available to that organi- because of all "bodily injury" and "property zation. However: damage" arising out of any one "occur- a. Coverage under this provision is afforded rence". only until the 90th day after you acquire 6. Subject to Paragraph 5. above, the Damage or form the organization or the end of the To Premises Rented To You Limit is the most policy period, whichever is earlier; we will pay under Coverage A for damages b. Coverage A does not apply to "bodily in- because of "property damage" to any one jury" or "property damage" that occurred premises, while rented to you, or in the case before you acquired or formed the orga- of damage by fire, while rented to you or tem- nization; and porarily occupied by you with permission of c. Coverage B does not apply to "personal the owner. and advertising injury" arising out of an 7. Subject to Paragraph 5. above, the Medical offense committed before you acquired Expense Limit is the most we will pay under or formed the organization. Coverage C for all medical expenses because No person or organization is an insured with re- of "bodily injury" sustained by any one per- spect to the conduct of any current or past part- son. nership, joint venture or limited liability company The Limits of Insurance of this Coverage Part ap- that is not shown as a Named Insured in the Dec- ply separately to each consecutive annual period $ larations. � and to any remaining period of less than 12 SECTION III -LIMITS OF INSURANCE months, starting with the beginning of the policy 1. The Limits of Insurance shown in the Declara- period shown in the Declarations, unless the poli- tions and the rules below fix the most we will cy period is extended after issuance for an addi- pay regardless of the number of: tional period of less than 12 months. In that case, a. Insureds; the additional period will be deemed part of the last preceding period for purposes of determining b. Claims made or "suits" brought; or the Limits of Insurance. c. Persons or organizations making claims SECTION IV - COMMERCIAL GENERAL or bringing "suits". LIABILITY CONDITIONS 2. The General Aggregate Limit is the most we 1. Bankruptcy will pay for the sum of: Bankruptcy or insolvency of the insured or of a. Medical expenses under Coverage C; the insured's estate will not relieve us of our obligations under this Coverage Part. CG 00 01 04 13 m Insurance Services Office, Inc., 2012 Page 11 of 17 2. Duties In The Event Of Occurrence, Offense, A person or organization may sue us to re- Claim Or Suit cover on an agreed settlement or on a final a. You must see to it that we are notified as judgment against an insured; but we will not soon as practicable of an "occurrence" or be liable for damages that are not payable un- an offense which may result in a claim. der the terms of this Coverage Part or that are To the extent possible, notice should in- in excess of the applicable limit of insurance. clude: An agreed settlement means a settlement (1) How, when and where the "occur- and release of liability signed by us, the in- rence or offense took place; sured and the claimant or the claimant's legal representative. (2) The names and addresses of any in- 4. Other Insurance jured persons and witnesses; and If other valid and collectible insurance is (3) The nature and location of any injury available to the insured for a loss we cover or damage arising out of the "occur- under Coverages A or B of this Coverage Part, rence" or offense. our obligations are limited as follows: b. If a claim is made or "suit" is brought a. Primary Insurance against any insured, you must: (7) Immediately record the specifics of This insurance is primary except when the claim or "suit" and the date re- Paragraph b. below applies. If this insur- ceived; and ance is primary, our obligations are not affected unless any of the other insur- (2) Notify us as soon as practicable. ance is also primary. Then, we will share You must see to it that we receive written with all that other insurance by the meth- notice of the claim or "suit" as soon as od described in Paragraph c. below. practicable. b. Excess Insurance c. You and any other involved insured (1) This insurance is excess over: must: (a) Any of the other insurance, (1) Immediately send us copies of any whether primary, excess, contin- demands, notices, summonses or le- gent or on any other basis: gal papers received in connection () That is Fire, Extended Cov- with the claim or"suit"; erage, Builder's Risk, Instal- (2) Authorize us to obtain records and lation Risk or similar other information; coverage for "your work"; (3) Cooperate with us in the investiga- (ii) That is Fire insurance for tion or settlement of the claim or de- premises rented to you or fense against the "suit"; and temporarily occupied by you (4) Assist us, upon our request, in the with permission of the own- enforcement of any right against any er; person or organization which may be (III) That is insurance purchased liable to the insured because of in- by you to cover your liability $ u to which this insur- j jury or damage g as a tenant for "property ance may also apply. damage" to premises rented d. No insured will, except at that insured's to you or temporarily occu- own cost, voluntarily make a payment, pied by you with permission 9 assume any obligation, or incur any ex- of the owner; or pense, other than for first aid, without our (iv) If the loss arises out of the consent. maintenance or use of air- 3. Legal Action Against Us craft, "autos" or watercraft No person or organization has a right under to the extent not subject to this Coverage Part: Exclusion g. of Section I - a. To join us as a party or otherwise bring Coverage A - Bodily Injury us into a "suit" asking for damages from And Property Damage Li- an insured; or ability. b. To sue us on this Coverage Part unless all of its terms have been fully complied with. Page 12 of 17 Insurance Services Office, Inc., 2012 CG 00 01 04 13 (b) Any other primary insurance b. Premium shown in this Coverage Part as available to you covering liabil- advance premium is a deposit premium ity for damages arising out of the only. At the close of each audit period we premises or operations, or the will compute the earned premium for products and completed oper- that period and send notice to the first ations, for which you have been Named Insured. The due date for audit added as an additional insured. and retrospective premiums is the date (2) When this insurance is excess, we shown as the due date on the bill. If the will have no duty under Coverages A sum of the advance and audit premiums or B to defend the insured against paid for the policy period is greater than any "suit" if any other insurer has a the earned premium, we will return the duty to defend the insured against excess to the first Named Insured. that "suit". If no other insurer de- c. The first Named Insured must keep fends, we will undertake to do so, but records of the information we need for we will be entitled to the insured's premium computation, and send us x rights against all those other insur- copies at such times as we may request. ers. 6. Representations (3) When this insurance is excess over By accepting this policy, you agree: other insurance, we will pay only our a. The statements in the Declarations are share of the amount of the loss, if accurate and complete; s any, that exceeds the sum of: (a) The total amount that all such b. Those statements are based upon repre- sentations you made to us; and other insurance would pay for the loss in the absence of this in- c. We have issued this policy in reliance surance; and upon your representations. (b) The total of all deductible and 7. Separation Of Insureds self-insured amounts under all Except with respect to the Limits of Insur- that other insurance. ance, and any rights or duties specifically as- (4) We will share the remaining loss, if signed in this Coverage Part to the first any, with any other insurance that is Named Insured, this insurance applies: not described in this Excess Insur- a. As if each Named Insured were the only ance provision and was not bought Named Insured; and specifically to apply in excess of the b. Separately to each insured against whom Limits of Insurance shown in the claim is made or "suit" is brought. Declarations of this Coverage Part. S. Transfer Of Rights Of Recovery Against Oth- c. Method Of Sharing ers To Us If all of the other insurance permits con- If the insured has rights to recover all or part tribution by equal shares, we will follow of any payment we have made under this this method also. Under this approach Coverage Part, those rights are transferred to $ each insurer contributes equal amounts us. The insured must do nothing after loss to until it has paid its applicable limit of in- impair them. At our request, the insured will surance or none of the loss remains, bring "suit" or transfer those rights to us and whichever comes first. help us enforce them. If any of the other insurance does not per- 9. When We Do Not Renew mit contribution by equal shares, we will If we decide not to renew this Coverage Part, contribute by limits. Under this method, we will mail or deliver to the first Named In- each insurer's share is based on the ratio sured shown in the Declarations written ho- of its applicable limit of insurance to the tice of the nonrenewal not less than 30 days total applicable limits of insurance of all before the expiration date. insurers. 5. Premium Audit If notice is mailed, proof of mailing will be sufficient proof of notice. a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 13 of 17 SECTION V- DEFINITIONS (3) "Personal and advertising injury" 1. "Advertisement" means a notice that is offenses that take place through the broadcast or published to the general public Internet or similar electronic means or specific market segments about your of communication; goods, products or services for the purpose of provided the insured's responsibility to pay attracting customers or supporters. For the damages is determined in a "suit" on the purposes of this definition: merits, in the territory described in Paragraph a. Notices that are published include mate- a. above or in a settlement we agree to. rial placed on the Internet or on similar 5. "Employee" includes a "leased worker". electronic means of communication; and "Employee" does not include a "temporary b. Regarding web sites, only that part of a worker". web site that is about your goods, pro- 6. "Executive officer" means a person holding ducts or services for the purposes of at- any of the officer positions created by your tracting customers or supporters is con- charter, constitution, bylaws or any other sidered an advertisement. similar governing document. 2. "Auto" means: 7. "Hostile fire" means one which becomes un- a. A land motor vehicle, trailer or controllable or breaks out from where it was semitrailer designed for travel on public intended to be. roads, including any attached machinery 8. "Impaired property" means tangible proper- or equipment; or ty, other than "your product" or "your work", b. Any other land vehicle that is subject to a that cannot be used or is less useful because: compulsory or financial responsibility a. It incorporates "your product" or "your law or other motor vehicle insurance law work" that is known or thought to be de- where it is licensed or principally ga- fective, deficient, inadequate or danger- raged. ous; or However "auto" does not include "mobile b. You have failed to fulfill the terms of a equipment". contract or agreement; 3. "Bodily injury" means bodily injury, sickness if such property can be restored to use by the or disease sustained by a person, including repair, replacement, adjustment or removal death resulting from any of these at any time. of "your product" or "your work" or your ful- 4. "Coverage territory" means: filling the terms of the contract or agreement. a. The United States of America (including 9. "Insured contract" means: its territories and possessions), Puerto a. A contract for a lease of premises. How- Rico and Canada; ever, that portion of the contract for a b. International waters or airspace, but only lease of premises that indemnifies any if the injury or damage occurs in the person or organization for damage by fire course of travel or transportation be- to premises while rented to you or tem- tween any places included in Paragraph porarily occupied by you with permission 2 a. above; or of the owner is not an "insured contract"; c. All other parts of the world if the injury or b. A sidetrack agreement; damage arises out of: c. Any easement or license agreement, ex- (1) Goods or products made or sold by cept in connection with construction or you in the territory described in Para- demolition operations on or within 50 graph a. above; feet of a railroad; (2) The activities of a person whose d. An obligation, as required by ordinance, home is in the territory described in to indemnify a municipality, except in Paragraph a. above, but is away for a connection with work for a municipality; short time on your business; or e. An elevator maintenance agreement; Page 14 of 17 Q Insurance Services Office, Inc., 2012 CG 00 01 04 13 f. That part of any other contract or agree- b. While it is in or on an aircraft, watercraft ment pertaining to your business (includ- or "auto"; or ing an indemnification of a municipality c. While it is being moved from an aircraft, in connection with work performed for a watercraft or "auto" to the place where it municipality) under which you assume is finally delivered; the tort liability of another party to pay but "loading or unloading" does not include for "bodily injury" or "property damage" the movement of property by means of a me- to a third person or organization. Tort li- chanical device, other than a hand truck, that ability means a liability that would be im- is not attached to the aircraft, watercraft or posed by law in the absence of any con- "auto". tract or agreement. Paragraph f. does not include that part of 12. "Mobile equipment" means any of the fol- any contract or agreement: lowing types of land vehicles, including any attached machinery or equipment: (1) That indemnifies a railroad for "bod- a. Bulldozers, farm machinery, forklifts and ily injury or property damage other vehicles designed for use principal- arising out of construction or ly off public roads; demolition operations, within 50 feet of any railroad property and affecting b. Vehicles maintained for use solely on or any railroad bridge or trestle, tracks, next to premises you own or rent; road-beds, tunnel, underpass or c. Vehicles that travel on crawler treads; crossing; d. Vehicles, whether self-propelled or not, (2) That indemnifies an architect, engi- maintained primarily to provide mobility neer or surveyor for injury or dam- to permanently mounted: age arising out of: (1) Power cranes, shovels, loaders, dig- (a) Preparing, approving, or failing gers or drills; or to prepare or approve, maps, (2) Road construction or resurfacing shop drawings, opinions, re- equipment such as graders, scrapers ports, surveys, field orders, or rollers; change orders or drawings and e. Vehicles not described in Paragraph a., specifications; or b., c. or d. above that are not self- (b) Giving directions or instructions, propelled and are maintained primarily to or failing to give them, if that is provide mobility to permanently attached the primary cause of the injury equipment of the following types: or damage; or (1) Air compressors, pumps and gener- (3) Under which the insured, if an archi- ators, including spraying, welding, tect, engineer or surveyor, assumes building cleaning, geophysical ex- liability for an injury or damage aris- ploration, lighting and well servicing ing out of the insured's rendering or equipment; or failure to render professional ser- (2) Cherry pickers and similar devices vices, including those listed in (2) used to raise or lower workers; above and supervisory, inspection, architectural or engineering activi- f. Vehicles not described in Paragraph a., ties. b., c. or d. above maintained primarily for 10. "Leased worker" means a person leased to purposes other than the transportation of you by a labor leasing firm under an agree- persons or cargo. ment between you and the labor leasing firm, However, self-propelled vehicles with the to perform duties related to the conduct of following types of permanently attached your business. "Leased worker" does not in- equipment are not "mobile equipment" clude a"temporary worker". but will be considered "autos": 11. "Loading or unloading" means the handling (1) Equipment designed primarily for: of property: (a) Snow removal; a. After it is moved from the place where it (b) Road maintenance, but not con- is accepted for movement into or onto an struction or resurfacing; or aircraft, watercraft or "auto`; (c) Street cleaning; CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 15 of 17 (2) Cherry pickers and similar devices 16. "Products-completed operations hazard": mounted on automobile or truck a. Includes all "bodily injury" and "property chassis and used to raise or lower damage" occurring away from premises workers; and you own or rent and arising out of "your (3) Air compressors, pumps and gener- product" or "your work" except: ators, including spraying, welding, (1) Products that are still in your phys- building cleaning, geophysical ex- ical possession; or ploration, lighting and well servicing (2) Work that has not yet been complet- equipment. ed or abandoned. However, "your However, "mobile equipment" does not in- work" will be deemed completed at clude any land vehicles that are subject to a the earliest of the following times: compulsory or financial responsibility law or (a) When all of the work called for in other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles your contract has been complet- subject to a compulsory or financial respon- sibility law or other motor vehicle insurance (b) When all of the work to be done law are considered "autos". at the job site has been complet- 13. "Occurrence" means an accident, including ed if your contract calls for work continuous or repeated exposure to substan- at more than one job site. tially the same general harmful conditions. (c) When that part of the work done 14. "Personal and advertising injury" means in- at a job site has been put to its jury, including consequential "bodily injury", intended use by any person or arising out of one or more of the following organization other than another offenses: contractor or subcontractor working on the same project. a. False arrest, detention or imprisonment; Work that may need service, main- b. Malicious prosecution; tenance, correction, repair or re- c. The wrongful eviction from, wrongful en- placement, but which is otherwise try into, or invasion of the right of private complete, will be treated as complet- occupancy of a room, dwelling or prem- ed. ises that a person occupies, committed b. Does not include "bodily injury" or by or on behalf of its owner, landlord or "property damage" arising out of: lessor; publication, in an man- (1) The transportation of property, un- d. Oral or written p Y less the injury or damage arises out ner, of material that slanders or libels a of a condition in or on a vehicle not person or organization or disparages a owned or operated by you, and that person's or organization's goods, pro- condition was created by the "load- ducts or services; ing or unloading" of that vehicle by e. Oral or written publication, in any man- any insured; ner, of material that violates a person's (2) The existence of tools, uninstalled s right of privacy; equipment or abandoned or unused f. The use of another's advertising idea in materials; or your "advertisement"; or (3) Products or operations for which the g. Infringing upon another's copyright, classification, listed in the Declara- trade dress or slogan in your "advertise- tions or in a policy Schedule, states ment". that products-completed operations 15. "Pollutants" mean any solid, liquid, gaseous are subject to the General Aggregate or thermal irritant or contaminant, including Limit. smoke, vapor, soot, fumes, acids, alkalis, 17. "Property damage" means: chemicals and waste. Waste includes materi- a. Physical injury to tangible property, fin- als to be recycled, reconditioned or re- cluding all resulting loss of use of that claimed. property. All such loss of use shall be deemed to occur at the time of the phys- ical injury that caused it; or Page 16 of 17 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 b. Loss of use of tangible property that is 21. "Your product": not physically injured. All such loss of a. Means: use shall be deemed to occur at the time (1) Any goods or products, other than of the 'occurrence" that caused it. real property, manufactured, sold, For the purposes of this insurance, electronic handled, distributed or disposed of data is not tangible property. by: As used in this definition, electronic data (a) You; means information, facts or programs stored (b) Others trading under your name; as or on, created or used on, or transmitted to or from computer software, including sys- or tems and applications software, hard or flop- py disks, CD-ROMs, tapes, drives, cells, data business or assets you have ac- processing devices or any other media which quired; and are used with electronically controlled equip- (2) Containers (other than vehicles), ma- ment. terials, parts or equipment furnished 18. "Suit" means a civil proceeding in which in connection with such goods or damages because of "bodily injury", "prop- products. erty damage", or "personal and advertising b. Includes: injury" to which this insurance applies are al- (1) Warranties or representations made leged. "Suit" includes: at any time with respect to the fit- a. An arbitration proceeding in which such ness, quality, durability, perfor- damages are claimed and to which the mance or use of "your product"; and insured must submit or does submit with (2) The providing of or failure to provide our consent; or warnings or instructions. b. Any other alternative dispute resolution c. Does not include vending machines or proceeding in which such damages are other property rented to or located for the claimed and to which the insured sub- use of others but not sold. mits with our consent. 22. "Your work": 19. "Temporary worker" means a person who is a. Means: furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or (1) Work or operations performed by short-term workload conditions. you or on your behalf; and 20. "Volunteer worker" means a person who is (2) Materials, parts or equipment fur- not your "employee", and who donates his or nished in connection with such work her work and acts at the direction of and with- or operations. in the scope of duties determined by you, and b. Includes: is not paid a fee, salary or other compensa- (1) Warranties or representations made tion by you or anyone else for their work per- at any time with respect to the fit- formed for you. ness, quality, durability, perfor- mance or use of "your work'; and (2) The providing of or failure to provide warnings or instructions. CG 00 01 04 13 m Insurance Services Office, Inc., 2012 Page 17 of 17 COMMERCIAL GENERAL LIABILITY CG 01 81 05 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON CHANGES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to "employees" of the insured A. Exclusion e. of Coverage A-Bodily Injury And whose employment is subject to the Indus- Property Damage Liability (Section I - Cover- trial Insurance Act of Washington, the refer- ages) applies only to "bodily injury" to any ence to "volunteer workers" is removed from "employee" of the insured whose employ- Paragraph 2.(a) of Section II - Who Is An In- ment is not subject to the Industrial Insurance sured and Paragraph 2.a.(1) of Section II is Act of Washington (Washington Revised replaced with the following: Code Title 51). 2. Each of the following is also an insured: With respect to "bodily injury" to "employ- a, Your "employees", other than either ees" of the insured whose employment is your "executive officers" (if you are subject to the Industrial Insurance Act of an organization other than a partner- Washington, Exclusion e. is replaced with the ship, joint venture or limited liability following: company) or your managers (if you This insurance does not apply to: are a limited liability company), but 1. "Bodily injury" to an "employee" of the only for acts within the scope of their insured arising out of and in the course employment by you or while per- of: forming duties related to the conduct of your business. However, none of a. Employment by the insured; or these "employees" is an insured for: b. Performing duties related to the con- (1) "Bodily injury" or "personal and duct of the insured's business; or advertising injury": 2. Any obligation to share damages with or (a) To you, to your partners or repay someone else who must pay dam- members (if you are a part- ages because of the injury. nership or joint venture), to This exclusion does not apply to liability as- your members (if you are a sumed by the insured under an "insured con- limited liability company), tract". or to a co-"employee" while B. Paragraphs 2.a.(1)(a), (b) and (c) of Section II - that co-"employee" is either Who Is An Insured apply only to "employees" in the course of his or her of the insured whose employment is not sub- employment or performing ject to the Industrial Insurance Act of Wash- duties related to the conduct ington (Washington Revised Code Title 51). of your business; (b) For which there is any obli- gation to share damages with or repay someone else who must pay damages be- cause of the injury described in Paragraph (1)(a) above; or (c) Arising out of his or her pro- viding or failing to provide professional health care ser- vices. CG 01 81 05 08 © ISO Properties, Inc., 2007 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 01 97 12 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON CHANGES - EMPLOYMENT- RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Para- B. The following exclusion is added to Para- graph 2., Exclusions of Coverage A - Bodily graph 2., Exclusions of Coverage B Personal Injury And Property Damage Liability (Sec- Injury And Advertising Injury Liability (Sec- tion I Coverages): tion I -Coverages): This insurance does not apply to: This insurance does not apply to: "Bodily injury" to: "Personal and advertising injury" to: 1. A person arising out of any: 1. A person arising out of any: 8 a. Refusal to employ that person; a. Refusal to employ that person; b. Termination of that person's employ- b. Termination of that person's employ- ment; or ment; or c. Employment-related practices, pol- c. Employment-related practices, poli- icies, acts or omissions, such as cies, acts or omissions, such as coercion, demotion, evaluation, rea- coercion, demotion, evaluation, ssignment, discipline, defamation, reassignment, discipline, defama- harassment, humiliation, discrimina- tion, harassment, humiliation, dis- tion or malicious prosecution direct- crimination or malicious prosecution ed at that person; or directed at that person; or 2. The spouse, child, parent, brother or sis- 2. The spouse, child, parent, brother or sis- ter of that person as a consequence of ter of that person as a consequence of "bodily injury" to that person at whom "personal and advertising injury" to that any of the employment- related practices person at whom any of the employment- described in Paragraphs a., b. and c. related practices described in Paragraphs above is directed. a., b. and c. above is directed. This exclusion applies: This exclusion applies: 1. Whether the injury-causing event de- 1. Whether the injury-causing event de- scribed in Paragraphs a., b. or c. above scribed in Paragraphs a., b. or c. above a occurs before employment, during em- occurs before employment, during em- ployment or after employment of that ployment or after employment of that person; person; 2. Whether the insured may be liable as an 2. Whether the insured may be liable as an " employer or in any other capacity; and employer or in any other capacity; and 3. To any obligation to share damages with 3. To any obligation to share damages with or repay someone else who must pay or repay someone else who must pay damages because of the injury. damages because of the injury. However, Paragraphs 1.a. and 2. of this exclu- However, Paragraphs 1.a. and 2. of this exclu- sion do not apply if such "bodily injury" is sion do not apply if such "personal and ad- sustained by any "employee" of the insured vertising injury" is sustained by any "employ- whose employment is subject to the Indus- ee" of the insured whose employment is trial Insurance Act of Washington (Washing- subject to the Industrial Insurance Act of ton Revised Code Title 51). Washington (Washington Revised Code Title 51). CG 01 97 12 07 © ISO Properties, Inc., 2006 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 21 06 05 14 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 I -Coverage A-Bod- As used in this exclusion, electronic ily Injury And Property Damage Liability is data means information, facts or pro- replaced by the following: grams stored as or on, created or 2. Exclusions used on, or transmitted to or from This insurance does not apply to: computer software, including sys- tems and applications software, hard p. Access Or Disclosure Of Confiden- or floppy disks, CD-ROMs, tapes, tial Or Personal Information And drives, cells, data processing devices Data-related Liability or any other media which are used Damages arising out of: with electronically controlled equip- (1) Any access to or disclosure of ment. any person's or organization's B. The following is added to Paragraph 2. Exclu- confidential or personal informa- sions of Section I-Coverage B-Personal And tion, including patents, trade se- Advertising Injury Liability: crets, processing methods, cus- 2. Exclusions tomer lists, financial This insurance does not apply to: information, credit card informa- tion, health information or any Access Or Disclosure Of Confidential Or other type of nonpublic informa- Personal Information tion; or "Personal and advertising injury" arising (2) The loss of, loss of use of, dam- out of any access to or disclosure of any age to, corruption of, inability to person's or organization's confidential or access, or inability to manipulate personal information, including patents, electronic data. trade secrets, processing methods, cus- This exclusion applies even if dam- tomer lists, financial information, credit ages are claimed for notification card information, health information or any other type of nonpublic information. costs, credit monitoring expenses, forensic expenses, public relations This exclusion applies even if damages expenses or any other loss, cost or are claimed for notification costs, credit x g expenses, expenses,monitoring ex , forensic expense incurred by you or others p arising out of that which is described public relations expenses or any other in Paragraph (1) or (2) above. loss, cost or expense incurred by you or others arising out of any access to or dis- However, unless Paragraph (1) above closure of any person's or organization's applies, this exclusion does not ap- confidential or personal information. ply to damages because of bodily injury". CG 21 06 05 14 © Insurance Services Office, Inc., 2013 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 21 70 01 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART �— OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY If aggregate insured losses attributable to terrorist "Certified act of terrorism" means an act that is acts certified under the federal Terrorism Risk In- certified by the Secretary of the Treasury, in con- s surance Act exceed $100 billion in a Program Year currence with the Secretary of State and the Attor- (January 1 through December 31) and we have ney General of the United States, to be an act of met our insurer deductible under the Terrorism terrorism pursuant to the federal Terrorism Risk Risk Insurance Act, we shall not be liable for the Insurance Act. The criteria contained in the Ter- payment of any portion of the amount of such rorism Risk Insurance Act for a "certified act of losses that exceeds $100 billion, and in such case terrorism" include the following: insured losses up to that amount are subject to 1. The act resulted in insured losses in excess of pro rata allocation in accordance with procedures established by the Secretary of the Treasury. $5 million in the aggregate, attributable to all types of insurance subject to the Terrorism Risk Insurance Act; and 2. The act is a violent act or an act that is dan- gerous to human life, property or infrastruc- ture and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. CG 21 70 01 08 © ISO Properties, Inc., 2007 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 21 76 01 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF PUNITIVE DAMAGES RELATED TO A CERTIFIED ACT OF TERRORISM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. The following exclusion is added: 2. The act is a violent act or an act that is This insurance does not apply to: dangerous to human life, property or in- frastructure and is committed by an in- TERRORISM PUNITIVE DAMAGES dividual or individuals as part of an effort Damages arising, directly or indirectly, out of to coerce the civilian population of the a"certified act of terrorism" that are awarded United States or to influence the policy or affect the conduct of the United States as punitive damages. Government by coercion. B. The following definition is added: "Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States, to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria contained in the Terrorism Risk Insur- ance Act for a "certified act of terrorism" in- clude the following: 1. The act resulted in insured losses in ex- cess of $5 million in the aggregate, attributable to all types of insurance sub- ject to the Terrorism Risk Insurance Act; $ and s CG 21 76 01 08 © ISO Properties, Inc., 2007 Page 1 of 1 COMMERCIAL GENERAL LIABILITY C G 22 24 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - INSPECTION, APPRAISAL AND SURVEY COMPANIES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2. This exclusion applies even if the claims against Exclusions of Section I - Coverage A - Bodily In- any insured allege negligence or other wrongdo- jury And Property Damage Liability and Para- ing in the supervision, hiring, employment, train- graph 2. Exclusions of Section I - Coverage B - ing or monitoring of others by that insured, if the Personal And Advertising Injury Liability: "occurrence" which caused the "bodily injury" or This insurance does not apply to "bodily injury", "property damage", or the offense which caused property damage" or personal and advertising the "personal and advertising injury", involved injury" for which the insured may be held liable the rendering of or failure to render professional 8 because of the rendering of or failure to render services in the performance of any claim, inves- professional services in the performance of any tigation, adjustment, engineering, inspection, ap- claim, investigation, adjustment, engineering, in- praisal, survey or audit services. spection, appraisal, survey or audit services. CG 22 24 04 13 o Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 24 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF INSURED CONTRACT DEFINITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The definition of "insured contract" in the Defini- Paragraph f. does not include that part of tions section is replaced by the following: any contract or agreement: "Insured contract" means: (1) That indemnifies a railroad for "bod- a. A contract for a lease of premises. How- ily injury" or "property damage" ever, that portion of the contract for a arising out of construction or lease of premises that indemnifies any demolition operations, within 50 feet person or organization for damage by fire of any railroad property and affecting to premises while rented to you or tem- any railroad bridge or trestle, tracks, porarily occupied by you with permission road-beds, tunnel, underpass or of the owner is not an "insured contract"; crossing; b. A sidetrack agreement; (2) That indemnifies an architect, engi- neer or surveyor for injury or dam- c. Any easement or license agreement, ex- age arising out of: cept in connection with construction or demolition operations on or within 50 (a) Preparing, approving, or failing to prepare or approve, maps, feet of a railroad; shop drawings, opinions, re- d. An obligation, as required by ordinance, ports, surveys, field orders, to indemnify a municipality, except in change orders or drawings and connection with work for a municipality; specifications; or e. An elevator maintenance agreement; (b) Giving directions or instructions, f. That part of any other contract or agree- or failing to give them, if that is ment pertaining to your business (includ- the primary cause of the injury ing an indemnification of a municipality or damage; or in connection with work performed for a (3) Under which the insured, if an archi- municipality) under which you assume tect, engineer or surveyor, assumes the tort liability of another party to pay liability for an injury or damage aris- for "bodily injury" or "property damage" ing out of the insured's rendering or to a third person or organization, pro- failure to render professional ser- vided the "bodily injury" or "property vices, including those listed in (2) damage" is caused, in whole or in part, above and supervisory, inspection, by you or by those acting on your behalf. architectural or engineering activi- However, such part of a contract or ties. agreement shall only be considered an "insured contract" to the extent your as- sumption of the tort liability is permitted by law. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. CG 24 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 26 77 12 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON - FUNGI OR BACTERIA EXCLUSION This endorsement modifies insurance provided under the following: A COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Para- B. The following exclusion is added to Para- graph 2., Exclusions of Section I - Coverage graph 2., Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Li- B - Personal And Advertising Injury Liabil- ability: ity: 2. Exclusions 2. Exclusions This insurance does not apply to: This insurance does not apply to: Fungi Or Bacteria Fungi Or Bacteria a. "Bodily injury" or "property dam- a. "Personal and advertising injury" " age" which would not have oc- which would not have taken place, curred, in whole or in part, but for in whole or in part, but for the ac- the actual, alleged or threatened in- tual, alleged or threatened inhala- halation of, ingestion of, contact tion of, ingestion of, contact with with, exposure to, existence of, or exposure to, existence of, or pres- presence of, any "fungi" or bacteria ence of any "fungi" or bacteria on on or within a building or structure, or within a building or structure, including its contents. including its contents. b. Any loss, cost or expenses arising b. Any loss, cost or expense arising out of the abating, testing for, mon- out of the abating, testing for, mon- itoring, cleaning up, removing, con- itoring, cleaning up, removing, con- taining, treating, detoxifying, neu- taining, treating, detoxifying, neu- tralizing, remediating or disposing tralizing, remediating or disposing s of, or in any way responding to, or of, or in any way responding to, or assessing the effects of, "fungi" or assessing the effects of, "fungi" or bacteria, by any insured or by any bacteria, by any insured or by any other person or entity. other person or entity. This exclusion does not apply to any C. The following definition is added to the "fungi" or bacteria that are, are on, or Definitions Section: are contained in, a good or product in- tended for bodily consumption. "Fungi" means any type or form of fungus, including mold or mildew and any mycotoxins, spores, scents or byproducts produced or released by fungi, CG 26 77 12 04 © ISO Properties, Inc., 2003 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 32 21 01 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON CONDITIONAL EXCLUSION OF TERRORISM INVOLVING NUCLEAR, BIOLOGICAL OR CHEMICAL 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 En- (2) Decrease the federal govern- dorsement ment's statutory percentage share in potential terrorism 1. The provisions of this endorsement be- losses above such deductible; come applicable commencing on the or date when any one or more of the fol- lowing first occurs. But if your policy (3) Redefine terrorism or make in- (meaning the policy period in which surance coverage for terrorism this endorsement applies) begins after subject to provisions or re- such date, then the provisions of this quirements that differ from endorsement become applicable on the those that apply to other types date your policy begins. of events or occurrences under this policy. a. The federal Terrorism Risk Insur- 2. If the provisions of this endorsement ante Program ("Program"), estab- lished by the Terrorism Risk Insur- ance Act, has terminated with a. Supersede any terrorism endorse- respect to the type of insurance ment already endorsed to this poli- provided under this Coverage Part cy that addresses "certified acts of or Policy; or terrorism" and/or "other acts of b. A renewal, extension or replace- terrorism", but only with respect ment of the Program has become to an incident(s) of terrorism (how- ever defined) which results in in- effective without a requirement to make terrorism coverage available jury or damage that occurs on or " to you and with revisions that: after the date when the provisions of this endorsement become appli- (1) Increase our statutory percent- cable (for claims made policies, age deductible under the Pro- such an endorsement is supersed- gram for terrorism losses. ed only with respect to an incident (That deductible determines of terrorism (however defined) that the amount of all certified ter- results in a claim for injury or dam- rorism losses we must pay in a age first being made on or after calendar year, before the fed- the date when the provisions of eral government shares in sub- this endorsement become applica- sequent payment of certified ble); and terrorism losses.); or CG 32 21 01 07 © ISO Properties, Inc., 2005 Page 1 of 2 b. Remain applicable unless we notify C. The following exclusion is added: you of changes in these provisions, EXCLUSION OF TERRORISM in response to federal law. We will not pay for "any injury or damage" 3. If the provisions of this endorsement caused directly or indirectly by "terrorism", do NOT become applicable, any terror- including action in hindering or defending ism endorsement already endorsed to against an actual or expected incident of this policy, that addresses "certified "terrorism". But this exclusion applies only acts of terrorism" and/or "other acts of when one or more of the following are terrorism", will continue in effect un- attributed to an incident of "terrorism": less we notify you of changes to that endorsement in response to federal 1. The "terrorism" is carried out by means law. of the dispersal or application of radio- active material, or through the use of a B. The following definitions are added and ap- nuclear weapon or device that involves ply under this endorsement wherever the or produces a nuclear reaction, nuclear term terrorism, or the phrase any injury or radiation or radioactive contamination; damage, are enclosed in quotation marks: or 1. "Terrorism" means activities against 2. Radioactive material is released, and it persons, organizations or property of appears that one purpose of the "terror- any nature: ism" was to release such material; or 8 a. That involve the following or prep- 3. The "terrorism" is carried out by means aration for the following: of the dispersal or application of patho- �— (1) Use or threat of force or vio- genic or poisonous biological or chemi- lence; or cal materials; or (2) Commission or threat of a dan- 4. Pathogenic or poisonous biological or gerous act; or chemical materials are released, and it (3) Commission or threat of an act appears that one purpose of the "terror- that interferes with or disrupts ism" was to release such materials. an electronic, communication, In the event of any incident of "terrorism" information, or mechanical sys- that is not subject to this Exclusion, cov- tem; and erage does not apply to "any injury or Jam- b. When one or both of the following age" that is otherwise excluded under this applies: Coverage Part or Policy. (1) The effect is to intimidate or coerce a government or the ci- vilian population or any seg- ment thereof, or to disrupt any segment of the economy; or (2) It appears that the intent is to intimidate or coerce a govern- ment, or to further political, ideological, religious, social or economic objectives or to ex- press (or express opposition to) a philosophy or ideology. 2. "Any injury or damage" means any in- jury or damage covered under any Cov- erage Part or Policy to which this en- dorsement is applicable, and includes but is not limited to "bodily injury", "property damage", "personal and ad- vertising injury", "injury" or "environ- mental damage" as may be defined in any applicable Coverage Part or Policy. CG 32 21 01 07 © ISO Properties, Inc., 2005 Page 2 of 2 COMMERCIAL GENERAL LIABILITY CG84990809 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NON-CUMULATION OF LIABILITY LIMITS (SAME OCCURRENCE) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Paragraph 5. under Section III -Limits Of Insurance: Non-Cumulation of Liability - Same Occurrence - If one "occurrence" causes "bodily injury" or "property damage" during the policy period and during the policy period of one or more prior, or future, general liability policies issued to you by us, then this policy's Each Occurrence Limit will be reduced by the amount of each payment made by us under the other policies because of such "occurrence." For purposes of this endorsement, the term "us" also includes all policies issued by any company within the Liberty Mutual Agency Markets division of Liberty Mutual Group. 0 N 02010 Liberty Mutual Insurance Company.All rights reserved. CG 84 99 08 09 Includes copyrighted material of Insurance Services Office,Inc.,with its permission . Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON-OWNED AIRCRAFT 2 NON-OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY -ELEVATORS 2 8 8 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 3 ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 $ KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 a LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU m 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON-OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g.Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON-OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I-Coverage A-Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2. Exclusions of Section I -Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 0 If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I-Coverage A-Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (1) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services office,Inc.,with its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III -Limits Of Insurance. 2. Paragraph 6. under Section III -Limits Of Insurance is replaced by the following: 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: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection Sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) -Paragraph 9.a. of Definitions is replaced with the following: 9.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, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C-Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 1. Under Supplementary Payments -Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 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. 8 2. Paragraph 1.d. is replaced by the following: 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 $500 a day because of time off from work. G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II -Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. 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 insur- ance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All 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. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. 0 s With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV -Commercial General Liability Condi- tions. 0 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I-Coverage A-Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (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 "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. "s g d. "Bodily injury" or "property damage" occurring after: (1) All 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 insured(s) 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. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III -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: a. Required by the contract or agreement; or b. 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 Declaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 5 of 8 b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a"suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/MALPRACTICE WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section 11 -Who Is An Insured is replaced with the following: (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 co-"employee" while in the course of his or her employ- ment 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 co-"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) 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 Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 6 of 8 advertising injury arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II -Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form 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 expiration of the policy period in which the entity was acquired or formed by you; 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. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint 8 venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV -Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: " Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV -Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II -Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V-Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: 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" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition B. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization 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" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. s 0 O 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 8 of 8 COMMERCIAL GENERAL LIABILITY CG 88 77 12 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MEDICAL EXPENSE AT YOUR REQUEST ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Section I -Coverage C-Medical Payments: If Medical Payments or Medical Expenses are not otherwise excluded from the policy, medical expenses will be paid only if an insured has requested that we pay such expenses. w 'o n n 0 3 N CG 88 77 12 08 Includes Copyrighted Material of ISO Properties,Inc.,with its permission. Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 89 27 10 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON EXCLUSION - ASBESTOS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS AND COMPLETED OPERATIONS COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of alleged or actual ingestion or inhalation of asbestos or asbestos -containing materials. We shall not have the duty to defend any such claim or "suit". 0 © 2010 Liberty Mutual Insurance.All rights reserved. CG 89 27 10 09 Includes copyrighted material of Insurance Services Office,with its permission. Page 1 of 1 IL 01 23 11 1S THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON CHANGES - DEFENSE COSTS This endorsement modifies insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL LIABILITY UMBRELLA COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART-LEGAL LIABILITY COVERAGE FORM COMMERCIAL PROPERTYCOVERAGE PART-MORTGAGEHOLDER'S ERRORS AND OMISSIONS COVERAGE FORM ELECTRONIC DATA LIABILITY COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART a PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART s RAILROAD PROTECTIVE LIABILITY COVERAGEPART UNDERGROUND STORAGE TANK COVERAGE PART A. The provisions of Paragraph B. are added to 5. Coverage C - Mortgageholder's Liability all Insuring Agreements that set forth a duty under the Mortgageholder's Errors And to defend under: Omissions Coverage Form. 1. Section I of the Commercial General Li- Paragraph B. also applies to any other provi- ability, Commercial Liability Umbrella, sion in the policy that sets forth a duty to de- Electronic Data Liability, Farm, Liquor Li- fend. ability, Owners And Contractors Protec- B. If we initially defend an insured ("insured") or tive Liability, Pollution Liability, Pro- pay for an insured's ("insured's") defense but ducts/Completed Operations Liability, later determine that none of the claims Product Withdrawal, Medical Profession- ("claims"), for which we provided a defense al Liability, Railroad Protective Liability or defense costs, are covered under this in- and Underground Storage Tank Cover- surance, we have the right to reimbursement age Parts, Auto Dealers Coverage Form for the defense costs we have incurred. and the Farm Umbrella Liability Policy; The right to reimbursement under this provi- 2. Section II under the Auto Dealers, Busi- sion will only apply to the costs we have in- ness Auto and Motor Carrier Coverage curred after we notify you in writing that s Forms; there may not be coverage and that we are 3. Section III under the Auto Dealers and reserving our rights to terminate the defense Motor Carrier Coverage Forms; or the payment of defense costs and to seek 4. Section A. Coverage under the Legal Li- reimbursement for defense costs. ability Coverage Form; and IL 01 23 11 13 0 Insurance Services Office, Inc., 2013 Page 1 of 1 IL 01 46 08 10 WASHINGTON COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. The conditions in this endorsement replace any 3. We may cancel the Commercial Property similar conditions in the policy that are less favor- Coverage Part and the Capital Assets Pro- able to the insured. gram (Output Policy) Coverage Part, if A. Cancellation made a part of this policy, by mailing or 1. The first Named Insured shown in the delivering to the first Named Insured and Declarations may cancel this policy by the first Named Insured's agent or broker notifying us or the insurance producer in written notice of cancellation at least five one of the following ways: days before the effective date of cancella- tion for any structure where two or more a. Written notice by mail, fax or e-mail; of the following conditions exist: b. Surrender of the policy or binder; or a. Without reasonable explanation, the c. Verbal notice. structure is unoccupied for more Upon receipt of such notice, we will can- than 60 consecutive days, or at least cel this policy or any binder issued as evi- 65% of the rental units are unoccu- dence of coverage, effective on the later pied for more than 120 consecutive of the following: days, unless the structure is main- a. The date on which notice is received tained for seasonal occupancy or is or the policy or binder is surren- under construction or repair; dered; or b. Without reasonable explanation, b. The date of cancellation requested progress toward completion of per- by the first Named Insured. manent repairs to the structure has not occurred within 60 days after re- 2. We may cancel this policy by mailing or ceipt of funds following satisfactory delivering to the first Named Insured and adjustment or adjudication of loss re- the first Named Insured's agent or broker sulting from a fire; written notice of cancellation, including c. Because of its physical condition, the the actual reason for the cancellation, to the last mailing address known to us, at structure is in danger of collapse; least: d. Because of its physical condition, a le vacation or demolition order has a. 10 days before the effective date of been issued for the structure, or it cancellation if we cancel for nonpay- has been declared unsafe in accor- ment of premium; or dance with applicable law; b. 45 days before the effective date of e. Fixed and salvageable items have cancellation if we cancel for any oth- been removed from the structure, in- er reason; dicating an intent to vacate the struc- except as provided in Paragraphs 3. and ture; 4. below. f. Without reasonable explanation, heat, water, sewer and electricity are not furnished for the structure for 60 consecutive days; or g. The structure is not maintained in substantial compliance with fire, safety and building codes. IL 01 46 08 10 © Insurance Services Office, Inc., 2010 Page 1 of 4 4. If: 7. If this policy is cancelled, we will send a. You are an individual; the first Named Insured any premium re- b. A covered auto you own is of the fund due. If we cancel, the refund will be "private passenger type'; and pro rata. If the first Named Insured can- cels, the refund will be at least 90/o of the c. The policy does not cover garage, pro rata refund unless the following ap- automobile sales agency, repair plies: shop, service station or public park- a. For Division Two - Equipment Break- ing place operations hazards; down, if the first Named Insured can- we may cancel the Commercial Auto- cels, the refund will be at least 75% mobile Coverage Part by mailing or of the pro rata refund. delivering to the first Named Insured and b. If: the first Named Insured's agent or broker written notice of cancellation, including (1) You are an individual; the actual reason for cancellation, to the (2) A covered auto you own is of the last mailing address known to us: "private passenger type'; a. At least 10 days before the effective (3) The policy does not cover ga- date of cancellation if we cancel for rage, automobile sales agency, nonpayment of premium; or repair shop, service station or b. At least 10 days before the effective public parking place operations s date of cancellation for any other rea- hazards; and a son if the policy is in effect less than (4) The first Named Insured cancels; 30 days; or the refund will be not less than 90% c. At least 20 days before the effective of any unearned portion not exceed- date of cancellation for other than ing $100, plus 95% of any unearned nonpayment if the policy is in effect portion over $100 but not exceeding 30 days or more; or $500, and not less than 97% of any d. At least 20 days before the effective unearned portion in excess of $500. date of cancellation if the policy is in The cancellation will be effective even if effect for 60 days or more or is a re- we have not made or offered a refund. newal or continuation policy, and the 8. If notice is mailed, proof of mailing will reason for cancellation is that your be sufficient proof of notice. driver's license or that of any driver B. Changes who customarily uses a covered The policy contains all the agreements be- 1.auto has been suspended or p y g revoked during policy period. tween you and us concerning the insurance 5. We will also mail or deliver to any mort- afforded. The first Named Insured shown in gage holder, pledgee or other person the Declarations is authorized to make shown in this policy to have an interest in changes in the terms of this policy with our any loss which may occur under this poli- consent. This policy's terms can be amended 8 cy, at their last mailing address known to or waived only by endorsement issued by us a us, written notice of cancellation, prior to and made a part of this policy. the effective date of cancellation. If can- C. Examination Of Your Books And Records cellation is for reasons other than those We may examine and audit your books and contained in Paragraph A.3. above, this records as they relate to this policy at any notice will be the same as that mailed or time during the policy period and up to three delivered to the first Named Insured. If years afterward. cancellation is for a reason contained in D. Inspection And Surveys Paragraph A.3. above, we will mail or de- liver this notice at least 20 days prior to 1. We have the right to: the effective date of cancellation. a. Make inspections and surveys at any 6. Notice of cancellation will state the effec- time; tive date of cancellation. The policy pe- b. Give you reports on the conditions riod will end on that date. we find; and c. Recommend changes. Page 2 of 4 © Insurance Services Office, Inc., 2010 IL 01 46 08 10 2. We are not obligated to make any inspec- G. Nonrenewal tions, surveys, reports or recommenda- 1. We may elect not to renew this policy by tions, and any such actions we do under- mailing or delivering written notice of take relate only to insurability and the nonrenewal, stating the reasons for premiums to be charged. We do not nonrenewal, to the first Named Insured make safety inspections. We do not un- and the first Named Insured's agent or dertake to perform the duty of any person broker, at their last mailing addresses or organization to provide for the health known to us. We will also mail to any or safety of workers or the public. And we mortgage holder, pledgee or other per- do not warrant that conditions: son shown in this policy to have an inter- a. Are safe or healthful; or est in any loss which may occur under b. Comply with laws, regulations, this policy, at their last mailing address codes or standards. known to us, written notice of 3. Paragraphs 1. and 2. of this condition ap- nonrenewal. We will mail or deliver these ply not only to us, but also to any rating, notices at least 45 days before the: advisory, rate service or similar organiza- a. Expiration of the policy; or tion which makes insurance inspections, b. Anniversary date of this policy if this surveys, reports or recommendations. policy has been written for a term of 4. Paragraph 2. of this condition does not more than one year. apply to any inspections, surveys, reports Otherwise, we will renew this policy un- or recommendations we may make rela- less: tive to certification, under state or mu- a. The first Named Insured fails to pay nicipal statutes, ordinances or regula- the renewal premium after we have tions, of boilers, pressure vessels or expressed our willingness to renew, elevators. including a statement of the renewal E. Premiums premium, to the first Named Insured The first Named Insured shown in the Dec- and the first Named Insured's insur- larations: ance agent or broker, at least 20 days 1. Is responsible for the payment of all pre- before the expiration date; miums; and b. Other coverage acceptable to the in- 2. Will be the payee for any return premi- sured has been procured prior to the expiration date of the policy; or ums we pay. c. The policy clearly states that it is not F. Transfer Of Your Rights And Duties Under This Policy renewable and is for a specific line, subclassification, or type of coverage Your rights and duties under this policy may that is not offered on a renewable ba- not be transferred without our written con- sis. sent except in the case of death of an individ- 2. If: ual Named Insured. a. You are an individual; If you die, your rights and duties will be trans- $ ferred to your legal representative but only b. A covered auto you own is of the s while acting within the scope of duties as "private passenger type"; and your legal representative. Until your legal re- c. The policy does not cover garage, presentative is appointed, anyone having automobile sales agency, repair proper temporary custody of your property shop, service station or public park- will have your rights and duties but only with ing place operations hazards; respect to that property. IL 01 46 08 10 Insurance Services Office, Inc., 2010 Page 3 of 4 the following applies to nonrenewal of b. We will not refuse to renew Liability the Commercial Automobile Coverage Coverage or Collision Coverage sole- Part in place of GA.: ly because an "insured" has submit- a. We may elect not to renew or con- ted claims under Comprehensive tinue this policy by mailing or Coverage or Towing And Labor Cov- delivering to you and your agent or erage. broker written notice at least 20 days c. If we fail to mail or deliver proper no- before the end of the policy period, tice of nonrenewal and you obtain including the actual reason for other insurance, this policy will end nonrenewal. If the policy period is on the effective date of that insur- more than one year, we will have the ance. right not to renew or continue it only at an anniversary of its original effec- tive date. If we offer to renew or con- tinue and you do not accept, this policy will terminate at the end of the current policy period. Failure to pay the required renewal or continuation premium when due shall mean that you have not accepted our offer. N b a n Page 4 of 4 Insurance Services Office, Inc., 2010 IL 01 46 08 10 IL 01 98 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 COMMERCIAL LIABILITY UMBRELLA COVERAGE PART FARM COVERAGE PART FARM UMBRELLA LIABILITY POLICY LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply: B. Under any Medical Payments Coverage, A. Under any Liability Coverage, to bodily to expenses incurred with respect to "bodily injury" resulting from the "haz- ardous properties" of "nuclear materi- (1) With respect to which an "insured" al" and arising out of the operation of a under the policy is also an insured "nuclear facility" by any person or or- under a nuclear energy liability poli- ganization. cy issued by Nuclear Energy Liabil- ity Insurance Association, Mutual C. Under any Liability Coverage, to "bodily Atomic Energy Liability Underwrit- injury" or "property damage" resulting from "hazardous properties" of "nuclear ers, Nuclear Insurance Association material", if: of Canada or any of their succes- sors, or would be an insured under (1) The "nuclear material" (a) is at any any such policy but for its termina- "nuclear facility" owned by, or op- tion upon exhaustion of its limit of erated by or on behalf of, an "in- liability; or sured" or (b) has been discharged (2) Resulting from the "hazardous or dispersed therefrom; properties" of "nuclear material" (2) The "nuclear material" is contained and with respect to which (a) any in "spent fuel" or "waste" at any s person or organization is required time possessed, handled, used, pro- to maintain financial protection pur- cessed, stored, transported or suant to the Atomic Energy Act of disposed of, by or on behalf of an 1954, or any law amendatory there- "insured"; or of, or (b) the "insured" is, or had this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agree- ment entered into by the United States of America, or any agency thereof, with any person or organi- zation. IL 01 98 09 08 ©ISO Properties, Inc., 2007 Page 1 of 2 (3) The "bodily injury" or "property "Nuclear facility" means: damage" arises out of the furnish- (a) Any "nuclear reactor"; ing by an "insured" of services, materials, parts or equipment in (b) Any equipment or device designed connection with the planning, con- or used for (1) separating the iso- struction, maintenance, operation or topes of uranium or plutonium, (2) use of any "nuclear facility", but if processing or utilizing "spent fuel", such facility is located within the or (3) handling, processing or pack- such "waste"; United States of America, its ter- ritories or possessions or Canada, (c) Any equipment or device used for this Exclusion (3) applies only to the processing, fabricating or "property damage" to such "nucle- alloying of "special nuclear mate- ar facility" and any property rial" if at any time the total amount thereat. of such material in the custody of r: 2. As used in this endorsement: the "insured" at the premises where such equipment or device is "Hazardous properties" include radioactive, located consists of or contains toxic or explosive properties; more than 25 grams of plutonium "Nuclear material" means "source materi- or uranium 233 or any combination al", "Special nuclear material" or "by-prod- thereof, or more than 250 grams of R uct material"; uranium 235; s "Source material", "special nuclear mate- (d) Any structure, basin, excavation, rial", and "by-product material" have the premises or place prepared or used meanings given them in the Atomic Energy for the storage or disposal of Act of 1954 or in any law amendatory there- "waste"; of; and includes the site on which any of the "Spent fuel" means any fuel element or fuel foregoing is located, all operations conduct- component, solid or liquid, which has been ed on such site and all premises used for used or exposed to radiation in a "nuclear such operations; reactor"; "Nuclear reactor" means any apparatus de- "Waste" means any waste material (a) contain- signed or used to sustain nuclear fission in ing "by-product material" other than the tailings a self-supporting chain reaction or to con- or wastes produced by the extraction or con- tain a critical mass of fissionable material; centration of uranium or thorium from any ore "Property damage" includes all forms of ra- processed primarily for its "source material" dioactive contamination of property. content, and (b) resulting from the operation by any person or organization of any "nuclear fa- cility" included under the first two paragraphs of the definition of "nuclear facility". a IL 01 98 09 08 @ISO Properties, Inc., 2007 Page 2 of 2